The CDC, with a staff of 20,000 people, has long served as a model for public health agencies around the world, with a global stature held by few U.S. agencies.
But even before the pandemic, Trump administration health officials had discussed shrinking the CDC’s purview — stressing to Redfield after his 2018 arrival that he should consider reorganizing and refocusing the public health agency.
The CDC had taken on a growing range of research projects and areas of study over the past several years, they argued, a steady expansion that risked distracting from its primary mission as the nation’s leading authority on identifying and responding to infectious disease threats. The CDC later published a strategic framework that defined the agency’s “five core capabilities.”
In Trump’s proposed budget for fiscal year 2021, the administration proposed a roughly 19 percent cut to the agency’s discretionary budget. This year’s budget plan also proposed to refocus the CDC on “its core mission of preventing and controlling infectious diseases and other emerging health issues, such as opioids.”
The coronavirus crisis — and the CDC’s high-profile missteps — have only strengthened the case for an overhaul, said a former senior official who was involved in those discussions.
“The thing to do is take a hard look at the CDC and say what are the five things that they really need to do, and do it to the exclusion of everything else,” the former official said, adding that Redfield had agreed with the prepandemic concerns that the agency’s activities were too scattered. “People have been talking about back to basics, core mission.”
Redfield’s job is not in danger with an election so close, but officials from across the White House orbit have zeroed in on the CDC as a major problem within the coronavirus response. The vice president’s office has expressed concern about the accuracy of the coronavirus death toll, while parts of the Office of Management and Budget, such as the United States Digital Service, have been involved in reviewing the data at the state level.
As the nation’s top public health authority, the CDC has traditionally played a central role in crafting the federal government’s response to health crises and communicating with the public. But the agency has assumed a far lower profile amid the pandemic, after a series of slip-ups that drew the ire of White House officials and hampered the administration’s early response effort.
Get the latest on the health care fight, every weekday morning — in your inbox.
Initial coronavirus tests developed by the CDC in February proved faulty, delaying widespread plans to screen for the virus and allowing it to spread throughout the nation for weeks. An internal HHS investigation released last week found that the faulty test kits were likely contaminated at the CDC.
Messages from CDC officials early in the crisis, while in line with assessments from the scientific community, have embarrassed White House officials trying to contain the political fallout.
Nancy Messonnier, a top CDC official, surprised the White House in late February when she told reporters that a coronavirus outbreak was inevitable — contradicting top officials’ assertions at the time that the disease was largely contained.
In April, Redfield drew Trump’s attention after he warned that the country could face a brutal second wave of the disease come the fall — a statement he was forced to clarify the next day.
And more recently, the agency has come under scrutiny from the White House over guidelines for reopening schools and institutions that were initially seen as overly prescriptive, and from public health experts for conflating two different types of coronavirus tests in its overall testing numbers.
One administration official said the main problem with the CDC has been with the data it receives from states about the Covid-19 death toll — creating a larger problem clouding the U.S. response.
“In Pennsylvania, if you have coronavirus and you die from a gunshot wound, it gets classified as a coronavirus death,” the administration official said. “If the data drives the decision-making, you want to make sure you have good data. When you have different ways of counting things, it can lead to distortion. The audit was suggested as means to confirm that or disprove that.”
This content was originally published here.