When the CDC issued new guidelines recently on when people still need to wear masks, the guidelines were seen as so conservative that they prompted a primetime rant on “The Daily Show.”
“I know science is difficult … but who’s running messaging at the CDC?” asked the show’s host, Trevor Noah.
Some public health experts are asking the same question. Most experts interviewed for this story say the agency has struggled to take advantage of the latest scientific findings to communicate as rapidly as possible with the American public. And when the guidance is issued, it tends to be overly cautious.
Still, public health officials say the conservative nature of the agency’s approach to Covid is a marked departure from how it deals with other major public health issues, like HIV and opioid use disorder.
Multiple experts told STAT that they fear the CDC’s recommendations are becoming irrelevant for most Americans. They worry, too, that guidelines, like the CDC’s advice on masking, so seriously underplay the benefits of getting vaccinated that they risk dissuading people from getting a shot in the first place.
The same section of the Federal Food, Drug, and Cosmetic Act that authorizes the FDA to grant emergency use authorization also requires the secretary of Health and Human Services to “ensure that individuals to whom the product is administered are informed … of the option to accept or refuse administration of the product.”
Likewise, the FDA’s guidance on emergency use authorization of medical products requires the FDA to “ensure that recipients are informed to the extent practicable given the applicable circumstances … That they have the option to accept or refuse the EUA product …”
The Centers for Disease Control and Prevention made headlines last week when it announced that Covid-19 had reduced the average life expectancy of Americans in 2020 by a full year. The news seemed to starkly illustrate the devastation wrought by our nation’s worst public health crisis in 100 years.
But there was a problem. The pandemic’s appalling toll could not have reduced life span by nearly that much. My own estimate is that when Covid-19’s ravages in 2020 are averaged across the country’s entire population, we each lost about five days of life.
The CDC’s mistake? It calculated life expectancy using an assumption that is assuredly wrong, which yielded a statistic that was certain to be misunderstood. That’s exactly the type of misstep the agency can’t afford to make. Not now, not after former President Trump’s relentless attacks on its credibility. Not after his advisers were caught altering and editing the agency’s monthly reports to downplay the pandemic.
Looking further at racial disparities in the data, the gap in life expectancy between non-Hispanic white and Black people widened from 4.1 years in 2019 to six years in the first half of 2020 — the largest gap since 1998.
“The disparities between those populations have been declining consistently, since we began estimating life expectancy, which goes back to 1900,” she said.
The gap between Hispanic and white non-Hispanic individuals narrowed, however, from three years in 2019 to 1.9 in 2020.
Basic assumptions about the long-term costs of a public option are flawed. Research we have done shows that a public option will mean soaring deficits and debts because politicians in Washington will eventually succumb to political pressure both to subsidize enrollee premiums and to pay doctors and hospitals closer to what they are paid by private insurance rather than by existing government programs like Medicare and Medicaid. According to our calculations, the public option would add $800 billion to deficits in the first 10 years and increase the federal debt by more than 30% of the gross domestic product by 2050 — the equivalent of $6 trillion in today’s economy.
The effects on the budget are even worse when the economy suffers or if health costs unexpectedly rise. How much worse? With support from the Partnership for America’s Health Care Future — a coalition of leading health care providers, insurers, biopharmaceutical companies and employers that oppose one-size-fits-all health care — we looked at a few ways policymakers might adjust the public option to respond to future economic shocks and the impact these changes would have on long-term deficits and debt.
Author(s): Lanhee J. Chen, Tom Church, and Daniel L. Heil