Medical experts sound alarm over CDC turmoil

Political maneuvering has overtaken disease as the greatest threat to national and global health, three public health experts told TribLive.

The experts, Drs. Amesh Adalja, Paul Offit and Syra Madad, are among those sounding alarms after the new director of the Centers for Disease Control and Prevention was fired by President Donald Trump and three senior officials quit and were escorted from the agency’s Atlanta headquarters.

“Things have been turned on their head” is how Offit, an internationally known vaccine expert based at Children’s Hospital of Philadelphia, characterized the situation in a Friday morning interview with TribLive.

The previous afternoon, Offit was on CNN as word spread that CDC Director Susan Monarez was on her way out after less than a month on the job.

Offit is a member of a committee of experts who advise the Food and Drug Administration about vaccines. He’s also a former member of the CDC’s Advisory Committee on Immunization Practices, which sets guidelines that health care providers follow.

Changes in those guidelines were among the reasons national pharmacy chains CVS and Walgreens announced this week they will not be providing the covid vaccine.

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. sought Dr. Monarez’s removal, and President Donald Trump ultimately fired her.

“There’s a lot of trouble at CDC, and it’s going to require getting rid of some people over the long term in order for us to change the institutional culture,” Kennedy said Thursday at a media briefing, according to The New York Times.

Kennedy is a longstanding critic of the CDC and has been a skeptic of vaccines while also trumpeting pseudoscience.

But he’s now the nation’s top-ranking health official and is leading what he calls a “Make American Healthy Again” agenda. He’s brought back things such as the President’s Physical Fitness Test and recommends people eat an apple a day to promote their health.

“The rules are based on the whim of one man, and that makes this a very frightening time,” Offit said of Kennedy.

Kennedy doesn’t believe in the germ theory of disease, Adalja said — something that’s foundational to the way medicine is practiced.

Instead, Kennedy ascribes to what’s known as the miasma theory, which posits that pollution in the air we breathe is what makes us sick.

The CDC doctors who quit cited Kennedy’s stances as the reason they were leaving.

Dr. Daniel Jernigan was director of the National Center for Emerging and Zoonotic Infectious Diseases, Dr. Demetre Daskalakis was director of the National Center on Immunization and Respiratory Diseases and Dr. Debra Houry was the CDC’s deputy director and chief medical officer.

“Given the current context in the department, I feel it is best for me to offer my resignation,” Jernigan wrote in his resignation letter.

Daskalakis and Houry were more detailed in their critique of the direction the agency and the views espoused by Kennedy.

“I find that the views he and his staff have shared challenge my ability to continue in my current role at the agency and in the service of the health of the American people,” Daskalakis wrote. “Enough is enough. … I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health.”

Daskalakis, who is gay, also cited what he called the recklessness of the Trump administration to erase transgender populations.

“Public health is not merely about the health of the individual, but it is about the health of the community, the nation, the world,” Daskalakis wrote. “The nation’s health security is at risk and is in the hands of people focusing on ideological self-interest.”

Houry’s letter invoked similar sentiments.

“For the good of the nation and the world, the science at CDC should never be censored or subject to political pauses or interpretations,” Houry wrote. “Vaccines save lives — this is an indisputable, well-established, scientific fact.

“Informed consent and shared decision-making must focus not only on the risks but also on the true, life-saving benefits that vaccines provide to individuals and communities.”

CDC workers are the soldiers on the front line of the fight against infectious disease around the world, said Adalja, an infectious disease expert based in the Pittsburgh area. The turmoil at the agency is paralyzing the world’s health security, he told TribLive.

“ ‘Crisis’ is putting it mildly,” Adalja said of the upheaval at the CDC.

Madad agreed.

Based in New York, Madad is an epidemiologist who works at NYC Health + Hospitals and several other institutions. She focuses on public health and preparing for infectious disease outbreaks of Ebola, measles and Zika around the world.

“Public health is grounded in science,” Madad said.

With Kennedy in charge, that is no longer the case, she said, which means people need to put their trust in other organizations and institutions instead of the government, CDC and FDA.

“Trust peer-reviewed science,” Madad said, referring people to seek out information from sources like the American Academy of Pediatrics, whose vaccine recommendations now may run counter to federal guidelines.

The CDC has long been the leader of the country’s response to diseases, treatment and prevention. State, county and municipal health departments relied on and/or deferred to the CDC for guidance, and health care providers and insurers followed the federal advice.

Now, confusion reigns.

“I think the point is to be confusing,” Offit said.

“It’s an extremely unfortunate time,” Madad said.

The Allegheny County Health Department is monitoring the situation, a spokesman said. The Pennsylvania Department of Health did not respond to a request for comment.

UPMC, Allegheny Health Network and Independence Health System declined to comment.