Tag Archives: CDC

To Appeal, Or Not To Appeal

Posted on by
1

The Biden Administration is weighing a tough decision: whether to appeal the federal court decision striking down the mask mandate the federal government imposed on air and train travelers during the COVID pandemic. It’s a very tough decision on both legal and political grounds.

According to news reports, the Justice Department will appeal the court ruling if the CDC decides that the mask mandate is still necessary to protect public health. That’s a bit strange, in a way, because the CDC decided only last week, just before the court ruling, that the mask mandate should be extended for an additional 15 days, until May 3, to allow the CDC to assess the impact of yet another COVID subvariant. It seems as though the DOJ is punting the decision to the CDC and, perhaps, hoping that the CDC will change course, decide that public health now doesn’t require an extension, and allow the DOJ to cite that determination in electing not to appeal. In the meantime, the DOJ won’t pursue an immediate stay of the federal court’s decision, which means that the mask mandate won’t be enforced unless and until an appeal occurs and the appellate court rules to the contrary.

The legal and political stakes in the decision on a potential appeal are high. Legally, the issue is whether the federal government wants to take the risk that a higher court will agree with the district court judge and establish a firmer precedent that the CDC doesn’t have the kind of sweeping power it has exercised over the past two years. Some people describe the district court decision as a poorly reasoned “legal disaster,” while others contend it is a reasonable interpretation of statutory text that simply was not intended to authorize an administrative agency to unilaterally impose nationwide mask mandates. Regardless of how you come out on that issue, for now the decision is simply the opinion of a single district court judge. If an appeal occurs, the federal government runs the risk of an adverse decision by a federal court of appeals and, potentially, the Supreme Court–raising the possibility that, if the nation’s highest court agrees with the federal district court judge in this case, the CDC’s ability to issue future public health mandates could be eliminated, unless and until Congress decides to amend the statute to clarify what is permitted.

Politically, the stakes are equally high because there are strong feelings on both sides of the masking issue. News reports in the wake of the federal court decision reported pro and con comments from travelers about the decision, while videos of cheering passengers removing their masks mid-flight appeared on social media. Whatever decision the federal government makes is likely to upset one faction or the other, leaving the Biden Administration at risk of being labeled irresponsible in its stewardship of public health, or a lily-livered adherent to pointless governmental paternalism. No politician would be happy about either of those outcomes. On the other hand, if the CDC suddenly decides that, under the current circumstances, the mask mandate is no longer needed to protect public health, it has provided the Biden Administration with some political cover–and those who want to wear masks will of course be permitted to do so.

It would be interesting to know whether, behind the scenes, the Biden Administration is encouraging the CDC to move in one direction or another. It’s hard for politicians to restrain themselves from politicking. We’ll never know for sure, because if that information came out it would undercut the depiction of the CDC as the neutral, objective, apolitical entity that is focused solely on scientific and medical evidence and the public health.

The New Mask Ask

Posted on by
1

In Columbus, at least, things seem to be moving back to more of a masked-up world, as businesses try to figure out what to do in view of the delta variant of COVID. You really need to pay attention to signs and notices when you go into commercial establishments.

Yesterday I went to grocery shop at the Giant Eagle in Grandview. There was a card table in front of the entrance with a sign that said that all patrons, vaccinated or not, had to wear a mask to enter the store; next to the sign was a box of those familiar white and blue masks that Giant Eagle was offering for free so customers could mask up. So I donned my mask and entered to do my shopping. It quickly became apparent that some people either hadn’t seen the sign or were ignoring it, as about half of the patrons I saw were unmasked. No one from Giant Eagle seemed to be enforcing this particular store’s “mask mandate,” either.

Then I went to another store where the sign on the door “strongly encouraged “ everyone to wear a mask in the interests of protecting everyone’s health. In deference to the proprietor’s wishes, I put my mask on again before entering. Most of the other patrons didn’t.

I’m not sure how widespread the masking requests and requirements are, although my very limited experience indicates that Columbus stores are definitely more mask-oriented than businesses in Stonington. So while I’m here, I’ll have to keep a mask at hand, just in case. And my rule will be to defer to the instructions of the business owners, who really are in a no-win situation in view of the scary stories in the media and the ever-changing CDC guidance. For many business owners, the path of least resistance will be to follow CDC instructions. Whether they will have employees tasked with the thankless job of trying to enforce the mask rules is another question.

After yesterday’s experience, I wonder if we aren’t sliding, slowly but surely, back into the masking and social distancing world, after an all-too-brief taste of the old maskless and carefree normal. I’m not looking forward to it.

The Delta Variant

Posted on by
1

The Delta Variant. It sounds like the title of a bad Robert Ludlum or Tom Clancy novel, doesn’t it? And according to the news reports it is lurking out there, ready to pounce, and threatening to propel us into a mask-wearing, social distancing, stay-inside-your-house reprise of what we went through in 2020–like the situation found in Australia, where a Wall Street Journal article recently argued that the governmental COVID responses have returned the Land Down Under to its roots as a nation of prisoners.

Already we’re starting to see signs of what might lie ahead. This week the CDC and the Biden Administration reversed course on mask-wearing, saying even fully vaccinated people should wear masks indoors in places with high COVID transmission rates. Only two months ago, the CDC said fully vaccinated people didn’t need to wear masks indoors. The CDC also recommends that everyone in grade schools–kids, teachers, staff, and visitors,–wear masks even if they are fully vaccinated. And the CDC’s abrupt reversal seems to presage additional policy shifts and concerns coming up. The CNBC article darkly warns: “The updated guidance comes ahead of the fall season, when the highly contagious delta variant is expected to cause another surge in new coronavirus cases and many large employers plan to bring workers back to the office.”

What caused the CDC to change its mind, again? The CNBC article linked above quotes CDC Director Rochelle Walensky as saying the change is based on “new science” and data showing that the delta variant behaves “uniquely differently from past strains of the virus,” suggesting that some vaccinated people “may be contagious and spread the virus to others.” But the description of the rationale sounds very contingent and conditional–and, frankly, perhaps the result of some guesswork. There seems to be healthy disagreement in the medical profession about just how dangerous the delta variant really is. And there definitely is disagreement about how to deal with COVID and kids, as a recent New York magazine article demonstrated.

Here’s the issue, as I see it: our health care experts and politicians don’t seem to realize that their credibility isn’t what it once was. They seem weirdly panicky and overly protective, and willing to reverse course and make sweeping decisions that disrupt the lives of millions on the basis of untested models and supposition, rather than hard science. They also don’t seem to take into account the cost and impact of their suggestions, whether it is the mental health impact of isolating people due to shutdowns, the health effect of breathing through masks for hours on end, or the economic effect of restrictions on activities. And their latest change also undercuts the impetus for the crucial public health initiative of encouraging COVID vaccination. Some who haven’t been vaccinated will reason that if even fully vaccinated people need to wear masks to protect the unvaccinated, what’s the point of vaccination in the first place? And if protecting the unvaccinated is the goal, how long will this latest round of mask-wearing rules last?

It’s obviously not ideal that there is growing distrust of the public health authorities and politicians, but it’s important that those people recognize that the distrust and skepticism and resistance to sweeping edicts exists, and won’t be going away. If autumn brings new calls for lockdowns to deal with the delta variant, the general level of skepticism about the need for that kind of draconian action will be heightened–and I expect that the level of acceptance and compliance among the general population will be affected, too.

Camp Maskedalot

Posted on by
1

The CDC has been hard at work. It has developed extensive COVID-related guidelines for virtually every activity or gathering Americans might conceivably participate in these days. There is specific CDC guidance for workplaces and businesses, schools, retirement communities, church functions–even something super-specific, like what to do if you are operating a community garden or outdoor learning garden. You can take a look at the roster of guidance here.

A lot of people are wondering what the CDC is doing to come up with its extensive guidance, and precisely what the scientific basis–if any–is for some of the ultra-cautious rules the CDC has laid down. One set of CDC recommendations in particular has been target of special criticism: the guidance for summer camps. In fact, a recent article in New York magazine called the CDC summer camp guidance “cruel” and “irrational.”

It’s fair to say that the CDC rules would produce a summer camp experience that would bear no resemblance to the summer camps many of us attended as kids. Let’s just say that the kids who were unlucky enough to go to a CDC-compliant camp wouldn’t be spending carefree hours around a campfire, playing capture the flag with their newfound camp friends, or sitting at long tables and making bad ashtrays for Mom and Dad during the “craft period.” The New York article summarizes some of the guidance as follows:

“Masks must be worn at all times, even outdoors, by everyone, including vaccinated adults and children as young as 2 years old. The exceptions are for eating and swimming. (The guidance helpfully notes that if a person is having trouble breathing or is unconscious, no mask need be worn.) Campers must remain three feet apart from each other at all times including, again, outdoors. Six feet of distance must be maintained during meals and between campers and staff. If you need to sneeze and you don’t have a tissue, do it into your mask. (Children presumably are expected to carry a cache of spares.) Campers and staff should be cohorted, and any interaction with a person outside the cohort must be conducted at a distance of six feet. Art supplies, toys, books, and games are not to be shared.”

(Other than that, kids, have a blast!)

The New York article notes that the science and statistics have shown that kids are at “exceedingly low” risk of any kind of serious illness from COVID–and that’s from statistics gathered before most of the adults around them, including, presumably, camp counselors, have been vaccinated. And there is very little evidence that there is a serious risk of COVID transmission from outdoor activity like hiking (or running around with fellow campers), either. As a result, the New York article observes: “The notion that children should wear masks outdoors all day in the heat of July, or that they can’t play any sport that involves physical contact, or put an arm around a friend strikes many experts in infectious diseases, pediatrics, epidemiology, and psychiatry as impractical, of dubious benefit, and punishing in its effects on children.”

Has anyone at the CDC even experienced a broiling Midwestern summer day? Anybody who masks up on a 90-degree day with the sun beating down on them is asking for a truly miserable time–and maybe heat stroke, besides. It’s hard to believe that any rational person reviewed this guidance, or ran it past others for comment and evaluation. It’s as if the CDC is so focused on the COVID boogeyman that it has forgotten all of the other health risks involved in life.

Our public health authorities haven’t exactly covered themselves with glory during this COVID period. They’ve sent out a lot of mixed messages, and in my view their hyper-cautious recommendations about what fully vaccinated people should be able to do is quashing enthusiasm for getting vaccinated. The absurd CDC guidance for summer camps is just another hard-scratcher that further undercuts the credibility of a once-esteemed institution. The CDC would benefit by taking a hard look at what it is doing.

The Middle Seat Muddle

Posted on by
Reply

This week the CDC released information about whether airlines should follow policies that block off the middle seat on their planes. The CDC announced that laboratory modeling showed that blocking off the middle passenger seat, in either single-aisle or double-aisle planes, reduced airborne exposure to infectious diseases from fellow passengers by 23 percent to 57 percent. Those in the airline industry promptly noted that “the CDC admits that the current studies quantifying the benefit of specific social distancing strategies in the cabin, such as keeping the middle seats vacant, are limited.”

I don’t know which airlines–if any–are still blocking off the middle seats of flights. We flew American to and from Arizona on our recent visit, and on our flights every seat, including the middle seat, was filed. The airlines not only take the position that the science cited by the CDC is “limited,” but also point out that the airline industry took a huge hit in the early days of COVID, when most people avoided travel, and they need to sell those middle seats to recover economically and become profitable again.

It’s a class example of the tug-of-war between public health and profitability. I’m convinced that, if the CDC had its druthers, they’d rather every American stayed in their homes and avoided any risks whatsoever. And when it comes to air travel, they’d rather people are more spaced out (cramped passengers wouldn’t mind that, either), everyone wears masks, no food is served, and aircraft are designed so that all potential disease transmission vectors are avoided. Of course, if the airlines followed all of the CDC’s guidance, the cost of air travel would inevitably increase, some airlines would go out of business, and people wouldn’t be happy about it.

I’m guessing the airlines will come out on top in the middle-seat muddle and will continue to fill those middle seats, unless the FAA or Congress actually mandates that middle seats be left vacant. But you can bet that the airlines won’t object to the public health requirements that don’t affect their bottom line–like requiring passengers to wear masks at all times, regardless of their vaccination status or COVID case data. I think air travelers are going to be masked for the foreseeable future–and maybe permanently.

Handwashing 101

Posted on by
Reply

This week small posters providing CDC guidance on techniques to combat the spread of the coronavirus have been popping up everywhere, including on the door to the men’s bathroom on my floor at the firm.  One of the topics addressed by the poster is the need to wash your hands for 20 seconds.  Looking at it moved me to compose some bad verse:

Handwashing 101

I learned it as a tiny tot, and it was kind of fun

But this week I’ve been enrolled in Handwashing 101.

I always wash up, for sure, but now from what I gather

The CDC says it’s quite key to work up a good lather.

Twenty seconds sure is long, much longer than my plans,

It’s tough indeed for those of us with short attention spans.

I rub away, in water warm, and feel my mind wander

“Is this how Pontius Pilate felt?” is one thing that I ponder.

The water’s getting hotter still, like flames from a lit torch

But if it helps to stop the spread, my fingers I will scorch.

At the end of my countdown, with digits squeaky clean

I feel that I have done my part to stop COVID-19.

My hands have been boiled red, redder than the setting sun

It’s how you get a passing grade in Handwashing 101.

 

The “Avoiding Panic” Dodge

Posted on by
Reply

These days we’ve got plenty of people advising us not to panic about the Ebola virus.  Whether it’s those ubiquitous, generic “psychologists” who seem to pop up whenever there is some significant incident, or public health officials who want to reassure us that in the grand scheme of things Ebola is really not that big a deal, experts galore are urging us to control the inner demons that might otherwise transform us into a howling, red-eyed, torch-wielding mob that could end modern civilization as we know it.

The counseling to avoid panic is a dodge, of course, because no one is panicking.  But by depicting concerns about how the Ebola issue has been poorly handled as indications of unfortunate mass hysteria, the people who have dropped the ball can deflect and avoid legitimate inquiry.  Tsk, tsk!  They’re the rational ones; the rest of us are excitable, poorly informed boobs who are just going to make matters worse.  Like the policeman at the yellow tape of a disastrous crime scene, they just want us to move along.

We shouldn’t fall for this sham in this case, and should insist on getting answers to some entirely reasonable questions.  Ebola isn’t a phantom menace; it is a deadly disease, and in the latest outbreak in West Africa it has had a mortality rate of 70 percent, according to  the World Health Organization.  In America, we have established the Centers for Disease Control and Prevention precisely to deal with the enormous risks posed by such dread infectious diseases. When a man infected with Ebola reached America and received treatment in Dallas before dying, it appears that the CDC and the Dallas hospital that provided the treatment were unprepared to deal with the case in a way that ensured effective containment of the disease.  First one nurse, and then another, were found to be infected, and now we learn that the second nurse was permitted to board an airplane when she was exhibiting a low-grade fever that is one of the first signs of the virus.

Is it panicky and irrational to question how and why these circumstances could possibly occur?  If you were one of the 132 unsuspecting passengers flying from Cleveland to Dallas with that nurse — people that officials are now trying to trace and presumably monitor — wouldn’t you think it was entirely legitimate to question the competence of the CDC and to ask whether it was following any kind of meaningful containment strategy?

It is becoming increasingly clear that the CDC has badly fumbled this situation, which means that it is failing at the principal reason for its existence in the first place.  Demanding answers about how that happened is not a a sign of hysteria, but rather of requiring accountability by a government agency that simply has not done its job and, in the process, is exposing the people it is supposed to protect to unnecessary risk.

Ebola On A Plane, And In The U.S.

Posted on by
Reply

The Centers for Disease Control and Prevention has announced that a person has brought the Ebola virus into the United States on a commercial airplane flight.  The man, who was not exhibiting symptoms of the virus at the time, landed in Dallas on September 20.  He is being treated at a Dallas hospital, and in the meantime the CDC is sending a team to Dallas to try to figure out who else may have been infected.

How big of a deal is this news?  That’s not clear — but it certainly would be better if it hadn’t happened.  According to the CDC website, Ebola is transmitted by coming into contact with the blood or bodily fluids of someone who is infected with the disease, or with the clothing or other items that have come into contact with those substances.  The website actually addresses what the CDC would do under these circumstances:  “If a traveler is infectious or exhibiting symptoms during or after a flight, CDC will conduct an investigation of exposed travelers and work with the airline, federal partners, and state and local health departments to notify them and take any necessary public health action.”  The website doesn’t specify what the “necessary public health action” might be.

For those of us who have to travel as part of their jobs, this news is somewhat unnerving.  Airports and airplanes are the great crossroads of the modern world, where your path might intersect for a few seconds with travelers from faraway lands while you wait to board a plane or go through security or get some crappy grub at a fast-food outlet.  In a modern airport, you could be sneezed upon by people from just about anywhere, or unknowingly sit in a seat that minutes ago was vacated by a complete stranger whose health condition is absolutely unknown.  How many people were transported in the plane that brought the infected man to this country before anyone became aware this issue existed?  How do we know where the infected man sat, or whether he used the bathroom?

We’re probably not to the point where people will be traveling in hazmat suits, but don’t be surprised if you see an outbreak of those mouth and nose masks the next time you take a commercial airline flight.

The CDC And The Mass Breakdown Of Governmental Competence

Posted on by
3

For years the Centers for Disease Control and Prevention was one federal agency that seemed to be a model of governmental efficiency and capability.  Like NASA in the glory days of the Mercury, Gemini, and Apollo programs, the CDC was a little agency with an important mission and dedicated employees who helped to guide the national responses to epidemics and infectious diseases.

That’s why the recent stories about some appalling security lapses at the CDC are so troubling.  In one instance, poor handling of anthrax — a disease that the CDC’s own website cautions can cause serious illness and death — potentially exposed a number of employees to the bacteria.  In another incident, CDC employees improperly shipped a deadly strain of bird flu to a Department of Agriculture poultry research lab.  The breakdowns are especially disturbing because the CDC also is supposed to ensure that other laboratories follow federal safety standards.  The CDC is investigating these breaches and developing new procedures to address the “potential for hubris” in an agency that may have grown too comfortable with working with dangerous spores, bacteria, and infectious agents.

Given the CDC’s public health mission, any security breakdown that could expose people to a deadly infectious disease could be catastrophic.  But the CDC’s problems seem to be symptomatic of a larger, equally concerning issue:  a broad-scale series of failures in federal agencies.  In the past year, we have witnessed a colossal failure in an attempt by the Department of Health and Human Services to build a functioning health insurance exchange website, mass failures by the Veterans Administration to provide adequate care for veterans, a stunning security breach that allowed Edward Snowden to spirit away enormous amounts of highly classified data, and a southern border so porous that thousands of unaccompanied minors have been able to cross into our country.  And those are just a few of the stories.

For years, there has been a divide in this country between those who want the government to assume a more significant role in regulating our affairs and those who resist that approach because they believe a larger government role means less freedom and fewer individual liberties.  The recent dismal performance of our federal agencies suggests that a new factor should enter into the equation:  is the federal government even competent to do what we are asking it to do?  In view of the many recent breakdowns in governmental performance, that is a very fair question.