How U.S. CDC missed chances to spot COVID’s silent spread
In early February, 57 people arrived at a Nebraska military base, among the first Americans evacuated from Wuhan, China, the epicenter of the new coronavirus outbreak. U.S. health officials knew very little then about the mysterious new virus, and the quarantined group offered an early opportunity to size up the threat.
The federal government sought help from a team at the University of Nebraska Medical Center, including Dr. James Lawler, an experienced infectious disease specialist. Lawler told Reuters he immediately asked the world-renowned U.S. Centers for Disease Control and Prevention (CDC) for permission to test the quarantined group, deeming it crucial to know whether people without symptoms were infected and could spread the deadly pathogen.
Agency officials worried that detained people couldn’t give proper consent because they might feel coerced into testing. “CDC does not approve this study,” an official at the quarantine site wrote to Lawler in a Feb. 8 email obtained by Reuters. “Please discontinue all contact with the travelers for research purposes.”
More than two months
passed before the CDC expanded its testing guidelines to include all asymptomatic people, saying soon afterward that this silent spread “may meaningfully contribute to the propagation of the COVID-19 pandemic.” By November, the agency estimated that more than half of cases were spread by people not currently experiencing symptoms.
Critics have widely asserted that the CDC fumbled key decisions during the coronavirus scourge because thenPresident Donald Trump and his administration meddled in the agency’s operations and muzzled internal experts. The matter is now the subject of a congressional inquiry. Yet Reuters has found new evidence that the CDC’s response to the pandemic also was marred by actions - or inaction - by the agency’s career scientists and frontline staff.
At a crucial moment in the pandemic when Americans were quarantined after possible exposure to the virus abroad, the agency declined or resisted potentially valuable opportunities to study whether the disease could be spread by those without symptoms, according to previously undisclosed internal emails, other documents and interviews with key players.
Soon after balking at testing the returnees from Wuhan, the agency delayed testing asymptomatic passengers among 318 evacuees from the Diamond Princess, a contaminated cruise ship in Japan. In addition, the agency failed at that time to make effective use of outside experts and appeared at times unprepared for the crisis on the ground, lacking adequate personal protective gear and ignoring established protocols, Reuters found.
“Yes, they were interfered with politically,” said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University, referring to alleged meddling by the Trump administration. “But that’s not the only reason CDC didn’t perform optimally during COVID-19. There are a lot of things that went wrong.”
Four top public health experts or ethicists told Reuters that the question of whether to test or engage in research on detained people has always been a sensitive topic. But all said the CDC should have proceeded given the fast-moving public health emergency.
Moreover, the CDC finalized rules in 2017 providing that medical testing was expressly allowed in quarantine, as long as participants were given the opportunity to give “informed consent” or opt out. Informed consent means giving people adequate information to understand the risks and benefits of a test or procedure.