CDC re­open­ing guide gets shelved

Ad­min­is­tra­tion puts onus on states to han­dle sit­u­a­tion

Orlando Sentinel - - Nation & World - By Ja­son Dearen and Mike Stobbe

GAINESVILL­E, Fla. — The Trump ad­min­is­tra­tion shelved a doc­u­ment cre­ated by the na­tion’s top dis­ease in­ves­ti­ga­tors with step-bystep ad­vice to lo­cal au­thor­i­ties on how and when to re­open restau­rants and other pub­lic places dur­ing the still-rag­ing coro­n­avirus out­break.

The 17-page re­port by a Cen­ters for Dis­ease Con­trol and Pre­ven­tion team, ti­tled “Guid­ance for Im­ple­ment­ing the Open­ing Up Amer­ica Again Frame­work,” was re­searched and writ­ten to help faith lead­ers, busi­ness own­ers, ed­u­ca­tors, and state and lo­cal of­fi­cials as they be­gin to re­open.

It was sup­posed to be pub­lished last Fri­day, but agency sci­en­tists were told the guid­ance “would never see the light of day,” ac­cord­ing to a CDC of­fi­cial, who spoke on the con­di­tion of anonymity.

The AP ob­tained a copy from a sec­ond fed­eral of­fi­cial who was not au­tho­rized to re­lease it. The guid­ance was de­scribed in AP sto­ries last week, be­fore the White House de­ci­sion to shelve it.

Tra­di­tion­ally, it’s been the CDC’s role to give the pub­lic and lo­cal of­fi­cials guid­ance and sci­ence­based in­for­ma­tion dur­ing pub­lic health crises. Dur­ing this one, how­ever, the CDC has not had a reg­u­lar, pan­demic-re­lated news brief­ing in nearly two months.

CDC di­rec­tor Dr. Robert Red­field has been a mem­ber of the White House coro­n­avirus task force but largely ab­sent from pub­lic ap­pear­ances.

“CDC has al­ways been the pub­lic health agency Amer­i­cans turn to in a time of cri­sis,” said Dr. Howard Koh, a Har­vard pro­fes­sor and for­mer health of­fi­cial in the Obama ad­min­is­tra­tion dur­ing the H1N1 swine flu pan­demic in 2009.

“The stan­dard in a cri­sis is to turn to them for the lat­est data, lat­est guid­ance and the lat­est press brief­ing. That has not oc­curred, and ev­ery­one sees that.”

The Trump ad­min­is­tra­tion has in­stead sought to put the onus on states to han­dle COVID-19 re­sponse.

This ap­proach to manag­ing the pan­demic has been re­flected in Pres­i­dent Don­ald Trump’s pub­lic state­ments, from the as­ser­tion that he isn’t re­spon­si­ble for the coun­try’s lack­lus­ter early test­ing ef­forts to his de­scrip­tion of the fed­eral gov­ern­ment’s role as a “sup­plier of last re­sort” for states in need of test­ing aid.

A per­son close to the White House’s coro­n­avirus task force said the CDC doc­u­ments were never cleared by CDC lead­er­ship for pub­lic re­lease. The per­son said that White House of­fi­cials have re­frained from of­fer­ing de­tailed guid­ance for how spe­cific sec­tors should re­open be­cause the virus is af­fect­ing var­i­ous parts of the coun­try dif­fer­ently.

The re­jected re­open­ing guid­ance was de­scribed by one of the fed­eral of­fi­cials as a touch­stone doc­u­ment that was to be used as a blue­print for other groups in­side the CDC that are cre­at­ing the same type of in­struc­tional ma­te­ri­als for other fa­cil­i­ties.

The guid­ance con­tained de­tailed ad­vice for mak­ing site-spe­cific de­ci­sions re­lated to re­open­ing schools, restau­rants, sum­mer camps, churches, day care cen­ters and other in­sti­tu­tions. One page of the doc­u­ment can be found on the

CDC web­site via search engines, but it did not ap­pear to be linked to any other CDC pages.

“States and lo­cal health depart­ments do need guid­ance on a lot of the chal­lenges around the de­ci­sion to re­open,” said Dr. Mar­cus Ples­cia, chief med­i­cal of­fi­cer of the As­so­ci­a­tion of State and Ter­ri­to­rial Health Of­fi­cials.

“You can say that restau­rants can open and you need to fol­low so­cial-distancing guide­lines. But restau­rants want to know, ‘What does that look like?’ ”

The White House’s own “Open­ing Up Amer­ica Again” guide­lines re­leased last month were more vague than the CDC’s un­pub­lished re­port. They in­structed state and lo­cal gov­ern­ments to re­open in ac­cor­dance with fed­eral and lo­cal “reg­u­la­tions and guid­ance” and to mon­i­tor em­ploy­ees for symp­toms of COVID-19.

The White House guid­ance also in­cluded ad­vice de­vel­oped ear­lier in the pan­demic that re­mains im­por­tant, such as so­cial distancing and en­cour­ag­ing work­ing from home.

At a brief­ing Wed­nes­day, White House spokes­woman Kayleigh McE­nany echoed the ad­min­is­tra­tion’s stance that states are most re­spon­si­ble for their own COVID-19 re­sponse: “We’ve con­sulted in­di­vid­u­ally with states, but as I said it’s (a) gov­er­nor-led ef­fort. It’s a state-led ef­fort on which the fed­eral gov­ern­ment will con­sult. And we do so each and ev­ery day.”

The CDC is hear­ing daily from state and county health depart­ments look­ing for sci­en­tif­i­cally valid in­for­ma­tion with which to make in­formed de­ci­sions.

Still, be­hind the scenes, CDC sci­en­tists like those who pro­duced the guid­ance for “Open­ing Up Amer­ica Again” are work­ing to get in­for­ma­tion to lo­cal gov­ern­ments.

The agency still em­ploys hun­dreds of the world’s most re­spected epi­demi­ol­o­gists and doc­tors, who in times of cri­sis are looked to for their ex­per­tise, said for­mer CDC di­rec­tor Tom Frieden. Peo­ple have clicked on the CDC’s coro­n­avirus web­site more than 1.2 bil­lion times.

States that di­rectly reach out to the CDC can tap guid­ance that’s been pre­pared but that the White House has not re­leased.

“I don’t think that any state feels that the CDC is de­fi­cient,” Ples­cia said. “It’s just the process of get­ting stuff out.”

ALEX BRAN­DON/AP

The Trump ad­min­is­tra­tion has shelved a guide for re­open­ing Amer­ica de­vel­oped by the na­tion’s top dis­ease in­ves­ti­ga­tors.

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