Consider This from NPR - How To Build Public Trust When Fighting A Pandemic

Episode Date: January 8, 2022

If you're confused about the new CDC Coronavirus guidelines, you're not alone. In fact, this week, the American Medical Association released a statement saying, "The new recommendations on quarantine and isolation are not only confusing, but are risking further spread of the virus." Adherence to public health guidelines is built on trust, and over the last few weeks, trust in the CDC seems to be eroding. Jessica Malaty Rivera, a Senior Advisor at the Pandemic Prevention Institute and a science communicator, explains how we got to this point...and what steps need to be taken to ensure public trust in the CDC.In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

The late-night talk shows have become a fairly reliable way to figure out what or who is getting on the nation's collective last nerve. Last week, they locked in on a new target, the CDC. Specifically, the latest CDC guidelines for controlling the coronavirus. Remember this rhyme. If symptoms again, the days are ten. If you're symptom-free, the days are thrift five. If you still wear a cloth mask, you've already died. That's Desi Lydon from The Daily Show on Comedy Central. Three, the days are thrift five. If you still wear a cloth mask, you've already died. That's Desi Lydon from The Daily Show on Comedy Central. I know it seems confusing, but by following these simple guidelines, we can finally beat smallpox.

COVID-19. COVID-19. And it's not just late night poking fun at the organization. Group chats, Twitter, and TikTok are flooded with memes and skits, like this one from Joy Afodu. Welcome to CDC Says, your favorite game from your favorite play cousin. CDC says put on your mask. CDC says take it off. CDC said put it on. Why not joke about it? That's better than tearing your hair out over guidance that in the kindest interpretation is not clear, and at its worst, makes no sense. Here's why. In a short press release put out on December 27th, the guidance to isolate for 10 days after an onset of symptoms turned to five. And there was

no requirement to test people who had COVID but are now symptom-free to end their isolation, just a directive to assess their own symptoms in order to re-enter society. Plus, at first, their guidelines did not come with a scientific brief explaining the changes. This week, they did update those guidelines to show some of their reasoning, but they still don't require a test to end isolation. Confused yet? You're not alone. In fact, the American Medical Association released a statement saying, quote, the new recommendations on quarantine and isolation are not only confusing, but are risking further spread of the virus, unquote. So there are a lot of questions about these guidelines and what's driving them. And some experts think it's not

just the science. So of course, we can't take science into a vacuum. We have to put science in the context of how it can be implemented in a functional society. So we always do that. That's the CDC director, Dr. Rochelle Walensky, talking to my colleague Ari Shapiro last week. We want to make sure that we can keep the critical functions of society open and operating. It's true good public health guidelines balance multiple priorities, but confusing communication about them threatens their effectiveness. Consider this. Adherence to public health guidelines is built on trust.

And over the last few weeks, trust in the CDC seems to be eroding. So how did we get here? And what do we do to fix it? That's coming up. From NPR, I'm Michelle Martin. It is Saturday, January 8th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit wise.com. T's and C's apply.

It's Consider This from NPR. Despite President Biden's promises to put public health experts front and center and restore public trust, the CDC scientists have remained out of the public eye during his tenure. Former CDC Director Tom Frieden, who served during the Obama administration, told NPR's Selina Simmons-Duffin that's a problem. The fact is there are dedicated scientists at CDC who are the world's experts in a lot of these issues, and they need to be speaking directly to the public along with Dr. Walensky. In fact, during the Trump administration, career scientists led CDC press briefings on the coronavirus every few days in the early months of 2020, before it was officially declared a pandemic by the WHO. On February 25, 2020, CDC scientists signaled that

things could get really bad, something President Donald Trump continuously downplayed. Trump sidelined those scientists and made COVID briefings a White House affair. And that practice continued during the Biden administration. But yesterday, after weeks of criticism... Good morning and thank you all for joining us for today's telebriefing. Finally, a CDC-led media telebriefing. We are joined by CDC Director Dr. Rochelle Walensky, who will provide opening remarks. Then we will be joined by Dr. Greta Massetti with CDC scientists and Dr. Henry

Walk. And there was clear relief from the reporters. Hi, Dr. Walensky, thank you for doing this. I'll second that. I really appreciate this opportunity, especially for giving us access to agency experts. Now, the briefing was supposed to focus on schools reopening. But it quickly digressed into questions about the CDC confused about the messaging from CDC. I'm wondering where is the science behind your isolation policy? And if you could explain why you are doing this briefing today. Well, we had heard clearly over the last week that there was interest in hearing from us independently, and so that was the reason for today.

It seems Dr. Walensky has gotten that message. And she clarified that the guidance is trying to balance dual priorities, So that was the reason for today. It seems Dr. Walensky has gotten that message. And she clarified that the guidance is trying to balance dual priorities, reducing enough transmission while keeping society open. But there's still a lot we don't know about how Omicron will change those calculations. I anticipate that this will be the first of many briefings, and I very much look forward to them. Coming up, our next guest thinks the CDC should do more to regain public trust.

This week, I had a chance to sit down with Jessica Malati-Rivera. She is a senior advisor at the Pandemic Prevention Institute, an infectious disease epidemiologist, and a science communicator. Now, that's a lot of balls to keep in the air, but I focused on that last one. What does a science communicator actually do? Well, for the last at least two years of the pandemic, I've been helping translate a lot of the emerging data, the headlines, the trends that we're seeing in COVID-19 statistics and numbers, translating it so that it's accessible to wide audiences. We asked Jessica Malati-Rivera if she agreed that the CDC communications with the public have been confusing.

Incredibly confusing. In fact, I was very pleased to see that the American Medical Association officially called them out to say that they were not only confusing, but that they were problematic and could cause more harm. So you listened to Walensky's media briefing. Do you think she made up for this confusion? Do you think she addressed it in an effective way? No, unfortunately, I don't.

And it's clear that that wasn't really even the intention of the teleconference, but it went there with the journalists. I'm glad it went there. But when pressed on where is the data and where is the science to justify this? I mean, she all but admitted that it's not based on Omicron data. They said that they don't have that data, the detailed data for Omicron, and they won't for weeks, so that they did decide this decision based on what they had from wild type and beta and delta,

which don't have the same kind of transmission dynamics as we are seeing with Omicron. I think a lot of people are scratching their heads, wondering what is going on with the CDC right now. I think a lot of people wonder why is it still so confusing? Is that just endemic to this field or are there things that they're just doing wrong? I think it's a little bit of both. I think the fact that it's really impossible to eliminate politics from a government agency. And in a time when we're still

recovering from a really botched response to the pandemic since day one, it's going to have to remain political because so many of the decisions are going to have to affect so many different industries. Do you think that the CDC is still experiencing political interference from the current administration? I do. I think that it's impossible to ignore that. Knowing the timing of when the president had a call with governors who put pressure on him about the burden, the economic burdens of 10-day isolations, and even knowing that there were letters sent from corporations on that particular burden as well. We know that the White House was pressuring that the CDC respond in this way and that there was an effort to kind of get that message out fast so that it seemed, you know, streamlined. Science and public health are political, but this politicization of it is where

all of us are feeling a bit uncomfortable. And it's impossible to remove that from what's happening right now. This is what I'm trying to understand is what is the line between political judgments and political interference? Because as you're pointing out, public health is in part about balancing different priorities. Right. Well, if you think about the outcry from public health professionals right now, we're asking for the data. We're asking for the evidence because that is what informs good policy. That's why we need science. We need the FDA, the CDC, the NIH to run the experiments, to collect the data so that they can make informed choices to inform really good policy for the public. And so I think that's where the line is. I think when you are making policies in the absence of very, very clear and significant and peer-reviewed and quality data, that's a red flag. I was wondering if there's any sympathy among public health

experts like yourself for the CDC because things change so quickly. I mean, Dr. Walensky pointed out that new data is coming out all the time. Is that a factor here and why the CDC is struggling to communicate effectively with the public. Absolutely. Their positions are not enviable. They have an enormous task in one of the most difficult times of our lives. This is exhausting, but what a time for all of us to kind of come in and step in and flex these muscles that we've been training for so long in a time where the American public needs us. But at the same time, it's not worth making rash decisions or decisions that are not based on very, very clear evidence or having messages that have to kind of continue to be

corrected because they were done possibly in haste. I definitely have sympathy for them. And I think that a lot of people in this space are burnt out, tired, and emotionally warned from the demands of this, you know this endless pandemic, it seems like. I mean, I'm sure you're aware of this history, but there have been times in the past when, because the job of the CDC is to weigh all these various factors, right? It's to weigh the science. And there have been times in the past, as I think people know, when maybe the CDC's call wasn't quite right. But even having said all that, I think there are those who worry that the CDC has lost its way in some way,

or who perhaps feel that the CDC has become too politicized. Is this actually endemic to the field, or is there something specifically wrong here right now? I think COVID-19 was a lesson that we were unprepared for because of the kind of years of devaluing and defunding public health. You know, we had systems in place prior to COVID-19 many, many years ago to do things like biosurveillance and tracking emerging threats for possible pandemics. And that funding dried up over time. And what we're seeing here is a consequence of that. You know, public health, when it works, it's invisible. And it's really hard to see the value of a lot of public health systems when there aren't a bunch of public health fires going off.

And then you have an unprecedented, you know, once in a century type pandemic that brings us to our knees and you realize, well, shoot, we probably shouldn't have devalued all of those resources and all of those industries. And so that's why you've seen a big outcry to prioritize public health and to even prioritize the communication of public health, because oftentimes you're dealing with folks who don't understand the science or who don't have context on how to normalize it so that people can make informed choices. I mean, the thing about public health too is that it's layers. It's not a black and white space. It's just multiple shades of gray. And to have messages that seem very, you know, black and white creates a bunch of false dichotomies on what mitigation efforts canceled at the next. And that's what we've been dealing with. We've

been dealing with this kind of yo-yo effect, taking one step forward, one step back, and back and forth messaging. And it's because of this lack of prioritization. And I think COVID-19 is probably going to be one of the most horrifying lessons learned for our country. So how should the CDC go about regaining the trust of the public, which some segments of the public, let us say, are so distrustful of any utterances by authority figures that do not come from, say, their own political orientation. I'll just put it that way. What should they do? I think Dr. Walensky even said that they were hearing that people wanted to have direct contact, you know, hearing from them alone. And I think that that's going to be a way to build

trust, not the only way, but a way to hear their tone, to hear the nuance and the gray areas that are not always reflected in the updates to the website and, you know, updates on Twitter. But I think it's going to take a while to do that. And I think that part of the process of regaining trust is also admitting when they've done wrong or admitting that things were bad or that they haven't been communicated well. I mean, I think one of the most poignant questions was when Walensky was asked if they would acknowledge that the CDC has done a bad job with messaging. And I think that's a necessary acknowledgement because it has been confusing when you have groups of medical doctors like the AMA saying this is harmful to the public and can cause more risk,

that should be responded to. And I think it shows ownership. I think it shows the humanity of people that are actual humans behind these personas online to kind of say, hey, this is a really difficult job. I mean, she said that to a degree. She did say that this is difficult. We're evolving with real-time data as it emerges, and it's hard to kind of aggregate it all and have streamlined messages, but there's got to be more of that. That was infectious disease epidemiologist and science communicator Jessica Malati-Rivera.

It's Consider This from NPR. I'm Michelle Martin. Consider This