Tangle - Changes at the CDC.

Episode Date: August 22, 2022

CDC director announces new COVID guidelines and an organizational overhaul. Plus, a question about politicians' priorities.You can read today's podcast here.You can subscribe to Tangle by clicking here or drop something in our tip jar by clicking here.Our podcast is written by Isaac Saul and produced by Trevor Eichhorn. Music for the podcast was produced by Diet 75.Our newsletter is edited by Bailey Saul, Sean Brady, Ari Weitzman, and produced in conjunction with Tangle’s social media manager Magdalena Bokowa, who also created our logo.--- Send in a voice message: https://podcasters.spotify.com/pod/show/tanglenews/message Hosted on Acast. See acast.com/privacy for more information.

The flu remains a serious disease. Last season, over 102,000 influenza cases have been reported across Canada, which is nearly double the historic average of 52,000 cases. What can you do this flu season? Talk to your pharmacist or doctor about getting a flu shot. Consider FluCellVax Quad and help protect yourself from the flu. It's the first cell-based flu vaccine authorized in Canada for ages 6 months and older, and it may be available for free in your province. Side effects and allergic reactions can occur, and 100% protection is not guaranteed. Learn more at flucellvax.ca. From executive producer Isaac Saul, this is Tangle.

Good morning, good afternoon, and good evening, and welcome to the Tangle Podcast, the place where you get views from across the political spectrum. Some independent thinking without all that hysterical nonsense you find everywhere else. I'm your host, Isaac Saul, and on today's episode, we are going to be talking about the CDC and some changes to its guidelines and a potential overhaul. Hope you had a great weekend. As always, before we kick it off, we'll jump in with some quick hits. some quick hits. First up, the daughter of a close ally to Vladimir Putin was killed in a car explosion in Moscow. Ukraine denied any involvement, but Russia's counterintelligence agency accused Ukrainian spies of the assassination. Number two, early polling shows the Mar-a-Lago search bolstered support for former President Donald Trump among Republican voters. Number three, the Islamic militant group al-Shabaab stormed a popular hotel in Somalia's capital, killing 21 people during the siege. Number four,

Senate Minority Leader Mitch McConnell predicted Republicans would have a hard time flipping the Senate due to candidate quality. Number five, a United States judge sentenced a member of the Islamic State militant cell known as the Beatles to life in prison. We've got a startling admission from the head of the cdc that the agency has made serious mistakes during this covid pandemic which has killed more than a million americans the u.s has by far the highest covid death toll in the world we goofed that was the admission essentially from the center for the disease control director rochelle walensky when she called for an overhaul of the agency saying that in response to COVID-19, the CDC did not meet many expectations of the American public.

She didn't get. You know, I've been working with them closely and it's not necessarily the individuals. It's the funding, the bureaucracy, the hierarchy at the CDC that is failing them. So CDC really needs to improve their operational capacity to move faster, their clearance process, and this issue of constant turnover of leadership. In the last two weeks, the CDC has been at the center of two major stories. First, the agency announced the relaxation of existing COVID-19 guidelines, dropping the recommendation that Americans quarantine if they come into close contact with someone who is infected with the virus. If a person is unvaccinated, they should wear a high-quality mask for 10 days and get tested after five days. The agency also said people no longer need to stay at least six feet away from each other and don't have to test after

exposure if they are not experiencing symptoms. While many states have long abandoned social distancing precautions, the changes are a major stepping stone for schools across the country who will also no longer need to do routine daily testing. The update ended the so-called test-to-stay policy, which required kids who had been exposed to COVID to obtain a negative test to return to school. Indoor masking continues to be recommended in communities where transmission is high, which is still about 34% of the country. The changes come after over two and a half years of the pandemic, and the CDC says are driven by the fact that an estimated 95% of Americans have acquired some immunity to the virus via infection or vaccine. Meanwhile, daily COVID-19 rates this summer have remained steady at about 100,000 new cases per day, with 300 to 400 deaths every day. Then, last week, CDC Director

Rochelle Walensky announced that the organization would undergo a shakeup, saying it fell short in responding to COVID-19 and needs to become more nimble and communicate better. The CDC leaders are calling it a reset and said they plan to make internal staffing changes and speed up data releases. The agency has faced immense criticism for a slow response to COVID-19 and an inability to act quickly enough against rising health threats like monkeypox. Among other changes, according to the Associated Press, the agency plans to release more pre-print scientific reports before peer review, restructure the communication office,

create a minimum six-month time period agency leaders are dedicated to an outbreak response to reduce turnover, and alter the agency's organization chart to undo changes made during the Trump administration. It's not lost on me that we fell short in many ways, Walensky said about COVID-19. We had some pretty public mistakes, and so much of this effort was to hold up the mirror to understand where and how we could do better. Below, we're going to take a look at some commentary from the right and the left on the latest guidance and the calls for CDC overhaul. First up, we'll start with what the right is saying. Many on the right criticize the CDC for it being so late.

They call out the mistakes the CDC made and the failure to consistently align their policies with science. Some say the same mistakes are still playing out right now during the monkeypox outbreak. In the New York Post, Carol Markowitz said it was too little, too late. The agency now believes we should be taking an individual approach to mitigating our COVID risk. In layman's terms, we are all Florida 2022 now, Markowitz said. The new guidance suggests ending tests to stay so kids exposed to someone with COVID-19 can remain in school. Of course, this was only related to known exposure. People are exposed to COVID all the time, but only children who were aware of that exposure were punished. Kids lost so much throughout the pandemic because of terrible, irrational CDC guidance like this. The fresh guidance also says people without symptoms no longer need to be routinely tested. Fresh Guidance also says people without symptoms no longer need to be routinely tested.

But most important, the agency has finally faced some truths about the vaccine that it should have long ago. CDC's COVID-19 prevention recommendations no longer differentiate based on a person's vaccination status because breakthrough infections occur. And it's admitted that persons who have COVID-19 but are not vaccinated have some degree of protection against severe illness from their previous infection. Cities across the country fired teachers, firefighters, healthcare staffers, police officers, sanitation workers, and so many others because they refused to get vaccinated, Markowitz said. Many of these people had worked through the early days of the pandemic and contracted

COVID many times over while we baked banana bread and patted ourselves on the back for ordering Uber Eats. Now the CDC acknowledges this was the wrong thing to do. Whoopsie. The new guidance is all fine and good, sane even, but it's August 2022 and fully absurd that the CDC is only now recognizing that people aren't staying six feet apart and that a previous COVID-19 infection offers a layer of protection similar to the vaccine. In the Wall Street Journal, John Tierney said Walensky and Dr. Anthony Fauci are doubling down on a failed response. Lockdowns and mask mandates were the most radical experiment in the history of public health, but Dr. Walensky isn't alone in thinking they failed because they didn't go far enough. Anthony Fauci, chief medical advisor to

the president, recently said there should have been much, much more stringent restrictions early in the pandemic, Tierney wrote. The World Health Organization is revising its official guidance to call for stricter lockdown measures in the next pandemic, and it is even seeking a new treaty that would compel nations to adopt them. The World Economic Forum hails the COVID lockdowns as the model for a great reset, empowering technocrats to dictate policies worldwide. Yet, these oppressive measures were taken against the long-standing advice of public health experts, who warned that they would lead to catastrophe and were proved right, Tierney wrote. U.S. states with more restrictive policies fare no better, on average, than states with less restrictive policies. There's still no convincing evidence that masks provided any significant benefits.

When case rates throughout the pandemic are plotted on a graph, the trajectory in states with mask mandates is virtually identical to the trajectory in states without mandates. The states without mandates actually had slightly fewer COVID deaths per capita. International comparisons yield similar results. A Johns Hopkins University meta-analysis of studies around the world concluded that lockdown and mask restrictions have had little to no effect on COVID-19 mortality. In the New York Times, Ross Dutat said the CDC continues to lead from behind. In an ideal view of how expertise informs society, CDC guidelines would track the

evolving nature of the pandemic closely and provide a roadmap back to normalcy. In reality, the CDC has been consistently behind, behind evolving scientific knowledge, behind the curve of COVID's evolution, behind how most Americans have already adapted. As my colleague Emily Anthes put it, gently, the new guidelines, quote, effectively acknowledge the way many Americans have been navigating the pandemic for some time, end quote. Except, of course, in those institutions that still dutifully try to respect public health authority, like, say, the public schools that have been stuck trying to implement early pandemic recommendations like the six feet rule or the three feet in masks in

classrooms and six feet everywhere else alternative which the new guidelines finally jettisoned. The arbitrariness of those distances was widely understood even before the contagiousness of the delta variant made the rules still more absurd. Yet it's taken a year at least for official science to finally catch up with the real thing, he said. That lag is, at this point, more familiar than maddening, but it is genuinely infuriating to see Covidian patterns replaying with a completely different disease, the broadly non-fatal but still pretty terrible monkeypox epidemic, which the Biden administration just officially declared a public health emergency. If COVID-19 probably would have

overwhelmed even the most effective public health bureaucracy, Monkey Box, which as of now is mostly spread through close human contact, especially sexual contact, and for which we already have a vaccine, offered a chance to replay the COVID outbreak at a milder degree of difficulty. Yet, the same kinds of bureaucratic failure were repeated. Too little testing early on, too little interagency coordination, too little preparation for what should have been predictable challenges. Alright, that is it for what the right is saying, which brings us to the left's take. The left is divided, with some critical of the new guidelines because COVID-19 is still spreading so rapidly, while others say it's time for bigger changes.

Some say the CDC changes need to be thought of as the beginning of preparing for the next pandemic. Others say the updated guidance for schools is mostly right. In NBC News, Brian Castrucci said COVID isn't done with us, whatever the CDC says. It's been two and a half years. More than 92 million people in the United States have gotten sick and one million have died. While it's true that we are no longer running out of ventilators and far fewer Americans are dying, there are still more than 34,000 hospitalizations and about 400 deaths every day from COVID. And those two trend lines are flat, not getting much worse or better, a steady toll of sickness and death, Kirstucci said.

This new guidance may be signaling a strategic shift in the nation's prevention strategy, but is everyone equally ready for that shift? If you are under 60, healthy, vaxxed, and boosted, the data suggests you are very unlikely to become severely ill or die from COVID. But what about all the people who don't fit those criteria? What if you're among the more than half of all Americans with a chronic disease or one of the 7 million plus who are immunocompromised? In a world where special shopping hours and accommodations for those at greater risk of hospitalization and death are long gone,

these relaxed criteria further leave behind people who are chronically ill, disabled, or immunocompromised, he said. How is it that we've become numb to losing 400 people each day? Just think what you would do to save one person from drowning. Would you dive in to save them or at least throw them a rope? How hard would you fight to save another human from imminent death? And why doesn't that concern for one life translate to saving 400 people day after day after day? While the guidelines are not binding laws, they will make it increasingly difficult for states and cities to maintain or propose more stringent preventative policies, and they will leave responsible and vulnerable people who are trying to protect themselves by wearing a mask open to increased ridicule, isolation, and even discrimination. The

Washington Post editorial board criticized the agency and said changes are needed. 52,000 cases. What can you do this flu season? Talk to your pharmacist or doctor about getting a flu shot. Consider FluCellVax Quad and help protect yourself from the flu. It's the first cell-based flu vaccine authorized in Canada for ages six months and older, and it may be available for free in your province. Side effects and allergic reactions can occur, and 100% protection is not guaranteed. Learn more at FluCellVax.ca. The agency dropped the ball on developing an early diagnostic test for the coronavirus. Once a trusted source of public information nationally and globally, in the first year of chaos and confusion, it went quiet under pressure from the Trump White House. Under the Biden administration, which promised competence and science-based policies, guidance and decision-making from the CDC on masking, isolation, and booster doses have been repeatedly faulted as slow,

opaque, and confusing, the board said. A swift internal review ordered by Dr. Walensky concluded the agency needs to share its scientific findings and data more quickly, translate science into practical, easy-to-grasp policy, prioritize its public health communications practices, and respond with greater alacrity to public health emergencies. Some fixes seem logical, such as rewiring the agency to expedite its scientific findings, creating incentives for experts to report promptly rather than hold back their papers for publication. Also, the agency must overcome its long-standing troubles with data sharing and modernize its laboratories, the board said. Finding a way to deliver crystal clear, action-oriented communications to the American people to protect their health should not be rocket science.

Along with the CDC's own troubles, the pandemic response was hampered from the outset by White House meddling under President Donald Trump. President Biden has vowed to rely on the science, but the pandemic response remains under a White House coordinator. Shortly before monkeypox became an emergency, it, too, was put under a White House overseer. The goal should be for experts at retooled public agencies to fight health crises, not politicians in the White House. In the Washington Post, Dr. Leanna Wen said the CDC is ushering in a new normal. The newly released CDC guidance that eases COVID-19 precautions in schools is mostly right. At this point in the pandemic, the emphasis must shift from universal mandates to individual decisions to minimize the disruption of in-person learning, she said. Previous guidance from the Centers for Disease

Control and Prevention was appropriate for the last school year, but it is out of step with the situation today. It referenced social distancing and separating kids into cohorts, which pose practical difficulties for many schools. It urged masking at schools and communities with higher levels of COVID transmission, which is the case for more than 40% of the United States. Mask and distancing are mitigation measures that were needed before vaccines became widely available for school-aged children. That's no longer the case. Everyone six months and older can be vaccinated and those five years old and above can be boosted. Moreover, the vast majority of children have been exposed to COVID, she said. The CDC's new guidance removes blanket distancing and cohorting requirements. Importantly, it also allows children exposed to COVID to stay in class. This should prevent entire classrooms from being forced to stay home because one child

tested positive and will come as a huge relief to parents who have seen how the unpredictability of COVID restrictions negatively affects their work and their children's education. All right, that is it for the left and the right are saying, which brings us to my take. So let's start with the good. It's good that the CDC is looking to overhaul itself. It's good that a public health official like Dr. Rochelle Walensky is openly and directly taking responsibility for the agency's failures. It's good that she is doing this without any qualifiers or excuses, and it is tremendous that she's saying the CDC needs to be a results-based organization. One could easily imagine a lesser leader taking the stance that the CDC did the best it could with what it had, that the public made some of its own choices,

and that the agency would change little. She isn't doing that. She is owning the failures and working to remedy them. Kudos. It also seems good that the agency is changing its guidelines in a nearly wholesale fashion. Frankly, I was surprised some of them were even still the official line. The recommendation to give six foot distance indoors has long been retired by most of the public, and with such high rates of both vaccination and infection in the US, it seems that everyone I know has some level of immunity, something that, for good reason, changes their behavior and calculus. Personally, I'm fully vaccinated, boosted, and have now had COVID twice. The second time I got it, I was taking Paxlovid within hours of testing positive. My symptoms were gone in three days and I was texting negative on day five with no bounce back case. Though I know the risk of long COVID is very real, I'm going to act much

differently now than I did in the first few months of the pandemic with so many added layers of protection, and with good reason since much of the country is in a similar boat I am. Which brings us to the bad. The CDC's failures are too numerous to really cover here, but most of them fall into buckets of being late to the party or actions clearly the product of politics. At this point, the hits are probably familiar to you. The initial misguidance on masks, the flip-flopping on closures and lockdowns during the George Floyd protests, the irrational restrictions on outdoor activity, the lack of consideration for the boost in immunity from being infected, the misunderstanding of the tremendous efficacy of children's immune systems against the virus,

and so on. The dynamics of these things were often broadly understood well before the agency incorporated that knowledge into its official protocol, which is why it's now being described as slow and derelict. What still seems largely under-discussed is the degree to which the CDC should be a function of American life rulemaking going forward. On the one hand, a cautious and deliberate organization is exactly what you want from your national health guidance makers. On the other hand, when you consider that caution produces guidance like not eating sushi or a medium-rare steak, we need to be more discerning about the degree to which

we empower such an agency to organize our lives. How and when we translate CDC guidelines into law is a complicated question we still need to reckon with. Of course, there are millions of Americans who are high-risk, immunocompromised, or disabled that may be more than wary about the latest guidelines. I'm not uninitiated on those fears. When the pandemic first struck, my mom was finishing up chemotherapy, and the first few months of my pandemic life, with no vaccines, no treatment, and the person I love most in every high-risk category known to man, was about as stressful as it gets.

But it's undeniable that the fundamentals of the pandemic have long since changed, and in some ways, the data we have should be encouraging. 95% of all Americans have some level of strong immunity. Among children, we know that 3 out of 4 kids have now had COVID, and all kids over the age of 6 months can be vaccinated. We know children getting very sick is still extremely rare. However rampant breakthrough infections are among the vaccinated, it's clear vaccines still dramatically reduce your chance of dying.

It also appears new variants, which are far more contagious, are less likely to result in long COVID. Treatments are effective for folks who are immunocompromised or elderly. We now know that one-way masking works, especially if you're vaccinated and properly wearing a quality mask. Of course, the encouraging numbers we see now follow a million dead and millions of others left with long COVID. Under two different administrations, the agency has failed in most conceivable metrics. So yes, the CDC needs an overhaul, its guidelines needed to change, and as it has throughout the pandemic, the concessions of both of those points seem to have come too late. Better late than never, sure, but hopefully whatever changes are ushered in can make the agency more agile and responsive for our next COVID-like pandemic.

All right, that is it for my take, which brings us to your questions answered. This one is from Eric in Virginia Beach, Virginia. Eric said, how should our elected officials vote? Align with political party platform? Align with constituent values and vote? Align with political party platform? Align with constituent values and views? Align with personal beliefs? Some combination depending on the situation? Do you have examples of how politicians have successfully or unsuccessfully employed those strategies? So this is a great question, Eric.

I'm not sure there's one formula I would prescribe, but I do think if I were, say, a member of Congress, there's a pyramid of priorities that I'd have. First and foremost is to your constituents. Vote in line with what you ran on. If you campaign, make promises, and get elected, your primary goal should be to fulfill those promises. Presumably, those things are aligned with your constituents' values and views, since they elected you. But when new issues arise, I think you should lean into what constituents want. Second is personal beliefs. I think politicians get elected

not just on their platform, but on their character, and they are expected to lead. So, politicians should also be prepared to make tough votes when they fully believe taking that position is right. I think this should be secondary to fulfilling your promises, but still highly prioritized. Third, I'd love to see party line voting de-emphasized for obvious reasons, but it's worth noting that falling in line with your party can be advantageous to get your constituents what they want or to vote your conscience more freely down the road. So to do one and two, sometimes you need to fall in line. That's just a political reality. I think the obvious example here is Joe Manchin. I'm not sure how successful he's been, but he has taken a lot of hard votes where he's had to weigh the opinion of his conservative constituents, his own personal

views and priorities, and whether to fall in line with the party he campaigned with. Clearly, it is not an easy calculus to make. an easy calculus to make. All right, that is it for your questions answered, which brings us to a story that matters. The cost of raising a child through the age of 17 is now over $310,000, according to a Brookings Institute estimate. A married middle-income couple with two children would spend $310,605, about $18,271 per year, to raise a child born in 2015 through 2017. The multi-year total is up 9% from two years ago, reflecting the rise in costs of goods and services driven by inflation. Isabel Sawhill, a senior fellow at Brookings, told the Wall Street Journal that a lot of people are going to think twice before they have either a first child or a subsequent child because everything is costing more. You also may feel like you have to work more. The Wall Street Journal has the

story and there's a link to it in today's newsletter. All right, next up is our numbers section. The percentage of Americans who said they trust what the CDC has to say about the pandemic is 44%, according to a January NBC News poll. The percentage of Americans who say America's best years are behind it is 58%, according to a new NBC News poll. The percentage of Republicans who express a high level of interest in the upcoming midterm elections is 68%. The percentage of Democrats who express a high level of interest in the upcoming midterm elections is 68%. The percentage of Democrats who express a high level of interest in the upcoming midterm elections is 66%. The percentage of voters who say the investigations into former President Trump should continue is 57%. The number of migrant children released into the United States since

President Biden took office, according to a U.S. Customs and Border Protection dataset, is 257,110. Alright, that is it for our numbers, which brings us to our have a nice day story. Last but not least, as always, 33 years ago, Brian Dahl put a message in a bottle as a 6th grader. A few months ago, that message was discovered by a salvage diver named Billy Mitchell, who made it his mission to find out who had written the message. When Mitchell finally got a lead, he discovered that Brian had died at the age of 29. Eventually, Mitchell connected with Brian's dad, Eric, who learned that the message had been cast by his late son when he was just a sixth grader.

It traveled almost 200 miles. Eric, his wife, and his son decided to go meet Brian's sixth grade teacher and reconnect with her. Now, the group considers themselves family. Brian, quote, was victorious in his life because of the relationships he established, the bonds with other people Eric told USA Today about his son, and he continues to inspire connections. USA Today has the tale, and there's a link to it in today's newsletter. All right, everybody, that is it for today's podcast. As always, if you want to support our work,

please go to readtangle.com slash membership and become a paying subscriber. That is the best way to keep this podcast running and to keep us afloat. We'll be right back here same time tomorrow. Have a good one. Peace. Our newsletter is written by Isaac Saul, edited by Bailey Saul, Sean Brady, Ari Weitzman, and produced in conjunction with Tangle's social media manager, Magdalena Bokova, who also helped create our logo. The podcast is edited by Trevor Eichhorn, and music for the podcast was produced by Diet75. For more from Tangle, subscribe to our newsletter or check out our content archives at www.readtangle.com. The flu remains a serious disease. Last season, over 102,000 influenza cases have been reported across Canada, which is nearly double the historic average of 52,000 cases. What can you do this flu season?

Talk to your pharmacist or doctor about getting a flu shot. Consider FluCellVax Quad and help protect yourself from the flu. It's the first cell-based flu vaccine authorized in Canada for ages six months and older, and it may be available for free in your province. Side effects and allergic reactions can occur, and 100% protection is not guaranteed. Learn more at flucellvax.ca.