Charles Seife wrote an article in Slate entitled “The CDC has been on a steady Decline. We’re Just Finally Noticing”. The thesis of the article is that the CDC’s credibility is being damaged by extensive political pressure. He states: “Sometimes an agency doesn’t decline from the zenith like a falling star, but its reputation slouches, bit by bit toward mediocrity.” (1)
Mr. Seife attributes much of the decline to President Trump. While there is some justification for that opinion, there is a more fundamental issue. That issue is the ability of government organizations to respond quickly to emergencies and the impact failures have on their reputations.
Covid-19, with its significant health and economic impact, has highlighted several actions and the attitudes of organizations, which would not come to light under normal circumstances. This piece examines some of consequences of Covid-19, the actions taken by organizations and how they damaged their reputation.
Because Covid-19’s impact is multifaceted and actions are reflective of what is know and not known, it is worth starting with the known, might be and unknown.
Covid-19
Known: Covid-19 came out of China. In the United States Covid-19 cases first appeared in the states of Washington and California. It is a deadly disease. It is easily transferred. It attacks the lungs. Those over 60 and those with underlying health issues such as high blood pressure, diabetes, and heart problems are most at risk. Wearing a mask will not prevent you from catching the virus. Children and adults under 30, if they come down with Covid19, recover quicker, often showing little or no symptoms. The models used to estimate Covid-19’s impact was generally wrong.
Might be: It does not last long on surfaces. Wearing a mask prevents you from transmitting the virus. The mortality rate may not be as high as originally predicted based on studies in California and Germany. Based on an NIH study, asymptomatic individuals do not infect many people. More people are infected staying at home than going out or to work.
Unknown: While it is known when the first diagnosed cases appeared in the United States, because of the asymptomatic nature of the virus, it is not known exactly when and where it came to the United States. The actual fatality rate is not known, because we do not know the percentage of people who are asymptomatic. It is not known if people who have recovered from Covid-19 can be re-infected. It is not known what the long-term damage is to a Covid-19 patient’s lungs. It is not known if there will be a second wave. It is not known if Covid-19 will be an annual reoccurrence.
The consequences of the virus can be seen in the reputational impact on several organizations.
CDC Reputational Hit
Because the virus is easily transmissible and can be deadly, there was a need to react quickly. At the national level, the Center for Disease Control should have taken the lead. Yet, it blundered badly. Seife notes: “the CDC seems baffled -bumbling, cowed, an above all, silent.”
The CDC failed to identify Covid-19 early on. A recent CDC study found that Covid-19 had entered the United States between January and February 2020. Yet, the CDC surveillance system failed to identify its arrival.
But, perhaps the most glaring incident which damaged the CDC’s reputation is the problem with test kits. The CDC wanted to control the roll out of virus test kits. The CDC assembled the test kits in its own facilities. It sent out kits which were faulty. It turns out that the CDC facilities violated sound manufacturing practice. The delay caused by the need to recall and replace the faulty kits, hampered the effort to quickly contain the virus.
This problem was further complicated because the CDC did not provide the Food and Drug Administration (FDA) with information on whether the problem was a design flaw or a manufacturing issue. As noted above, it turned out it was a manufacturing issue. Private companies authorized to manufacture the test kits, using the CDC design, had no trouble obtaining FDA approval.
The response to the virus required the CDC to respond quickly and effectively. It failed to do so. The CDC’s reputational hit is obvious. What is less obvious is the reputational hit epidemiological forecasters have taken.
Epidemiological Forecasters
Governor Cuomo recently stated that the forecasts were wrong. Since the models, the forecasters developed, were used by policy makers to make important decisions, errors resulted in bad decisions.
As someone who developed a model for his dissertation, I understand the difficulty associated with such development. In the case of Covid-19 there were numerous models used. Some models used data from major cities. The most frequently cited model was the one from the University of Washington’s Institute for Health Metrics and Evaluation (IHME). It used data from China and Italy, adjusting weekly. The differences in approaches resulted in different estimates. For instance, the IHME model tended to underestimate fatalities. Other models overestimated fatalities.
One of the key problems with the models is missing data. It is known that there is a part of the population who have the virus but are asymptomatic. Asymptomatic individuals do not show symptoms. The actual fatality rate can only be determined by dividing deaths by the known cases plus the asymptomatic numbers. The failure to have accurate asymptomatic numbers meant decisions were made on partially complete information.
The importance of this fact can be seen in two recent findings. An NIH study found that the transmission of Covid-19 by Asymptomatic Covid-19 carriers is low. In other words, those showing Covid-19 symptoms are more likely to transmit the virus than those who are Asymptomatic. Further, a CDC study shows that based on the inclusion of asymptomatic figures, the fatality rate is around 0.26% instead of the 2-3% stated in the models. The 0.25% number is 8 to 15 times lower than the estimates. (2)
The combination of these two studies means that the models created greater fear and delays in opening the economy. This resulted in the loss of trust and respect for model forecasters.
The CDC and health metrics professional are not the only organization or individual to suffer such damage.
National Institute of Health and Dr. Fauci
The issues around Covid-19 has revealed that the National Institute of Health (NIH) funded research conducted by the Chinese Wuhan Institute of Virology lab. This is the lab which is thought to be the source of Covid-19. In addition, Dr. Anthony Fauci’s National Institute of Allergy and Infectious Diseases gave $7.4 million to the Wuhan Institute. (3) Some of the research was for gain of function. Gain of function is research which attempts to increase a virus’ lethality and transmissibility. Such studies were banned in the United States in 2014.The focus on Covid-19 resulted in the termination of such grants several weeks ago. There is concern that the funding help create Covid-19. The issue has brought into question NIH’s and Dr. Fauci’s judgement. This has resulted in reputational loss for both.
Conclusion
Covid-19 has parted the curtain revealing the flawed responses of several key organizations and professionals. Some of those actions may have facilitated the spread of Covid-19 and slowed the availability of test kits. Similarly, the failure to identify the numbers of asymptomatic people lead to decisions which created greater levels of fear, financial loss and economic disruption than necessary.
In every emergency, problems occur. But in the case of Covid-19, the institutions and professionals that are depended upon to stabilize the situation, failed in key areas. In many cases, these failures were glaring and unnecessary. The glaring nature of the failures has resulted in significant reputational damage.
Endnote
- Seife, Charles, 2020, “The CDC Has Been on a Steady Decline, We’re Just Finally Noticing”, Slate, May 6. https://slate.com/technology/2020/05/cdc-coronavirus-decline.html.
- Mora, Edwin, 2020, “CDC: Coronavirus Fatality Rate 0.26%, 8-15x Lower Than Estimates”, Breitbart, May 27, https://www.breitbart.com/politics/2020/05/27/cdc-suggests-coronavirus-fatality-rate-higher-than-flus-but-at-least-8x-lower.
- Tacopino, Joe, 2020, “Dr. Fauci backed funding for controversial Wuhan lab studying origin of coronavirus”, April 29, https://nypost.com/2020/04/29/dr-fauci-backed-controversial-wuhan-lab-studying-coronavirus.
BIO:
James J. Kline, Ph.D., CERM, is the author of numerous articles on quality in government and risk analysis. He is a senior member of the American Society for Quality. A Manager of Quality/Organizational Excellence and a Six Sigma Green Belt. He has consulted for the private sector and local governments. His book, Enterprise Risk Management in Government: Implementing ISO 31000:2018, is available on Amazon. He can be reached at jeffreyk12011@live.com.