WILLIAM FOEGE, a legendary figure in public health who helped devise the strategy that curtailed smallpox in West and Central Africa in the late 1960s and who led the Centers for Disease Control and Prevention under Presidents Jimmy Carter and Ronald Reagan, wrote a letter Sept. 23 to the current CDC director, Robert Redfield. The letter has now been disclosed by USA Today and should be read by everyone concerned by President Trump’s dreadful response to the coronavirus pandemic and his corrosive politicization of public health.

Dr. Foege, an epidemiologist who received the Presidential Medal of Freedom in 2012, said he wasn’t sure what he would do in Dr. Redfield’s shoes, but the first thing “would be to face the truth.” Despite spin from the White House, “this will go down as a colossal failure of the public health system of this country. The biggest challenge in a century and we let the country down.” In the future, public health textbooks “will use this as a lesson on how not to handle an infectious disease pandemic.” The cause, he said, has been “the incompetence and illogic” of the White House.

Not placing the CDC in charge of the pandemic response violated “every lesson learned in the last 75 years that made CDC the gold standard for public health in the world,” he wrote. The need for a “coherent federal plan, the backbone of every former response, has been ignored,” leaving it to the states, often competing among themselves. The “absolute need to form and guide coalitions” was ignored, he wrote, and the need for global cooperation squandered. Dr. Foege recalled the lesson that “the best decisions are based on the best science while the best results are based on the best management.” In this case, he lamented, “the White House has rejected both science and good management.”

He said he initially thought White House officials would “see how disastrous their approach was and finally turn the job over to professionals. Now I know that won’t happen.” He bemoaned how the White House “manipulated the valuable reputation” of the agency by diluting its warnings of the virus’s dangers. Many current and former CDC employees think Dr. Redfield caved in to the White House’s orders “without sufficient resistance,” he asserted. He urged Dr. Redfield to come clean, apologize in a letter and declare his intention to lead the agency without meddling. “Don’t shy away from the fact this has been an unacceptable toll on our country,” he wrote. “It is a slaughter and not just a political dispute.”

Dr. Foege appealed to Dr. Redfield’s conscience, saying he should resign on principle if necessary, that he shouldn’t want to be remembered as “forsaking your role as a servant to the public in order to become a servant to a corrupt president.” Whether Dr. Redfield takes the advice or not, it is certainly long past time for him to reject the White House pressure on the CDC and embrace the primacy of science and expertise in managing public health.

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