What ever happened to the CDC?

I’ll leave it to the professional hair-splitters to argue over who did or didn’t fund the federal Centers for Disease Control and Prevention and when and how much and how come. Only Washington reduces every question of competence to a budget line-item.

I prefer to laser in on one simple proposition. The United States faces a disease, covid-19, that is killing thousands, shattering the economy and upending our way of life. And the agency charged with controlling and preventing has done neither.

Maybe that’s too much to ask. But what has the CDC done to help? The Atlanta laboratories, formerly the gold standard for battling emerging disease, punted away weeks of precious time by botching a test when aggressive testing of the public might have meaningfully slowed the coronavirus. Then the agency dithered on travel advisories as the pandemic swept the globe and rooted itself deeply in the United States. Even today, months into the crisis — when clear, actionable information is desperately needed by the public — the CDC’s coronavirus website is a scandal. Wonder whether you ought to be examined for the disease? Click on the CDC’s “Should You Get Tested” page. There is no better example of thorough hand-washing than this. “Try calling your state or local health department or a medical provider,” says the sad shell of its former self. “While supplies of these tests are increasing, it may still be difficult to find a place to get tested.”

It certainly may. It may also be difficult to get results of your test in less than a week or more. For that matter, you may be among the estimated 30 percent of tested patients who are getting false results. Or your results may be among the estimated 650,000 tests — half of the national total — that haven’t been communicated to the White House task force.

If you read deeply enough into the page, all the way to the bottom, the CDC will eventually encourage you to be more aggressive about seeking aid should you lose consciousness and turn blue.

The sad decline of the CDC was spotlighted on March 6, when President Trump ducked into the labs on his way to a weekend at Mar-a-Lago, sporting a red campaign cap and musing on his natural gifts as a scientist. The actual scientists standing awkwardly beside him looked like shovel-struck sheep. Markets correctly diagnosed a florid outbreak of federal fecklessness; the bottom dropped out of stocks. And that was the last we heard from Atlanta.

Now the agency is agonizing over the efficacy of bandannas and scarves for blocking transmission, but it’s too late for the CDC to assert itself into the current crisis. Instead, the agency should leapfrog ahead to redeem its reputation. The United States needs a strategy for managing covid-19 after the current shutdown runs its course.

How long that takes is anyone’s guess. Trump has said in recent weeks it might be August, or July, or June. At some point, social distancing and the arrival of summer will — with luck — slow the spread of covid-19 enough to allow the the United States to regroup for the next wave of disease in the fall.

Having blown round one, the CDC should gird for round two. Long before Labor Day, the United States needs practical, working solutions to at least three problems that could make the difference between winning and catastrophically losing another round.

The first problem: We must figure out who has already been infected with covid-19. Those whose bodies have successfully fought off the virus — with or without symptoms — can be a resource to the nation, using their antibodies to keep businesses afloat and services running. Given the massive failure of diagnostic testing, however, we need widespread tools to look back at past infection. The science exists to screen for antibodies; by Memorial Day we require such testing on a quick, accurate, inexpensive, mass-produced basis. This screening will be meaningless without a national registry of covid-19 survivors — a huge challenge for health privacy experts and medical records companies. The CDC can be the spur.

The second problem: We still need diagnostic testing. The United States can’t begin to restore normal life until we have some alternative to blunt lockdowns, crude distancing and vague quarantines. The CDC should prepare the the United States to do what the South Koreans have done: broadly examine the public for telltale fevers, then aggressively isolate and test feverish individuals for covid-19. By August, schools, sporting events, transportation hubs and other public places must be ready for routine, airport-security-style temperature scans.

The third problem: We need to accelerate covid-19 therapies. If we have effective testing, we will catch more cases early, allowing us to treat them with supportive therapies before they reach the blue-lips stage. This will cut the mortality rate.​

It’s a big agenda, and there’s not much time. But that’s what we used to expect from the CDC: leadership, clarity, action. It’s what we ought to expect again.

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