I hate to say this, but I fear it is over. For our entire relationship, I have looked to the CDC to guide and educate me. I have put my faith in their recommendations. I have defended their stances on everything from obesity to Lyme disease to influenza across decades. I have done so because they never let me down. Until now. I am not sure that the powers that be at the CDC appreciate just how hard it is to practice medicine today — or how much we depend on them. Yesterday, one of my last patients of the day was golfing when she developed a toothache. One week later, she was told she had Stage IV cancer of the mandible. I am not an oncologist, but yesterday, my patient needed me to navigate her cancer diagnosis. After that, I sat as a 47-year-old patient told me of neck pain so severe, it had ruined her life. I am not a neurosurgeon, but yesterday I had to help my patient understand the risks of cervical spine surgery. I am not an infectious disease specialist, but for the past six months, I have been forced to practice like one. Today, I will see 20 patients. Some are sick; some are well; all are tired. All my patients, without exception, are tired of living with COVID. They are tired of fear, uncertainty, and chaos. And now, I am tired of the CDC and the decrepit, impotent, puppet of an entity it has become. I am tired of the missteps, take-backs, and blame games. For our entire relationship, we doctors paid and paved the way for this agency. The currency was our trust and, in turn, the trust of our patients. The road we paved led to this—a global health crisis. The novel coronavirus pandemic was the epic performance for which the CDC has been rehearsing for the past 75 years. On March 14th, my college sophomore was sent home, and my other kids were pulled from school. My husband’s pediatric practice came to a screeching halt, and mine scrambled to implement virtual care. We all, none excepted, did what we had to do. We are doctors. We manage crises. That is what we do. That is what we did. And the CDC? With all due respect, they sh*t the bed. The endless fits and starts and errors and retractions have not just undermined my ability to point to the CDC’s COVID guidelines, they have undermined me. Period. Until this year, I invoked the Centers for Disease Control with pride and utter confidence to patients, friends, and colleagues. “According to the CDC …” was my failsafe. If the CDC said so, I counted on it. I taught my patients to count on it. My reputation and their lives depended on it. I am angry, frustrated, and disappointed. But I also need to get over myself. Patients still need me. They still trust me. So now, along with caring for 20+ patients a day and navigating the chaos of my children’s upturned lives, and all the other normal “life stuff,” I will also have to read .. .a lot. I used to trust that the CDC would evaluate all the millions of pieces of data and that the recommendations rendered and posted would be trustworthy and reliable. CDC guidelines were not only a time-saver; they were my guiding light. Now that light has gone out, and somewhere, I, and every doctor practicing, need to dig even deeper for a few minutes to read a paper or look at a graph more closely. We didn’t really have that time six months ago. I honestly have no idea where we will find it now. But, again, we are doctors. We manage crises. We will manage this one. I had been writing this letter since the first of countless head-scratching moments months ago. Travelers came from overseas to Seattle. Over 600 were potential carriers of SARS-CoV-2. The CDC said, “we can only test 250.” When their antiquated systems and data failed in the quest to trace contacts way back in February, designated officials said, “let them go.” They had access to millions of tests and botched them. They had the time and wasted it. They had the well of science and allowed it to be contaminated. They had our trust and squandered it. Today my hand was forced. For weeks I have read in horror about the leaked emails and alleged political pressure. But yesterday, when I read that the published and retracted aerosol guidelines were the result of “someone pushing a button,” that was it. I do not blame them; the politicians or media or so-called “button-pushers,” I blame the CDC as an entity. I blame the leadership and those responsible for communication. I believe that the career scientists at the CDC are tireless and brilliant, but this is the Centers for Disease Control. The country’s most respected health agency — arguably, the world’s. How could Redfield and the leaders there allow such idiotic mistakes to happen? Damage like this after a decades-long relationship is probably irreparable. But all is not (yet) lost. We are standing on the edge of what could be the most disastrous months of our infectious disease lives. While I personally cannot fathom times darker than the past six, we, here in the trenches, are bracing for it. This is the CDC’s last chance to pull it together — to be the Michael Jordan of this crisis. They can either crumble, or they can allow the cuts and losses and disappointments of earlier days shape them into a powerhouse public health agency. I am holding my breath one last time. I know many will disagree with me, but I believe the CDC can rise again — can be the greatest public health agency in the world. But the time is right now. I read a story about how RBG loved the opera. When her 85-pound diminutive frame entered the Kennedy Center from the side door, a quiet rumble would begin in the far edges of the audience as she was recognized and within minutes would erupt into an impossible roar of applause. Relatively speaking, the CDC has the stature of a gorilla. Can they walk onto the world stage this fall with dignity? Can they restore our faith? Instead of the jeers, can they finally earn the ovation? Christine Meyer is an internal medicine physician. Source
