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United States Science

The CDC Needs To Stop Confusing the Public (nytimes.com) 219

Dr. Zeynep Tufekci, an associate professor at the University of North Carolina, writing at The New York Times: The C.D.C. faces three major problems. The first is reality: a sustained campaign of misinformation against vaccines and other public health measures, originating mostly with right-wing commentators and politicians, and a new media environment that has upended traditional information flows.

Second, the C.D.C. is still mired in the fog of pandemic, with too little data, collected too slowly, leaving it chasing epidemic waves and trying to make sense of information from other countries. Epidemics spread exponentially, so delayed responses make problems much worse. If the response to a crisis comes after many people are already aware of it brewing, it leaves them confused and fearful if they look to the C.D.C. for guidance, and vulnerable to misinformation if they do not.

Third, the agency is simply not doing a good job at what the pamphlet advises: being first, right and credible, and avoiding mixed messaging, delays and confusion. It's hard not to have sympathy for its predicament. The previous administration undermined the C.D.C., and anti-vaxxers' deliberate misinformation assault has not made the agency's job any easier. The digital public sphere operates fast and furious, and that's difficult for traditional institutions to keep up with or to counter. All this makes it even more important that the C.D.C. properly handle what's under its control.

The response to the Delta variant has been too slow. Data from other countries made it clear months ago that it posed a great threat. Unfortunately, the United States already doesn't systematically collect the kind of data needed on many important indicators. Making things worse, in early May, the C.D.C. stopped tracking breakthrough infections among the vaccinated unless they were hospitalized or worse, even though the reason for continued surveillance is to see and understand changes in an outbreak as early as possible. June passed with little change in the government's response, despite multiple technical papers from Public Health England showing that the Delta variant was much more transmissible and possibly more severe and that it was able to cause more breakthrough infections among the vaccinated. Detailed contact tracing from Singapore also showed that some of the vaccinated were transmitting.

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The CDC Needs To Stop Confusing the Public

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  • Don't confuse? (Score:5, Insightful)

    by Mal-2 ( 675116 ) on Thursday August 05, 2021 @05:01PM (#61661085) Homepage Journal

    You say "don't confuse people" -- but you have to consider what that actually means. For a lot of people (about 40% at this point) it means "never change your position", and any change in the messaging is considered proof of malfeasance. "They told us not to wear masks before they told us to wear masks, and they don't do anything anyhow." The Bible never changes, so why should any other truth?

    • Re:Don't confuse? (Score:4, Insightful)

      by fahrbot-bot ( 874524 ) on Thursday August 05, 2021 @05:12PM (#61661123)

      The Bible never changes, so why should any other truth?

      Publishers have sent out requests to the author(s), but, so far, no one has shown up.

      ... any other truth?

      Presuming The Bible contains "truth" and not just (hugely inconsistent) stories. Just sayin' ...

      • Some of what you type reads accurate as all get out...just remember, like science for the facts guys {(and dolls} (I feel plausibly less comfortable representing the XX humans as dolls, due in great part to the increasing penalty for that particular sort of gender branding, and yet, somehow, I still cannot stop myself.}

        The odds are good, no, great, that given the behavior of a large percentage of humans in the not too recent past, they're also planning to fuck up our future. Stock up on important shit like

    • What does the bible have to do with truth?

    • Re: (Score:2, Interesting)

      by chispito ( 1870390 )
      The CDC is also still maintaining the inane position [cdc.gov] that two-year-olds should wear masks at the supermarket.

      If you are not fully vaccinated and aged 2 or older, you should wear a mask in indoor public places.

      Even the WHO only recommends masks for children six and up: [who.int]

      In general, children aged 5 years and under should not be required to wear masks. This advice is based on the safety and overall interest of the child and the capacity to appropriately use a mask with minimal assistance. There may be local requirements for children aged 5 years and under to wear masks, or specific needs in some settings, such as being physically close to someone who is ill. In these circumstances, if the child wears a mask, a parent or other guardian should be within direct line of sight to supervise the safe use of the mask.

    • Re:Don't confuse? (Score:5, Informative)

      by Voyager529 ( 1363959 ) <voyager529 AT yahoo DOT com> on Thursday August 05, 2021 @06:06PM (#61661399)

      You say "don't confuse people" -- but you have to consider what that actually means. For a lot of people (about 40% at this point) it means "never change your position", and any change in the messaging is considered proof of malfeasance. "They told us not to wear masks before they told us to wear masks...

      Let's spell this out a bit more:

      "Lockdowns for two weeks to flatten the curve and not-overwhelm the hospitals; everyone's going to be exposed, let's make sure there are beds available."
      "Lockdowns for two more weeks to slow the spread. Essential businesses can remain open...like grocery stores...and lawyers, apparently. Don't wear masks right now because healthcare workers need them and there isn't enough supply for everyone."
      "A handful of businesses can reopen, but most can't. Also, there are strict capacity limits."
      "If you've got N95 masks, wear them, if you don't, just make sure your face is covered...a few more businesses can be opened."
      "Restaurants can open for outdoor dining, and you have to give them your name and address every time you go there. Also, protests with thousands of people participating are completely safe and not superspreader events, but a backyard wedding with 30 people in attendance is dangerous."
      "Restaurants have to close again. Also, if you travel, you have to quarantine for 14 days wherever you're going, and then quarantine 14 days when you get back, because everyone has 28 days' worth of vacation time, apparently."
      "Don't go to Thanksgiving with your family. Christmas isn't looking good, either."
      "Don't listen to Trump; he said to inject bleach so obviously his vaccine is crap."
      "January is a second wave because none of you behaved during the holidays. We'll hold steady until the vaccine is distributed."
      *Biden gets sworn into office*
      "We have a vaccine! And it's safe! And good for three months! Anyone who says otherwise is a conspiracy nutjob or hated vaccines already, don't listen to them!"
      "More vaccinations...but we're still wearing masks and social distancing and quarantining between states."
      "we're three months into mass vaccinations...oh wow! immunity from the vaccine lasts six months, but the actual-virus only gives immunity for three months."
      "We're pulling the J&J vaccine because there were health issues from some people who got it...okay, nevermind, it's safe, those people were just unlucky."
      "If everyone is really, really good, and follows the rules and eats their vegetables, we can have 4th of July parties."
      "Restrictions can relax, but we're still wearing masks until we hit herd immunity at 70%."
      "[Region] hit 70%! You can stop wearing a mask if you're vaccinated! If you're not, you still have to wear your mask. We might ask for proof...or not."
      "[Region] is still under 40%! And there's a delta variant now! Which you can get even if you're vaccinated! So wear your mask, still!"
      "Employers can mandate vaccines for their employees."
      "The delta variant is so dangerous! We may go back to lockdowns and social distancing and masks even for the vaccinated! But get the shot! It's a pandemic of the unvaccinated!"

      Now, some of the above is an oversimplification, some of it is a distortion of what was actually said, and some of it was legitimately recommended by Fauci and/or the CDC and/or the WHO. Keeping track of exactly who said what, in what context, and in what sequence, was a ridiculous amount of work.

      I can't think of a single news outlet that did a good job in consistently reporting actual, cited statistics alongside their recommendations. Some did when it had graphs that supported a narrative, but most were inconsistent at best.

      Similarly, very few of the mandates seemed to be tied to reported statistics. "Restaurants can stay open as long as infection rates stay below 3% for a two week period; if it goes above for a two week period then they will have a week to wind down and go back to carry-out only until there are two consecu

      • Except the article is explicitly about what the CDC needs to do better. The CDC aren't to blame for "oversimplifications" and "distortions of what was actually said", they don't have a cure for stupid.
      • by djinn6 ( 1868030 )

        I'd love to see you in command of an army.

        Officer: The enemy's not moving, commander. What do we do?
        You: We charge straight in.
        Officer: It looks like the enemy is retreating.
        You: Good. We'll push our advantage.
        Officer: The enemy started a pincer movement, they're trying to surround us!
        You: What? That's not what you said just now! You said they're retreating.
        Officer: We're receiving fire from our rear! It's an ambush!
        You: What? Why didn't you tell me there's an ambush waiting? I wouldn't have ordered us forw

        • I'd love to see you in command of an army.

          Oh, this is a crap analogy. Let's see...

          tl;dr: you're right, I'd be terrible at commanding a military unit. A single officer and a single commander with a single, 100% reliable source of information with which to lead a small squad of trained soldiers is a terrible metaphor representing a counterpoint to what I was expressing.

          For starters, there is a reason why armies have things like "basic training". Half the reason is to weed out people who can't function properly in an armed conflict, and the other half

      • Masks made out of whatever fashionable fabric you like are safe! (ignoring that fact they wouldnt stop bacteria, let alone a virus).
        Reused masks are safe, ignoring the fact that COVID-19 can survive on surfaces for hours to days.
        The vaccines work! But dont stop you being infected, or infecting others, or long term effects, and you should still wear that ineffective mask.
        There is almost no correlation between how much of our advice you take, and your chance of getting infected.

        Not to mention the small 'The p

    • Re: Don't confuse? (Score:4, Interesting)

      by RightwingNutjob ( 1302813 ) on Thursday August 05, 2021 @06:49PM (#61661543)

      No, not never change your position.

      Don't keep changing your position repeatedly based on conspicuously low-quality evidence and/or obvious political influence.

      Two examples of the former would be the CDC scaremongering from April 2020 or so about covid aerosols being infectious for 3 days when the actual experiment measured the detectability of viral rna in aerosols sprayed from a purpose designed nozzle and not whether the virus was alive and could be cultured or what it was like from actual breathing or sneezing.

      The second example of low quality evidence is the recent report from Provincetown which is all well and good in documenting the number of breakthroughs except that it is missing the denominator: how many vaxxed people were exposed and either had no infection or mild/asymptomatic but not enough to infect anyone else.

      And we're not even getting into the exaggeration of outdoor spread by a factor of 100, the discovery and calling out of which led to the reveral on outdoor masking.

      For examples of blatant political influence, look no further than schools: in-person vs remote and masking/no masking. An obvious tug of war between AFT and not AFT.

      These guys look for all the world like they're typing questions into google news and google scholar to come up with their answers and recommendations, not doing measurements and analysis themselves.

      Par for the course in academic medicine. The wife being a doctor gets NEJM and I leaf through it once in a while. And I usually find a glaring arithmetic error...like that "covid suppression with bnt612" article that claimed the viral load in vaxxed exposed individuals was 40% lower...except it was a logrithmic scale and ot was really 97% lower.

      • Two examples of the former would be the CDC scaremongering from April 2020 or so about covid aerosols being infectious for 3 days when the actual experiment measured the detectability of viral rna in aerosols sprayed from a purpose designed nozzle and not whether the virus was alive and could be cultured or what it was like from actual breathing or sneezing.

        You misremember. From the article:

        SARS-CoV-2 remained viable in aerosols throughout the duration of our experiment (3 hours), with a reduction in infectious titer from 103.5 to 102.7 TCID50 per liter of air. This reduction was similar to that observed with SARS-CoV-1, from 104.3 to 103.5 TCID50 per milliliter (Figure 1A).

        https://www.nejm.org/doi/10.10... [nejm.org]

        The article also describes that the virus stays viable for three days (not hours) on some surfaces. They didn't test the aerosols for longer than 3 hours, but the data suggests that it could survive much longer if you somehow don't ventilate the environment and have enough turbulence to keep the aerosols afloat.

    • You say "don't confuse people" -- but you have to consider what that actually means. For a lot of people (about 40% at this point) it means "never change your position", and any change in the messaging is considered proof of malfeasance. "They told us not to wear masks before they told us to wear masks, and they don't do anything anyhow." The Bible never changes, so why should any other truth?

      The weather and forecasts change all the time. Large numbers of people are not up in arms deriding the weather service because the weather is different with each passing day/hour.

      You can blame communications problems on the people yet anytime you find yourself doing that as a public official it is always without exception because you have failed at your job.

      • No meteorologist in the world will look you in the eye and tell you with a straight face that his forecast for three days out is completely and totally accurate because it is science.

        Hurricane track predictions are a good example because loss of life is possible if a prediction is off and needless severe loss of economic activity if it's off the other way.

        That's why they publish uncertainty bounds.

    • And if you change your position because you learned new information how do you stop yourself from being compared to John Kerry?
  • by magzteel ( 5013587 ) on Thursday August 05, 2021 @05:01PM (#61661087)

    "Third, the agency is simply not doing a good job at what the pamphlet advises: being first, right and credible, and avoiding mixed messaging, delays and confusion."

    This should have been first. Stop blaming everyone else for the misinformation.

    • Contradictory goals. Short delay may mean your message changes more quickly as more info comes in. Trying to get all the information first means delays. So it's impossible to be credible with the people who accuse politicians of being "wafflers" merely because their views have changed over time.

      • Contradictory goals. Short delay may mean your message changes more quickly as more info comes in. Trying to get all the information first means delays. So it's impossible to be credible with the people who accuse politicians of being "wafflers" merely because their views have changed over time.

        This is the CDC. They are supposed to be scientists, not politicians.

  • Propaganda apparatus actively trying to create confusion for a variety of political reasons. The CDC is a bunch of scientists. They don't stand a snowballs chance in hell against that. Doesn't help that we've had 50 years of non-stop attacks on science in an effort to discredit evidence on climate change, the dangers of smoking, lead in gasoline and a bewildering number of issues. We've also been cutting funding to schools, and it's to the point where a lot of the education focused around critical thinking
    • There is no part of the government that is without political influence. Once it's politicized, there is no chance of rational action.

  • by Whateverthisis ( 7004192 ) on Thursday August 05, 2021 @05:16PM (#61661137)
    I know my subject is inflammatory to this crowd, but it's true. The inherent problem the CDC has is it's full of scientists. In most cases that's a good thing, and when the CDC needs to take a methodical, logical approach it's structure works well. This crisis is different.

    I work with scientists extensively. Every single one equivocates on any solid conclusion, always qualifying it with "well the data suggests..." and "well we don't know for sure until we run more experiments...". While a sound, logical approach when it comes to developing good science, the problem here is that COVID unfolded as we were doing the science. The average person needed guidance on what to do, and doesn't understand the particulars and complexity to the methodical scientific method.

    As a result, you get people like Fauci saying early on things like Americans don't need to wear masks because they didn't think they were effective, adn then later changing his stance because the data suggests otherwise. While scientifically or technically correct, from a public policy and guidance perspective this serves to make people mistrust that the government knows what they're doing and is an absolute disaster. It's a shame we didn't have a good political leader in place when this happened too, because what the government should have said was "we don't know for sure, but it's not going to hurt to wear masks and it might help some so please plan to stay indoors and wear masks around others at all times."

    Unfortunately the CDC, in the practice of developing data, makes statements about what the latest data shows that often helps them learn something new, but in those statements they end up confusing the public, because the public does not understand the scientific process and was just looking for guidance and security. Many blame solely Trump for the mixed messaging; he had his fair share no doubt about it but the CDC has made some royal screw ups with this pandemic.

    Let's not forget also they royally screwed up the COVID test rollout requiring a recall and a delay of a month of tests being rolled out. And the screw up was one they shouldn't have made if htey were following Good Lab Practices; that was just amateur hour that cost people lives.

    • Re: (Score:3, Informative)

      by XanC ( 644172 )

      Not quite. Fauci admitted that he intentionally lied about the utility of masks in order to try to manage the supply of them.

    • What should we staff it with? Talentless idiots who double as celebrities today, is that who has the ear of the masses?

    • by davide marney ( 231845 ) on Thursday August 05, 2021 @05:41PM (#61661253) Journal

      The problem is they don't TRUST the public to handle the equivocations, so they bounce from one categorical statement to the next contradicting themselves.

  • by Xylantiel ( 177496 ) on Thursday August 05, 2021 @05:37PM (#61661221)

    The CDC did not stop tracking breakthrough cases... They stopped tracking them in all venues because the the quality of public health reporting in the US is very non-uniform. Also the rise of delta DID turn out to be faster than the models. This guy's criticism is nonsense because it ignores the details and could be leveled for any increase due to delta. The problem is NOT the CDC, it is the governors and state legislatures *outlawing* simple public health measures like vaccine requirements and mask usage.

    The CDC has to depend on data from other countries because the type of contract tracing needed has become near-impossible in the US because of the level rhetoric in the US and the rate of spread that we have. That's right our country is so broken that it cannot even help fix itself. Almost every time an "outbreak" is reported in another country, the per capita rates are well below even the moderately-bad places in the US, and there are no travel controls between different areas in the US. You cannot study the contagiousness of a disease when it is so prevalent that people get it from unknown sources all the time! This guy is basically saying the CDC should be able to put the genie back in the bottle.

    And I daresay the problem is the press, not the CDC. The number of places, of all stripes, that the CDC's recommendation for masks in *public* places was reported an a blanket mask mandate for all situations was really sad.

  • Changing guidance in intervals of less than 3 months, three times... giving out a vaccination card that doesn't fit in wallet or pocketbook and that is easily forged, unable to follow what better monitoring countries have known for months about variants... CDC can't plan or execute on anything. Wonder what their body count is?

    • by smap77 ( 1022907 )

      Changing guidance in intervals of less than 3 months, three times...

      If we had the answers in advance, it'd be easy to give guidance for the long term, wouldn't it?

      Also keep in mind that the uptake of vaccines has been less than expected with a variant that is more infectious than expected. So... the alternative to frequent guidance updates is infrequent guidance. Would that make you feel better?

      • That's the point, the CDC had the answers in advance, other countries were giving variant stats and warnings. They were even in the mainstream news... yet somehow CDC dollar short and day late.

        • by smap77 ( 1022907 )

          So happy you were paying attention! So.. why the disparaging remarks about messaging timing? Feeling sorry for the ostriches out there? I'd still argue that the CDC has the answers in advance-- like for example, how many people will get Pfizer in Louisiana this month? Or, will Bitcoin hit $60k by October?

          And as far as this "easily forged" card goes, until there's like a like congressional action that creates something other than the standard vaccination card, like can you imagine if the CDC rolled out a

    • Pretty sure the vaccine card is sized to fit a passport. Like every other vaccine document in the world.

  • by djp2204 ( 713741 ) on Thursday August 05, 2021 @06:34PM (#61661481)

    I think wall to wall denunciation of the vaccine at the start of warp speed by so called experts telling us that there was no way a safe and effective vaccine could be brought to bear in less than 10 years had a lot more to do with it. People just listened and are rightly concerned about a vaccine that has at best emergency approval for certain high risk groups. After all the covid survival rate is somewhere north of 99% for most.

  • What do these right-wing outlets have to gain from spreading the misinformation?

    Unless, there is Russian money driving it?

  • And it's clear the CDC is not adequately prepared to track anything this fast moving. They're really good at tracking stuff where you're concerned how things are changing year to year -- like the rate of heart disease. Look at the way they lump influenza and pneumonia deaths together. In an ordinary year that makes perfect sense, because most of the year to year variation in pneumonia is due to flu. It's not at all what you want when there's a non-flu respiratory virus killing thousands of people.

    The prob

  • OP makes three points, with a link to a paywalled NY Times article:

    1) there is "a sustained campaign of misinformation against vaccines and other public health measures, originating mostly with right-wing commentators and politicians". You have to actually say what the supposed misinformation is. You kind of left that part out entirely. So your point is basically that right wing is bad (because science). "Misinformation" now means "disagrees with a democrat". It's really sickening how the left wants to sile

  • by holophrastic ( 221104 ) on Friday August 06, 2021 @11:22AM (#61664019)

    I think people misread "we're going to follow the data". People tend to focus on data=good. They miss the part about follow=late.

    Decades ago, when my father would drive me to school in the morning, there was a major intersection. We could turn left, with the left-turn lane and the advanced green, or we could turn right into the dead-end, make a u-turn, and cross the intersection straight.

    Dad would tell me to make the decision, as we approach the intersection. Which path would be faster? It all came down to the current status of the light, the number of cars in the left-turn lane, and the chaos of cars in general.

    One day came the advice:
    Son, if you choose one path over the other, we might gain 30 seconds, or lose 30 seconds. But if you take too long to make the decision, we'll have missed the intersection entirely, and it'll be 3 minutes before we can turn around. In life, it's often more important to make a decision quickly, than to make it correctly.

    Waiting for covid data to make covid decisions is probably the all-time dumbest plan. It amounts to: wait until many people have died, then do what they didn't. It's simply way too late for action, because data is, by very definition, past tense.

    We seem to be training people to act-on-evidence, which presumes a few things: that evidence always exists, that we'll receive it in-time, that it'll be meaningful, and that we'll understand it.

    Doing so, I encounter endless streams of people who say carp like: there's no evidence to believe [something] is a problem.

    Perhaps they forget that there's actually no evidence to believe that [something] is safe.

    Allow me to introduce what I call "squirrel mode". It's actually true of every non-human mammal, absolutely all birds, and some insects. But I've named it after squirrels because it's so readily observed in my backyard.

    Squirrel Mode:
    if it's new, it's probably dangerous
    if it moves, it's probably dangerous
    if it changes, it's probably dangerous
    if it's probably dangerous, I'll run away
    if it's old, and it doesn't move, and it doesn't change, I'll take one step closer to it, then I'll run away, and see if it moved.

    covid is new, it travels the globe, it changes into delta. it's probably dangerous. there was no evidence to believe that covid was dangerous...until there was. scratch that. covid was a virus, many viruses are dangerous, that's enough evidence already. there was no evidence to believe that covid was safe. perhaps some day there will be.

    what kind of mammal would choose to run into a swarm of bees that they can see? covid is a swarm of virus that we know is there. why would I choose to run into it? Bees don't always sting.

    I didn't need to wait for experts to tell me that covid was dangerous.
    I'm now waiting for experts to tell me that covid is safe.
    I expect to be waiting for quite some time.

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