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Robert Redfield, director of the Centers for Disease Control and Prevention, describes the coronavirus pandemic as the greatest public health crisis in a century.

And yet the storied agency that Redfield leads — one that has been used as a model by countries around the world, including the China CDC — has played a largely invisible role in the nation’s response since the White House took over communications about the outbreak last month.

CDC experts, who held regular briefings to update the public about previous health threats such as the H1N1 flu pandemic and the Zika outbreak, have been silenced. It has been nearly a month since the last CDC media briefing, which took place March 9.

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STAT asked Redfield about the agency’s role, whether he was satisfied with it, the agency’s evolving thinking about whether people should wear cloth masks in public, and how he sees the pandemic unfolding. The conversation has been lightly edited for length and clarity.

How are you? It’s a very challenging time.

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I’m doing fine.

I would like to ask you a bit about the mask issue. [After this interview with Redfield, the CDC issued guidance urging the public to wear cloth masks in public to slow spread of the disease. President Trump announced the new recommendation at a press briefing.]

We strongly continue to recommend that N95 masks and surgical masks really be committed to the health care workers that are on the frontlines. Our nation owes them all a great gratitude as they continue to confront what you and I now know is the greatest public health crisis that’s hit this nation in more than a century.

But we actually have one of the most powerful weapons that we need to defeat the spread of this virus. And I know a lot of people may not see it as a powerful weapon, but it is. And that’s social distancing. This virus cannot jump 6 feet. So this is why the president’s recommendation is to slow the spread of the coronavirus. 

I want to constantly thank the American public that have taken these social distancing recommendations and operationalized them into action with vigor and vigilance. And I just want to petition the remainder to have everybody go all in. That big, powerful weapon that we have is just to stay 6 feet apart.

Now that said, there’s probably greater numbers of individuals that are without symptoms, and have this virus and can shed this virus than I think was originally appreciated. So we are discussing in detail whether a face covering, a face barrier, whether that would modify the ability of those of us that may be infected and don’t know it to actually infect others. It’s not a decision to try to protect me from getting coronavirus. It’s to help modify spreading. And there is scientific data to show that when you aerosolized virus through a cloth barrier, you have a reduction in the amount of virus that gets through the other side. 

Kind of a homemade, make-it-yourself barrier, whether it’s a bandana or a scarf.

Are you going to give people some advice on what kind of fabric? Because all fabrics are not created equal. 

Obviously, there will be guidance on the fabrics, guidance on how to make them.

You mentioned earlier that the biggest tool that we have is social distancing. But it is being applied in a patchwork manner across the country. Some states have been more aggressive. Others are not. Do you think it’s time for a national stay-at-home order?

I think ultimately in these things it’s, how do you get full participation? I think you have to get the hearts and minds of people behind this. And so I think, you know, different jurisdictions will approach it in different ways. I will say what I’ve seen is the American public is embracing these strategies. 

Dr. [Deborah] Birx says not enough of them. 

I think people can decide independently in these states, the governors, and the mayors, how they think they’re best going to motivate their individuals to adhere to the social distancing. My own personal view is the best way to motivate is to have them shut their eyes and see their parents’ faces, their grandparents’ faces, their neighbors that have chronic illness, children that are suffering from cancer and say, “I need you to do it for them.” 

What is the next year, the next 18 months going to look like in your estimation? 

I think there’s a reasonable probability that this virus is going to have a seasonality to it. And that means that there’s a potential global catastrophe that may, in fact, be on its way to the Southern Hemisphere, particularly sub-Saharan Africa. And we need to prepare for that.

Related to us, that means that we may, in fact, get through in the weeks ahead, the months ahead into a lull. But I would say [if] we’re lucky enough to have that we need to get very prepared because next late fall and early winter, like most respiratory viruses, coronavirus 19 will be an enemy that we’re going to have to face again. Now we’re going to have time to prepare. We’re going to have, I think, hopefully time to reinforce our public health capacity in many parts of the nation so that we can do early diagnosis, isolation, contact tracing, prevent large community clusters, prevent what we call sustained community transmission. Just one of our challenges next season is going to be two simultaneous outbreaks: coronavirus 19, second wave, and our regular flu season. And they both compete for the same hospital resources. 

The CDC hasn’t had a briefing in almost one month. That is extraordinary. Don’t you fear that your agency has been sidelined in this? 

No, I wouldn’t say that at all. I think we’re fully engaged in all of the decisions. If you look at CDC’s website and what we’re doing constantly in our communications …

People are not going to dive through the website and read hundreds of words. 

CDC is at the table in every decision. We’re at the task force meeting every single day. We’re giving our public health guidance and our recommendations. 

We’ve got literally thousands of people working 24/7 gathering data all over this nation, not to mention sending people across this country to help with outbreak responses. So I think we’re fully engaged in the operations of the response. You know, if others seem to communicate some of that, that’s a decision that the administration can make. But I will guarantee you we’re 100% engaged 24/7 in operationalizing the response throughout this nation.  

So you’re OK with the fact that the CDC hasn’t briefed for a month? 

I’m saying that we’re giving our recommendations at the highest level on a daily basis and on a daily basis we’re working 24/7 to actually operationalize the day-to-day response throughout this nation. 

In this incredibly polarized time something that should be pretty basic — a virus is looking for throats to infect and it doesn’t care which way those throats vote — has become utterly polarized. Having the messaging come from the CDC, which is completely agnostic on a political basis, could strip out some of that politicalization that is just really not helpful.

I don’t think there’s any way you can even overstate how aggressively the CDC is involved throughout this nation in operationalizing the response. You know, we do think that we have a calming effect in being viewed as being basically …

But you’re invisible now, sir. Your agency is invisible.

You may see it as invisible on the nightly news, but it’s sure not invisible in terms of operationalizing this response. And all you have to do to find that is go talk to your state and territorial health departments. Go out and look at the outbreaks. Go look in the field. So I guess it depends on how you define visibility.

Who is in charge of the outbreak response at the CDC now? 

Anne Schuchat [CDC’s principal deputy director] is running the day-to-day response down at CDC. 

So was Nancy Messonnier, director of the CDC’s Center for Immunization and Respiratory Diseases, sidelined? 

It was an evolution. Nancy really activated her center for the response in very early January when China probably still had less than 50 cases. But it was clear that this was going to be a broader agency wide response. Nancy is a very important technical person involved in the response.

So this has nothing to do with the fact that it was felt that she was contradicting the messaging from the White House? 

I think Nancy Messonnier is a gift to this nation. She’s a great talent. She continues to provide those talents and recommendations to the agency. She continues to run one of our most important centers for respiratory disease and immunization. 

I did mean to ask you, have you had Covid-19? 

Not to my knowledge. 

Have you been tested for it? 

No.

  • This guy has clearly been ordered to muzzle. That last question and answer is telling. KNOWING that you can’t tell if you’re infected or not unless you’ve been tested for it, he hasn’t been tested. Oy!

  • He was never up to the job and it shows – every day of this outbreak it shows. He’s a sycophant. The US is safer if he and Alex Azar are sidelined. Trust Fauci!

  • Good interview I wish other media didn’t pull their punches like you. I worked at an airport for a until a couple weeks ago, and the only notice from the CDC was from early January and was never updated, only warning about people from Wuhan. Then the ongoing testing fiasco/deficit, and the obvious untruth about the masks and face coverings they are just coming clean on, all lend Americans to dismiss the CDC as a politically diseased impediment to combatting this pandemic.

  • I have already seen studies that detected it in the air 27 feet away from an infected patient and outside the room. What good is 6 feet in a Circulated Ventilation System? “It can’t go 6 feet.” Doh.

  • Excellent exposure of this assistant chief nut job’s worship of the “word” OPERATIONALIZE, and it’s unheard-of variations. What a display of uselessness.

  • I worry that amateur masks will make people sicker. The test he mentioned is absolutely not relevant as the virus is not aerosolized. That is what we mean when we say it isn’t airborne. Breathing into a scarf that will not catch the virus particles is more likely to cause them to circulate in the mouth and be breathed into the lungs, which is exactly what we want to avoid. There seems to be a concerted effort to make people sicker and make the virus into much more than it is. We see this with the government out-bidding supplies for state medical systems and even internal policies of hospitals from California to New York forbidding nurses from wearing surgical masks when treating Covid-19 patients. Meanwhile, government is very obviously poised to take over healthcare….

    Last please understand that there is absolutely zero correlation between 18 months and vaccine development except that to it takes 18 months you patent a virus. Bill Gates is an absolute kook who bases his idea that vaccines will lower population on studies of primitive tribes in African countries. Using these atypical conditions and societies, he showed that by lowering infant mortality rates, it would stabilize population growth. This is based on the fact that these tribes would try for more children because many would die before reaching adulthood. He seems to entirely forget that these structures also need more people to help with the work of primitive living. And how that relates to the developed world is anybody’s guess. The man is dangerously out of touch, and stark raving mad. Do NOT listen to anything he says.

  • CDC has totally fallen onto their rear ends on this crisis and they can’t seem to get up. Just like they did with the ebola scare, and just like they did with “swine” flu. And their widely publicized influenza “deaths” estimates are a ridiculous and pointless handout to the influenza vaccine makers, for very little benefit and at times like this, a real crisis, have only served to confuse and mislead people and leadership trying to deal with a real problem. When are we going to learn people?

  • Typo: I am lost faith in CDC

    Their blunder have cost so many life to be lost and many more will be lost. The golden time to control the virus was squandered partly due to their blunders.

    Let’s add the Surgeon General to the list. He says wearing a mask will not help you. He also has blood in his hand.

    How many dead could have been avoided if they communicated the seriousness of this virus and asked people to wear a mask early on.

    • because, at the time, wearing a mask really wouldn’t have helped.

      medical professionals need those masks more than ordinary people do. the virus will still infect you through a regular surgical mask-the particles are too small.

      the case is only NOW that a mask is a good idea, as it will help limit the infected from spreading the infection by droplets, even if it won’t stop the particles.

      why has it changed? because there weren’t as many infected people before. if they’d handed out masks to everyone, doctors wouldn’t have those masks, and then we wouldn’t be able to treat our limited numbers of infected patients. now it has spread out of control, so the tiny level of reduced infectivity the masks provide is actually noticeable, so it’s worth using them.

      had we told everyone ‘wear masks’ sooner, doctors wouldn’t have been able to treat patients and we’d still see similar levels of infection. now we’re just trying frantically to stop it.

    • Anon 2 – I do not see how your comment is logical. Yes, there were very few people spreading infection a few weeks back – but still they were doing it – and since many were aymptomatic, some of them would have worn a mask if they had been told to do so. So, even there were only 1/10th as many, stopping some of them from spreading it would have been just as beneficial then as it is now. I agree totally with the OP.

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