The People's CDC: Getting out accurate information, not what is popular

I think I’ll start with the following message:

COVID is not over. Even if you want it to be. You can still get sick, get hospitalized, and die. People who are more vulnerable are even more likely to. Masks still are protection. Even if you don’t want to wear them.

I’ll say it again later. I think I’ll keep repeating it. It’s good, and nice, to want positive things. There are a lot of things that I want. World peace, for one. A reversal of global warming. An end to world hunger. They are not happening. And, unlike COVID, people could end them if they wanted to, as a group, as a world. COVID is a virus and doesn’t care what we do, but there are things that we can do to decrease its threat to health and life. We mostly know what they are – immunizations, wearing masks. Limiting interpersonal interaction, especially with large groups and groups with people we don’t know. We’ve been doing it for several years.

But we’re tired of it. We don’t want COVID to be around. We don’t want to wear masks, especially those uncomfortable N-95s (i.e., the ones that work best, the ones that protect you from others; most masks only protect others from you). We want to get together with our families, most especially around important events like the holidays, even if we’re not sure if they’re infected, or were vaccinated, or even if we know they haven’t been. Or if they have been exposed by going to places – like school and work – where they are more likely to be exposed. And we want to, some of us, go out like we used to, to movies and museums and clubs. We want to party. We want to go back to what we think of as normal. But…

COVID is not over. Even if you want it to be. You can still get sick, get hospitalized, and die. People who are more vulnerable are even more likely to. Masks still are protection. Even if you don’t want to wear them.

And so we get infected, and maybe do ok. Especially if we have been immunized. Especially if we are relatively young and healthy and not immunocompromised. It’s not fun, but I survived, right? Oh, yeah, Uncle George didn’t. And Cousin Minnie, who had cancer, and my friend Kim, who has diabetes, almost didn’t, they were hospitalized on a ventilator. And yes, I admit it, I got sick after a small Christmas – or Chanukah, or Kwanzaa or New Year’s – party where I thought I knew everyone and they were my ‘pod’ and I was safe. And, yes, a bunch of people got it. So lucky that none of them have been really sick!

You get the point. But the other point is that we want it to be over! We don’t want  to wear masks! We want to get back to normal! And the government, including the CDC, hears you. They want you to be happy. They want you to support their policies so you will vote for them in the next election. So they say things that are more likely what you want to hear. Like most people don’t need to wear masks indoors in most situations (read: you don’t need to wear a mask. People who do are overreacting). Like you are non-infectious after 5 days, and can go back to work, and if you are infectious still, too bad. Like “the pandemic is over”, comment that President Biden made in a television interview, this past September. Hopefully, you are not coming into contact with people who are susceptible and vulnerable. They want you to like them!

COVID is not over. Even if you want it to be. You can still get sick, get hospitalized, and die. People who are more vulnerable are even more likely to. Masks still are protection. Even if you don’t want to wear them.

To say that “the media is complicit” sound trite, like a bad meme, like what you hear from the right-wing fringe. Whether it is or not might, I suppose, depend upon what you mean by “complicit”, but most of the media certainly reinforces this “it’s gonna be all right!” message. This particularly takes the form of disparaging those who point out danger. Recently, for example, the New York Times ran a piece called “The Last Holdouts”, about those folks who continue to wear masks. It was on page 1 on December 26. However, in the same issue ran another story updated from December 13 titled “It’s Time to Wear a Mask Again, Health Experts Say: A high-quality, well-fitting mask is your best protection against infection from the coronavirus, influenza and R.S.V.”. That, in the print edition, was at the bottom of page D6! What is the message? If you ever found the latter story, you might be convinced, but the main big story was that masks are for sick people, immunocompromised people, paranoid people – not you!

And now the New Yorker magazine has entered the arena with a piece about the “People’s CDC”, a group of physicians, epidemiologists, public health professionals and others who, very concerned about the upbeat “Pollyanna” messages from CDC, have gotten together to try to disseminate accurate, if often unpopular, information. By writer Emma Green, under a head “Annals of Activism”, the title is “The Case for Wearing Masks Forever”. Well, good. But is that title sincere or snarky? Maybe the subhead gives a clue: ‘A ragtag coalition of public-health activists believe that America’s pandemic restrictions are too lax—and they say they have the science to prove it.’ Oh, they’re ‘rag-tag’! Like internet conspiracy folks! Well, no. They are people like

‘Mindy Thompson Fullilove, a professor of urban policy and health at the New School…who has spent her career studying epidemics: first AIDS, then crack, then multidrug-resistant tuberculosis. She has seen how disease can ravage cities, especially in Black and working-class communities. From the beginning, Fullilove was skeptical of how the federal government handled the coronavirus pandemic. But these new recommendations from the C.D.C., she said, were “flying in the face of the science.” Not long after the announcement, she sent an e-mail to a Listserv called The Spirit of 1848, for progressive public-health practitioners. “Can we have a people’s CDC and give people good advice?” she asked. A flurry of responses came back.’

That doesn’t sound negative. But, overall, the tone of the article is snarky and dismissive of the People’s CDC. It is also laced with red-baiting as well as “realism” in the form of comments from former CDC director Tom Frieden. While he praises ‘the organization’s [People’s CDC] guide to self-protection for immunocompromised people, and agreed that some of their recommendations, like universal masking in times of high COVID spread, were good ideas in theory,’ he added

“But is that going to happen? Absolutely not,” he said. The next best thing is to try to get people vaccinated and boosted and to increase access to high-quality masks and Paxlovid. “If you’re giving recommendations that no one’s going to follow, that’s not only nonproductive,” he said. “It’s counterproductive, because that undermines your credibility.”

Let’s do polling and find out what people want to do and recommend that! Of course, if they get sick and die, your credibility could also suffer…

One of the big things the  article sees wrong with People’s CDC, apparently, is its emphasis on collective action and the health of the community, including efforts to protect its most vulnerable members. This, of course, is contrary to the idea that “it’s all about me”. However, despite its tone and basic support for the current “it’s gonna be all right”, the article is worth reading for the perspectives and data-driven information provided by members and supporters of the People’s CDC, who say things like “There’s a struggle going on right now for the soul of public health.”

People’s CDC takes issue with the way that the C.D.C. emphasizes individual choices over collective action. The current CDC director, Rochelle Walensky, has said, “Your health is in your hands.” Well, as much as I wish it were not, and that CDC and Walensky and the rest of the government, federal, state and local, were doing what needs to be done, I guess it is. And if it is you should wear a mask when you’re indoors with others. Preferably an N-95,

COVID is not over. Even if you want it to be. You can still get sick, get hospitalized, and die. People who are more vulnerable are even more likely to. Masks still are protection. Even if you don’t want to wear them.