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Will the president end the politicization of science now that he’s tested positive for COVID-19?

getty: President Trump

Science should not be politicized. The public needs to trust scientific information to adhere to guidance, get vaccinated, and ultimately end the pandemic caused by SARS-CoV-2. Yet the President and his politically appointed “yes men” have undermined science, public health, and the regulatory process for their own political purposes. These actions sew doubt and will leave deep-seated distrust of federal guidance for years to come, resulting in unnecessary deaths. 

Before the outbreak of SARS-CoV-2, the U.S. Center for Disease Control and Prevention (CDC) was heralded as the world’s premier public health agency. Other countries relied on research and assistance from the agency. But a slew of mistakes this year — including flawed testing kits, poor contact tracing, and mixed messages over mask-wearing, knocked the agency on its heels and contributed to the United States’ poor response to the outbreak of the novel virus.

Six months later, the CDC has tried to find its footing, but unfortunately, rather than building the agency back up, President Trump continues undermined it. 

Just this week, the CDC posted and then quickly removed new guidance that said the coronavirus spreads beyond six feet through tiny aerosol droplets suspended in the air. Previously, the agency had been advising that the virus transmits through larger droplets from coughing and sneezing. Still, other scientists, including the World Health Organization, were warning of spread through aerosol transmission. The new CDC guidance said that indoor ventilation would be key to preventing transmission. But then just a few days later, the new advice was gone — with the agency saying that a draft revision was posted before technical review. However, what’s more, likely is that the new guidance did not align with what the Trump administration had been saying about opening schools, resuming sports, and holding political rallies.

This was just the latest in a long list of political interference examples with the agency’s scientific judgments. Last week, President Trump contradicted CDC director Robert Redfield twice. He said that Redfield misspoke and was confused after Redfield testified to Congress that masks could be more effective than a vaccine and that a vaccine wouldn’t be widely available for another year. Trump has repeatedly downplayed the importance of wearing masks and said that a vaccine would be available by October

Additionally, a former Trump campaign staffer and political appointee with no background or experience in health care, Michael Caputo, interfered with the CDC’s weekly Morbidity and Mortality Weekly Reports documenting the COVID-19 spread. When news of his attempts to edit MMWR reports surfaced, Caputo went on a Facebook live rant where he accused CDC and other government scientists of plotting to discredit Trump.

A few weeks ago, the CDC also revised its guidance about who should get tested for the coronavirus after exposure to someone with the virus. The revision discouraged people without symptoms from getting tested and was widely criticized. But media reports discovered that the guidance was posted to the CDC website without the CDC’s scientific review or approval. 

With the emergence of a new pathogen like it’s natural, public guidance and advice will change over time as scientists learn more about combatting the disease. But the Trump administration is undermining the technical guidance from scientists to align with his political desires, not the public’s health and safety. And because of his actions, public health experts like Harold Varmus, the former director of the National Institutes of Health and Rajiv Shah, the Rockefeller Foundation president, are writing op-eds with titles like, “It Has Come to This: Ignore the CDC.”

Trump’s political interference has also undermined the integrity of the Food and Drug Administration (FDA). Early on, Trump pushed hydroxychloroquine – without evidence – as an effective treatment for COVID-19. Rick Bright, a career official at Biomedical Advanced Research and Development Authority (BARDA), says he was pushed from the White House to request the FDA to grant it an Emergency Use Authorization. (An EUA is not the same as an FDA approval but is a type of authorization granted during public health emergencies when no other treatments are available.) Hydroxychloroquine is approved by FDA to treat malaria, lupus and rheumatoid arthritis. FDA withdrew its EUA after it said the risks of the drug outweighed its potential benefits. But a top White House aide, Peter Navarro, has continued to tout the drug after its EUA was revoked

The politicization of EUAs continued with the approval of convalescent plasma therapy on August 23. This therapy entails giving plasma – the liquid part of blood – from people who have recovered from COVID-19 to people with an active infection. After Trump accused the FDA of slowing down COVID-19 treatments’ approvals to hurt his re-election prospects, the agency issued a EUA for convalescent plasma. But almost immediately, that decision was criticized by the National Institutes of Health, which said the evidence for its effectiveness was “insufficient” to warrant the approval.

It’s possible that convalescent plasma could prove an effective treatment for COVID-19. But the Trump administration’s actions to rush its approval bypassed the customary methods for gathering scientific proof of efficacy. Because most COVID-19 patients recover on their own, any potential treatment requires a controlled clinical trial. This requires sorting patients into two groups — one that receives the treatment and one that receives a placebo — and then studying the outcomes. This type of data does not currently exist for convalescent plasma treatment. It will now be harder to recruit patients into clinical trials because they know they may only get a placebo instead of the actual treatment. 

It’s little wonder that Americans are increasingly skeptical of the public health information they get from Washington. In March, 86 percent of voters said they trusted the CDC for accurate information about the virus, but only 54 percent do it six months later. This lack of trust is likely to have calamitous consequences. It’s a bad sign, for example, when fewer than half of Americans say they will get a COVID-19 vaccine when it’s available

Trust in our scientific institutions is paramount for success not only against COVID-19 but also against future pandemics and other health emergencies. Thanks to Trump and his political henchmen, science’s politicization will undo years of progress in public health, resulting in preventable deaths for years to come. 

Arielle Kane is the director of health policy at the Progressive Policy Institute. Her research focuses on what comes next for health policy to expand access, reduce costs and improve quality.

Tags Coronavirus disease Donald Trump Hydroxychloroquine Management of COVID-19 Morbidity and Mortality Weekly Report Zoonoses

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