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Former CDC Director Discusses Balancing Science And Politics In Pandemic Response


Of course, this week's recommendation on masking from the CDC differs from what the agency had said previously. Tom Frieden directed the CDC during the Obama administration and was New York City's health commissioner before that. He now leads the public health organization Resolve to Save Our Lives (ph) and joins us. Dr. Frieden, thanks so much for being with us.

TOM FRIEDEN: Great to speak with you, Scott.

SIMON: We just heard, of course, from Maria Godoy about the risks of a vaccine-resistant version of the virus emerging. How worried are you about that?

FRIEDEN: Vaccines protect us, and unless we're not careful, we won't be good at protecting vaccines. I think the thing that makes me most concerned about the future in terms of the virus changing is the possibility that there will be strains that are more resistant to vaccination. We don't know for sure how possible that is, but it's clear that some of the strains out there - in fact, the beta strain, for one of them, is somewhat resistant to vaccination. But we have to keep coming back to the bottom line, which is that the vaccines that we're using in this country are stunningly effective. They're saving tens of thousands of lives, and they are our way to end the pandemic.

SIMON: Doctor, I wonder what you'd say to people who say, look; a few months ago, the CDC said that those who've been vaccinated can remove their masks, now they say they can't or shouldn't remove their masks, so why bother to get vaccinated? What good does it do?

FRIEDEN: Vaccination is still the best way to save your life. If you get vaccinated, your risk of getting the infection, of spreading it to others, of getting very sick and especially of dying is drastically reduced. Now, in this country, there are different groups that are hesitant to get vaccinated. And the key, I think, is to listen to what the concerns are in each group and then to figure out what are the messengers, what are the messages, what are the incentives, positive and negative, that are going to get people vaccinated because vaccination is essential to get our jobs, our economy, our schooling, our society back.

SIMON: Dr. Frieden, when the CDC issues guidelines, some kind of directive, who does that? Take us in the room.

FRIEDEN: Well, first, it's not a directive. They really are guidelines and recommendations. The CDC has very little regulatory authority - a little bit on quarantine and things like that. But generally, they are recommendations that are going to go to state and local health departments, to health care providers, doctors and hospitals, and to the general public. That would start with someone who is a super expert in that area and a team of people drafting a recommendation, looking at the best available science. It would then go through various levels of review within CDC and ultimately be signed off by the people running the response or the emergency, as well as the director - Dr. Walensky at this time.

SIMON: Do any politicians get their thumbs on it?

FRIEDEN: You know, Scott, it's an interesting dynamic. I think it's very clear that in the prior administration, there was totally inappropriate meddling with CDC guidance, development and publication. I'm not certain, but I have the sense that in the current administration, at the current time, it may have even gone too far in the other direction. They're so determined to be clear that they're not involved that there isn't the kind of discussion that's sometimes helpful. And what I found very helpful, ironically, particularly when Ron Klain was the Ebola czar, was that Ron would convene meetings for people to give input. It was always 100% clear that it was up to CDC to make the recommendations, but sometimes we heard interesting feedback and concerns and suggestions from other parts of the government. The final decision on what to recommend scientifically was with CDC. The final policy call is really in Washington, not CDC, if...

SIMON: Yeah.

FRIEDEN: ...The government decides something to do or not do on a policy basis.

SIMON: And is it hard to separate a policy decision from at least some consideration of the political aspects?

FRIEDEN: There's no doubt that politics plays a major role in public health decisions. You sometimes hear people say, let's get the politics out of public health. Well, public health is the activity of communities getting safer and healthier. And there are many political decisions that happen during that process. What's problematic is when partisanship gets in the way because there really shouldn't be a Democratic or Republican way to control pandemics. There should be a scientific way or a way that ignores the science, and let's choose the scientific way.

SIMON: Dr. Frieden, we've got a little over 30 seconds left, so I'm going to ask you an impossible question to answer. When will this be over globally? Can you foresee an end?

FRIEDEN: Globally, this will not be over until we drastically increase the production of vaccines. We're falling far behind, particularly with the most promising vaccines, the mRNA vaccines. Until we get at least 70%, 80% of the world vaccinated, the risk of more dangerous variants, the disruption to our society, to travel, to trade and avoidable deaths are going to continue to propagate this pandemic and raise the possibility of an even worse strain emerging.

SIMON: Dr. Tom Frieden, who's now CEO of Resolve to Save Our Lives (ph). Thanks so much, Doctor.

FRIEDEN: Thank you, Scott. Transcript provided by NPR, Copyright NPR.