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Rachel Feltman: For Scientific American’s Science Quickly, I’m Rachel Feltman.
In recent weeks, several prominent public health experts have resigned from the Centers for Disease Control and Prevention, citing concerns about the agency’s shift away from science-based decision-making.
Among them was Demetre Daskalakis, who until recently directed the CDC’s National Center for Immunization and Respiratory Diseases. He’s here today to tell us more about what’s going on at the CDC—and what concerned experts are doing to try to keep America healthy.
Thanks so much for, for joining us today.
Demetre Daskalakis: Thanks for having me.
Feltman: So, to start, could you tell me a bit about your former role at the CDC and what you did there?
Daskalakis: I, actually, in my five years at CDC had seven separate roles …
Feltman: Mm.
Daskalakis: So I will just focus on the last two years, where I was the center director for the National Center for Immunization and Respiratory Diseases.
So, you know, CDC is made out of centers—that’s what Centers for Disease Control and Prevention mean—and so the National Center for Immunization Respiratory Diseases, which we’ll call NCIRD for short, is the center that is responsible for a lot of vaccine policy and vaccine-preventable diseases for the country, as well as the jurisdictional immunization programs and the very important Vaccines for Children Program.
Feltman: And how have things been changing there over the last year or so?Daskalakis: I mean, not for the good. I think that with the installation of the new secretary of health, Robert F. Kennedy Jr., I was seeing a pretty significant shift away from sort of science-based work, more toward this ideologic, almost authoritarian-style leadership coming from the Health and Human Services secretary that didn’t really value or listen to any expert information or advice
Feltman: You recently resigned, as did several other prominent experts at the CDC. And the feeling in, in a lot of your resignation statements was that you felt that the CDC had become something so different from what it was supposed to be that you could do more work from the outside. What do you think that’s going to look like?
Daskalakis: I mean, unfortunately, I think my resignation letter was a little bit prophetic because, I mean, literally right after I resigned, you know, CDC put up a political manifesto as their mission statement that really, again, was all ideology and very light on science or public health. And then, you know, we’ve seen the Advisory Committee [on] Immunization Practices, where the firewall between science and ideology and politics completely broke down, and I feel like I’m sort of in a unique position: I really understand what is supposed to happen and what the normal process is. And so I feel like one of my main roles outside of CDC is going to be to sort of identify when there are glitches in the Matrix and when there are things happening that are atypical and things that aren’t sort of going through a process that value science before sweeping statements and policies are made. And so I will have that utility for as long as I sort of have the awareness; I can point at the chaos.
Feltman: Yeah, and what do you think some of the solutions look like for public health organizations outside of the CDC to keep America actually healthy [laughs]?
Daskalakis: Yeah, I think that this is, like, the key moment where, as someone who’s worked in governmental public health for over a decade and in health care for two decades-plus, it hurts me to say that I don’t trust what’s coming out of the CDC. And as an infectious disease doctor, when I see patients and I have a question, that’s where I go. And so, unfortunately, I think that we’re seeing the decay of the quality of information, and it’s not, like, a random decay; it is a specifically targeted decay to create an ideology propaganda machine that’s Orwellian, as opposed to a trusted health source …
Feltman: Hmm.
Daskalakis: So I think that the first is that this won’t last forever, but it’s what has to happen for now because of the way leadership is at HHS. So I think that, really, a lot of the onus and responsibility now falls on—I’m gonna call them “para-public health”—paragovernmental organizations that are actually using process and data to sort of generate sort of recommendations and, you know, in effect, replacement policies to make sure that the health machine of the U.S. continues to function even as people are trying to destroy it. I think that the answer is that those organizations are going to have to carry the water for a lot of this. They’re going to need to be the trusted voices for the folks at the front line, whether they’re public health practitioners or medical providers.
And what I hope is that they are forming deeper and stronger alliances so that they are gonna be more unified in what they say, because one of the scary parts is these states that are putting together coalitions, they’re doing the right thing, right—let’s just be clear. But it’s gonna create a tapestry across the U.S. that is about have and have-nots. So your California-Hawaii axis and your, like, Northeast axis, you know, they’re doing great. The question’s gonna be: Is there going to be something for the South and parts of the Midwest that may not have that political will that’s necessary to lift up [that works] to make sure that folks are protected? And if government funding—which could be taken away at any minute, and they have really created some levers where they’re going to be able to potentially pull funding with not a good reason from a lot of jurisdictions—like, how is that gonna play out in places that don’t have tax base to be able to cover what the federal government normally provides?
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