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Reproduced and adapted from USA Today, October 6, 2020
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Letter from Bill Foege, Past CDC Director, to Robert Redfield, Current
CDC Director
Sept 23,
2020
Dear
Bob,
I start
each day thinking about the terrible burden you bear. I don't know
what I would actually do, if in your position, but I do know what I
wish I would do. The first thing would be to face the truth. You and I
both know that:
1)
Despite the White House spin attempts, this will go down as a colossal
failure of the public health system of this country. The biggest
challenge in a century and we let the country down. The public health
texts of the future will use this as a lesson on how not to handle an
infectious disease pandemic.
2) The
cause will be the incompetence and illogic of the White House program.
3) The
White House has had no hesitation to blame and disgrace CDC, you and
the State
Governors. They will blame you for the disaster. In six months, they
have caused CDC to go from gold to tarnished brass.
Why and
how has that happened? The failure of the White House to put CDC in
charge, has resulted in the violation of every lesson learned in the
last 75 years that made CDC the gold standard for public health in the
world.
For
example, the prime lesson of "Know the Truth," has been so obscured by
the White House that people and the media go to the academic community
for truth, rather than to CDC.
Second
the need for a coherent federal plan, the backbone of every former
response, has been ignored, resulting in 50 states developing their
own plans, often in competition.
Third, the absolute need to form and guide coalitions
has been ignored as the president thrives instead on causing
divisions.
Fourth,
the need for global cooperation, which you clearly understand from
your work in Africa, has been squander[ed] by an "America First"
policy that mocks what we learned in Sunday School, and leaves us on
the outside of the global public health community.
Fifth,
we have learned the best decisions are based on the best science while
the best results are based on the best management. The White House has
rejected both science and good management. To depend on someone like
Dr. Atlas, who doesn't understand herd immunity, is simply one of
multiple examples. It was our ability to refocus India from herd
immunity to attacking the virus that allowed smallpox eradication to
succeed.
I won't
continue with the lessons learned, but I continued to live with the
hope that the White House task force would forge a consensus. When
Debbie Birx said she wouldn't believe anything coming out of the CDC,
I realized how dysfunctional the group had become but I still thought
the White House would see how disastrous their approach was and
finally turn the job over to professionals. Now I know that won't
happen.
You have
shown great resilience in being willing to take their abuse. Now that
the truth has been revealed in how they manipulated the valuable
reputation of CDC by changing items on the website and changing
recommendations for workers in slaughter houses etc., you have a short
window to change things.
As I
have indicated to you before, resigning is a one day story and you
will be replaced. But you could send a letter to all CDC employees (a
letter leaves a record and avoids the chance of making a mistake with
a speech) laying out the facts. At the moment, they feel you accepted
the White House orders without sufficient resistance. I am on several
round robin email chains with ex-CDC employees and they feel the same.
You
could upfront, acknowledge the tragedy of responding poorly, apologize
for what has happened and your role in acquiescing, set a course for a
how CDC would now lead the country if there was no political
interference, give them the ability to report such interference to a
neutral ombudsman, and assure them that you will defend their attempts
to save this country. Don't shy away from the fact this has been an
unacceptable toll on our country. It is a slaughter and not just a
political dispute.
You
don't want to be seen, in the future, as forsaking your role as
servant to the public in order to become a servant to a corrupt
president. The White House will, of course, respond with fury. But you
will have right on your side. Like Martin Luther, you can say, "Here I
stand, I cannot do otherwise." When they fire you, this will be a
multi-week story and you could hold your head high. That will take
exceptional courage on your part. I can't tell you what to do except
to revisit your religious beliefs and ask yourself what is right.
I don't
for one-minute relish your position but FDA or NIH cannot make a
statement that changes the course of this epidemic. You and CDC could.
I wish
you the very best, Bill.
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