The United States is currently breaking a record after another in the number of daily infections with the “Corona” virus, due to the spread of the “Omicron” mutant there, which is the highly contagious mutant of that virus. Receiving the vaccine, at a rate five times higher than the “delta” mutant, which explains the great repercussions of it on the American workforce in all sectors; A surge in cases among essential workers has put many health care workers out of action, thousands of flights have been canceled during the holiday season, and supply chains are once again disrupted.
In the midst of it all, the US Centers for Disease Control and Prevention (CDC) made matters worse by the way it changed its recommendations for isolation; The isolation period, which was originally 10 days after the initial contact with a person who tested positive for “Covid” disease, turned into five days, after which the contact is obliged to wear the muzzle for another five days once he returns to daily life alongside his fellow human beings, and to add To complicate matters further, the Centers for Disease Control and Prevention (CDC) has offered another option whereby a contact can terminate isolation by submitting a test to confirm the presence or absence of infection if the test is available and accessible (which is not the case currently in the United States).
These changes, first issued as directives aimed at health care workers before being rolled out to the general public, raise suspicions that the CDC's actions were not made on scientific grounds, but rather were motivated by pressure from the business community, as reported recently , the CEO of Delta Air Lines sent a letter pressuring the head of the CDC to enact these changes in the name of preserving the company's workforce, and so, coinciding with this shift in the position of our largest public health agency, the country There is a palpable sense of frustration, and the rate with which people's confidence in science, scientific procedures, and the scientists themselves is eroding is increasing.
For our part, as clinicians who are well-versed in the evidence from scientific experience, the mere thought that our health and the health of our patients might be jeopardized by commercial interests can feel like we've been dealt a fatal blow, which is enough to undermine our own confidence in this agency. But this feeling did not catch us; It is possible that we all expected such a scenario to happen.
Throughout the pandemic, we have seen how the conflicting messages in official discourse about Covid have cast doubt on the credibility of science, giving way to misinformation with more consistent messages, and then to communities across the country. This has undermined our ability to develop policies based on data from these societies. Even before the outbreak of the pandemic, science was attacked with debates targeting its credibility with questions such as: Is climate change real? Does smoking tobacco or e-cigarettes cause lung damage? Is possession of firearms linked to armed violence? Is mental illness just a chemical imbalance in the brain, or is it part of a broader biological, psychological and social context?
Similarly, anti-vaccine opinions have surged in the wake of Andrew Wakefield's publication of his research linking autism to vaccination, but dozens of peer-reviewed studies have proven the opposite, denying any association of the kind that Wakefield claimed. The publisher side withdrew Wakefield's paper, thereby publicly losing Wakefield's scientific credibility, but the damage had already been done; Before the emergence of the “Covid-19” pandemic, we witnessed the measles outbreak reaching its highest rates since it was almost eliminated, and the reason was that small segments of American societies refrained from vaccination for fear of developing autism, and so, quite simply, children died as a result of A disease that could have been prevented.
As the pandemic continues, public health agencies - largest before smallest - must be a source of reliable, evidence-based, and consistent information. But this is not the case for centers of disease control and prevention alone. The largest drug regulatory agency in the United States—the US Food and Drug Administration (FDA)—has shown a contradiction that affects not only the general public but also everyone involved in providing health care.
To take the drug “Adohelm” as an example in this regard, several months before the approval of the drug designed to treat Alzheimer’s disease was issued, a group of senior US Food and Drug Administration officials agreed that there was insufficient evidence to allow approval, and officials said at the time that the agency should To demand more evidence that the drug works in the way the company described it before it could be reconsidered or given approval was a blow to patients, doctors and researchers who were hopeful about a possible cure for a deadly disease that has no treatment options.
Despite this setback, the scientific community agreed that more work was needed at the clinical level, and shortly after the consensual decision taken by the advisory members and senior scientists, the US Food and Drug Administration issued - in a controversial position - its approval for the use of the drug. Without additional clinical studies and without the slightest acknowledgment of the lack of data on which the approval was supposed to be based, and after weeks of outrage and the resignation of several key consultants, Acting Food and Drug Administration Commissioner Janet Woodcock turned on her heels; Its position on making statements expressing confidence in the agency's decision changed to support an independent investigation, and the investigation led to the approval of the drug. Which is still difficult to explain.
Scientists and health-care professionals have long looked up to institutions like the Centers for Disease Control and Prevention and the US Food and Drug Administration, yet the conflicting attitudes and suspicions of these institutions all point to a much deeper problem that will require innovative solutions.
We are entering the third year of our war against an infectious disease that has killed more than 800,000 Americans, and at the same time, many more Americans are dying from gun injuries, drug overdose, suicides and delayed medical care, and care workers are suffering. health from physical and emotional exhaustion; They have worked during the darkest times of this pandemic, whether it is in times of shortage of personal protective equipment (PPE), when personal sacrifices have been required, or when family and loved ones are at risk of contracting the virus. Senior government officials such as US Secretary of Defense Lloyd Austin are contracting cases of hacking infection with “Covid”, and the American workforce is facing paralysis due to the massive increase in positive cases. Our success in this depends on our ability to restore trust in our scientific institutions.
Leaders of government agencies and the public sector—including public institutions, for-profit health care organizations, and research institutions—should establish a rapid response system that quickly assesses and provides feedback on the latest data on COVID-19, to ensure that the health care workforce and the general public receive more Formal messaging Consistent and evidence-based, and similar to the peer review process, the benefit of escalating the task of assessing impactful policies to a larger group of peers at a higher level. It is also important that these conversations include frontline health care workers; That's because they're the party farthest into the battle and often the ones with the best knowledge of the best solutions.
Public health practitioners and scientific organizations, as an important group of trusted professionals, must work to better get our message across, especially during one of the crises in which the landscape is changing so quickly, we are all prone to making mistakes, and no one expects to reach anyone or Perfect organization, but setting consistent expectations during a public health crisis is critical. The strategy and approach followed in conveying the message are no less important than the correctness of its content.