The worst measles resurgence in the U.S. in decades keeps growing. Vaccination rates keep falling. Flu, COVID-19, and RSV keep coming back. Against this backdrop, many public health experts are worried about the reliability of health information coming from the Centers for Disease Control and Prevention.
"Red flag. Red alert," says Dr. Demetre Daskalakis, who resigned last year as the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention to protest what he called political interference at the agency.
Daskalakis and other independent public health authorities around the country are alarmed by how the CDC handled two deaths that Pennsylvania state officials recently blamed on measles. Health and Human Services Secretary Robert F. Kennedy Jr. took the unprecedented step of questioning the deaths, and the CDC removed them from the agency's website.
"When they raise doubt on the adjudication that a state may have made around a death, that is highly problematic," says Daskalakis. "This is dangerous."
Usually, when someone dies from measles, the state where the tragedy happened determines the cause of death and reports the death to the CDC so the agency can alert the public, doctors and health officials around the country. The CDC usually defers to the state's determination.
So Kennedy's public dispute with the state and the CDC's response is concerning for what it may mean for the relationship between states and federal health officials, who have to work closely to protect the public, Daskalakis and others say. That relationship has already become strained under the Trump administration.
"What we have been seeing, that got amplified even more with these measles cases, is a breakdown in the coordination and trust between states and the federal government," says Dr. Anne Zink, a senior fellow at the Yale School of Public Health who previously served as Alaska's chief medical officer and president of the Association for State and Territorial Health Officers. "That to me is a significant concern. These partnerships are critical and essential to making us healthy and well."
Zink and others also worry about whether the public, state and local health officials, doctors and others will be able to trust federal health data about measles as well as other diseases, such as flu, COVID-19 and RSV. Could CDC succumb to pressure to suppress information to minimize concerns about those diseases and the impact of falling immunization rates? Kennedy has long questioned vaccines.
"We need to have good solid evidence-based national data. And I'm obviously concerned that it will happen again for other infectious diseases," says Dr. Georges Benjamin, who heads the American Public Health Association. "If it happens with flu and with COVID, the question is: Who can we rely on for the data on a national level. More people will get sick and more people because they won't know what to do. They won't know who to trust. And that is the problem here."
Many also worry about what this means for the effectiveness of the new CDC director, Dr. Erica Schwartz, who recently took over after a tumultuous year that has left the CDC demoralized and diminished. Many hoped Schultz, a well-respected physician and attorney with solid public health experience, would restore the CDC's morale and credibility by pushing back against political pressure. But many say the way the CDC handled the Pennsylvania measles cases don't bode well for Schultz pushing back against political pressure.
"We are seeing a pretty compromised CDC and a director who is at best facilitating non-scientific behavior and at worst colluding with non-scientific behavior," says Daskalakis.
Others agree.
"What the director should be doing instead of looking into these disease counts is responding to the outbreak itself," says Dr. Debra Houry, who resigned as the CDC's chief medical officer at the same time as Daskalakis for the same reasons. "I haven't heard from her talking about the importance of getting kindergarteners vaccinated when we're seeing declining rates. It's back to school time around the United States. We need her to step up publicly to talk about what can be done."
Neither the CDC nor the Department of Health and Human Services responded to NPR's repeated requests for comment.
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