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Former CDC Director On How To Restore Faith In Agency

AUDIE CORNISH, HOST:

Dr. William Foege, a former director of the CDC under both Republican and Democratic presidents, wrote a private letter to the current head, Dr. Robert Redfield. Someone from inside the CDC leaked it. And in it, Foege demonstrates empathy for Redfield, writing, Dear Bob, I start each day thinking about the terrible burden you bear. But the letter focuses on his concern for the fate of the CDC and for the country, saying, quote, "the failure of the White House to put the CDC in charge has resulted in the violation of every lesson learned in the last 75 years that made the CDC the gold standard for public health in the world."

When we spoke earlier today, I asked Foege to talk about his decision to write Redfield.

WILLIAM FOEGE: Dr. Redfield is the one person that could turn this around. And so what I was appealing for is for him to actually tell CDC employees, who have gone through a terrible time of being denigrated by the White House, we are now going to come up with a national plan, and I'll stand behind you. And I said to him in the letter that he would undoubtedly be fired, but he could leave with his head held high that he had done the right thing to try to correct the course of this pandemic.

CORNISH: You wrote that Robert Redfield has, quote, "shown great resilience" in being willing to take White House abuse. What should the role of the CDC director be in this current situation? I mean, how are you thinking he has failed to fulfill it?

FOEGE: We've had 75 years of experience at CDC on how to handle outbreaks and pandemics. It appears to me that every one of those lessons has been violated. The first one is to know the truth. We do not know what the truth is. We end up going to journalists and to Johns Hopkins to find the truth, where we should be able to go to CDC. You have to have a national plan. You can't have 50 states trying to figure this out on their own.

It felt to me like President Trump had his knee on the neck of the public health community, holding them down so that they could not actually do their work. You can't sit by and let this happen. I think often about the "Survival At Auschwitz" (ph) book by Primo Levi. He said, if you know how to prevent torture and don't do it, you become the torturer. This was the burden I found myself living under, that silence was complicity, and I had to do something. But I did not want to go public with it; I wanted to give Dr. Redfield a chance to turn this around on his own, and I think he still could.

CORNISH: I want to talk about that for a second. Beyond being sidelined, the CDC has made critical mistakes in the pandemic response in terms of the testing at the beginning, which really set the U.S. back in its ability to track the virus. You know, these are costly mistakes. How do you think the CDC could have recovered from that?

FOEGE: Well, I think that it was a setback, but it wasn't a permanent setback. What was a permanent setback is the inability to actually develop a national plan. And the White House plan has not worked out at all. We got about the worst response to this pandemic that you could possibly have, and it's because CDC was not allowed to do the thing that they're trained to do.

CORNISH: You also write that the CDC's reputation has gone from gold to tarnished brass in this pandemic, that career scientists are fed up and thinking of leaving. Is there anything you think the CDC can do to stop, I guess, sliding into the failures you describe?

FOEGE: Well, you know, that's a phrase I would not have used if I'd known this was going to go public. At 84 years of age, I'm always surprised at how naive I still am. What could they do? Well, the amazing thing is how good the workers still are at CDC. I presented last night with a CDC worker about the allocation of vaccine. The CDC worker was talking about their plans for actually delivering it, and I was astounded by how good those plans are. But they have this terrible political blanket over them that makes it difficult to do their scientific work.

CORNISH: What are they saying to you? Like, you referenced that some employees or Listservs you were on - that people were talking.

FOEGE: Well, you can imagine how disheartening it is to write up recommendations for what should be done in a situation only to have the White House change those recommendations, and then they have to walk it back. This is the sort of thing that just drives scientists wild, that they cannot use the facts.

CORNISH: Can I ask if Robert Redfield has responded to your letter?

FOEGE: We've exchanged emails, but I'm not going to get into that.

CORNISH: Well, he hasn't resigned (laughter). So what's your advice to him now that your letter has leaked?

FOEGE: Well, a person suggested to me that going public this way may have strengthened his position. Now President Trump sees that he got this advice, but he stood up for the White House, and that may put him in a position to make recommendations to the White House that he could not make before.

CORNISH: Dr. William Foege, thank you so much for speaking with us.

FOEGE: Thanks for having me. Transcript provided by NPR, Copyright NPR.

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