The Centers for Disease Control and Prevention must adjust their Covid recommendations faster as new scientific knowledge emerges, said Dr. Scott Gottlieb told CNBC on Monday, adding that the agency needs to do the same with more transparency.
“These guidelines have more of an economic impact than regulation,” but Gottlieb said in Squawk Box that they are much less publicly scrutinized.
The former Commissioner of the Food and Drug Administration’s comments came after the CDC changed its guidelines on social distancing in schools, not society at large, on Friday. The Public Health Agency said that with universal masking, most students can sit 3 feet apart instead of the previous 6 foot protocol. The CDC also continued to recommend a separation of at least 6 feet between adults in schools and between adults and students.
In an opinion piece in the Wall Street Journal on Sunday, Gottlieb urged the CDC to be more open about the science behind their guidelines, writing that the “exact basis for their initial view of staying 6 feet apart” remains unclear . In the Journal and on CNBC, he said initial recommendations and precautions early last year were based on the novel coronavirus, which spread like seasonal influenza.
“It was sensible to do this because we didn’t know much about the coronavirus and therefore assumed that it would behave like the flu. It didn’t behave like the flu,” said Gottlieb in “Squawk Box” and claimed it crucially led health officials to “both overestimate and underestimate this virus”.
“It’s not so much an important question: ‘Were we wrong?’ We were wrong in some ways, “added Gottlieb, who headed the FDA in the Trump administration from 2017 to 2019. “But: ‘Have we learned quickly enough and adjusted our recommendations and guidelines quickly enough?’ The answer is no. “
In a statement to CNBC, a CDC spokesman said that “during the first year of the pandemic, there were concerns about some of the CDC’s guidelines.” However, the spokesman said the agency’s new director under President Joe Biden, Dr. Rochelle Walensky, has “pledged to restore scientific credibility and public confidence in the agency” the latest science.
We underestimated the role of air quality and quality masks because we underestimated that aerosol transmission spreads this.
Dr. Scott Gottlieb
Former FDA commissioner
Gottlieb said on CNBC that health officials “have overestimated the benefits of physical distancing because the flu spreads primarily through droplet transmission, and we know droplets don’t spread more than six feet.” On the other hand, he added, “We underestimated the role of air quality and quality masks because we underestimated the fact that aerosol transmission spreads it.”
Initially, doctors had expressed some skepticism about whether advising Americans to wear face covering – especially something homemade like a scarf or headscarf – would be effective. However, in early April last year, the CDC began recommending that people wear them in public, especially in environments like grocery stores where social distancing was more difficult to maintain.
There is little debate in the public health community these days about the importance of wearing face masks, and some experts like White House Chief Medical Officer Dr. Anthony Fauci, even started to suggest that wearing two masks is probably more effective.
As early as October, the CDC recognized the spread of the coronavirus through particles in the air that “linger in the air for minutes to hours” and infect people who were more than a meter apart.
On the CDC website, titled “How COVID-19 Spreads,” the health department says it “most often” happens through close contact between people within 6 feet.
“There is evidence that, under certain conditions, people with COVID-19 appear to have infected others more than three feet away,” adds the CDC. “These transmissions took place in closed rooms with insufficient ventilation. Sometimes the infected person breathed heavily, for example when singing or exercising.”
Some of the areas where Covid risks were initially overestimated also included contaminated surfaces, Gottlieb told CNBC. The CDC updated its website in May 2020 – about two months after the World Health Organization declared the coronavirus a pandemic – to emphasize that the virus did not spread easily from a person touching a contaminated surface, according to NBC News.
Gottlieb acknowledged that in the early stages of a health crisis like the Covid pandemic, there may be a lack of quality information to use as a basis for guidelines.
“When the CDC makes recommendations, there are different levels of evidence and different levels of security behind those recommendations,” he said. “If the agency is unsure or suggests a recommendation for a less specific science, they should be really transparent about it so that we can take seriously an interpretation we want to take, but they usually don’t.”
The CDC spokesman told CNBC that “key findings” have already been implemented following the agency’s latest review, including “reviewing key guidelines for possible updates at least every three months” and “improving clarity and usability”.
Dr. Scott Gottlieb is a CNBC employee and board member of Pfizer, the genetic testing startup Tempus, healthcare technology company Aetion, and Illumina biotech. He is also co-chair of Norwegian Cruise Line Holdings and Royal Caribbean’s Healthy Sail Panel.