CDC Covid advice must adapt to new science faster

The Centers for Disease Control and Prevention must adapt their Covid recommendations more quickly when new scientific data emerges, Dr Scott Gottlieb told CNBC on Monday, adding that the agency must also do so with more transparency.

“These guidelines have more of an impact on the economy than regulation,” but go through much less public scrutiny, Gottlieb said on “Squawk Box.”

The comments from the former Food and Drug Administration commissioner came after the CDC changed its guidelines on social distancing in schools on Friday, not in society at large. 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 at least 6 feet of distance 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 its guidelines, writing that “the exact basis of its initial vision of staying 6 feet away” remains unclear . In the Journal and on CNBC, he said the initial recommendations and precautions early last year were based on the novel coronavirus spreading like the seasonal flu.

“It was reasonable to do it because we didn’t know much about the coronavirus, so we assumed it was going to behave like the flu. It didn’t behave like the flu,” Gottlieb said. on “Squawk Box,” claiming he was leading health officials. “Both overestimate and underestimate this virus” crucially.

“It’s not so much of an important question of ‘Are we wrong about this? “We were wrong in some ways,” added Gottlieb, who led the FDA from 2017 to 2019 in the Trump administration. “But,“ Did we learn quickly enough and adapt our recommendations and guidelines quickly enough ? ” The answer is no.”

In a statement to CNBC, a spokesperson for the CDC said that during “the first year of the pandemic, there were concerns about some of the direction of the CDC.” However, the spokesperson said that the agency’s new director under President Joe Biden, Dr Rochelle Walensky, is “committed to restoring scientific credibility and public confidence in the agency,” noting that this included a review of the agency’s Covid guidelines to ensure they reflect the latest science.

Gottlieb told CNBC that health officials “overestimated the usefulness of physical distance because influenza is spread primarily by droplet transmission, and we know droplets don’t spread more than about six feet.” . On the other hand, he added, “We underestimated the role of air quality and high quality masks because we underestimated that it was spread through the transmission of aerosols. . “

Initially, there had been some skepticism from doctors about whether advising Americans to wear face coverings – especially something homemade like a scarf or bandana – would be effective. In early April last year, however, the CDC began recommending that people wear them in public, especially in settings like grocery stores where social distancing was more difficult to maintain.

There is little debate in the public health community about the importance of wearing face masks, and some experts like White House Chief Medical Advisor Dr.Anthony Fauci have even started to say that wearing of two masks is probably more effective.

In October, the CDC acknowledged that the spread of the coronavirus can occur through airborne particles, which can “linger in the air for minutes to hours” and end up infecting people. that were more than six feet from each other.

On the CDC’s webpage titled “How COVID-19 Spreads,” the public health agency says it does it “most often” through close contact between people within 6 feet.

“There is evidence that under certain conditions, people with COVID-19 appear to have infected others who were more than 6 feet away,” the CDC adds. “These transmissions occurred in enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.”

Areas where Covid risks were initially overestimated also included contaminated surfaces, Gottlieb told CNBC. The CDC in May 2020 – about two months after the World Health Organization declared the coronavirus a pandemic – updated its website to emphasize that the virus is not easily spread by 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 guidance.

“When the CDC makes recommendations, there are different levels of evidence behind those recommendations and different levels of certainty,” he said. “When the agency is uncertain, or is predicting a recommendation on less certain science, they should really be transparent about it so that we can make a serious interpretation that we want to take it, but they usually don’t. not.”

The CDC spokesperson told CNBC that following the agency’s recent review, “key learnings” have already been implemented, including “reviewing key directions for potential updates to the agency. less every three months “, as well as” improved clarity and usability “.

Dr. Scott Gottlieb is a CNBC contributor and board member of Pfizer, genetic testing start-up Tempus, health technology company Aetion and biotechnology company Illumina. He is also co-chair of Norwegian Cruise Line Holdings‘and Royal Caribbean‘s “Healthy Sail Panel.