FDA and CDC = confusing and off-message again?

Discussion in 'Coronavirus Pandemic Discussions' started by CenterField, Nov 21, 2021.

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  1. CenterField

    CenterField Well-Known Member Past Donor

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    I've been disappointed with the current leadership at the FDA and the CDC. There's been a number of unforgivable blunders. Frankly, I had hoped for better management when the administration changed hands, but I'm not seeing it. They continue to be quite unable to convey clear messages to the public.

    Sure, for someone like me, a medical scientist, most of the decisions are somewhat understandable in view of the data available at the time. But for the unwashed masses, it's incredibly confusing. In an environment in which Covid-19 became terribly politicized, it's not sufficient to be scientifically correct. It's also important to convey consistency and transparency, in order to inspire trust and to dispel misinformation and conspiracy theories. When the message seems wishy-washy and contradictory, you actually give ammunition to the forces that seek to discredit science and perpetuate misinformation and conspiracies.

    Clear example: the CDC said that vaccinated people didn't need to wear masks indoors, when at the time the Delta variant was making havoc in Europe and predictably was about to arrive here, which then forced the CDC to take back the advice. That was stupid. They should simply have refrained from changing the advice, noticing that in a month or so Delta was likely to vacate that change anyway; going back and forth is confusing and decreases trust.

    Now, another example. The complicated, chopped-up process of authorizing boosters, piece-meal. European countries (and even some American states) jumped onto it and simply said, "boosters are safe, and dramatically increase protection, so anybody who wants one, can have one." Well, the FDA and the CDC made a huge mess of it, just to end up recommending boosters for everybody anyway, this past week.

    Yes, scientifically speaking, it would make some sense to look a little longer at the risk of myocarditis before authorizing Moderna boosters, if this were an academic point to be made in a non-urgent situation. But no, the confusion generated among the public wasn't worth the delay, given that the increased risk is infinitesimal as compared to the risk of myocarditis from the virus itself (a handful of cases in 1 million doses, versus the virus causing it in up to 45.8% of cases, almost 1 in 2). You know, trying to establish if the risk is 2 in one million for Pfizer versus 10 in one million for Moderna when the pandemic continued to spread, with the virus causing the same risk in almost 1 in 2, is just plain stupid.

    There is a reason why these are called EMERGENCY use authorization, and if you delay a very urgent decision due to negligible differences, that is not right and doesn't foster trust.

    The impression I have is that the current leadership at the FDA and the CDC are not comfortable with the political and public relations aspect of this. They want a scientific precision that is not what the public wants and needs. In other words, they may be good scientists, but they are not good politicians.

    A good politically-minded scientist would have thought like this: "on one hand, there is this very complex scientific point that only learned specialists can fully understand. On the other hand, the public wants simple and clear guidance. So, we'll get to a happy medium and will issue advice that is still FAIRLY scientifically accurate but doesn't need to be 100% scientifically accurate, in case this degree of absolute precision will make it too confusing for the public. So, yes, there are some nuances in terms of relative risks and relative efficacy of difference vaccines as boosters, but for public consumption, saying "boosters are safe and effective and everybody should have them" is close enough to the scientific details, and much clearer for the public. Period, full stop."

    Some public health officials blame the vaccine-hesitant... without noticing that part of the hesitancy is generated by their own confusing messaging.

    Are there some nuances? Yes, there are. But the FDA and the CDC could have issued the above clear and simple advice, and could have added "ask your primary care provider for what's best for you in terms of what booster to have, and when." Then, the FDA and the CDC could issue the full detailed guidance TO THE PROFESSIONALS. The public won't need to know the fine points. They can ask their doctors.

    It's not a question of hiding anything from the public either. The "for the professionals" sections of the CDC website are clickable by anybody and you don't need to show your credentials to have access to the pages. So if a member of the public is more curious and wants the full info, it's there. But the general advice for the public should be clear and simple, period.

    -----------

    This article makes some of the points I'm making:

    https://www.yahoo.com/news/too-why-boosters-weren-t-093159463.html
     
    GrayMan and Melb_muser like this.
  2. kreo

    kreo Well-Known Member

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    I guess some people at CDC are not comfortable spreading the lie.
    E.g. about 90% of COVID vaccine efficiency.
    It is good to know, that finally so called "doctor" found the truth.
     
  3. Eleuthera

    Eleuthera Well-Known Member Donor

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    The CDC, FDA, Congress and the White House, and the employees of the manufacturers are all exempt from having to take the clot shots. HELL YES they are happy!

    Happy Thanksgiving!
     
  4. Melb_muser

    Melb_muser Well-Known Member Donor

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    A couple of points if I may:

    I agree that clear messaging and consistency is important. But is it more important than the absolute truth? A respectable contributor like @557 would probably say no.

    I'm on the fence.

    Here's how we solved conundrums like this in Australia. The politicians and health experts (chief medical officers) worked very closely. In tandem, if you will. The politicians (front line) gave the press reports and made the rules. The CMOs (rear guard) were there to answer more detailed questions. Nevertheless there was always the perception that rear guard guided the front line. Despite this our politicians always took full responsible for tough decisions and abrupt changes of policy, therefore the integrity of the CMOs was more or less maintained.

    Worth noting that they all got death threats across the board, including family, by the way. Tough job & you can't please everyone.
     
    Last edited: Nov 25, 2021
  5. CenterField

    CenterField Well-Known Member Past Donor

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    I'm not advocating for lies. Like I said, the full information needs to be available. But we shouldn't overwhelm lay people with the complex details.

    In medical practice, we do present to the patient the pros and cons of a therapeutic option. But we don't flood the patient with too much information and all the details that go into state-of-the-art practice recommendations, like number-needed-to-treat, number-needed-to-harm, confidence intervals, strength of evidence, etc., because there is always some degree of uncertainty. If we were to describe everything in full detail the patient would be puzzled, anxious, and uncertain. In evidence-based medicine, when we analyze dozens of factors and reach a reasonable conclusion on what advice to provide, then we provide the advice without going into the whole process that led to the advice.

    You know, some gourmet specialty sausages are delicious but one would not want to look at the process of making them or else the person's appetite would be ruined. The public doesn't really want to know about the sausage-making process.

    Often if we try to explain too much, some patients get really confused, stop us, and say "please, doctor, just give me the bottom line; what of these options you think is the best one for me?"
     

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