The US is confronting coronavirus without the CDC. It’s ‘like fighting with one hand tied behind your back,’ ex-director says. – USA TODAY

Dr. Tom Frieden, former head of the Centers for Disease Control and Prevention, warns of 'catastrophic scenes' in New York. USA TODAY

The United States'response to the COVID-19 pandemic is haphazard, uncoordinated and sorely missing the guidance of the U.S. Centers for Disease Control and Prevention, that agency's former director told USA TODAY on Tuesday.

And the "extraordinary" absence of the nation's lead public health agency at the forefront of the coronavirus fightmakesTom Frieden feel "less safe."

Now president of the nonprofit Resolve to Save Lives, Frieden advises other nations on how toorganize against epidemics. He said global best practice is to designateone incident manager reporting to ahealth department official who then communicates to the head of state.

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That's not how it's working in the U.S.

Weve heard that FEMAs in charge. Weve heard that the vice presidents in charge. Weve heard that (U.S. Ambassador-at-Large) Dr. (Deborah) Birx is the coordinator. Weve heard that (Health and Human Services Secretary Alex)Azar is in charge of the task force. Whos on first here? Frieden told USA TODAYs Editorial Board on a video call.

Former CDC director Dr. Tom Frieden(Photo: Jasper Colt)

The one agency that definitely isnt in charge is the CDC, which Frieden directed from 2009 to 2017.

It's a stark reversal fromthe past, when the CDC not only took the lead in the U.S. but globally against the threat of infectious disease. From the SARS epidemic in 2002, to the 2009 H1N1 flu, the beginning of the Ebola outbreak in 2014 and through the 2015Zika virus outbreak, the CDCheld frequent and sometimes daily briefings as the coordination center for the U.S. government and beyond.

This time, however, the agency that has led every major epidemic response in the nation for the past seven decades is just not there, Frieden said. Its 700 professionals specifically focused on infectious and lung disease appear sidelined.

Fighting an epidemic without CDC involved at the decision table and at the podium is like fighting with one hand tied behind your back, he said.

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In previous outbreaks, the CDC had often daily calls with reporters.This time, the CDC has had multiple news conferences canceled because if the White House is having a press conference, they cant have one, Frieden said. The last one archived on the CDCs media page is from March 9.

Asked about Frieden's comments, the CDC responded that it is still actively engaged in the country's COVID-19 response and working with the entirety of the federal government.

Robert Redfield, the current director of the CDC, is a member of the White House Coronavirus Task Force buthas rarely appeared in its almost daily video briefings.

In a wide-ranging conversation with the editorial board, Frieden also said testing for the coronavirus is being mismanaged.

The drive to get everyone everywhere tested for COVID-19 is simply wrong from a public health perspective, he said.In areas with many cases, no one other than people who need to be hospitalized for the illness caused by the virus should be tested.

Theres every reason to not get tested, he said. "If youve got mild symptoms, stay home!" Trying to get tested just meansusing up protective equipment, staff time and scarce test kits and might infect others.

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If youre positive, its not going to make any difference. Youre going to be told to stay home unless youre having trouble breathing. Then you need to go to the hospital."

In places with relatively few COVID-19 cases, however, testing makes sense, Frieden said. In these areaspublic health officials can track contacts, call for self-isolation and slow the spread of the disease.

He also disagreed with the focus of the Trump administration's task force on "high-throughput" testing. Quick-turnaround is whats needed, Frieden said.

That may sound like a technical difference but its a big difference, he said.

High-throughput testing requires using centralized labs and can take between a day to four days to get results. Thats useless to front-line medical professionals seeing large numbers of people in emergency rooms, he said. They need to know within an hour whether someone has coronavirus and should be admitted and put into quarantine.

And that's going to be increasingly important if, as Frieden predicted, a big wave of infections comes crashing down on the United States.

The severely ill patients today were infected 10 to 12 days ago. It takes about 10 days to get sick and 5 fivedays to get very sick, he said. There will be an exponential increase in cases."

That worries the 35-year public health veteran. The decentralization of the U.S. health system only works if there is clear guidance from the top, Frieden said.

We can expect innovation and proactive action from states and local areas," he said. "But we really need to have clear guidance and coordination at the federal level."

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The US is confronting coronavirus without the CDC. It's 'like fighting with one hand tied behind your back,' ex-director says. - USA TODAY

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