WASHINGTON -- Pressure is mounting on the leaders of the Centers for Disease Control and Prevention -- from inside and outside the agency -- to speak publicly against the White House's manhandling of CDC research and public-health decisions.
The situation came to a boiling point last week when William Foege, a giant in public health who led the CDC under Democratic and Republican presidents, called for its current director, Dr. Robert Redfield, to "stand up to a bully" -- he meant President Donald Trump -- even at the risk of being fired.
"Silence becomes complicity," he said in an interview after a private letter he wrote to Redfield leaked to the news media.
Redfield further infuriated public-health experts by issuing a memo, released by the White House, that cleared Vice President Mike Pence to participate in the vice presidential debate Wednesday, even as the White House became a coronavirus hot spot. Nearly a dozen current and former CDC officials -- including six who still work there -- called the letter highly inappropriate.
And Sen. Patty Murray of Washington, the ranking Democrat on the Senate health committee, said she told Redfield in a private telephone conversation before he testified on Capitol Hill last month that he had to take a stand.
"What I said to him was that my concern was about the agency's credibility today -- and the agency's credibility that we need as a country in the future," Murray said in an interview. "This isn't just about right now. If we lose all the really good scientists there, if people don't believe the CDC when they put out guidance, what happens in the next flu outbreak? What happens in the next public health crisis?"
The Food and Drug Administration also gave in to White House demands to grant emergency approvals for two unproven covid-19 therapies, but more recently, the FDA withstood enormous pressure -- and issued tough new guidelines for emergency approval of a coronavirus vaccine that almost certainly pushes any vaccine release past the election.
The National Institutes of Health has remained above the political fray, and one of its top officials, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has become a symbol of scientific defiance to Trump.
But the CDC leadership has proved far more malleable. The White House succeeding in getting the agency to revise guidelines on matters like school reopenings, church gatherings and whether cruise ships can sail.
The CDC, over the serious objections of its own scientists, posted coronavirus testing guidelines that suggested asymptomatic people should not be tested. Redfield later walked that back after the resulting uproar, and it was ultimately reversed. And the White House thwarted a plan, laid out in a directive drafted last month by Redfield, to require masks on all commercial transportation in the United States.
Supporters of the agency fear the CDC's reputation will be irrevocably damaged if Redfield does not start more vigorously defending its science.
"What has happened at CDC has been horrifying to see," said Dr. Mark Rosenberg, who pioneered public-health research into gun violence at the CDC but was pushed out after Republicans in Congress effectively cut off funding for his work. "It's been terribly demoralizing to people who have been working 16- and 17-hour days for weeks or months at a time while taking on covid-19."
Redfield declined to comment. Murray said he had given her his assent in their conversation, acknowledging without saying much that he agreed with what she said. A spokesperson for the Department of Health and Human Services, the CDC's parent agency, said, "The American people are fortunate to have Dr. Redfield leading the CDC."
Political appointees of the president meddled in the agency's Morbidity and Mortality Weekly Reports, regarded as the "holiest of the holy" in medical literature. Equally troubling, agency officials say, is that the White House has muzzled the CDC, refusing to allow the nation's leading public-health experts to talk directly and regularly to the American people -- a critical component of any successful infectious-disease response.
The CDC has made its own missteps. Sloppy laboratory practices caused the botched introduction of coronavirus tests early in the pandemic. More recently, the agency withdrew a notice on its website acknowledging for the first time that the coronavirus spreads mainly by air, saying that it had been "posted in error" on the agency's website. The weaker version was later published.