As we approach a full year of the pandemic, one thing is clear: we must rebuild our nation’s public health system, including the confidence of those it serves. Only half of Americans trust the federal government to combat COVID-19, according to a recent Axios-Ipsos poll. As former leaders of the CDC and FDA during the Bush and Obama administrations, we know first-hand the importance of building trust in leadership, in the work of our nation’s world class scientists and researchers, and in the mission of our public health agencies. Building trust is vital to ending this pandemic, as well as to future efforts to promote health and control disease. To do this, each agency must commit to honest, consistent communication with the public that articulates the latest science, and take transparent, evidence-based actions to accelerate the nation’s response to the pandemic.
Recently, we joined 12 of our colleagues at the Bipartisan Policy Center to develop and release recommendations to bolster the immediate public health response to COVID-19 and to help restore that trust. The recommendations are based on five core principles. First, political and public health leadership are central to successfully coordinating and managing a pandemic crisis. Second, trust in science and a commitment to public health are paramount to making progress in fighting the pandemic. Third, national leaders must communicate and adhere to clear, consistent, and customized public health and safety messages and serve as role models. Fourth, federal, state, and local leaders – Democrats and Republicans – must take action to debunk conspiracy theories. And fifth, federal efforts must recognize and address vulnerable communities.
Based on these principles, here are three ways the CDC and FDA can begin to restore their standing with the public.
Expand COVID-19 testing and surveillance
The CDC’s ability to track coronavirus variants over the next few months through genomic screening and analysis will be important to better tailor the most appropriate public health measures and messaging to fight the pandemic. Congress should also authorize the CDC to require states to submit race and ethnicity data on COVID-19 testing, cases, hospitalizations, and deaths on a regular basis. Currently, this information is only reported voluntarily. Absent consistent and comprehensive data to guide the allocation of resources, communities of color will continue to bear the greatest burden of COVID-19 cases.
Both agencies are central to developing a federally led standardized testing strategy that outlines a path forward to reduce positivity rates in each state to under 5% and providing guidance to support the safe reopening of schools and workplaces. Specifically, the FDA will need to continue performing pre- and post-market evaluation of rapid antigen test accuracy and precision and offer guidance for manufacturers to improve upon current tests. In addition, the CDC should develop more user-friendly algorithms for the use of screening tests in specific at-risk populations and high-risk settings, as well as schools and various workplaces and activities to reopen safely.
Ensure vaccine transparency, equitable distribution, and uptake
Arguably, there is no COVID-19 issue more public-facing at the current moment than vaccinating Americans. The CDC needs to make good on President Biden’s call for a bold vaccination campaign and continue providing guidance to states on vaccine prioritization and visibility on vaccine supply availability. We recommend the federal government consider allocating vaccines based on criteria such as priority group population size and severity of outbreak rather than solely on a per capita basis.
The FDA should work with manufacturers to ensure that vaccine clinical trials data are made public upon submission. This will allow independent scientific researchers and experts to review the data, raise questions arising with the FDA, and build public trust and confidence in the vaccine approval process. FDA leadership is also critical in developing a regulatory strategy for second-generation coronavirus vaccines that takes into account concerning circulating variants and in supporting global vaccine efforts. We hope a new commissioner is chosen soon to lead these important efforts, along with the many other vital functions of FDA.
Launch a national public education campaign
The CDC should execute a nationwide science-based education campaign, partnering with key stakeholders and especially tailored to vulnerable populations such as communities of color. Evidence shows that focused and culturally competent messaging can improve health outcomes. Language and outreach matter. Building institutional credibility in these communities must be leveraged to increase participation in mask-wearing, testing, contact tracing, and vaccination efforts.
The campaign should also focus on health care professionals. A recent national study shows that 11% of health care workers offered a vaccine declined to take it, with allied health professionals more likely to refuse. As we learn more about the durability of the vaccines and the new variants, communicating the need to remain vigilant with personal protective measures is imperative even among those who have received the vaccine.
Trust in our nation’s public health agencies is essential during the COVID-19 pandemic. With strong leadership, public health actions and information based on science, and transparent and consistent communication, building back trust in these renowned federal agencies is achievable. This public health emergency demands it.
Peggy Hamburg, MD, served as FDA commissioner in the Obama administration. Bill Roper, MD, was CDC director in the George W. Bush administration. They are both members of the Bipartisan Policy Center’s Future of Health Care Task Force.
Source: MedicalNewsToday.com
