Few figures have been as relentlessly vilified by the Republican Party as Anthony Fauci. In 2021, a group of House Republicans introduced a piece of legislation, called the Fire Fauci Act, to eliminate the salary of the top health official. More recently, when the the director of the National Institute of Allergy and Infectious Diseases announced his plan to retire, House Republicans sworn to pursue the investigation of Fauci after he left public service, although it is unclear what form he would take.
And then there’s Florida Governor Ron DeSantis, perhaps the GOP’s fiercest Fauci opponent, who sells t-shirts and koozie drinks decorated with slogans like “Don’t Fauci my Florida” and flip flops with the words “Fauci can pound sand. . ” DeSantis gave the public health official a typically crude greeting, saying: “Someone has to grab that little elf and throw him across the Potomac.”
As DeSantis’ slogan koozie suggests, many of these objections are similar to what one might call Faucism as for Fauci himself. These Republicans, and the voters they are trying to appeal to, are opposed not only to the man, but also to the bureaucratic public health ethics he represents.
There is no need to approve of DeSantis’ crude remarks find flaws in the way the American public health establishment has behaved over the past two years and the shift from failed tests to controversial school closures to confusing and contradictory masking recommendations to vaccine approval hesitations.
At best, the nation’s public health apparatus has communicated its leadership poorly and slowly, relying on euphemisms and distortions born of the sense that the public cannot be trusted with simple, straightforward language. At worst, it acted imperiously, pushing highly politicized policies backed by scant evidence while claiming the authority of science and refusing to acknowledge the considerable human and economic costs of its pandemic response policies.
Furthermore, there is reason to be concerned that the public health community has not learned any lessons from COVID: Many of the same mistakes are committed again, in response to monkeypox.
All of which is to say that American public health agencies represent a legitimate target for both criticism and reform. Although the Republican Party has delivered the former in abundance, they have hardly produced any plans for the latter. Republicans have spent the past two years blaming the public health establishment for its failures, but they have no apparent plan to reform the agencies. With a handful of exceptions, they’re stuck at the level of backyard insults and koozie slogans.
It’s not that the public health agency’s dysfunction hasn’t been diagnosed. In his book Uncontrolled spreadformer Trump administration Food and Drug Administration (FDA) director Scott Gottlieb paints a damning portrait of the bureaucratic mistakes made by the Centers for Disease Control and Prevention (CDC) not only during the COVID-19 pandemic but also in previous years it.
It has been widely reported, for example, that the agency failed to launch the test kit during COVID, releasing a defective and contaminated test when COVID first spread.
But what is less well known is that the agency also struggled with test kits during the Zika outbreak years earlier. Like the Government Accountability Office reported all the way back in 2017, the agency’s process for licensing diagnostic tests was plagued by communication and production difficulties. Both CDC and the FDA did not follow “some of their guidelines in communicating with users of diagnostic tests, including providing clear information that would allow users to more easily compare performance between different tests,” concluded the GAO report.
Gottlieb also recounts how the CDC withstood the first widespread testing requests during COVID, in part because that would have meant relying on private labs, giving up its gatekeeper status in the process. Gottlieb also documents how the agency promoted arbitrary rules of physical distancing that had little basis in science until 2021, even though those rules contributed to the closure of schools.
So the agency has both mundane bureaucratic process problems and deeper internal culture problems that interested critics could address through reform.
Most Republicans, however, offered little beyond sneers and slogans to advance their criticisms. An exception is that of Senator Mitt Romney (R-Utah) plan to create a separate public health data agency aimed at responding more quickly during outbreaks. This might have some marginal advantages, but it would hardly amount to the vast cultural reform that the public health bureaucracy needs.
If anything, the CDC seems more likely to reform than most of its more vocal critics of the GOP seem likely to reform the agency: Officials recently announced an internal review focusing on faster analytics and clearer public communications. , although the agency it has not yet spelled out its reform plan in detail.
Unfortunately, bureaucratic inertia is a powerful force, and centralized processes and the CDC gatekeeper mentality will not be solved by more capable communications. After all, the problem of the agency, how ReasonRon Bailey recently stated, is that it has moved away from its core mission of fighting infectious diseases, becoming a broader “public health” agency that deals with social issues such as obesity and gun violence when what is needed is a narrower and more discreet focus on virus pathogens. The Centers for Disease Control and Prevention should focus on, well, diseases.
For now, critics will have to hope that the CDC’s internal reforms make productive progress because there is little evidence that political public health critics have plans to solve the problems they so incessantly complain about.