Speed over accuracy? COVID, monkeypox research would get less vetting under CDC 'reorganization'

Already under fire from experts for promoting pandemic falsehoods and shoddy research  that "shattered the public's trust in science and public health," the CDC is planning a reorganization that aims to push out more timely but possibly less vetted information about public health threats including COVID-19 and monkeypox, increasing the likelihood it will spread well-intentioned misinformation.

The agency has long faced criticism across the political spectrum for hoarding its information. It only started publishing state-submitted wastewater data in February and admitted withholding information about breakthrough COVID infections so as not to cast doubt on vaccines.

CDC Director Rochelle Walensky gave employees a preview of her reorganizaton plans, which must receive Department of Health and Human Services signoff, in response to an internal review that has not been made public, according to media reports. A briefing document given to The Washington Post says it wants to speed up "publish[ing] its data and science for decision-making." 

This would mean bypassing the agency's in-house journal, Morbidity and Mortality Weekly Report, so the CDC could quickly issue scientific preprints, which do not undergo peer review. Contrary to Associated Press reporting, MMWR is not peer-reviewed in the traditional sense either, but the pace of publishing is slower. 

The journal "has long been mired in excessive layers of review," Stat News paraphrased Jay Varma, a 20-year CDC veteran now leading pandemic efforts at Weill Cornell Medicine. "Getting information out, even if it's preliminary and imperfect, is a priority," he said in praise of Walensky's plan.

MMWR has a reputation among medical experts and science writers as an inconsistent source of quality research related to COVID, however, raising the question how faster publishing would help.

Just this winter MMWR faced rigorous methodological critiques for studies crediting school mask mandates with heavily reducing transmission, indoor masking with lower infection rates and vaccines with a sharply lower incidence of pediatric diabetes.

The reorganization announcement ignores the "industry subservience and epidemiologic incompetence" at the heart of the CDC's problems, longtime Yale epidemiologist Harvey Risch wrote Thursday, calling for a "completely different independent external review."

He mocked the idea that "moving faster" can fix the problem of "fatally flawed" MMWR studies. The agency only recently acknowledged COVID vaccines aren't effective in reducing transmission and still refuses to see that "masks are useless ... distancing is useless ... general population testing is virtually useless for managing the population pandemic."

"Lack of integrity is the problem," not the "speed of data release and public communication," mRNA vaccine pioneer-turned-critic Robert Malone wrote in his newsletter Thursday. "Dishonesty, regulatory capture, rampant evidence of corruption."

The MMWR studies "are reviewed to make sure they fit the CDC narrative," Georgia COVID data tracker Kelley Krohnert tweeted, noting the journal's 50th anniversary supplement acknowledged its research isn't peer-reviewed and is edited for consistency with CDC policy. 

"And honestly, the last thing I want CDC doing is relying *more* on pre-prints," Krohnert said, citing a slide deck shown to the agency's advisory committee that went viral on Twitter.

It referenced a U.K. preprint that claimed COVID was a "leading cause" of pediatric deaths in the U.S., which falsely asserted it only looked at "underlying" COVID deaths and inexplicably counted both "cumulative" and "annualized" deaths, among other errors, according to Krohnert's analysis.

"How did I uncover these issues, instead of them being identified by someone whose job it is to evaluate this kind of data?" she wrote. Krohnert was also one of the first to publicly question the CDC's COVID pediatric death count, which the agency drastically lowered this spring.

The CDC did not respond to queries about the tradeoffs between publishing information more quickly and ensuring its quality when the agency doesn't use external reviewers.

"There will be no meaningful offer of reform from within the CDC," Indiana University immunologist Steve Templeton told Just the News. "It has to be outside pressure, and they will fight it tooth and nail."

The CDC's belated recognition of natural immunity in revised COVID guidance is an invitation to hold the agency broadly accountable, Templeton wrote in his newsletter Thursday.

"From pushing damaging and unsustainable lockdowns to contriving a false consensus on masks to massively inflating risks of COVID-19 in children and schools, the CDC's record has been utterly dismal," he wrote.

While Walensky's "cosmetic" reorganization ensures "the ossified, dysfunctional culture will continue to balloon and lumber on," Templeton argued there was no "mastermind" and urged readers to "look in the mirror" at how a "pervasive safety-at-all costs culture enabled all of it."

Part of the CDC overhaul is improving its "messaging," a common explanation in the mainstream media for the agency's loss of public trust. The communications office is getting restructured, and CDC websites will aim to make guidance more accessible.

Indiana University Chief Health Officer Aaron Carroll partly attributed low COVID vaccine uptake in children to "inconsistent and often suboptimal science communication," in a New York Times essay Thursday.

"Too many messages are still centered on trying to frighten people into compliance by arguing about worst-case scenarios and ‌‌convincing them that things are as dangerous as ever," which contrasts with starkly different European vaccine recommendations for children, he wrote, recommending more focus on "collective benefits" for vaccination ‌‌instead of individual risks.

The CDC's monkeypox communication has apparently failed to inform Americans that the infection has overwhelmingly targeted a specific sexual practice.

A new YouGov survey found 42% think that monkeypox, which has infected few and killed no one, is at least as much of a threat as COVID. Only 2% said they or someone they knew had been diagnosed with monkeypox, and about half said they aren't following monkeypox news at all or "very closely."

The fear of monkeypox is disproportionate among blacks, a majority of whom believe the two viruses are equal threats.

While the 2022 U.S. outbreak page from the CDC monkeypox index notes that "gay, bisexual, and other men who have sex with men make up the majority of cases in the current monkeypox outbreak," it emphasizes that "anyone ... who has been in close, personal contact with someone who has monkeypox is at risk."

The "how it spreads" page deems all "close, personal, often skin-to-skin contact" a risk for up to a month. Specifically: "Hugging, massage, and kissing" and any kind of sexual intercourse or touching. "A pregnant person can spread the virus to their fetus through the placenta."