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That Leaked CDC Presentation Is a Hot Mess Wrapped in a Disaster

Stefani Reynolds/The New York Times via AP, Pool

Much has been made of the leaked CDC presentation that the Washington Post published. Even reading it with the level of contempt and skepticism that our entire health bureaucracy deserves at this point, it resembles a pile of flaming garbage. The CDC has access to detailed and accurate data from two countries that are ahead of us in the Delta variant curve. Yet, they completely ignore what any American can look up on the internet and make ridiculous proclamations based on outliers like India.

Let’s start with the things that are becoming evident about the SARS-CoV-2 at this point. First, the virus is not going away. It will be a fellow traveler for the foreseeable future with or without the vaccine. The efficacy of the Pfizer mRNA vaccines is waning for early adopters. It is becoming more likely that these could be called therapeutics that reduce the severity of symptoms for those willing to take periodic boosters.

Second, it is highly likely that SARS-CoV-2 will behave like other human coronaviruses. Our grandchildren will contract it when they are young and develop mediating immunity that will result in something like a head cold when they contract it as adults. Healthy children do not seem to suffer significant illness from the virus, which is a blessing.

Third, the United States’ experience with the Delta variant is more likely to mirror other Western nations that have relatively high rates of vaccination and experienced at least one significant wave of COVID-19 already.

The CDC appears to be looking to India to predict how the Delta variant will behave in the U.S., which is absurd. For a country with over a billion people, India had relatively low infection levels from the beginning of the pandemic to April this year. Delta was their first significant wave. The only thing you can hypothesize from the data collected by the World Health Organization and India’s seroprevalence studies is that you can’t make any hypothesis. Their data collection during the wave is estimated to have vasty undercounted the deaths. That means that you must assume their positive test numbers are just as incomplete. India also uses a vaccine the United States doesn’t permit. There is almost no reason for experts in this country to make any assumptions based on India’s data.

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The United Kingdom and Israel both had a previous wave of COVID-19 infections. Israel uses the Pfizer mRNA vaccine, and the U.K. uses AstraZeneca, which is similar in construction to Johnson & Johnson in this country. Both countries have health systems that are more accessible for all citizens than India’s. They also keep detailed data in centralized healthcare systems. This is the data the CDC should be looking at to determine health policy.

Then, of course, there is the distribution problem, which is not surprising since that is the way the CDC has managed the entire pandemic. We shut down the whole country because the tail of the distribution, those over 65, had a higher case fatality rate. The RT-PCR test was ramped up to a cycle count of 37-40 and stayed there when studies showed that only 3% of samples above a Ct of 35 were capable of replication. We shut down the nation’s schools because a relatively small number of teachers were old enough to be in the high-risk category. Our public health bureaucracy has always created policies and recommendations aimed at the exception rather than the rule.

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The latest guidance recommending that everyone mask indoors is no different. Nearly 80% of our most vulnerable citizens over 65 are fully vaccinated, and 60% of those over 18. That doesn’t include the almost 140 million Americans of all ages who have likely recovered according to the CDC’s disease burden estimates. The U.K. is at 71%, and Israel has vaccinated 85% of adults. As of July 29, hospital admissions appear to have peaked in the United Kingdom, and new cases are declining rapidly. It is easy to see that, in contrast to the previous wave, illness from COVID-19 has been decoupled from death.

(UK government)
(UK government)

Israel appears to be about two weeks ahead of us in an upswing in cases, and they currently have 168 patients in the hospital that are suffering from severe illness. In the past month, the largest number of deaths in a single day was four, compared to more than 60 during the last wave. Israel is also the only country that monitors those who have recovered from COVID-19 and did not require them to get a vaccine to obtain a green passport. The recovered made up only 1% of new cases as of mid-July, and the fully vaccinated made up approximately 40%.

But according to the CDC presentation, our “experts” decided to use a rejected study from India and an outlier from Provincetown, Mass., to guide national policy. This approach is either ignorant and driven by people who do not understand the concept of a confounding variable or intentional. If it is intentional, there are only two reasons for it. Either they are driving for zero COVID-19 cases, or the CDC has seen a signal in the data globally or domestically that they have not shared. If it is the former, the CDC is entirely irrational. No serious scientist believes eradication is possible at this point. If it is the latter, the CDC had better come clean. It is the only way they can restore their credibility after eighteen months of horrible messaging and 500 days to slow the spread.