A set of detailed documents created by top disease investigators in the United States meant to give step-by-step advice to local leaders deciding when and how to reopen public places such as mass transit, daycare centres and restaurants during the coronavirus pandemic has been shelved by the Trump administration.
The 17-page report by a Centers for Disease Control and Prevention (CDC) team, titled “Guidance for Implementing the Opening Up America Again Framework”, was researched and written to help faith leaders, business owners, educators and state and local officials as they begin to reopen.
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It was supposed to be published last Friday, but agency scientists were told the guidance “would never see the light of day”, a CDC official told the Associated Press news agency.
The AP obtained a copy from a second federal official who was not authorised to release it. The guidance was described in AP stories last week, prior to the White House decision to shelve it.
A White House told Axios on Thursday that administration officials were unaware of the guidelines’ existence until it was leaked to the media and described the original document as “overly prescriptive”. Requested revisions were never delivered, the official said.
“Guidance in rural Tennessee shouldn’t be the same guidance for urban New York City,” the official said.
The Trump administration has been closely controlling the release of guidance and information during the pandemic spurred by a new coronavirus that scientists are still trying to understand, with the president himself leading freewheeling daily briefings until last week.
Traditionally, it has been the CDC’s role to give the public and local officials guidance and science-based information during public health crises. During this one, however, the CDC has not had a regular, pandemic-related news briefing in nearly two months. CDC Director Dr Robert Redfield has been a member of the White House coronavirus taskforce, but largely absent from public appearances.
The dearth of real-time, public information from the nation’s experts has struck many current and former government health officials as dangerous.
“CDC has always been the public health agency Americans turn to in a time of crisis,” said Dr Howard Koh, a Harvard professor and former health official in the Obama administration during the H1N1 swine flu pandemic in 2009. “The standard in a crisis is to turn to them for the latest data and latest guidance and the latest press briefing. That has not occurred, and everyone sees that.”
The Trump administration has instead sought to put the onus on states to handle COVID-19 response. This approach to managing the pandemic has been reflected in President Donald Trump’s public statements, from the assertion that he is not responsible for the country’s lacklustre early testing efforts, to his description last week of the federal government’s role as a “supplier of last resort” for states in need of testing aid.
White House spokeswoman Kayleigh McEnany echoed that at a briefing on Wednesday. “We’ve consulted individually with states, but as I said, it’s [a] governor-led effort. It’s a state-led effort on … which the federal government will consult. And we do so each and every day.”
Resources are available to states, tribes, localities, & territories to help to get and keep America open. See important info on identifying new #COVID19 cases, protecting healthcare workers, and more: https://t.co/9GuA4VA7sy. pic.twitter.com/tneqh6eLI7
— CDC (@CDCgov) May 5, 2020
The rejected reopening guidance was described by one of the federal officials as a touchstone document that was to be used as a blueprint for other groups inside the CDC who are creating the same type of instructional materials for other facilities.
The guidance contained detailed advice for making site-specific decisions related to reopening schools, restaurants, summer camps, churches, daycare centres and other institutions. It had been widely shared within the CDC, and included detailed “decision trees”, flow charts to be used by local officials to think through different scenarios.
For example, the report suggested restaurants and bars should install sneeze guards at cash registers and avoid having buffets, salad bars and drink stations. Similar tips appear on the CDC’s site and a Food and Drug Administration page.
But the shelved report also said that as restaurants start seating diners again, they should space tables at least 6 feet (about 1.8 metres) apart and try to use phone app technology to alert a patron when their table is ready to avoid touching and use of “buzzers”.
“You can say that restaurants can open and you need to follow social distancing guidelines. But restaurants want to know, ‘What does that look like?’ States would like more guidance,” said Dr Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials.
The White House’s own “Opening Up America Again” guidelines released last month were vaguer than the CDC’s unpublished report. They instructed state and local governments to reopen in accordance with federal and local “regulations and guidance”, and to monitor employees for symptoms of COVID-19. The White House guidance also included advice developed earlier in the pandemic that remains important like social distancing and encouraging working from home.
A person close to the White House’s coronavirus taskforce said the CDC documents were never cleared by CDC leadership for public release. The person said White House officials do not want to offer detailed guidance for how specific sectors can reopen, calling it a “slippery slope” because the virus is affecting various parts of the country differently.