The sad decline of CDC

Some stories just won't go away. Problems with transparency in China, an impotent government facing a bird flu crisis in Indonesia -- and morale, expertise and credibility going down the toilet at the US Centers for Disease Prevention and Control (aka CDC). Yesterday a very long article in the Atlanta Journal Constitution went over the ground again (hat tip to reader LG). The occasion was an unprecedented letter to CDC Director Julie Gerberding from five of the last six of her predecessors, sent last December:

An exodus of key leaders and scientists from the Centers for Disease Control and Prevention has raised "great concern" among five of the six former directors who led the agency over the past 40 years.

Their concerns, expressed in a rare joint letter to current CDC Director Dr. Julie Gerberding, come amid growing staff complaints about whether her strategic shifts in the agency's focus are putting public health at risk, according to interviews with current and former CDC officials and documents obtained by The Atlanta Journal-Constitution.

Critics say the agency is changing to a top-down management style that stifles science and that new layers of bureaucracy are being created, making agency operations more cumbersome.
The most visible sign of potential trouble at CDC is the loss of more than a dozen high-profile leaders and scientists since 2004. By the end of this year, all but two of the directors of CDC's eight primary scientific centers will have left the Atlanta-based federal agency. The wave of departures --- which numerous CDC leaders call unprecedented --- also includes the agency's top vaccine expert and world experts in several diseases. Just last week CDC's pandemic flu coordinator said he's leaving. (Alison Young, Atlanta Journal Constitution)

This is not a new story here. A few of many previous posts here, here, here, here and here. There are several things at issue. One is the catastrophic reorganization that Gerberding initiated and pursues with bullheaded purpose. Beyond the (de)merits of the plan itself, so much time and energy within the agency is wasted in meetings, office and title shuffling, and reorganization related paperwork and bureaucracy that even if it were the best plan in the world it would be like a cancer eating up the agency from within.

But it isn't the best plan in the world. Allegedly designed to put the agency on a broader base to respond to a wider range of health threats, it is changing the agency from one whose expertise was an inch wide but a mile deep in several selected but important areas, like infectious diseases, to one whose health expertise is a mile wide and an inch deep all over the place. With its new breadth and shallowness has come a dramatic exodus of institutional memory and world class scientific knowledge:

The chorus of strongly voiced concerns coming from inside the agency is what alarmed five former CDC directors and spurred them to send the joint letter to Gerberding on Dec. 22.

"We have all gone through periods of change and recognize the difficulties attendant to change. However, we are concerned about the previous and impending losses of highly qualified and motivated staff," wrote former CDC directors Dr. William Foege, Dr. James Mason, Dr. David Satcher, Dr. Jeffrey Koplan and Sencer.

Their leadership of the agency spans Republican and Democratic administrations dating back to 1966.
"We are concerned that so many of the staff have come to us to express their concerns about the low morale in the agency. We are concerned about the inability of many of the partners to understand the direction in which CDC is headed," they said in the letter.

"I think all of us were receiving virtually constant messages from staff expressing concerns about morale and their ability to do their work --- and all of it unsolicited," Koplan said in a recent interview. He preceded Gerberding as CDC director and now is vice president for academic health affairs at Emory University's Woodruff Health Sciences Center.

The CDC staff members who are raising concerns, Koplan said, are not complainers.

"In my 34 years of affiliation with the CDC, I've never seen this level of concern," Koplan said. "The rate and number of turnover has been exceptional. And it's not just senior leadership, which would be huge in and of itself."

Retirements among one category of scientists last year were up 77 percent over previous years, CDC employment data show.

The badly conceived and executed reorganization isn't the only issue affecting morale. Gerberding has surrounded herself with yes-men and receives criticism badly. There is an air of intimidation and fear in the agency. She is not trusted and viewed by many in the agency as more interested in control and power than furthering the public health mission. Part of that charge has been a willingness to bend the agency's priorities to those of the Bush administration, whether they make sense or not, and her failure to fight or stand up to the administration regarding its cuts into CDC's programmatic bone and muscle.

Some examples from the AJC article:

  • While the CDC's overall budget from Congress has risen dramatically in recent years, to $8.4 billion this year, much of the increases are because of terrorism and other urgent threats. Many of CDC's bread-and-butter programs have taken significant cuts.
  • Since 2001, funding for domestic HIV/AIDS programs is down by 19 percent, tuberculosis by 16 percent and injury prevention by 12 percent. Terrorism funding is up 701 percent; the Strategic National Stockpile (vaccines, emergency medical supplies) is up 895 percent.
  • Financial erosion left CDC without a mumps specialist when the disease swept the Midwest this year. The agency's rabies researchers this year didn't have enough funding to keep crucial supplies in stock until Gerberding diverted $325,000 to them from a discretionary fund. Bathrooms in many CDC buildings now only are cleaned every other weekday.

Not everyone interviewed by the AJC was negative. Here's one of the most positive views:

"A large proportion of us are more focused on trying to get our work done," said Dr. Rick Goodman, a former editor-in-chief of CDC's Morbidity and Mortality Weekly Report who now works in the agency's public health law program. "We've got a lot to do. We get compensated well. We have good job security, health care benefits, and it's a pretty decent place to work."

Jeez. If the best you can say is the pay is good and you have job security and benefits, then we are really in trouble. We've worked with CDC scientific colleagues for decades and the people we worked with used to be some of the best in the business. The agency is now full of second and third raters and its competency in even simple programmatic matters, like designing a data collection system, is dreadful. They can't even do paperwork right. And if you speak out about your concerns, the job security isn't that good either. Like others, we watch in horror as the agency is being systematically destroyed just at the point in history when we need it most.

But the Bush Administration is sticking with Dr. Julie, even though five of six former Directors, Republican and Democrat, think things are amiss. Just like the Bush Administration is sticking with Donald Rumsfeld, even though half a dozen retired Generals think things are amiss. Is there a pattern here? I see The Medial of Freedom in Dr. Gerberding's future.

More like this

Thanks for this horrifying look inside the CDC. The story is familiar and very sad. It will take the U.S. 20 years to recover from the Bush administration, if we manage to do so at all.

This does directly reflect the Bush administration. I cannot understand the underlying callousness of their concept of federal government. This goes way beyond cutting social programs and "Big government is wasteful and bad." Although there is a minority push for an essential theocracy, it seems that is more a red herring. This appears to be about a government of the corporations, by the corporations, for the corporations (or the rich, or some ruling elite cabal). If we talk about free-market capitalism sorting out good companies from poor companies, we feel no remorse when a less than successful company fails (assuming the fault is entirely theirs - which may not be true anyway). But to apply that kind of "morality" to people and classes of people should be criminal within the context of justice-for-all, sinful within any spiritual sense, and just generally despicable within any citizenship context. Why is "Support our Troops!" a rallying cry, while "Support our citizens" gets no respect (e.g. New Orleans)? When did this become the vision and mission for America?

This trend is reflected in so many fields that government should be responsible for. Public Health is certainly one where the veil of "management for efficiency" is thin indeed. You cannot cut funds for Public Health and still be for Public Health (meaning in support of the public!). But apparently with enough spin and enough distraction, you can give it your best shot...

A terrible, frightening story.

It sounds like the CDC is being turned into an arm of the Bush Administration.

Hyped Threats (if sub rosa) : Terrorism, anthrax, lack of vaccines, etc.

While private corps have made hay out of selling 'security' - cameras and duct tape, and all the rest, as well as providing state/gvmt funded employment thru Gvmt. contracts, a barely hidden war economy - one would like to imagine the State would nevertheless prefer to have a functioning CDC (mumps, etc.)

No. Ordinary people, ordinary risks, ordinary procedures are to be thrown out, people are on their own. Danger and death lurk everywhere! Nothing to be done about it!

See Katrina, see Iraq, see Palestine, see the American heartland. To have 'security', the only thing to do is bow down to authority, agree to fight, pray hard or sincerely and hope, and stick to 'core' values.

A clear sign of complete corporate take over.

It is unbelievable how long this story has been around. Gerberding chalked everything up to discomfort with change as she reorganizes the Centers. But you can't use that same rationalization throughout your whole tenure. Jeez.

By traumatized (not verified) on 11 Sep 2006 #permalink

When China said a couple days ago that they hadn't released viruses to the CDC because proper import procedures were not in place, I thought this was buck-passing. But then the U.S. apologized for the delay and says it's fixed things... if the Peoples Online Daily story is to be believed. We haven't gotten any samples since 2004 because of a minor bureaucratic hurdle, and it's been fixed in two days? What the hell?

caia: As I said to another commenter, either story seems plausible, unfortunately. My guess is that China has been dragging its feet for a long time and when it finally was forced to send some samples discovered that the bureaucratic dunderheads at CDC made it less than easy. The hold up was over something really stupid and CDC should not have let it happen (but it is full of incompetents these days) but it was a recent and last step hold up that China conveniently trotted out, not the reason they haven't provided the isolates sooner.

I agree with Revere's assessment that China has been stalling on releasing the poultry virus samples, because the genetics of the viruses might provide insights into just how long and how widely H5N1 has been circulating in China.

Genetic data anayses have shown that Indonesia's principal H5N1 virus strain is derived from a strain recorded in Yunnan province sometime in early 2003, at about the same time that two human H5N1 cases (one fatal) were confirmed in Hong Kong in residents returning from a Lunar New Year visit with family in Fujian Province.

High genetic diversity and divergence among H5N1 poultry strains from the mainland will be a smoking gun that China doesn't want revealed to the world, and so any specimens that they do release will probably have been carefully screened and selected with this factor in mind.

off topic but, help me out:

this joseph mercola character. i need to debunk him but couldnt find anything on flu wiki or snopes. i suspect he has some valid points but is largely full of it-- best mkting strategy for BS.

whats his agenda (besides making money) and can anyone point me to some info for my friends who want to believe him?

tia!

chivito: Don't know much about him. The stuff sounds both nutso and exploitative. He's a former evangelical who I guess found another scam, one where he's the vitimizer and not the victim.

Back in the months following 9-11 when the anthrax terrorism scare hit, I began to have serious misgivings about the CDC. Why? Because they took so long to put in place quarantines at postal facilities after the anthrax laden letters went through them, claiming (after several postal workers became infected) that they'd had no idea the spores could escape through the envelopes they were in and contaminate the facilities. I knew instantly this was an outright lie.

If you go to the CDC web site (which I had on a previous occasion to research something about biohazards for my science classes) you can (or at least could back then) locate their protocols on sending biohazards (specifically including bacterial pathogens such as anthrax) through the mail. Their protocols included wrapping the specimens in multiple layers of plastic, specifically because - as they pointed out - these tiny organisms can easily slip through the pores in ordinary envelope paper. They have had these protocols, this knowledge, in place for years and years. So to pretend surprise that anthrax spores could have escaped from paper envelopes and contaminated postal facilities was patently absurd. It was, to me, a smoking gun showing knowing complicity from the CDC and the government they served in perpetrating the anthrax scare. My conclusion was and still is that it was a government hoax designed to further terrify the US public into approving the soon to be created Patriot Act as well as the attack on Iraq. But whether my conclusion as to reason for this knowing subterfuge is right or wrong, the fact that the CDC was lying is absolute and unquestionable. To see this organization now become nothing but a shill for the government's ongoing "anti-terrorism" campaign is no surprise at all.

By mary in hawaii (not verified) on 11 Sep 2006 #permalink

In terms of the anthrax issue specifically...I'm not so sure that the government necessarily was slow to quarantine so much as a means of pushing through the Patriot Act, as it may have been a means of not testing the effect that shutting down a few post offices, which would potentially snowball into offices across the country (probably not limited to post offices either), may have had on the economy. I just don't know that we can be so sure either way on that one.

Maia: It doesn't matter what the government's "reason" was, the point is the CDC who is supposed to be the source authority for protecting us against such outbreaks LIED. They flat out LIED about "not knowing" bacteria could escape through envelope paper. They allowed postal employees and citizens receiving mail from the contaminated post offices to be infected and some to die. That is a GROSS violation of public trust. No wonder their employees are quitting in droves. I wonder what else they've been up to since, in service of the Bush administration?

By mary in hawaii (not verified) on 11 Sep 2006 #permalink

David B wonders if it will take 20 years to recover. No. We can never recover what has been lost. For the perfect illustration look at the way CDC handled HIV during the Reagan/Bush administration. Scientists inside the agency were alarmed, but the politicians (both within the agency, and especially without) supressed the response because, after all, it was only happening to "those" [gay] people, and it was God's retribution for their sins. Had we hit the problem early and hard, who knows how many lives would have been saved. Now, it's a pandemic.

Like father, like son. The more things change, the more they remain the same. Greed is good, and the poor get just what they deserve.

By A nonny mouse (not verified) on 12 Sep 2006 #permalink

Here's the paradigm you need in order to understand what's going on.

Almost all of us who read and post on this blog, operate on the basis of the assumption that the most significant problems we face today are inherently scientific, i.e. caused by factors that are best understood by science, and solveable by methods that are inherently science-based.

The Regime and its minions and supporters, operate on the basis of the assumption that most of the significant problems we face today are inherently moral, i.e. caused by failures of character and faith on the part of individuals, and solveable by methods that are inherently faith-based.

These two sets of assumptions are so disjunct that the potential for understanding between them is approximately zero. It is as if one person is speaking German and the other is speaking Spanish.

In the midst of this is another, held by those who are the de-facto power behind the Regime's throne, who are not based in faith but in simple greed. Their assumption set is social darwinism, the unscientific bastardisation of natural selection that is used to rationalize a complete lack of morals and scruples in dealing with others. The social darwinists can't quite come out of the closet because their overt message will be heartily rejected; however, they are skillful manipulators and can translate their message to language the religious extremists can accept.

The social darwinists don't care about public health because they've got theirs and Devil take the hindmost. They in turn get the religious extremists on-side by talking about sinful behaviors and atheistic scientists and so on. Meanwhile, the appointed minions do as they're told (e.g. destroy CDC slowly) and the mass of supporters outside give a standing ovation.

Know what? If all this stuff was fiction it wouldn't be accepted by any respectable publisher because the plot was too obvious and the characters too one-dimensional, and the apocalypse unfolding before our eyes was too formulaic. If it was fiction, it would not even rise to the level of being believable.

And yet here we are. Headed over the edge of the cliff because the people in charge are the textbook definition of malevolently incompetent. It's as tragic as a bunch of teenagers getting killed by riding in a car with a drunk driver.

MiH: I've looked fairly carefully at the CDC mismanagement of the anthrax attack and I don't think they lied. In some sense, it was worse. They didn't realize that weaponized anthrax (and in some sense they may have been kept in the dark by the military about how dispersible this form was) could infect at doses orders of magnitude less than they were figuring. They repeatedly told the media, and it appears on good evidence, believed themselves that it took 10,000 spores to infect someone. In reality, data in the scientific literature (e.g., Meselson's article in Science in 1994 on Sverdlovsk) would have told them the dose was far lower. Gerberding and the CDC scientists allowed themselves to be pressured to keep the postal system operating, which they could do by not knowing the science. This is one example of how CDC's decline in recent years and its increasing susceptibility to political pressure has endangered us all. The latest Bush is not the only culprit here, although he is the one doing the most damage to an already damaged agency. Congress, the former Bush and Clinton didn't help that much.

Thinking they lied both gives CDC too much credit and also unfairly accuses it of callousness (or worse), one crime I don't think it is guilty of.

Well revere, you may be right about the infectivity level error, but I do remember with absolute clarity that the public reason the CDC gave for not closing the post offices earlier was that they "did not realize" the spores could escape the pores in the paper envelopes...which is equivalent to saying that they didn't realize a dog could run under the arc d'triumph ( probably mispelled, but similar size comparison.) I do, now that you mention it, remember that they ALSO were saying they thought it took far more spores to infect someone than it did. But the other excuse was definitely given and is definitely a lie. Perhaps they were just covering their asses because they were ordered to keep the Post Offices open to avoid panic or economic repercussions. Yet they knew it was not just possible but a given that the spores would have escaped the envelopes. Maybe they hoped that the spores would have escaped in less than infective or lethal concentrations, but they still knew they would have escaped. I have to stand by that, as I am absolutely positive about what they said in public, and that it went against their own prior knowledge and protocols. By the way, did you read the comment by Dennis Heath in crofs blog today re the CDC. Quite an eye opener.

By mary in hawaii (not verified) on 12 Sep 2006 #permalink

Ooops...that comment in crofs blog was by Dennis H. Clarke. That's what I get for writing anything before 6AM. time for coffee.

By mary in hawaii (not verified) on 12 Sep 2006 #permalink

g510,

"In the midst of this is another, held by those who are the de-facto power behind the Regime's throne, who are not based in faith but in simple greed. Their assumption set is social darwinism, the unscientific bastardisation of natural selection that is used to rationalize a complete lack of morals and scruples in dealing with others. The social darwinists can't quite come out of the closet because their overt message will be heartily rejected; however, they are skillful manipulators and can translate their message to language the religious extremists can accept."
If you extrapolate the application of the above logic outside the realm of the CDC to Iran, I think a case could easily be made that Cheney, et.al.; would have no problem directing the military to bomb Iran with tactical nuclear weapons. Of course, at least 20 B60-111 tactical nuclear bombs would have to be used during the attack.
First, Iran is part of the Axis of Evil. Second, Iran may develop an atomic bomb. Once Iran gets an atomic bomb, they will be able to kick ass in the Darwinian jungle.
Therefore, since the Darwinists have no morals, it is easy to decide to bomb Iran using tactical nuclear weapons.
Just think of the benefits. You eliminate part of the axis of evil. You stop Iran from developing an atomic bomb that might be used to destroy Israel. Later, when there is less radiation in Iran, you send in Rabbis to convert everyone to Judaism. Later still, you rebuild the oil installations , and steal the oil. It is good to kill Arabs in order to steal oil, because Americans need a lot of gasoline.
Obviously you cannot leave all the cadavers of the dead Iranian civilians above ground, because it will be unhealthy for our military when they arrive. So you use small bombs to open large holes in the ground, and you use bulldozers to move the bodies into the holes.
The only complication to this plan is that the Russian Darwinians may decide to nuke the US and Israel, in retaliation.
Then as nuclear winter decends on the planet, Cheney, who will be in an underground bunker, can watch MTV and torture lawyers for fun.

Regarding my claims that the CDC knowingly left US citizens exposed to anthrax through the mail during the 2001 anthrax incidents: I looked up the references to CDC and WHO requirements for the packaging of biological agents. The CDC's was published (last) in 1999, the WHO's in 1997. CDC's requirements can be found under the category "Biosafety in Microbiological and Biomedical Laboratories", and was in appendix C, "the transportation and transfer of biological agents" on page 221 of the document. They state "Figure 1 shows the generalized "triple" ( primary receptacle, water tight secondary packaging, durable outer packaging) packaging required for a biological agent of human disease....This packaging must be certified to meet rigorous performance tests as outlined in the DOT, USPS, PHS and IATA regulations." They referenced several sites regarding this packaging requirement, including WHOs. The WHO site,
http://www.who.int/csr/resources/publications/anthrax/whoemczdi986annex…

gave essential the same packaging requirements as the CDC's, but in more detail, and was most particularly concerned with the transport of anthrax, which most of the references they cited were in relation to.

The point is, CDC knew full well that anthrax spores could indeed escape from ordinary paper envelopes, as they had in place protocols for transport which would prevent that. I looked up the archival data on the 2001 anthrax incidents to refresh my memory, and it was nearly six weeks after the first case of anthrax surfaced that the CDC finally decided to close the post offices. So you decide why they waited so long, but if you think it was ignorance then I have some new real estate in Hawaii to sell you...on the undersea volcano of Loihi (should surface in another 2000 years!)

Seriously, no one wants to believe that our government and its agents could be so dastardly as to purposely kill its own citizens to further its agenda...but historically it happens all the time. Why do we insist America's leaders are any better or purer of motive than any others? We really need to take off the blinders and look the truth in the eye before the lies swallow us whole.

By mary in hawaii (not verified) on 12 Sep 2006 #permalink

MiH: The packaging requirements and knowingly exposing people are quite different. There are anthrax spores all over Texas, in the soil. Those requirements are designed to prevent breakage and spillage of specimens shipped through the mail. The envelopes were sealed and CDC didn't realize two things: that weaponized spores could escape sealed envelopes when they passed through sorting machines; and that the infective dose was much smaller than they were assuming. On both counts there was scientific information they should have known but did not.

It is very hard to weaponize anthrax. A bottle of anthrax spores usually isn't that dangerous because it is hard to make them respirable. A Japanese cult tried to do it by spraying spores from a truck a few years before and nothing happened. The fact that CDC didn't understand the nature of weaponized anthrax was a result of the military spooks not talking to CDC and CDC not realizing they needed to ask (and likely not being told if they did, anyway). The incorrect information and understanding of the infective dose was CDC error and lack of competence.

It's not that we don't want to believe CDC knowingly endangered people. It's that they didn't. They should have known, but not for the reasons you give. The packaging regs are irrelevant to this.

Mary in Hawaii,
"We really need to take off the blinders and look the truth in the eye before the lies swallow us whole."
You are correct about the Anthrax hoax.
Below is an article that may remove the blinders. Israeli leaders are not going to wait very long before Israel attacks Iran. The Israeli military has received shipments of the B60-111 tactical nuclaer bomb from the US.
They have at least 30 of these bombs.
US military commanders have stated these bombs are not dangerous for civilians since they explode underground. But the Iranian nuclear facilities are near cities. And the B60-111 is a dirty bomb that will spread radiation. Even if conventional bombs are used on the nuclear reactors, it will disperse radioactive material from the reactors over large areas. The winds over Iran will probably carry the radiation over India.
No matter what happens, Isreal plans to attack Iran, if the US does not. That has already been decided by the Israeli government, because Isreal cannot allow a nuclear Iran to exist.
This is the most dangerous situation since the 1962 Cuban missile crisis.
The day these bombs are released on Iran, Cheney and the Neo-Cons will have a big party at the White House.
The civilian slaughter caused by these bombs in Iran will make the Nazi gas chambers look very small in comparison. Six million Jews were killed during WW2. How many millions of Iranians will be killed by these bombs, or large conventional bombs? Will Americans be safe after the bombs are released?

Israel Fears Nobody Will Stop Iran

September 11, 2006 4:30 p.m. EST

Ryan R. Jones - All Headline News Middle East Correspondent

Jerusalem, Israel (AHN) - With the international community reluctant to impose sanctions on Iran, the head of Israel's military intelligence warned the Cabinet Sunday that the Islamic Republic's nuclear program is unlikely to be stopped in time, reported The Jerusalem Post.

Maj.-Gen. Amos Yadlin said the international community has reacted slowly and in an ineffective manner to Iran's nuclear program, in particular the enrichment of uranium, and its defiance in the face of UN demands and deadlines.

Yadlin warned that Iran is growing increasingly confident that its defiance will result in no punitive action, as leading world powers choose to engage in endless rounds of diplomatic talks.

The European Union on Sunday said that the latest talks between its envoy and Iran's top negotiator were "very serious," and should remain the preferred avenue for seeking a halt to Iran's nuclear program, according to the AP.

But hours later, Reuters reported that Tehran publicly denied that it had offered a two-month suspension of its efforts to enrich uranium in order to give negotiations a chance.

Under threat of economic sanctions, the UN had given Iran until August 31 to halt uranium enrichment, a key step in the production of nuclear arms.

Israeli officials last month said that the Jewish state would likely have to take matters into its own hands if Iran was not stopped soon. Jerusalem views a nuclear Iran as an existential threat, after Iranian President repeatedly expressed his desire to see Israel destroyed.

A nonny mouse wrote: David B wonders if it will take 20 years to recover. No. We can never recover what has been lost.

In this case, I tend to agree. But something new might be created, something different. Who knows.

When Gvmt. no longer relies on, accepts or uses the expert advice, proposals, it gets from Gvmt. paid agencies, be it on health, climate, terrorism, war strategy, energy management, catastrophe response, schooling and testing, visa criteria, and much more (all have been analyzed and denounced by professionals who must be accepted as knowing their business, as there is nobody else around claiming expertise) what you have is Gvmt. that co-opts or controls those 'external' agencies for its own ends, and will gradually control all info and pay a huge number of workers to write, speak, publish and advise what can only be called BS, what suits The Gvmt at that point.

Mussolini never even dreamt of such powers, the world was different then.

g510, yes.

CDC and anthrax: so why didn't they come out and say, our protocols are this and that, they failed, sorry, we will do better next time, we are not up to date, we need to x y and z, that the postal workers died is sad, our failure? Nope. Not as far as I know. No moving forward on that one.

Revere: I am sorry, I know you are "revered" and especially here on your website, but your statements are a bit misleading. First you say:
"Those requirements are designed to prevent breakage and spillage of specimens shipped through the mail." This makes it sound like they are for "specimens" that might "break or spill". Like something in liquid or glass containers. However, they are for the shipping of ALL biological specimens. The identical WHO protocols, upon which the CDC and all the other protocols (DOT, USPS etc) are based were apparently developed related to the shipping of anthrax,as the great majority of the references that WHO cites in relation to these mailing requirements are research papers on anthrax. And these shipping requirements are not just for "weapons grade" anthrax.

Further, a junior high school student studying basic use of the microscope would know that microorganisms the size of bacteria spores could easily escape through the pores in ordinary paper. Yet you go on to claim:

"The envelopes were sealed and CDC didn't realize two things: that weaponized spores could escape sealed envelopes when they passed through sorting machines; and that the infective dose was much smaller than they were assuming."

This is not a simple error. They can not excuse this by saying they didn't know they were dealing with weapons grade anthrax, especially as several people had died of inhalation anthrax by this time.
This is complicity.

By mary in hawaii (not verified) on 13 Sep 2006 #permalink

To all of you who are sure the CDC "knew" in early October 2001 that anthrax spores could pass through sealed envelopes:

Check out this New York Times article from January 6, 2002: "Anthrax Missteps Offer Guide to Fight Next Bioterror Battle" at: http://tinyurl.com/qxpd7

The article describes how a researcher at one of Canada's Defense Research Establishment labs, Bill Kournikakis, had done unpublished (as of October 2001) work showing that anthrax spores could escape from sealed envelopes.

When Dr. Kournikakis heard about the inhalation anthrax cases and their relationship to mail, he tried very hard -- he said -- to get through to CDC to tell them about his research. But he claims he could not get through.

I have always found that unconvincing; he could have gone urgently up the chain of command, rather than trying to get through to CDC himself on its busiest day.

I am, however, convinced that CDC officials did not know that a significant number of anthrax spores could escape a sealed envelope.

I personally know several senior CDC officials who experienced months of anguish because they had reassured postal workers that the spores could not escape -- and they turned out wrong.

By Path Forward (not verified) on 14 Sep 2006 #permalink

PF: Thank you for the comment (which I agree with, not surprisingly). I remember the flap about the Canadian paper, which was notable because it was counterintuitive. If you put powder in a sealed envelope it stays in a sealed envelope. I am willing to bet that ordinary anthrax spores also won't pass through a sealed envelope. Weaponized spores are in a physically different form.

The demonizing of CDC is a bad idea. Being incompetent, screwing up, making very bad mistakes, being mismanaged are one set of things. Knowingly ignoring peril to fellow federal employees is quite another. Like PF I know many CDC employees, past and current. That's just not what is happening in that sad agency. They are being wrecked but they aren't the kind of evil outfit that is being made out here.

The pattern of exposure in the Brentwood Mail facility came from using compressed air to clean out the automated sorting machines. Those machines compressed the sorted envelopes in ways that spores got through them. This wasn't ordinarily handling. The big issue here was failure to understand the dose response relationship, something CDC should have known and didn't, even though some of us were saying so at the time and doing it publicly.

Revere,
I agree that "ordinary" anthrax spores would have difficulty escaping from a sealed envelope. They just like to clump up. Probably a natural selection feature related to the infective dose for cattle or something.

But I have to disagree with the difficulty in producing "weaponized" anthrax. It is dangerous, but fairly easy. In fact, frighteningly easy.

Apparently the recent departure of SG Carmona may well be another example of "malevolent incompetence" and hostility to any scientific "aggression" towards business or government - second hand smoke research in this case. Any scuttlebutt on your edge of the web Revere?

By tympanachus (not verified) on 15 Sep 2006 #permalink