The Centers for Disease Control and Prevention (CDC) was set up in part to act as a leader for state and local public health officials and doctors on the ground in moments of crisis. But during this pandemic, the CDC has been more reactive than proactive, waffling on the guidance it issues and causing some to question whether the agency has become politicized. It’s put experts who are supposed to rely on the CDC in a tough position. Dr. Nahid Bhadelia, director of the Special Pathogens Unit at Boston Medical Center and a professor at the Boston University School of Medicine, discussed the CDC’s recent issues with GBH All Things Considered host Arun Rath. This transcript has been edited for clarity.
Arun Rath: So the latest example of the CDC seeming to not know exactly what it’s doing came recently: On Friday, they put language up on their website saying that it’s possible that aerosol transmission of the coronavirus is one of the most common ways the virus is spread. That language was pulled on Monday — the CDC says that it came from a draft that was published in error. So just taking this latest example, where does something like that leave you?
Dr. Nahid Bhadelia: Yeah, great question. I think it’s probably important to start with, what is all this brouhaha about? What are we talking about? And so the gist of this is that, as months have gone, our understanding of this virus and how it’s transmitted has grown. We’ve always known that this is a respiratory virus. It had been thought that the main route and potentially the only route to transmit this virus is when people speak or breathe when they’re infected, or talk or sing. They are expelling that virus in their environment, but the virus tends to drop down close to where they are, within six feet, through droplets. So it’s transmitted if you’re in close proximity to somebody.
What we’re realizing over time — and there’s been signals even from the spring — is that in some settings, when people are in an enclosed area and they’re not wearing a mask, the virus actually travels in smaller particles. It goes farther into the room, up to 20 feet in some studies, and it lasts longer in the room. So what we’re saying is that it could potentially, in some settings, be airborne. And if that’s true, even if it’s a smaller number of settings than what we see transmitted in droplets, that means that any indoor settings are even more dangerous than we thought before. We already know that indoor settings are about 20 times more dangerous than outdoor settings, more likely to cause transmissions. And so the CDC, by admitting that they know this is potentially a route of transmission, is saying that then we have to think about what that means. That means that every place where we do instruction indoors, where we take care of patients indoors, where we conduct business indoors, we need to think about what else we need to do to make those environments safer.
Within the health care setting for us, for example, does that mean that we need now to use N95 masks in every scenario where we might encounter somebody who’s infected? Does that mean for the general public that they need higher quality masks than what we’ve been seeing so far? But the big important parts of this is the distances between people, how long people are indoors, and ventilation — particularly when you think about things like schools and things like that. You can see why this is a big deal, because it has a huge impact. If you admit to the fact that there is, as we all now know, this potential the virus could be airborne, then that means we need to think about how we change the rest of the guidelines and make things safer for everybody.
The thing that’s worrisome about this change is that it’s just this one in a line of many changes that we’ve seen the CDC do that make experts like me worry that they have lost their independence, that they’re being potentially politicized. Because admitting these things would then suggest everybody should wear a mask, we should mandate masks, we should support schools in a better way. And so are they getting pressured for political reasons? That’s the concern.
Rath: Everything you’re saying about aerosolization feels very uncontroversial from what we’ve been seeing and hearing about virus transmission, everything we’ve learned over the summer. The reason we’re talking about ventilation in schools right now is because of all of that. So is it as strange as it seems that the CDC would back off from saying something that seems fairly well established?