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Keeping a Watchful Eye on the CDC

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Recently, our Dallas-based study club held an online meeting about where to find authoritative information during the COVID-19 pandemic. It was noted the Texas State Board of Dental Examiners recommends the U.S. Center for Disease Control and Prevention (CDC) as the go-to agency for this data. Several of our members expressed concern about this choice.

Think about that for a minute. The CDC is the world’s premier health agency, and yet members were questioning some of its information. Why? Concerns were expressed that the agency had not been living up to its impartial reputation. Reservations began with the handling of the first known U.S. case of COVID-19. The patient traveled to Washington State from Wuhan, China, the center of the outbreak. For unspecified reasons, the CDC only tested and followed a few individuals who were exposed to the patient, leading to a widespread outbreak. It later delayed testing in New York City — with devastating results. While it is conjecture, perhaps at this stage the CDC did not fully understand — or at least underestimated — the contagion factor.

It was also noted the agency had developed a test for the virus, while apparently suppressing the use of other tests. Unfortunately, just as it was ready to ship the kits, the CDC discovered some of the reagents had been contaminated. These are chemicals used to test swab samples, and, like assays used in testing, were already in short supply.

Where do providers turn for trusted data?

Some opined the agency’s lack of consistent guidance had negatively affected their practices. For example, early in the outbreak, the CDC said N-95 respirators were indicated only when treating symptomatic patients. This ruling was changed after it was discovered many COVID-positive patients were not symptomatic — although it quickly became evident widespread use of N-95 respirators was not possible due to shortages. The CDC then changed recommendations to allow the use of less-protective masks, including those made of cloth. What was the scientific rationale for these decisions? Was the agency acting on new information in a rapidly evolving situation, or were recommendations softened due to political pressure?

These observations suggest the need for critical thinking when considering any agency’s guidance. For perspective, it is helpful to remember the CDC is a division of the Department of Health and Services, and its director is a presidential appointee. In its defense, the CDC has been underfunded for years and its systems for collecting and disseminating data are antiquated. That said, clinicians still need up-to-date information.

Where do providers turn for trusted data? Vetting information from multiple sources seems like the prudent course of action. One resource for objective information has been journals like this, which, through its daily COVID news alert (decisionsindentistry.com/covid-19), have provided a steady stream of new information. Professional organizations are another source for updates and guidance.

As the scientific community learns more about COVID-19, our understanding of appropriate responses will help curb transmission and support safe care. Moving forward, it will be important to keep a watchful eye on the CDC to ensure its recommendations are grounded in science. Only then can clinicians rely on this premier agency to guide us safely through the pandemic.

Thomas G. Wilson Jr., DDS
Editor in Chief
twilson@belmontpublications.com

From Decisions in Dentistry. October 2020;6(9):4.

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