The CDC review worries already underpinned public health departments

With the already exhausting rules of public planning and omicron surgery, some public health professionals have struggled


Drs. Michael Kilkenny did not anticipate the release of the Centers for Disease Control and Prevention he received on December 27.

Four days earlier, the CDC had cut the divisions of Covid medical staff into seven days, if they were asymptomatic and had negative tests. A new proclamation said people with Covid could separate themselves just five days after symptoms appeared, instead of 10.

"When we received a media report on the 27th that seemed to contradict the directive we received on the 23rd - that was a bomb for us," said Kilkenny, chief executive and health officer of the Cabell-Huntington Department of Health, who works for Huntington. , West Virginia, and the surrounding district.

Across the country, schools and health organizations struggled to interpret the news and adjusted their policies - they also changed course when the CDC filled in its details and reasons in a comprehensive guide published about a week later.

"That gap has left us guessing what we should do," Kilkenny said. “That is not good management and good communication. It leads to misunderstanding. It leads to mistrust. ”

The CDC's decision to reduce the duration of separation by half the majority of Covid-19 holders surprised public health facilities and left some struggling to explain to their communities what these changes meant and why they made government officials. The gaps in communication between government, state and local officials have left some public health leaders fearful that they have lost trust in those they serve in the midst of public confusion.

In the interviews, three local community health leaders, one country leader and two leaders of medical organizations provided a mix of responses to the recent changes of the CDC: frustration due to lack of communication but also understanding that every public health official faces challenges in making timely changes and contributions. clear direction. No one challenged the direction itself.

"We have been helped by the hospitals, in particular, with great concern about how we will be able to keep the surgery going," said Drs. Philip Huang, director of the Department of Health and Human Services in Dallas County, Texas, said the agency was looking at changes in geographical segregation procedures and segregation procedures before the CDC made its recommendations. “Was it worth it? No. I do think, though, that these are wonderful times with many ups and downs. ”

The rapid spread of the omicron variant has intensified the epidemic in public health officials: How to move quickly while sending clear and consistent messages to a tired community. It did not help that this type of start started when many were hoping it would be a holiday.

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As the omicron took over in December, government officials responded with a number of changes.

First, the CDC summarized its solitary confinement recommendations for Covid-positive health workers to seven days after a negative evaluation on December 23. It said health workers who received stimulant guns did not need solitary confinement after exposure.

Then, on December 27, the organization announced in a press release that it would reduce the separation period to five days if the symptoms were resolved, and another five days to cover the face.

The institute did not publish a full review and reason for the new policies until Jan. 4, where we also clarify the policies of special groups such as those in health care, prisons and homeless shelters.

Some health experts have criticized the policies, which do not meet the needs of the general public. Meanwhile, many in the community expressed confusion.

Government officials have said they have changed guidelines about concerns that the spread of the omicron will shut down vital resources and because they believe most of the virus is likely to occur early in the infection.

But local officials say they have been left in the dark about what they should have told members of their community who have questions about the new advice.

"The press release on Dec. 27 surprised me," said Kilkenny, who added that he hopes the agency will make sound scientific decisions and that it is following the agency's recommendations almost religiously. “We work with leadership. We are not working on media releases. ”

Lori Freeman, chief executive of the National Association of County and City Health Officials (NACCHO), said the CDC often communicated early on major policy changes. That did not happen at this time.

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"There were no places to talk, if you like, or details about the changing direction," Freeman said, adding that local health officials "had difficulty answering questions and responding in a constructive or informed way."

That left some officials in a state of shock.

"The more inconsistent it seems, the more people begin to question the real guide," Freeman said.

And local community health leaders are concerned that their impact on vital health systems has already dropped dramatically.

“Most of our community is not listening at all. Certainly, I will not be able to get more people to be vaccinated or to wear a mask than they do now based on whatever I say, ”said Kilkenny.

Michael Fraser, executive director of the Association of State and Territorial Health Official, said the omicron had become an emergency situation, during the holiday season when tired public health officials and the rest of the country longed for a vacation.

But the omicron was spreading so fast that it became, in his opinion, terrifying.