To us specialists in Infectious Diseases, there are certain verities we hold near and dear to our hearts:
- Antibiotics are miracle drugs, but the bugs will become resistant if we don’t use them responsibly.
- Certain childhood vaccines (e.g., measles, polio, H flu type B) stand as some of the greatest scientific accomplishments in human history.
- To understand infectious risks, you have to have good data, carefully sourced and analyzed.
Number 3 is why this week’s non-publication of the Morbidity and Mortality Weekly Report (MMWR) came as such a shock. MMWR is the CDC’s primary way of publishing and communicating important data for public health. It didn’t go out because of a communications pause at federal health agencies issued by the new administration. The gap in publication marks the first time in its more than 60-year history that the CDC didn’t release a new issue.
Want an example of how useful the MMWR is for us ID people? Here’s a good one:
Highlighted in red, dear friends, is the first report of the disease now known as AIDS occurring in five previously healthy gay men in Los Angeles. The text from this account has always struck me as a perfect example of careful but prescient scientific reporting:
The occurrence of pneumocystosis in these 5 previously healthy individuals without a clinically apparent underlying immunodeficiency is unusual … All the observations suggest the possibility of a cellular immune dysfunction related to a common exposure that predisposes individuals to opportunistic infections.
Spot-on accurate. The second MMWR detailing more AIDS cases occurred less than a month later. Remember, these publications appeared 2 years before the discovery of HIV, the virus that causes the disease.
Subsequent MMWR reports on the rising incidence of AIDS, the populations at risk, and the strong epidemiologic evidence for modes of transmission played key roles in figuring out what was happening on a national and global level. We knew even before the virus was discovered that sexual, perinatal, and blood-borne infection were all implicated, and that household and other “casual” contact posed little, if any, risk.
Want more recent examples of infectious threats all reported in MMWR? A partial list:
- SARS
- MERS
- Zika
- Ebola
- Chikungunya
- Candida auris
- Mpox
- H5N1 avian influenza
- Innumerable food-borne outbreaks
- And yes, of course, COVID-19
I put COVID-19 last because I strongly believe this is the primary motivation for the communications pause issued by the new administration. The pandemic was so horrifically disruptive — so traumatic — to our society that we’re still grappling with the best way to deal with it.
And one unfortunate coping mechanism is the urge to scapegoat individuals and organizations for what happened. The CDC and its publications were often in the center of this storm, and some now want to blame them for all that they were unhappy about.
Was CDC perfect? Of course not. But they tirelessly worked to get things right, and reported abundant COVID-19 data on case numbers, hospitalizations, deaths, and vaccinations that we all turned to regularly. To expect, in hindsight, that they would do so infallibly is setting an impossible standard — one no organization, government or otherwise, can meet.
Apparently, the MMWR staff are still at work, so let’s hope that the pause in communication is brief. There always will be infectious threats out there, with H5N1 avian influenza now being foremost on our minds. It’s only through careful and regular reporting of data that we can face these threats responsibly.
