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Centers for Disease Control and Prevention - History

Centers for Disease Control and Prevention - History


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Centers for Disease Control and Prevention

Its annual budget reflects political pressure and interests of the pharmaceutical industry rather than the incidence of disease and health problems among Americans. There have been frequent complaints of conflicts of interest by officials at the CDC. The CDC has made many high-profile mistakes in recommending vaccines wanted by the pharmaceutical industry, such as the Lyme disease vaccine, the rotavirus vaccine and the swine flu vaccine, all of which were later pulled from the market.

In mishandling the coronavirus crisis, the totalitarian CDC insisted on using its own defective testing rather than allow superior private testing to be done, which would have helped minimized the spread of the disease at a crucial time. In addition, on April 13, 2020, Dr. Annie Bukachek, citing a memo from the CDC dated March 24, [2] indicated that the CDC deliberately overcounted deaths caused by COVID-19 by telling doctors to count anyone who had COVID-19 in their system at the time of death as a COVID-19 death, regardless of the actual cause of death. [3] Even worse, leaked emails revealed that the CDC's policy regarding school systems was influenced more by the American Federation of Teachers more than in science. [4]

Founded in 1946, the CDC is based in Atlanta. [5] Atlanta was chosen as its first act was to handle the growing malaria problem Atlanta was located in the center of the malaria outbreak. It remained there due in large part to the work of Coca-Cola (also based in Atlanta): the CEO of the company made a deal with Emory University to sell some of its land at a highly discounted price.


From Malaria Control to a Larger Purpose

By the 1940s, communications and graphic styles had evolved into direct, no-nonsense messages—far from the dramatic illustrations used in the late 19th century to depict serious health issues (such as the Harper’s Weekly drawing on page 16). The cover of this yearly progress report left no doubt about the subject matter: the relationship between malaria control and mosquitoes. This book contains numerous examples of successful posters produced by the US Public Health Service and CDC to communicate with the public about urgent health issues in a simple, easy-to-understand manner.

Organized on July 1, 1946, The Centers for Disease Control evolved from a World War II agency, the Office of Malaria Control in War Areas (MCWA), a program within the US Public Health Service (PHS). Established in 1942, MCWA’s primary job was malaria control and prevention in areas around military bases and industrial sites tasked with production related to World War II. These “war areas” were primarily located in 15 southeastern states, Puerto Rico, the Virgin Islands, and Caribbean areas related to the United States. Once World War II was over, the federal government converted MCWA operations from war-related efforts to addressing more general communicable disease problems that affect the nation as a whole, and MCWA became the Communicable Disease Center (CDC), with headquarters in Atlanta, Georgia. It is fitting that CDC emerged from a wartime effort, because from its inception, it has been waging war against the world’s gravest health threats and medical mysteries.

A brief glimpse at the nation’s public health landscape prior to the creation of CDC may offer added appreciation for the agency’s stunning accomplishments over the years.

When the country’s founders formed the United States, the 13 original colonies were primarily seaports on the Atlantic Coast with outlying small towns inland. The colonies had local sanitation laws and were keenly aware of diseases being carried on ships sailing to the New World. Even after the formal creation of the United States, public health was not addressed by the government the US Constitution makes no mention of it. However, following a yellow fever epidemic in 1798, Pres. John Adams signed the first federal public health law, which created the Marine Hospital Service (MHS) for merchant seamen—a forerunner of the modern PHS. This law imposed a monthly hospital tax of 20¢ that was deducted from the pay of merchant seamen for the care of sick seamen and the building of independently operated Marine hospitals. An amending act to the legislation of 1798 extended MHS benefits to officers and enlisted men of the US Navy. MHS was also responsible for the medical inspection of immigrants, the supervision of national quarantine, and prevention and control of the interstate spread of diseases such as yellow fever, cholera, and smallpox.

Throughout the 18th and 19th centuries, diseases ran rampant due to poor sanitation and the limited availability of doctors. Most family illnesses were treated at home using homemade herbal remedies. Often, if no cause for an epidemic was known, people simply waited until it had run its course. Although “doctors” were officially recognized in 1769, they were only educated to take care of broken bones and to prescribe herbs and hard liquor that would vanquish evil spirits. Few doctors had any formal training most learned from other physicians in an informal setting.

In 1902, Congress enacted a bill to increase the efficiency and change the name of the Marine Hospital Service to the Public Health and Marine Hospital Service. The law authorized the establishment of specified administrative divisions and, for the first time, designated a bureau of the federal government as an agency in which public health matters could be coordinated. In 1912, it simply became the US Public Health Service, broadening the PHS research program to include “disease of man” and contributing factors such as pollution of navigable streams and information dissemination. By the early 20th century, some progress had been made in treating communicable diseases, but epidemics—such as the plague that hit San Francisco in the early 1900s and the global Spanish influenza epidemic in 1918 and 1919—showed that despite PHS efforts, there was still much to be done to address health emergencies.

When the Centers for Disease Control was created in 1946, the fledgling program had an ambitious agenda, but with a core staff of only 430 and a budget of $1.6 million, it faced formidable challenges. Dr. Joseph Mountin, a visionary leader in the PHS, hoped to expand CDC’s interests to include all communicable diseases and to provide guidance and practical help to all entities associated with the United States. World-class scientists soon began filling CDC’s laboratories, and many states and foreign countries sent staff members to Atlanta for training. Although the new agency was making headway in the prevention and control of malaria, typhus, and yellow fever, Dr. Mountin was not satisfied with this progress and impatiently pushed the staff to do more. He reminded them that CDC was responsible for any communicable disease. To survive, it had to become a center for epidemiology.

In 1949, Dr. Alexander Langmuir came to CDC to head the epidemiology division. He quickly organized a disease surveillance system that would ultimately become the cornerstone of CDC. The threat of biological warfare that loomed after the outbreak of the Korean War in 1950 led to the organization of CDC’s Epidemic Intelligence Service (EIS). EIS officers were charged with guarding against ordinary threats to public health while simultaneously watching for new and emerging infectious diseases.

The first class of EIS officers began work in 1951, pledging to go wherever they were needed over the following two years. They quickly became known as “disease detectives.” Using “shoe-leather epidemiology,” they traveled door-to-door in areas suffering from a disease outbreak to gather surveillance data, literally making house calls around the world. There were 23 recruits in the first EIS class: 22 physicians and one sanitary engineer. Today, classes of around 80 EIS officers are given two-year assignments domestically and internationally. Classes are composed of medical doctors, veterinarians, nurses, researchers, dentists, and scientists. In addition to working with CDC public health advisors in global disease “hot spots,” the majority of EIS graduates work with state and local health departments to address a broad spectrum of health challenges including chronic disease, injury prevention, violence, environmental health, occupational safety and health, and maternal and child health, as well as infectious diseases.


Contents

Establishment Edit

The Communicable Disease Center was founded July 1, 1946, as the successor to the World War II Malaria Control in War Areas program [6] of the Office of National Defense Malaria Control Activities. [7]

Preceding its founding, organizations with global influence in malaria control were the Malaria Commission of the League of Nations and the Rockefeller Foundation. [8] The Rockefeller Foundation greatly supported malaria control, [8] sought to have the governments take over some of its efforts, and collaborated with the agency. [9]

The new agency was a branch of the U.S. Public Health Service and Atlanta was chosen as the location because malaria was endemic in the Southern United States. [10] The agency changed names (see infobox on top) before adopting the name Communicable Disease Center in 1946. Offices were located on the sixth floor of the Volunteer Building on Peachtree Street. [11]

With a budget at the time of about $1 million, 59 percent of its personnel were engaged in mosquito abatement and habitat control with the objective of control and eradication of malaria in the United States [12] (see National Malaria Eradication Program).

Among its 369 employees, the main jobs at CDC were originally entomology and engineering. In CDC's initial years, more than six and a half million homes were sprayed, mostly with DDT. In 1946, there were only seven medical officers on duty and an early organization chart was drawn, somewhat fancifully, in the shape of a mosquito. Under Joseph Walter Mountin, the CDC continued to advocate for public health issues and pushed to extend its responsibilities to many other communicable diseases. [13]

In 1947, the CDC made a token payment of $10 to Emory University for 15 acres (61,000 m 2 ) of land on Clifton Road in DeKalb County, still the home of CDC headquarters as of 2019. CDC employees collected the money to make the purchase. The benefactor behind the "gift" was Robert W. Woodruff, chairman of the board of The Coca-Cola Company. Woodruff had a long-time interest in malaria control, which had been a problem in areas where he went hunting. The same year, the PHS transferred its San Francisco based plague laboratory into the CDC as the Epidemiology Division, and a new Veterinary Diseases Division was established. [6]

Growth Edit

An Epidemic Intelligence Service (EIS) was established in 1951, originally due to biological warfare concerns arising from the Korean War it evolved into two-year postgraduate training program in epidemiology, and a prototype for Field Epidemiology Training Programs (FETP), now [ when? ] found in numerous countries, reflecting CDC's influence in promoting this model internationally. [14]

The mission of the CDC expanded beyond its original focus on malaria to include sexually transmitted diseases when the Venereal Disease Division of the U.S. Public Health Service (PHS) was transferred to the CDC in 1957. Shortly thereafter, Tuberculosis Control was transferred (in 1960) to the CDC from PHS, and then in 1963 the Immunization program was established. [15]

It became the National Communicable Disease Center (NCDC) effective July 1, 1967, and the Center for Disease Control (CDC) on June 24, 1970. At the end of the Public Health Service reorganizations of 1966–1973, it was promoted to being a principal operating agency of PHS. It was renamed the Centers for Disease Control effective October 14, 1980. [7] In 1987, the National Center for Health Statistics became part of CDC. [16] An act of the United States Congress appended the words "and Prevention" to the name effective October 27, 1992. However, Congress directed that the initialism CDC be retained because of its name recognition. [17]

Since the 1990s, the CDC focus has broadened to include chronic diseases, disabilities, injury control, workplace hazards, environmental health threats, and terrorism preparedness. CDC combats emerging diseases and other health risks, including birth defects, West Nile virus, obesity, avian, swine, and pandemic flu, E. coli, and bioterrorism, to name a few. The organization would also prove to be an important factor in preventing the abuse of penicillin. In May 1994 the CDC admitted having sent samples of communicable diseases to the Iraqi government from 1984 through 1989 which were subsequently repurposed for biological warfare, including Botulinum toxin, West Nile virus, Yersinia pestis and Dengue fever virus. [18]

Recent history Edit

On April 21, 2005, then–CDC Director Julie Gerberding formally announced the reorganization of CDC to "confront the challenges of 21st-century health threats". [19] She established four Coordinating Centers. In 2009 the Obama Administration re-evaluated this change and ordered them cut as an unnecessary management layer. [20]

As of 2013, the CDC's Biosafety Level 4 laboratories are among the few that exist in the world. [21] They constitute one of only two official repositories of smallpox in the world. The second smallpox store resides at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation. In 2014, the CDC revealed they had discovered several misplaced smallpox samples while their lab workers were 'potentially infected' with anthrax. [22]

The city of Atlanta annexed the property of the CDC headquarters effective January 1, 2018, as a part of the city's largest annexation within a period of 65 years the Atlanta City Council had voted to do so the prior December. [3] The CDC had requested that the Atlanta city government annex the area. The headquarters were located in an unincorporated area, [23] statistically in the Druid Hills census-designated place. [24]

The CDC is organized into "Centers, Institutes, and Offices" (CIOs), with each organizational unit implementing the agency's activities in a particular area of expertise while also providing intra-agency support and resource-sharing for cross-cutting issues and specific health threats. Generally, CDC "Offices" are subdivided into Centers, which in turn are composed of Divisions and Branches. [6] However, the Center for Global Health and the National Institute for Occupational Safety and Health are freestanding organizational units and do not belong to a parent Office.

As of August 2019, the CIOs are:

  • Director
    • Principal Deputy Director
      • Deputy Director – Public Health Service and Implementation Science
        • Office of Minority Health and Health Equity
        • Center for Global Health
        • Center for Preparedness and Response
        • Center for State, Tribal, Local, and Territory Support
        • Office of Science
        • Office of Laboratory Science and Safety
        • Center for Surveillance, Epidemiology, and Laboratory Services
        • National Center on Birth Defects and Developmental Disabilities
        • National Center for Chronic Disease Prevention and Health Promotion
        • National Center for Environmental Health and Agency for Toxic Substances and Disease Registry
        • Chief of Staff
        • Chief Operating Officer
          • Human Resources Office
          • Office of Financial Resources
          • Office of Safety, Security, and Asset Management
          • Office of the Chief Information Officer

          The Office of Public Health Preparedness was created during the 2001 anthrax attacks shortly after the terrorist attacks of September 11, 2001. Its purpose was to coordinate among the government the response to a range of biological terrorism threats. [26]

          Locations Edit

          Most CDC centers are located in Atlanta. A few of the centers are based in or operate other domestic locations: [27]

          • The National Center for Emerging and Zoonotic Infectious Diseases' Division of Vector-Borne Diseases is based in Fort Collins, Colorado, with a branch in San Juan, Puerto Rico its Arctic Investigations Program is based in Anchorage, Alaska.
          • The National Center for Health Statistics is primarily located in Hyattsville, Maryland, with a branch in Research Triangle Park in North Carolina.
          • The National Institute for Occupational Safety and Health's primary locations are Cincinnati, Ohio Morgantown, West Virginia Pittsburgh, Pennsylvania Spokane, Washington and Washington, D.C., with branches in Denver, Anchorage, and Atlanta.
          • The CDC Washington Office is based in Washington, D.C.
          • Building 18, which opened in 2005 at the CDC's main Roybal campus (named in honor of the late Representative Edward R. Roybal), contains the premier BSL4 laboratory in the United States. [28][29][30]

          In addition, CDC operates quarantine facilities in 20 cities in the U.S. [31]

          CDC's budget for fiscal year 2018 is $11.9 billion. [32] The CDC offers grants that help many organizations each year advance health, safety and awareness at the community level throughout the United States. The CDC awards over 85 percent of its annual budget through these grants. [33]

          As of 2021 [update] , CDC staff numbered approximately 15,000 personnel (including 6,000 contractors and 840 United States Public Health Service Commissioned Corps officers) in 170 occupations. Eighty percent held bachelor's degrees or higher almost half had advanced degrees (a master's degree or a doctorate such as a PhD, D.O., or M.D.). [34]

          Common CDC job titles include engineer, entomologist, epidemiologist, biologist, physician, veterinarian, behavioral scientist, nurse, medical technologist, economist, public health advisor, health communicator, toxicologist, chemist, computer scientist, and statistician. [35]

          The CDC also operates a number of notable training and fellowship programs, including those indicated below.

          Epidemic Intelligence Service (EIS) Edit

          The Epidemic Intelligence Service (EIS) is composed of "boots-on-the-ground disease detectives" who investigate public health problems domestically and globally. [36] When called upon by a governmental body, EIS officers may embark on short-term epidemiological assistance assignments, or "Epi-Aids", to provide technical expertise in containing and investigating disease outbreaks. [37] [38] [39] The EIS program is a model for the international Field Epidemiology Training Program.

          Public Health Associates Program Edit

          The CDC also operates the Public Health Associate Program (PHAP), a two-year paid fellowship for recent college graduates to work in public health agencies all over the United States. PHAP was founded in 2007 and currently [ when? ] has 159 associates in 34 states. [40]

          The Director of CDC is a Senior Executive Service position [41] that may be filled either by a career employee, or as a political appointment that does not require Senate confirmation, with the latter method typically being used. The director serves at the pleasure of the President and may be fired at any time. [42] [43] [44] The CDC director concurrently serves as the Administrator of the Agency for Toxic Substances and Disease Registry. [45]

          Twenty directors have served the CDC or its predecessor agencies, including three who have served during the Trump administration (including Anne Schuchat who twice served as acting director). [7] [46]

            Jr., MD (1942–1943) , ScD (1944–1946) , MD (1947–1951) , ScD (1952–1953) , MD (1953–1956) , MD, MPH (1956–1960) , MD, MPH (1960–1962) , MD, MPH (1962–1966) , MD, MPH (1966–1977) , MD, MPH (1977–1983) , MD, MPH, Ph.D (1983–1989) , MD, MPH (1990–1993) , MD, PhD (1993–1998) , MD, MPH (1998–2002) [47] , MD, MPH (2002–2008) , MD, MPH (2009 – Jan 2017) [42] , MD, RADMUSPHS (acting, Jan–July 2017) [48] , MD (July 2017 – Jan 2018) [49] , MD (acting, Jan–Mar 2018) , MD (March 2018–Jan 2021) [50] , MD, MPH (Jan 2021–present)
          • CDC Scientific Data, Surveillance, Health Statistics, and Laboratory Information. [51] (BRFSS), the world's largest, ongoing telephone health-survey system. [52] . [53][54]
          • CDC WONDER (Wide-ranging ONline Data for Epidemiologic Research)[2]
          • Data systems of the National Center for Health Statistics[3]

          Communicable diseases Edit

          The CDC's programs address more than 400 diseases, health threats, and conditions that are major causes of death, disease, and disability. The CDC's website has information on various infectious (and noninfectious) diseases, including smallpox, measles, and others.

          Influenza Edit

          The CDC targets the transmission of influenza, including the H1N1 swine flu, and launched websites to educate people about hygiene. [55]

          Division of Select Agents and Toxins Edit

          Within the division are two programs: the Federal Select Agent Program (FSAP) and the Import Permit Program. The FSAP is run jointly with an office within the U.S. Department of Agriculture, regulating agents that can cause disease in humans, animals, and plants. The Import Permit Program regulates the importation of "infectious biological materials." [56]

          The CDC runs a program that protects the public from rare and dangerous substances such as anthrax and the Ebola virus. The program, called the Federal Select Agent Program, calls for inspections of labs in the U.S. that work with dangerous pathogens. [57]

          During the 2014 Ebola outbreak in West Africa, the CDC helped coordinate the return of two infected American aid workers for treatment at Emory University Hospital, the home of a special unit to handle highly infectious diseases. [58]

          As a response to the 2014 Ebola outbreak, Congress passed a Continuing Appropriations Resolution allocating $30,000,000 towards CDC's efforts to fight the virus. [59]

          Non-communicable diseases Edit

          The CDC also works on non-communicable diseases, including chronic diseases caused by obesity, physical inactivity and tobacco-use. [60]

          Antibiotic resistance Edit

          The CDC implemented their National Action Plan for Combating Antibiotic Resistant Bacteria as a measure against the spread of antibiotic resistance in the United States. This initiative has a budget of $161 million and includes the development of the Antibiotic Resistance Lab Network. [61]

          Global health Edit

          Globally, the CDC works with other organizations to address global health challenges and contain disease threats at their source. They work with many international organizations such as the World Health Organization (WHO) as well as ministries of health and other groups on the front lines of outbreaks. The agency maintains staff in more than 60 countries, including some from the U.S. but more from the countries in which they operate. [62] The agency's global divisions include the Division of Global HIV and TB (DGHT), the Division of Parasitic Diseases and Malaria (DPDM), the Division of Global Health Protection (DGHP), and the Global Immunization Division (GID). [63]

          The CDC is integral in working with the WHO to implement the International Health Regulations (IHR), an agreement between 196 countries to prevent, control, and report on the international spread of disease, through initiatives including the Global Disease Detection Program (GDD). [64]

          The CDC is also a lead implementer of key U.S. global health initiatives such as the President's Emergency Plan for AIDS Relief (PEPFAR) and the President's Malaria Initiative. [65]

          Travelers' health Edit

          The CDC collects and publishes health information for travelers in a comprehensive book, CDC Health Information for International Travel, which is commonly known as the "yellow book." [66] The book is available online and in print as a new edition every other year and includes current travel health guidelines, vaccine recommendations, and information on specific travel destinations. The CDC also issues travel health notices on its website, consisting of three levels:

          "Watch": Level 1 (practice usual precautions)

          "Alert": Level 2 (practice enhanced precautions)

          "Warning": Level 3 (avoid nonessential travel) [67]

          Vaccine safety Edit

          The CDC monitors the safety of vaccines in the U.S. via the Vaccine Adverse Event Reporting System (VAERS), a national vaccine safety surveillance program run by CDC and the FDA. "VAERS detects possible safety issues with U.S. vaccines by collecting information about adverse events (possible side effects or health problems) after vaccination." [68] The CDC's Safety Information by Vaccine page provides a list of the latest safety information, side effects, and answers to common questions about CDC recommended vaccines. [69]

          The CDC Foundation operates independently from CDC as a private, nonprofit 501(c)(3) organization incorporated in the State of Georgia. The creation of the Foundation was authorized by section 399F of the Public Health Service Act to support the mission of CDC in partnership with the private sector, including organizations, foundations, businesses, educational groups, and individuals. [70] [71]

          Tuskegee study of untreated syphilis in Black men Edit

          For 15 years, the CDC had direct oversight over the Tuskegee syphilis experiment. [72] In the study, which lasted from 1932 to 1972, a group of Black men (nearly 400 of whom had syphilis) were studied to learn more about the disease. The disease was left untreated in the men, who had not given their informed consent to serve as research subjects. The Tuskegee Study was initiated in 1932 by the Public Health Service, with the CDC taking over the Tuskegee Health Benefit Program in 1995. [72]

          Gun violence Edit

          An area of partisan dispute related to CDC funding is studying firearms effectiveness. Although the CDC was one of the first agencies to study gun violence as a public health issue, in 1996 the Dickey Amendment, passed with the support of the National Rifle Association, states "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control". [73] Advocates for gun control oppose the amendment and have tried to overturn it. [74]

          Looking at the history of the passage of the Dickey Ammendment, in 1992, Mark L. Rosenberg and five CDC colleagues founded the CDC's National Center for Injury Prevention and Control, with an annual budget of approximately $260,000. They focused on "identifying causes of firearm deaths, and methods to prevent them". [75] Their first report, published in the New England Journal of Medicine in 1993 entitled "Guns are a Risk Factor for Homicide in the Home", reported "mere presence of a gun in a home increased the risk of a firearm-related death by 2.7 percent, and suicide fivefold—a "huge" increase." [75] In response, the NRA launched a "campaign to shut down the Injury Center." Two conservative pro-gun groups, Doctors for Responsible Gun Ownership and Doctors for Integrity and Policy Research joined the pro-gun effort, and, by 1995, politicians also supported the pro-gun initiative. In 1996, Jay Dickey (R) Arkansas introduced the Dickey Amendment statement stating "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control" as a rider. [73] in the 1996 appropriations bill." [75] In 1997, "Congress re-directed all of the money for gun research to the study of traumatic brain injury." [75] David Satcher, CDC head 1993-98 before he was fired [76] advocated for firearms research. [75] In 2016 over a dozen "public health insiders, including current and former CDC senior leaders" told The Trace interviewers that CDC senior leaders took a cautious stance in their interpretation of the Dickey Amendment and that they could do more but were afraid of political and personal retribution. [75] Rosenberg told The Trace, "Right now, there is nothing stopping them from addressing this life-and-death national problem!" [75]

          In 2013, the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics sent a letter to the leaders of the Senate Appropriations Committee asking them "to support at least $10 million within the Centers for Disease Control and Prevention (CDC) in FY 2014 along with sufficient new taxes at the National Institutes of Health to support research into the causes and prevention of violence. Furthermore, we urge Members to oppose any efforts to reduce, eliminate, or condition CDC funding related to violence prevention research." [77] Congress maintained the ban in subsequent budgets. [74]

          COVID-19 Edit

          The first confirmed case of COVID-19 was discovered in the U.S. on January 20, 2020. [78] But widespread COVID-19 testing in the United States was effectively stalled until February 28, when federal officials revised a faulty CDC test, and days afterward, when the Food and Drug Administration began loosening rules that had restricted other labs from developing tests. [79] In February 2020, as the CDC's early coronavirus test malfunctioned nationwide, [80] CDC Director Robert R. Redfield reassured fellow officials on the White House Coronavirus Task Force that the problem would be quickly solved, according to White House officials. It took about three weeks to sort out the failed test kits, which may have been contaminated during their processing in a CDC lab. Later investigations by the FDA and the Department of Health and Human Services found that the CDC had violated its own protocols in developing its tests. [80] [81] In November 2020, NPR reported that an internal review document they obtained revealed that the CDC was aware that the first batch of tests which were issued in early January had a chance of being wrong 33 percent of the time, but they released them anyway. [82]

          In May 2020, The Atlantic reported that the CDC was conflating the results of two different types of coronavirus tests — tests that diagnose current coronavirus infections, and tests that measure whether someone has ever had the virus. The magazine said this distorted several important metrics, provided the country with an inaccurate picture of the state of the pandemic, and overstated the country's testing ability. [83]

          In July 2020, the Trump administration ordered hospitals to bypass the CDC and instead send all COVID-19 patient information to a database at the Department of Health and Human Services. Some health experts opposed the order and warned that the data might become politicized or withheld from the public. [84] On July 15, the CDC alarmed health care groups by temporarily removing COVID-19 dashboards from its website. It restored the data a day later. [85] [86] [87]

          In August 2020, the CDC recommended that people showing no COVID-19 symptoms do not need testing. The new guidelines alarmed many public health experts. [88] The guidelines were crafted by the White House Coronavirus Task Force without the sign-off of Anthony Fauci of the NIH. [89] [90] Objections by other experts at the CDC went unheard. Officials said that a CDC document in July arguing for "the importance of reopening schools" was also crafted outside the CDC. [91] On August 16, the chief of staff, Kyle McGowan, and his deputy, Amanda Campbell, resigned from the agency. [92] The testing guidelines were reversed on September 18, 2020, after public controversy. [93]

          In September 2020, the CDC drafted an order requiring masks on all public transportation in the United States, but the White House Coronavirus Task Force blocked the order, refusing to discuss it, according to two federal health officials. [94]

          In October, it was disclosed that White House advisers had repeatedly altered the writings of CDC scientists about COVID-19, including recommendations on church choirs, social distancing in bars and restaurants, and summaries of public-health reports. [95]

          In the lead up to 2020 Thanksgiving, at a press conference on November 20 the CDC advised Americans not to travel for the holiday saying, "It's not a requirement. It's a recommendation for the American public to consider." The White House coronavirus task force had its first public briefing in months on that date but travel was not mentioned. [96]

          Controversy over the Morbidity and Mortality Weekly Report Edit

          During the pandemic the CDC Morbidity and Mortality Weekly Report (MMWR) came under pressure from political appointees at the Department of Health and Human Services (HHS) to modify its reporting so as not to conflict with what Trump was saying about the pandemic. [97] Starting in June 2020, Michael Caputo, the HHS assistant secretary for public affairs, and his chief advisor Paul Alexander tried to delay, suppress, change, and retroactively edit MMR releases about the effectiveness of potential treatments for COVID-19, the transmissibility of the virus, and other issues where the president had taken a public stance. [97] Alexander tried unsuccessfully to get personal approval of all issues of MMWR before they went out. [98] Caputo claimed this oversight was necessary because MMWR reports were being tainted by "political content" he demanded to know the political leanings of the scientists who reported that hydroxychloroquine had little benefit as a treatment while Trump was saying the opposite. [97] In emails Alexander accused CDC scientists of attempting to "hurt the president" and writing "hit pieces on the administration". [99] In October 2020, emails obtained by Politico showed that Alexander requested multiple alterations in a report. The published alterations included a title being changed from "Children, Adolescents, and Young Adults" to "Persons." One current and two former CDC officials who reviewed the email exchanges said they were troubled by the "intervention to alter scientific reports viewed as untouchable prior to the Trump administration" that "appeared to minimize the risks of the coronavirus to children by making the report’s focus on children less clear." [100]

          Eroding trust in the CDC as a result of COVID-19 controversies Edit

          A poll conducted in September 2020 found that nearly 8 in 10 Americans trusted the CDC, a decrease from 87 percent in April 2020. Another poll showed an even larger drop in trust with the results dropping 16 percentage points. [101] As the trustworthiness eroded, so too did the information it disseminates. [92] The diminishing level of trust in the CDC and the information releases also incited "vaccine hesitancy" with the result that "just 53 percent of Americans said they would be somewhat or extremely likely to get a vaccine." [101]

          In September 2020, amid the accusations and the faltering image of the CDC the agency's leadership was called into question. Former Acting Director at the CDC, Richard Besser, said of Dr. Redfield that “I find it concerning that the CDC director has not been outspoken when there have been instances of clear political interference in the interpretation of science.” [102] In addition, Mark Rosenberg, the first director of CDC’s National Center for Injury Prevention and Control, also questioned Redfield's leadership and his lack of defense of the science. [102]

          Historically the CDC has not been a political agency, however, the COVID-19 pandemic, and specifically the Trump Administration's handling of the pandemic, resulted in a "dangerous shift" according to a previous CDC director and others. Four previous directors claim that the agency's voice was "muted for political reasons." [103] Politicization of the agency has continued into the Biden administration as COVID-19 guidance is contradicted by State guidance [104] and the agency is criticized as "CDC's credibility is eroding". [105]

          In 2021, the CDC, then under the leadership of the Biden Administration, received criticism for its mixed messaging surrounding COVID-19 vaccines, mask-wearing guidance, and the state of the pandemic. [106] [107]

          • CDC publications [108]
          • State of CDC report [109]
          • CDC Programs in Brief [110]
          • Morbidity and Mortality Weekly Report[111]
          • Emerging Infectious Diseases (monthly journal) [112]
          • Preventing Chronic Disease[113]

          Zombie Apocalypse campaign Edit

          On May 16, 2011, the Centers for Disease Control and Prevention's blog published an article instructing the public on what to do to prepare for a zombie invasion. While the article did not claim that such a scenario was possible, it did use the popular culture appeal as a means of urging citizens to prepare for all potential hazards, such as earthquakes, tornadoes, and floods. [114]

          According to David Daigle, the Associate Director for Communications, Public Health Preparedness and Response, the idea arose when his team was discussing their upcoming hurricane-information campaign and Daigle mused that "we say pretty much the same things every year, in the same way, and I just wonder how many people are paying attention." A social-media employee mentioned that the subject of zombies had come up a lot on Twitter when she had been tweeting about the Fukushima Daiichi nuclear disaster and radiation. The team realized that a campaign like this would most likely reach a different audience from the one that normally pays attention to hurricane-preparedness warnings and went to work on the zombie campaign, launching it right before hurricane season began. "The whole idea was, if you're prepared for a zombie apocalypse, you're prepared for pretty much anything," said Daigle. [115]

          Once the blog article was posted, the CDC announced an open contest for YouTube submissions of the most creative and effective videos covering preparedness for a zombie apocalypse (or apocalypse of any kind), to be judged by the "CDC Zombie Task Force". Submissions were open until October 11, 2011. [116] They also released a zombie-themed graphic novella available on their website. [117] Zombie-themed educational materials for teachers are available on the site. [118]


          Centers for Disease Control and Prevention - History

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          June 22-23, 2001: Bio-Terror Exercise Simulates Smallpox Attack

          A dozen leading politicians, scholars, journalists, and security experts meet at Andrews Air Force Base in Maryland for an exercise simulating the consequences of a biological terrorist attack, in this case the release of smallpox by terrorists. The participants include: Senator Sam Nunn (D-GA), who plays the president of the United States former presidential adviser David Gergen as the national security advisor Governor Frank Keating (R-OK), who plays himself James Woolsey playing the CIA director and Jerome Hauer as the FEMA director. The exercise, named “Dark Winter,” starts with three states suddenly confronted with an outbreak of smallpox. Americans are no longer vaccinated against this virus because it was eradicated decades ago. Thousands quickly fall ill. The medical system is overwhelmed. Masses start to flee from the infected areas, but are stopped at the borders of neighboring states. Faced with chaos, the exercise ends with the president declaring martial law. Reviewing the exercise, participants and observers agree that the nation is vulnerable to biological terrorism and unprepared for an actual attack. [Time, 9/24/2001 US Medicine, 12/2001 Center for Biosecurity, 2002 O'Toole, Mair, and Inglesby, 4/1/2002] In the days following 9/11, Vice President Dick Cheney will watch a video report on the exercise, and, at his urging, the National Security Council will receive a “harrowing” and “gruesome” briefing on September 20, on the possibility of a biological attack. [Mayer, 2008, pp. 3-4] At about the same time as Dark Winter is taking place, the Centers for Disease Control (CDC) returns smallpox to the list of reportable diseases. Smallpox had been removed from the list decades ago after worldwide eradication. The agency says it is increasing its surveillance efforts of infectious pathogens that could be used in a biological terrorist attack. [United Press International, 5/31/2001] After the 9/11 attacks, public health officials will deny that the re-listing of smallpox was the result of any specific intelligence warnings. [UPI, 10/22/2001]


          Difficult relationship with ME/CFS communities [ edit | edit source ]

          Patients, advocates, and physicians affiliated with ME/CFS have had a cautious, and at times fractured, relationship with the CDC. After the 1984 Incline Village chronic fatigue syndrome outbreak of ME/CFS, the CDC was dismissive to the clinical findings of Dr. Daniel Peterson and the afflicted patients. Hillary Johnson wrote her renowned book, Osler's Web, about this frustrating period. During this time the CDC coined the trivializing name, "chronic fatigue syndrome." [13]

          Diverted research funding [ edit | edit source ]

          In 1999, Senator Harry Reid requested the Justice Department start a criminal investigation into the diversion of research funds at the CDC that was earmarked for chronic fatigue syndrome. The U.S. Department of Health and Human Services (HHS) reported that the agency misspent millions of dollars appropriated by Congress for research on chronic fatigue syndrome. According to an article in the Las Vegas Sun: "An inspector general reported in May that only $9.8 million of the $22.7 million Congress set aside to study chronic fatigue syndrome from 1995 to 1998 was actually spent on the illness. At least $8.8 million was spent on other research, including measles and polio. But government auditors said they could not determine what happened to an additional $4.1 million and the CDC has not explained where the money went." [14]

          Dr. William Reeves [ edit | edit source ]

          Another piece to explain the difficult relationship between the CDC and the CFS community was the leadership of Dr. William Reeves, the CFS Research Chief. The CFIDS Association of America, the International Association of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and CFSAC all criticized Dr. Reeves for his autocratic research style and his lack of collaboration. According to Cort Johnson: "Dr. Reeves started out with a disorder that few researchers at the CDC took seriously. Ironically even as his CDC prevalence and economic studies demonstrated it was a serious disorder, he seemed to take it less seriously in the end calling it ‘unwellness’ and referring to a broad range of triggering factors (obesity, inactivity, alcoholism, mood disorders, etc.) which ME/CFS professionals felt leery about." [15]

          In the aftermath, Jeffrey Koplan, the CDC Director from 1998 to 2002, placed the chronic fatigue syndrome programs ­on budgetary probation and announced mandatory legal training for all budget managers. [ citation needed ]

          Fake CDC Letter [ edit | edit source ]

          In 1986, a fake letter posted on a CDC bulletin board was discovered and copied by Hillary Johnson in her book, illustrating the belittling attitude the CDC staff had towards the patient population. [16] [17]


          Contents

          Establishment Edit

          The Communicable Disease Center was founded July 1, 1946, as the successor to the World War II Malaria Control in War Areas program [6] of the Office of National Defense Malaria Control Activities. [7]

          Preceding its founding, organizations with global influence in malaria control were the Malaria Commission of the League of Nations and the Rockefeller Foundation. [8] The Rockefeller Foundation greatly supported malaria control, [8] sought to have the governments take over some of its efforts, and collaborated with the agency. [9]

          The new agency was a branch of the U.S. Public Health Service and Atlanta was chosen as the location because malaria was endemic in the Southern United States. [10] The agency changed names (see infobox on top) before adopting the name Communicable Disease Center in 1946. Offices were located on the sixth floor of the Volunteer Building on Peachtree Street. [11]

          With a budget at the time of about $1 million, 59 percent of its personnel were engaged in mosquito abatement and habitat control with the objective of control and eradication of malaria in the United States [12] (see National Malaria Eradication Program).

          Among its 369 employees, the main jobs at CDC were originally entomology and engineering. In CDC's initial years, more than six and a half million homes were sprayed, mostly with DDT. In 1946, there were only seven medical officers on duty and an early organization chart was drawn, somewhat fancifully, in the shape of a mosquito. Under Joseph Walter Mountin, the CDC continued to advocate for public health issues and pushed to extend its responsibilities to many other communicable diseases. [13]

          In 1947, the CDC made a token payment of $10 to Emory University for 15 acres (61,000 m 2 ) of land on Clifton Road in DeKalb County, still the home of CDC headquarters as of 2019. CDC employees collected the money to make the purchase. The benefactor behind the "gift" was Robert W. Woodruff, chairman of the board of The Coca-Cola Company. Woodruff had a long-time interest in malaria control, which had been a problem in areas where he went hunting. The same year, the PHS transferred its San Francisco based plague laboratory into the CDC as the Epidemiology Division, and a new Veterinary Diseases Division was established. [6]

          Growth Edit

          An Epidemic Intelligence Service (EIS) was established in 1951, originally due to biological warfare concerns arising from the Korean War it evolved into two-year postgraduate training program in epidemiology, and a prototype for Field Epidemiology Training Programs (FETP), now [ when? ] found in numerous countries, reflecting CDC's influence in promoting this model internationally. [14]

          The mission of the CDC expanded beyond its original focus on malaria to include sexually transmitted diseases when the Venereal Disease Division of the U.S. Public Health Service (PHS) was transferred to the CDC in 1957. Shortly thereafter, Tuberculosis Control was transferred (in 1960) to the CDC from PHS, and then in 1963 the Immunization program was established. [15]

          It became the National Communicable Disease Center (NCDC) effective July 1, 1967, and the Center for Disease Control (CDC) on June 24, 1970. At the end of the Public Health Service reorganizations of 1966–1973, it was promoted to being a principal operating agency of PHS. It was renamed the Centers for Disease Control effective October 14, 1980. [7] In 1987, the National Center for Health Statistics became part of CDC. [16] An act of the United States Congress appended the words "and Prevention" to the name effective October 27, 1992. However, Congress directed that the initialism CDC be retained because of its name recognition. [17]

          Since the 1990s, the CDC focus has broadened to include chronic diseases, disabilities, injury control, workplace hazards, environmental health threats, and terrorism preparedness. CDC combats emerging diseases and other health risks, including birth defects, West Nile virus, obesity, avian, swine, and pandemic flu, E. coli, and bioterrorism, to name a few. The organization would also prove to be an important factor in preventing the abuse of penicillin. In May 1994 the CDC admitted having sent samples of communicable diseases to the Iraqi government from 1984 through 1989 which were subsequently repurposed for biological warfare, including Botulinum toxin, West Nile virus, Yersinia pestis and Dengue fever virus. [18]

          Recent history Edit

          On April 21, 2005, then–CDC Director Julie Gerberding formally announced the reorganization of CDC to "confront the challenges of 21st-century health threats". [19] She established four Coordinating Centers. In 2009 the Obama Administration re-evaluated this change and ordered them cut as an unnecessary management layer. [20]

          As of 2013, the CDC's Biosafety Level 4 laboratories are among the few that exist in the world. [21] They constitute one of only two official repositories of smallpox in the world. The second smallpox store resides at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation. In 2014, the CDC revealed they had discovered several misplaced smallpox samples while their lab workers were 'potentially infected' with anthrax. [22]

          The city of Atlanta annexed the property of the CDC headquarters effective January 1, 2018, as a part of the city's largest annexation within a period of 65 years the Atlanta City Council had voted to do so the prior December. [3] The CDC had requested that the Atlanta city government annex the area. The headquarters were located in an unincorporated area, [23] statistically in the Druid Hills census-designated place. [24]

          The CDC is organized into "Centers, Institutes, and Offices" (CIOs), with each organizational unit implementing the agency's activities in a particular area of expertise while also providing intra-agency support and resource-sharing for cross-cutting issues and specific health threats. Generally, CDC "Offices" are subdivided into Centers, which in turn are composed of Divisions and Branches. [6] However, the Center for Global Health and the National Institute for Occupational Safety and Health are freestanding organizational units and do not belong to a parent Office.

          As of August 2019, the CIOs are:

          • Director
            • Principal Deputy Director
              • Deputy Director – Public Health Service and Implementation Science
                • Office of Minority Health and Health Equity
                • Center for Global Health
                • Center for Preparedness and Response
                • Center for State, Tribal, Local, and Territory Support
                • Office of Science
                • Office of Laboratory Science and Safety
                • Center for Surveillance, Epidemiology, and Laboratory Services
                • National Center on Birth Defects and Developmental Disabilities
                • National Center for Chronic Disease Prevention and Health Promotion
                • National Center for Environmental Health and Agency for Toxic Substances and Disease Registry
                • Chief of Staff
                • Chief Operating Officer
                  • Human Resources Office
                  • Office of Financial Resources
                  • Office of Safety, Security, and Asset Management
                  • Office of the Chief Information Officer

                  The Office of Public Health Preparedness was created during the 2001 anthrax attacks shortly after the terrorist attacks of September 11, 2001. Its purpose was to coordinate among the government the response to a range of biological terrorism threats. [26]

                  Locations Edit

                  Most CDC centers are located in Atlanta. A few of the centers are based in or operate other domestic locations: [27]

                  • The National Center for Emerging and Zoonotic Infectious Diseases' Division of Vector-Borne Diseases is based in Fort Collins, Colorado, with a branch in San Juan, Puerto Rico its Arctic Investigations Program is based in Anchorage, Alaska.
                  • The National Center for Health Statistics is primarily located in Hyattsville, Maryland, with a branch in Research Triangle Park in North Carolina.
                  • The National Institute for Occupational Safety and Health's primary locations are Cincinnati, Ohio Morgantown, West Virginia Pittsburgh, Pennsylvania Spokane, Washington and Washington, D.C., with branches in Denver, Anchorage, and Atlanta.
                  • The CDC Washington Office is based in Washington, D.C.
                  • Building 18, which opened in 2005 at the CDC's main Roybal campus (named in honor of the late Representative Edward R. Roybal), contains the premier BSL4 laboratory in the United States. [28][29][30]

                  In addition, CDC operates quarantine facilities in 20 cities in the U.S. [31]

                  CDC's budget for fiscal year 2018 is $11.9 billion. [32] The CDC offers grants that help many organizations each year advance health, safety and awareness at the community level throughout the United States. The CDC awards over 85 percent of its annual budget through these grants. [33]

                  As of 2021 [update] , CDC staff numbered approximately 15,000 personnel (including 6,000 contractors and 840 United States Public Health Service Commissioned Corps officers) in 170 occupations. Eighty percent held bachelor's degrees or higher almost half had advanced degrees (a master's degree or a doctorate such as a PhD, D.O., or M.D.). [34]

                  Common CDC job titles include engineer, entomologist, epidemiologist, biologist, physician, veterinarian, behavioral scientist, nurse, medical technologist, economist, public health advisor, health communicator, toxicologist, chemist, computer scientist, and statistician. [35]

                  The CDC also operates a number of notable training and fellowship programs, including those indicated below.

                  Epidemic Intelligence Service (EIS) Edit

                  The Epidemic Intelligence Service (EIS) is composed of "boots-on-the-ground disease detectives" who investigate public health problems domestically and globally. [36] When called upon by a governmental body, EIS officers may embark on short-term epidemiological assistance assignments, or "Epi-Aids", to provide technical expertise in containing and investigating disease outbreaks. [37] [38] [39] The EIS program is a model for the international Field Epidemiology Training Program.

                  Public Health Associates Program Edit

                  The CDC also operates the Public Health Associate Program (PHAP), a two-year paid fellowship for recent college graduates to work in public health agencies all over the United States. PHAP was founded in 2007 and currently [ when? ] has 159 associates in 34 states. [40]

                  The Director of CDC is a Senior Executive Service position [41] that may be filled either by a career employee, or as a political appointment that does not require Senate confirmation, with the latter method typically being used. The director serves at the pleasure of the President and may be fired at any time. [42] [43] [44] The CDC director concurrently serves as the Administrator of the Agency for Toxic Substances and Disease Registry. [45]

                  Twenty directors have served the CDC or its predecessor agencies, including three who have served during the Trump administration (including Anne Schuchat who twice served as acting director). [7] [46]

                    Jr., MD (1942–1943) , ScD (1944–1946) , MD (1947–1951) , ScD (1952–1953) , MD (1953–1956) , MD, MPH (1956–1960) , MD, MPH (1960–1962) , MD, MPH (1962–1966) , MD, MPH (1966–1977) , MD, MPH (1977–1983) , MD, MPH, Ph.D (1983–1989) , MD, MPH (1990–1993) , MD, PhD (1993–1998) , MD, MPH (1998–2002) [47] , MD, MPH (2002–2008) , MD, MPH (2009 – Jan 2017) [42] , MD, RADMUSPHS (acting, Jan–July 2017) [48] , MD (July 2017 – Jan 2018) [49] , MD (acting, Jan–Mar 2018) , MD (March 2018–Jan 2021) [50] , MD, MPH (Jan 2021–present)
                  • CDC Scientific Data, Surveillance, Health Statistics, and Laboratory Information. [51] (BRFSS), the world's largest, ongoing telephone health-survey system. [52] . [53][54]
                  • CDC WONDER (Wide-ranging ONline Data for Epidemiologic Research)[2]
                  • Data systems of the National Center for Health Statistics[3]

                  Communicable diseases Edit

                  The CDC's programs address more than 400 diseases, health threats, and conditions that are major causes of death, disease, and disability. The CDC's website has information on various infectious (and noninfectious) diseases, including smallpox, measles, and others.

                  Influenza Edit

                  The CDC targets the transmission of influenza, including the H1N1 swine flu, and launched websites to educate people about hygiene. [55]

                  Division of Select Agents and Toxins Edit

                  Within the division are two programs: the Federal Select Agent Program (FSAP) and the Import Permit Program. The FSAP is run jointly with an office within the U.S. Department of Agriculture, regulating agents that can cause disease in humans, animals, and plants. The Import Permit Program regulates the importation of "infectious biological materials." [56]

                  The CDC runs a program that protects the public from rare and dangerous substances such as anthrax and the Ebola virus. The program, called the Federal Select Agent Program, calls for inspections of labs in the U.S. that work with dangerous pathogens. [57]

                  During the 2014 Ebola outbreak in West Africa, the CDC helped coordinate the return of two infected American aid workers for treatment at Emory University Hospital, the home of a special unit to handle highly infectious diseases. [58]

                  As a response to the 2014 Ebola outbreak, Congress passed a Continuing Appropriations Resolution allocating $30,000,000 towards CDC's efforts to fight the virus. [59]

                  Non-communicable diseases Edit

                  The CDC also works on non-communicable diseases, including chronic diseases caused by obesity, physical inactivity and tobacco-use. [60]

                  Antibiotic resistance Edit

                  The CDC implemented their National Action Plan for Combating Antibiotic Resistant Bacteria as a measure against the spread of antibiotic resistance in the United States. This initiative has a budget of $161 million and includes the development of the Antibiotic Resistance Lab Network. [61]

                  Global health Edit

                  Globally, the CDC works with other organizations to address global health challenges and contain disease threats at their source. They work with many international organizations such as the World Health Organization (WHO) as well as ministries of health and other groups on the front lines of outbreaks. The agency maintains staff in more than 60 countries, including some from the U.S. but more from the countries in which they operate. [62] The agency's global divisions include the Division of Global HIV and TB (DGHT), the Division of Parasitic Diseases and Malaria (DPDM), the Division of Global Health Protection (DGHP), and the Global Immunization Division (GID). [63]

                  The CDC is integral in working with the WHO to implement the International Health Regulations (IHR), an agreement between 196 countries to prevent, control, and report on the international spread of disease, through initiatives including the Global Disease Detection Program (GDD). [64]

                  The CDC is also a lead implementer of key U.S. global health initiatives such as the President's Emergency Plan for AIDS Relief (PEPFAR) and the President's Malaria Initiative. [65]

                  Travelers' health Edit

                  The CDC collects and publishes health information for travelers in a comprehensive book, CDC Health Information for International Travel, which is commonly known as the "yellow book." [66] The book is available online and in print as a new edition every other year and includes current travel health guidelines, vaccine recommendations, and information on specific travel destinations. The CDC also issues travel health notices on its website, consisting of three levels:

                  "Watch": Level 1 (practice usual precautions)

                  "Alert": Level 2 (practice enhanced precautions)

                  "Warning": Level 3 (avoid nonessential travel) [67]

                  Vaccine safety Edit

                  The CDC monitors the safety of vaccines in the U.S. via the Vaccine Adverse Event Reporting System (VAERS), a national vaccine safety surveillance program run by CDC and the FDA. "VAERS detects possible safety issues with U.S. vaccines by collecting information about adverse events (possible side effects or health problems) after vaccination." [68] The CDC's Safety Information by Vaccine page provides a list of the latest safety information, side effects, and answers to common questions about CDC recommended vaccines. [69]

                  The CDC Foundation operates independently from CDC as a private, nonprofit 501(c)(3) organization incorporated in the State of Georgia. The creation of the Foundation was authorized by section 399F of the Public Health Service Act to support the mission of CDC in partnership with the private sector, including organizations, foundations, businesses, educational groups, and individuals. [70] [71]

                  Tuskegee study of untreated syphilis in Black men Edit

                  For 15 years, the CDC had direct oversight over the Tuskegee syphilis experiment. [72] In the study, which lasted from 1932 to 1972, a group of Black men (nearly 400 of whom had syphilis) were studied to learn more about the disease. The disease was left untreated in the men, who had not given their informed consent to serve as research subjects. The Tuskegee Study was initiated in 1932 by the Public Health Service, with the CDC taking over the Tuskegee Health Benefit Program in 1995. [72]

                  Gun violence Edit

                  An area of partisan dispute related to CDC funding is studying firearms effectiveness. Although the CDC was one of the first agencies to study gun violence as a public health issue, in 1996 the Dickey Amendment, passed with the support of the National Rifle Association, states "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control". [73] Advocates for gun control oppose the amendment and have tried to overturn it. [74]

                  Looking at the history of the passage of the Dickey Ammendment, in 1992, Mark L. Rosenberg and five CDC colleagues founded the CDC's National Center for Injury Prevention and Control, with an annual budget of approximately $260,000. They focused on "identifying causes of firearm deaths, and methods to prevent them". [75] Their first report, published in the New England Journal of Medicine in 1993 entitled "Guns are a Risk Factor for Homicide in the Home", reported "mere presence of a gun in a home increased the risk of a firearm-related death by 2.7 percent, and suicide fivefold—a "huge" increase." [75] In response, the NRA launched a "campaign to shut down the Injury Center." Two conservative pro-gun groups, Doctors for Responsible Gun Ownership and Doctors for Integrity and Policy Research joined the pro-gun effort, and, by 1995, politicians also supported the pro-gun initiative. In 1996, Jay Dickey (R) Arkansas introduced the Dickey Amendment statement stating "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control" as a rider. [73] in the 1996 appropriations bill." [75] In 1997, "Congress re-directed all of the money for gun research to the study of traumatic brain injury." [75] David Satcher, CDC head 1993-98 before he was fired [76] advocated for firearms research. [75] In 2016 over a dozen "public health insiders, including current and former CDC senior leaders" told The Trace interviewers that CDC senior leaders took a cautious stance in their interpretation of the Dickey Amendment and that they could do more but were afraid of political and personal retribution. [75] Rosenberg told The Trace, "Right now, there is nothing stopping them from addressing this life-and-death national problem!" [75]

                  In 2013, the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics sent a letter to the leaders of the Senate Appropriations Committee asking them "to support at least $10 million within the Centers for Disease Control and Prevention (CDC) in FY 2014 along with sufficient new taxes at the National Institutes of Health to support research into the causes and prevention of violence. Furthermore, we urge Members to oppose any efforts to reduce, eliminate, or condition CDC funding related to violence prevention research." [77] Congress maintained the ban in subsequent budgets. [74]

                  COVID-19 Edit

                  The first confirmed case of COVID-19 was discovered in the U.S. on January 20, 2020. [78] But widespread COVID-19 testing in the United States was effectively stalled until February 28, when federal officials revised a faulty CDC test, and days afterward, when the Food and Drug Administration began loosening rules that had restricted other labs from developing tests. [79] In February 2020, as the CDC's early coronavirus test malfunctioned nationwide, [80] CDC Director Robert R. Redfield reassured fellow officials on the White House Coronavirus Task Force that the problem would be quickly solved, according to White House officials. It took about three weeks to sort out the failed test kits, which may have been contaminated during their processing in a CDC lab. Later investigations by the FDA and the Department of Health and Human Services found that the CDC had violated its own protocols in developing its tests. [80] [81] In November 2020, NPR reported that an internal review document they obtained revealed that the CDC was aware that the first batch of tests which were issued in early January had a chance of being wrong 33 percent of the time, but they released them anyway. [82]

                  In May 2020, The Atlantic reported that the CDC was conflating the results of two different types of coronavirus tests — tests that diagnose current coronavirus infections, and tests that measure whether someone has ever had the virus. The magazine said this distorted several important metrics, provided the country with an inaccurate picture of the state of the pandemic, and overstated the country's testing ability. [83]

                  In July 2020, the Trump administration ordered hospitals to bypass the CDC and instead send all COVID-19 patient information to a database at the Department of Health and Human Services. Some health experts opposed the order and warned that the data might become politicized or withheld from the public. [84] On July 15, the CDC alarmed health care groups by temporarily removing COVID-19 dashboards from its website. It restored the data a day later. [85] [86] [87]

                  In August 2020, the CDC recommended that people showing no COVID-19 symptoms do not need testing. The new guidelines alarmed many public health experts. [88] The guidelines were crafted by the White House Coronavirus Task Force without the sign-off of Anthony Fauci of the NIH. [89] [90] Objections by other experts at the CDC went unheard. Officials said that a CDC document in July arguing for "the importance of reopening schools" was also crafted outside the CDC. [91] On August 16, the chief of staff, Kyle McGowan, and his deputy, Amanda Campbell, resigned from the agency. [92] The testing guidelines were reversed on September 18, 2020, after public controversy. [93]

                  In September 2020, the CDC drafted an order requiring masks on all public transportation in the United States, but the White House Coronavirus Task Force blocked the order, refusing to discuss it, according to two federal health officials. [94]

                  In October, it was disclosed that White House advisers had repeatedly altered the writings of CDC scientists about COVID-19, including recommendations on church choirs, social distancing in bars and restaurants, and summaries of public-health reports. [95]

                  In the lead up to 2020 Thanksgiving, at a press conference on November 20 the CDC advised Americans not to travel for the holiday saying, "It's not a requirement. It's a recommendation for the American public to consider." The White House coronavirus task force had its first public briefing in months on that date but travel was not mentioned. [96]

                  Controversy over the Morbidity and Mortality Weekly Report Edit

                  During the pandemic the CDC Morbidity and Mortality Weekly Report (MMWR) came under pressure from political appointees at the Department of Health and Human Services (HHS) to modify its reporting so as not to conflict with what Trump was saying about the pandemic. [97] Starting in June 2020, Michael Caputo, the HHS assistant secretary for public affairs, and his chief advisor Paul Alexander tried to delay, suppress, change, and retroactively edit MMR releases about the effectiveness of potential treatments for COVID-19, the transmissibility of the virus, and other issues where the president had taken a public stance. [97] Alexander tried unsuccessfully to get personal approval of all issues of MMWR before they went out. [98] Caputo claimed this oversight was necessary because MMWR reports were being tainted by "political content" he demanded to know the political leanings of the scientists who reported that hydroxychloroquine had little benefit as a treatment while Trump was saying the opposite. [97] In emails Alexander accused CDC scientists of attempting to "hurt the president" and writing "hit pieces on the administration". [99] In October 2020, emails obtained by Politico showed that Alexander requested multiple alterations in a report. The published alterations included a title being changed from "Children, Adolescents, and Young Adults" to "Persons." One current and two former CDC officials who reviewed the email exchanges said they were troubled by the "intervention to alter scientific reports viewed as untouchable prior to the Trump administration" that "appeared to minimize the risks of the coronavirus to children by making the report’s focus on children less clear." [100]

                  Eroding trust in the CDC as a result of COVID-19 controversies Edit

                  A poll conducted in September 2020 found that nearly 8 in 10 Americans trusted the CDC, a decrease from 87 percent in April 2020. Another poll showed an even larger drop in trust with the results dropping 16 percentage points. [101] As the trustworthiness eroded, so too did the information it disseminates. [92] The diminishing level of trust in the CDC and the information releases also incited "vaccine hesitancy" with the result that "just 53 percent of Americans said they would be somewhat or extremely likely to get a vaccine." [101]

                  In September 2020, amid the accusations and the faltering image of the CDC the agency's leadership was called into question. Former Acting Director at the CDC, Richard Besser, said of Dr. Redfield that “I find it concerning that the CDC director has not been outspoken when there have been instances of clear political interference in the interpretation of science.” [102] In addition, Mark Rosenberg, the first director of CDC’s National Center for Injury Prevention and Control, also questioned Redfield's leadership and his lack of defense of the science. [102]

                  Historically the CDC has not been a political agency, however, the COVID-19 pandemic, and specifically the Trump Administration's handling of the pandemic, resulted in a "dangerous shift" according to a previous CDC director and others. Four previous directors claim that the agency's voice was "muted for political reasons." [103] Politicization of the agency has continued into the Biden administration as COVID-19 guidance is contradicted by State guidance [104] and the agency is criticized as "CDC's credibility is eroding". [105]

                  In 2021, the CDC, then under the leadership of the Biden Administration, received criticism for its mixed messaging surrounding COVID-19 vaccines, mask-wearing guidance, and the state of the pandemic. [106] [107]

                  • CDC publications [108]
                  • State of CDC report [109]
                  • CDC Programs in Brief [110]
                  • Morbidity and Mortality Weekly Report[111]
                  • Emerging Infectious Diseases (monthly journal) [112]
                  • Preventing Chronic Disease[113]

                  Zombie Apocalypse campaign Edit

                  On May 16, 2011, the Centers for Disease Control and Prevention's blog published an article instructing the public on what to do to prepare for a zombie invasion. While the article did not claim that such a scenario was possible, it did use the popular culture appeal as a means of urging citizens to prepare for all potential hazards, such as earthquakes, tornadoes, and floods. [114]

                  According to David Daigle, the Associate Director for Communications, Public Health Preparedness and Response, the idea arose when his team was discussing their upcoming hurricane-information campaign and Daigle mused that "we say pretty much the same things every year, in the same way, and I just wonder how many people are paying attention." A social-media employee mentioned that the subject of zombies had come up a lot on Twitter when she had been tweeting about the Fukushima Daiichi nuclear disaster and radiation. The team realized that a campaign like this would most likely reach a different audience from the one that normally pays attention to hurricane-preparedness warnings and went to work on the zombie campaign, launching it right before hurricane season began. "The whole idea was, if you're prepared for a zombie apocalypse, you're prepared for pretty much anything," said Daigle. [115]

                  Once the blog article was posted, the CDC announced an open contest for YouTube submissions of the most creative and effective videos covering preparedness for a zombie apocalypse (or apocalypse of any kind), to be judged by the "CDC Zombie Task Force". Submissions were open until October 11, 2011. [116] They also released a zombie-themed graphic novella available on their website. [117] Zombie-themed educational materials for teachers are available on the site. [118]


                  Centers for Disease Control and Prevention

                  The United States Centers for Disease Control and Prevention (CDC or U.S. CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, [2] and is headquartered in Atlanta, Georgia. [3]

                  The agency professes its main goal to be the protection of public health and safety through the control and prevention of disease, injury, and disability in the US and worldwide. [4] The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention and educational activities designed to improve the health of United States citizens. The CDC also conducts research and provides information on non-infectious diseases, such as obesity and diabetes, and is a founding member of the International Association of National Public Health Institutes. [5]

                  History

                  Establishment

                  The Communicable Disease Center was founded July 1, 1946, as the successor to the World War II Malaria Control in War Areas program [6] of the Office of National Defense Malaria Control Activities. [7]

                  Preceding its founding, organizations with global influence in malaria control were the Malaria Commission of the League of Nations and the Rockefeller Foundation. [8] The Rockefeller Foundation greatly supported malaria control, [8] sought to have the governments take over some of its efforts, and collaborated with the agency. [9]

                  The new agency was a branch of the U.S. Public Health Service and Atlanta was chosen as the location because malaria was endemic in the Southern United States. [10] The agency changed names (see infobox on top) before adopting the name Communicable Disease Center in 1946. Offices were located on the sixth floor of the Volunteer Building on Peachtree Street. [11]

                  With a budget at the time of about $1 million, 59 percent of its personnel were engaged in mosquito abatement and habitat control with the objective of control and eradication of malaria in the United States [12] (see National Malaria Eradication Program).

                  Among its 369 employees, the main jobs at CDC were originally entomology and engineering. In CDC's initial years, more than six and a half million homes were sprayed, mostly with DDT. In 1946, there were only seven medical officers on duty and an early organization chart was drawn, somewhat fancifully, in the shape of a mosquito. Under Joseph Walter Mountin, the CDC continued to advocate for public health issues and pushed to extend its responsibilities to many other communicable diseases. [13]

                  In 1947, the CDC made a token payment of $10 to Emory University for 15 acres (61,000 m 2 ) of land on Clifton Road in DeKalb County, still the home of CDC headquarters as of 2019. CDC employees collected the money to make the purchase. The benefactor behind the "gift" was Robert W. Woodruff, chairman of the board of The Coca-Cola Company. Woodruff had a long-time interest in malaria control, which had been a problem in areas where he went hunting. The same year, the PHS transferred its San Francisco based plague laboratory into the CDC as the Epidemiology Division, and a new Veterinary Diseases Division was established. [6]

                  Growth

                  An Epidemic Intelligence Service (EIS) was established in 1951, originally due to biological warfare concerns arising from the Korean War it evolved into two-year postgraduate training program in epidemiology, and a prototype for Field Epidemiology Training Programs (FETP), now [ when? ] found in numerous countries, reflecting CDC's influence in promoting this model internationally. [14]

                  The mission of the CDC expanded beyond its original focus on malaria to include sexually transmitted diseases when the Venereal Disease Division of the U.S. Public Health Service (PHS) was transferred to the CDC in 1957. Shortly thereafter, Tuberculosis Control was transferred (in 1960) to the CDC from PHS, and then in 1963 the Immunization program was established. [15]

                  It became the National Communicable Disease Center (NCDC) effective July 1, 1967, and the Center for Disease Control (CDC) on June 24, 1970. At the end of the Public Health Service reorganizations of 1966–1973, it was promoted to being a principal operating agency of PHS. It was renamed the Centers for Disease Control effective October 14, 1980. [7] In 1987, the National Center for Health Statistics became part of CDC. [16] An act of the United States Congress appended the words "and Prevention" to the name effective October 27, 1992. However, Congress directed that the initialism CDC be retained because of its name recognition. [17]

                  Since the 1990s, the CDC focus has broadened to include chronic diseases, disabilities, injury control, workplace hazards, environmental health threats, and terrorism preparedness. CDC combats emerging diseases and other health risks, including birth defects, West Nile virus, obesity, avian, swine, and pandemic flu, E. coli, and bioterrorism, to name a few. The organization would also prove to be an important factor in preventing the abuse of penicillin. In May 1994 the CDC admitted having sent samples of communicable diseases to the Iraqi government from 1984 through 1989 which were subsequently repurposed for biological warfare, including Botulinum toxin, West Nile virus, Yersinia pestis and Dengue fever virus. [18]

                  Recent history

                  On April 21, 2005, then–CDC Director Julie Gerberding formally announced the reorganization of CDC to "confront the challenges of 21st-century health threats". [19] She established four Coordinating Centers. In 2009 the Obama Administration re-evaluated this change and ordered them cut as an unnecessary management layer. [20]

                  As of 2013, the CDC's Biosafety Level 4 laboratories are among the few that exist in the world. [21] They constitute one of only two official repositories of smallpox in the world. The second smallpox store resides at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation. In 2014, the CDC revealed they had discovered several misplaced smallpox samples while their lab workers were 'potentially infected' with anthrax. [22]

                  The city of Atlanta annexed the property of the CDC headquarters effective January 1, 2018, as a part of the city's largest annexation within a period of 65 years the Atlanta City Council had voted to do so the prior December. [3] The CDC had requested that the Atlanta city government annex the area. The headquarters were located in an unincorporated area, [23] statistically in the Druid Hills census-designated place. [24]

                  Organization

                  The CDC is organized into "Centers, Institutes, and Offices" (CIOs), with each organizational unit implementing the agency's activities in a particular area of expertise while also providing intra-agency support and resource-sharing for cross-cutting issues and specific health threats. Generally, CDC "Offices" are subdivided into Centers, which in turn are composed of Divisions and Branches. [6] However, the Center for Global Health and the National Institute for Occupational Safety and Health are freestanding organizational units and do not belong to a parent Office.

                  As of August 2019, the CIOs are:

                  • Director
                    • Principal Deputy Director
                      • Deputy Director – Public Health Service and Implementation Science
                        • Office of Minority Health and Health Equity
                        • Center for Global Health
                        • Center for Preparedness and Response
                        • Center for State, Tribal, Local, and Territory Support
                        • Office of Science
                        • Office of Laboratory Science and Safety
                        • Center for Surveillance, Epidemiology, and Laboratory Services
                        • National Center on Birth Defects and Developmental Disabilities
                        • National Center for Chronic Disease Prevention and Health Promotion
                        • National Center for Environmental Health and Agency for Toxic Substances and Disease Registry
                        • Chief of Staff
                        • Chief Operating Officer
                          • Human Resources Office
                          • Office of Financial Resources
                          • Office of Safety, Security, and Asset Management
                          • Office of the Chief Information Officer

                          The Office of Public Health Preparedness was created during the 2001 anthrax attacks shortly after the terrorist attacks of September 11, 2001. Its purpose was to coordinate among the government the response to a range of biological terrorism threats. [26]

                          Locations

                          Most CDC centers are located in Atlanta. A few of the centers are based in or operate other domestic locations: [27]

                          • The National Center for Emerging and Zoonotic Infectious Diseases' Division of Vector-Borne Diseases is based in Fort Collins, Colorado, with a branch in San Juan, Puerto Rico its Arctic Investigations Program is based in Anchorage, Alaska.
                          • The National Center for Health Statistics is primarily located in Hyattsville, Maryland, with a branch in Research Triangle Park in North Carolina.
                          • The National Institute for Occupational Safety and Health's primary locations are Cincinnati, Ohio Morgantown, West Virginia Pittsburgh, Pennsylvania Spokane, Washington and Washington, D.C., with branches in Denver, Anchorage, and Atlanta.
                          • The CDC Washington Office is based in Washington, D.C.
                          • Building 18, which opened in 2005 at the CDC's main Roybal campus (named in honor of the late Representative Edward R. Roybal), contains the premier BSL4 laboratory in the United States. [28][29][30]

                          In addition, CDC operates quarantine facilities in 20 cities in the U.S. [31]

                          Budget

                          CDC's budget for fiscal year 2018 is $11.9 billion. [32] The CDC offers grants that help many organizations each year advance health, safety and awareness at the community level throughout the United States. The CDC awards over 85 percent of its annual budget through these grants. [33]

                          Workforce

                          As of 2021 [update] , CDC staff numbered approximately 15,000 personnel (including 6,000 contractors and 840 United States Public Health Service Commissioned Corps officers) in 170 occupations. Eighty percent held bachelor's degrees or higher almost half had advanced degrees (a master's degree or a doctorate such as a PhD, D.O., or M.D.). [34]

                          Common CDC job titles include engineer, entomologist, epidemiologist, biologist, physician, veterinarian, behavioral scientist, nurse, medical technologist, economist, public health advisor, health communicator, toxicologist, chemist, computer scientist, and statistician. [35]

                          The CDC also operates a number of notable training and fellowship programs, including those indicated below.

                          Epidemic Intelligence Service (EIS)

                          The Epidemic Intelligence Service (EIS) is composed of "boots-on-the-ground disease detectives" who investigate public health problems domestically and globally. [36] When called upon by a governmental body, EIS officers may embark on short-term epidemiological assistance assignments, or "Epi-Aids", to provide technical expertise in containing and investigating disease outbreaks. [37] [38] [39] The EIS program is a model for the international Field Epidemiology Training Program.

                          Public Health Associates Program

                          The CDC also operates the Public Health Associate Program (PHAP), a two-year paid fellowship for recent college graduates to work in public health agencies all over the United States. PHAP was founded in 2007 and currently [ when? ] has 159 associates in 34 states. [40]

                          Leadership

                          The Director of CDC is a Senior Executive Service position [41] that may be filled either by a career employee, or as a political appointment that does not require Senate confirmation, with the latter method typically being used. The director serves at the pleasure of the President and may be fired at any time. [42] [43] [44] The CDC director concurrently serves as the Administrator of the Agency for Toxic Substances and Disease Registry. [45]

                          Twenty directors have served the CDC or its predecessor agencies, including three who have served during the Trump administration (including Anne Schuchat who twice served as acting director). [7] [46]

                            Jr., MD (1942–1943) , ScD (1944–1946) , MD (1947–1951) , ScD (1952–1953) , MD (1953–1956) , MD, MPH (1956–1960) , MD, MPH (1960–1962) , MD, MPH (1962–1966) , MD, MPH (1966–1977) , MD, MPH (1977–1983) , MD, MPH, Ph.D (1983–1989) , MD, MPH (1990–1993) , MD, PhD (1993–1998) , MD, MPH (1998–2002) [47] , MD, MPH (2002–2008) , MD, MPH (2009 – Jan 2017) [42] , MD, RADMUSPHS (acting, Jan–July 2017) [48] , MD (July 2017 – Jan 2018) [49] , MD (acting, Jan–Mar 2018) , MD (March 2018–Jan 2021) [50] , MD, MPH (Jan 2021–present)

                          Datasets and survey systems

                          • CDC Scientific Data, Surveillance, Health Statistics, and Laboratory Information. [51] (BRFSS), the world's largest, ongoing telephone health-survey system. [52] . [53][54]
                          • CDC WONDER (Wide-ranging ONline Data for Epidemiologic Research)[2]
                          • Data systems of the National Center for Health Statistics[3]

                          Areas of focus

                          Communicable diseases

                          The CDC's programs address more than 400 diseases, health threats, and conditions that are major causes of death, disease, and disability. The CDC's website has information on various infectious (and noninfectious) diseases, including smallpox, measles, and others.

                          The CDC targets the transmission of influenza, including the H1N1 swine flu, and launched websites to educate people about hygiene. [55]

                          Within the division are two programs: the Federal Select Agent Program (FSAP) and the Import Permit Program. The FSAP is run jointly with an office within the U.S. Department of Agriculture, regulating agents that can cause disease in humans, animals, and plants. The Import Permit Program regulates the importation of "infectious biological materials." [56]

                          The CDC runs a program that protects the public from rare and dangerous substances such as anthrax and the Ebola virus. The program, called the Federal Select Agent Program, calls for inspections of labs in the U.S. that work with dangerous pathogens. [57]

                          During the 2014 Ebola outbreak in West Africa, the CDC helped coordinate the return of two infected American aid workers for treatment at Emory University Hospital, the home of a special unit to handle highly infectious diseases. [58]

                          As a response to the 2014 Ebola outbreak, Congress passed a Continuing Appropriations Resolution allocating $30,000,000 towards CDC's efforts to fight the virus. [59]

                          Non-communicable diseases

                          The CDC also works on non-communicable diseases, including chronic diseases caused by obesity, physical inactivity and tobacco-use. [60]

                          Antibiotic resistance

                          The CDC implemented their National Action Plan for Combating Antibiotic Resistant Bacteria as a measure against the spread of antibiotic resistance in the United States. This initiative has a budget of $161 million and includes the development of the Antibiotic Resistance Lab Network. [61]

                          Global health

                          Globally, the CDC works with other organizations to address global health challenges and contain disease threats at their source. They work with many international organizations such as the World Health Organization (WHO) as well as ministries of health and other groups on the front lines of outbreaks. The agency maintains staff in more than 60 countries, including some from the U.S. but more from the countries in which they operate. [62] The agency's global divisions include the Division of Global HIV and TB (DGHT), the Division of Parasitic Diseases and Malaria (DPDM), the Division of Global Health Protection (DGHP), and the Global Immunization Division (GID). [63]

                          The CDC is integral in working with the WHO to implement the International Health Regulations (IHR), an agreement between 196 countries to prevent, control, and report on the international spread of disease, through initiatives including the Global Disease Detection Program (GDD). [64]

                          The CDC is also a lead implementer of key U.S. global health initiatives such as the President's Emergency Plan for AIDS Relief (PEPFAR) and the President's Malaria Initiative. [65]

                          Travelers' health

                          The CDC collects and publishes health information for travelers in a comprehensive book, CDC Health Information for International Travel, which is commonly known as the "yellow book." [66] The book is available online and in print as a new edition every other year and includes current travel health guidelines, vaccine recommendations, and information on specific travel destinations. The CDC also issues travel health notices on its website, consisting of three levels:

                          "Watch": Level 1 (practice usual precautions)

                          "Alert": Level 2 (practice enhanced precautions)

                          "Warning": Level 3 (avoid nonessential travel) [67]

                          Vaccine safety

                          The CDC monitors the safety of vaccines in the U.S. via the Vaccine Adverse Event Reporting System (VAERS), a national vaccine safety surveillance program run by CDC and the FDA. "VAERS detects possible safety issues with U.S. vaccines by collecting information about adverse events (possible side effects or health problems) after vaccination." [68] The CDC's Safety Information by Vaccine page provides a list of the latest safety information, side effects, and answers to common questions about CDC recommended vaccines. [69]

                          Foundation

                          The CDC Foundation operates independently from CDC as a private, nonprofit 501(c)(3) organization incorporated in the State of Georgia. The creation of the Foundation was authorized by section 399F of the Public Health Service Act to support the mission of CDC in partnership with the private sector, including organizations, foundations, businesses, educational groups, and individuals. [70] [71]

                          Controversies

                          Tuskegee study of untreated syphilis in Black men

                          For 15 years, the CDC had direct oversight over the Tuskegee syphilis experiment. [72] In the study, which lasted from 1932 to 1972, a group of Black men (nearly 400 of whom had syphilis) were studied to learn more about the disease. The disease was left untreated in the men, who had not given their informed consent to serve as research subjects. The Tuskegee Study was initiated in 1932 by the Public Health Service, with the CDC taking over the Tuskegee Health Benefit Program in 1995. [72]

                          Gun violence

                          An area of partisan dispute related to CDC funding is studying firearms effectiveness. Although the CDC was one of the first agencies to study gun violence as a public health issue, in 1996 the Dickey Amendment, passed with the support of the National Rifle Association, states "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control". [73] Advocates for gun control oppose the amendment and have tried to overturn it. [74]

                          Looking at the history of the passage of the Dickey Ammendment, in 1992, Mark L. Rosenberg and five CDC colleagues founded the CDC's National Center for Injury Prevention and Control, with an annual budget of approximately $260,000. They focused on "identifying causes of firearm deaths, and methods to prevent them". [75] Their first report, published in the New England Journal of Medicine in 1993 entitled "Guns are a Risk Factor for Homicide in the Home", reported "mere presence of a gun in a home increased the risk of a firearm-related death by 2.7 percent, and suicide fivefold—a "huge" increase." [75] In response, the NRA launched a "campaign to shut down the Injury Center." Two conservative pro-gun groups, Doctors for Responsible Gun Ownership and Doctors for Integrity and Policy Research joined the pro-gun effort, and, by 1995, politicians also supported the pro-gun initiative. In 1996, Jay Dickey (R) Arkansas introduced the Dickey Amendment statement stating "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control" as a rider. [73] in the 1996 appropriations bill." [75] In 1997, "Congress re-directed all of the money for gun research to the study of traumatic brain injury." [75] David Satcher, CDC head 1993-98 before he was fired [76] advocated for firearms research. [75] In 2016 over a dozen "public health insiders, including current and former CDC senior leaders" told The Trace interviewers that CDC senior leaders took a cautious stance in their interpretation of the Dickey Amendment and that they could do more but were afraid of political and personal retribution. [75] Rosenberg told The Trace, "Right now, there is nothing stopping them from addressing this life-and-death national problem!" [75]

                          In 2013, the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics sent a letter to the leaders of the Senate Appropriations Committee asking them "to support at least $10 million within the Centers for Disease Control and Prevention (CDC) in FY 2014 along with sufficient new taxes at the National Institutes of Health to support research into the causes and prevention of violence. Furthermore, we urge Members to oppose any efforts to reduce, eliminate, or condition CDC funding related to violence prevention research." [77] Congress maintained the ban in subsequent budgets. [74]

                          COVID-19

                          The first confirmed case of COVID-19 was discovered in the U.S. on January 20, 2020. [78] But widespread COVID-19 testing in the United States was effectively stalled until February 28, when federal officials revised a faulty CDC test, and days afterward, when the Food and Drug Administration began loosening rules that had restricted other labs from developing tests. [79] In February 2020, as the CDC's early coronavirus test malfunctioned nationwide, [80] CDC Director Robert R. Redfield reassured fellow officials on the White House Coronavirus Task Force that the problem would be quickly solved, according to White House officials. It took about three weeks to sort out the failed test kits, which may have been contaminated during their processing in a CDC lab. Later investigations by the FDA and the Department of Health and Human Services found that the CDC had violated its own protocols in developing its tests. [80] [81] In November 2020, NPR reported that an internal review document they obtained revealed that the CDC was aware that the first batch of tests which were issued in early January had a chance of being wrong 33 percent of the time, but they released them anyway. [82]

                          In May 2020, The Atlantic reported that the CDC was conflating the results of two different types of coronavirus tests — tests that diagnose current coronavirus infections, and tests that measure whether someone has ever had the virus. The magazine said this distorted several important metrics, provided the country with an inaccurate picture of the state of the pandemic, and overstated the country's testing ability. [83]

                          In July 2020, the Trump administration ordered hospitals to bypass the CDC and instead send all COVID-19 patient information to a database at the Department of Health and Human Services. Some health experts opposed the order and warned that the data might become politicized or withheld from the public. [84] On July 15, the CDC alarmed health care groups by temporarily removing COVID-19 dashboards from its website. It restored the data a day later. [85] [86] [87]

                          In August 2020, the CDC recommended that people showing no COVID-19 symptoms do not need testing. The new guidelines alarmed many public health experts. [88] The guidelines were crafted by the White House Coronavirus Task Force without the sign-off of Anthony Fauci of the NIH. [89] [90] Objections by other experts at the CDC went unheard. Officials said that a CDC document in July arguing for "the importance of reopening schools" was also crafted outside the CDC. [91] On August 16, the chief of staff, Kyle McGowan , and his deputy, Amanda Campbell , resigned from the agency. [92] The testing guidelines were reversed on September 18, 2020, after public controversy. [93]

                          In September 2020, the CDC drafted an order requiring masks on all public transportation in the United States, but the White House Coronavirus Task Force blocked the order, refusing to discuss it, according to two federal health officials. [94]

                          In October, it was disclosed that White House advisers had repeatedly altered the writings of CDC scientists about COVID-19, including recommendations on church choirs, social distancing in bars and restaurants, and summaries of public-health reports. [95]

                          In the lead up to 2020 Thanksgiving, at a press conference on November 20 the CDC advised Americans not to travel for the holiday saying, "It's not a requirement. It's a recommendation for the American public to consider." The White House coronavirus task force had its first public briefing in months on that date but travel was not mentioned. [96]

                          During the pandemic the CDC Morbidity and Mortality Weekly Report (MMWR) came under pressure from political appointees at the Department of Health and Human Services (HHS) to modify its reporting so as not to conflict with what Trump was saying about the pandemic. [97] Starting in June 2020, Michael Caputo, the HHS assistant secretary for public affairs, and his chief advisor Paul Alexander tried to delay, suppress, change, and retroactively edit MMR releases about the effectiveness of potential treatments for COVID-19, the transmissibility of the virus, and other issues where the president had taken a public stance. [97] Alexander tried unsuccessfully to get personal approval of all issues of MMWR before they went out. [98] Caputo claimed this oversight was necessary because MMWR reports were being tainted by "political content" he demanded to know the political leanings of the scientists who reported that hydroxychloroquine had little benefit as a treatment while Trump was saying the opposite. [97] In emails Alexander accused CDC scientists of attempting to "hurt the president" and writing "hit pieces on the administration". [99] In October 2020, emails obtained by Politico showed that Alexander requested multiple alterations in a report. The published alterations included a title being changed from "Children, Adolescents, and Young Adults" to "Persons." One current and two former CDC officials who reviewed the email exchanges said they were troubled by the "intervention to alter scientific reports viewed as untouchable prior to the Trump administration" that "appeared to minimize the risks of the coronavirus to children by making the report’s focus on children less clear." [100]

                          A poll conducted in September 2020 found that nearly 8 in 10 Americans trusted the CDC, a decrease from 87 percent in April 2020. Another poll showed an even larger drop in trust with the results dropping 16 percentage points. [101] As the trustworthiness eroded, so too did the information it disseminates. [92] The diminishing level of trust in the CDC and the information releases also incited "vaccine hesitancy" with the result that "just 53 percent of Americans said they would be somewhat or extremely likely to get a vaccine." [101]

                          In September 2020, amid the accusations and the faltering image of the CDC the agency's leadership was called into question. Former Acting Director at the CDC, Richard Besser, said of Dr. Redfield that “I find it concerning that the CDC director has not been outspoken when there have been instances of clear political interference in the interpretation of science.” [102] In addition, Mark Rosenberg, the first director of CDC’s National Center for Injury Prevention and Control, also questioned Redfield's leadership and his lack of defense of the science. [102]

                          Historically the CDC has not been a political agency, however, the COVID-19 pandemic, and specifically the Trump Administration's handling of the pandemic, resulted in a "dangerous shift" according to a previous CDC director and others. Four previous directors claim that the agency's voice was "muted for political reasons." [103] Politicization of the agency has continued into the Biden administration as COVID-19 guidance is contradicted by State guidance [104] and the agency is criticized as "CDC's credibility is eroding". [105]

                          In 2021, the CDC, then under the leadership of the Biden Administration, received criticism for its mixed messaging surrounding COVID-19 vaccines, mask-wearing guidance, and the state of the pandemic. [106] [107]

                          Publications

                          • CDC publications [108]
                          • State of CDC report [109]
                          • CDC Programs in Brief [110]
                          • Morbidity and Mortality Weekly Report[111]
                          • Emerging Infectious Diseases (monthly journal) [112]
                          • Preventing Chronic Disease[113]

                          Popular culture

                          Zombie Apocalypse campaign

                          On May 16, 2011, the Centers for Disease Control and Prevention's blog published an article instructing the public on what to do to prepare for a zombie invasion. While the article did not claim that such a scenario was possible, it did use the popular culture appeal as a means of urging citizens to prepare for all potential hazards, such as earthquakes, tornadoes, and floods. [114]

                          According to David Daigle, the Associate Director for Communications, Public Health Preparedness and Response, the idea arose when his team was discussing their upcoming hurricane-information campaign and Daigle mused that "we say pretty much the same things every year, in the same way, and I just wonder how many people are paying attention." A social-media employee mentioned that the subject of zombies had come up a lot on Twitter when she had been tweeting about the Fukushima Daiichi nuclear disaster and radiation. The team realized that a campaign like this would most likely reach a different audience from the one that normally pays attention to hurricane-preparedness warnings and went to work on the zombie campaign, launching it right before hurricane season began. "The whole idea was, if you're prepared for a zombie apocalypse, you're prepared for pretty much anything," said Daigle. [115]

                          Once the blog article was posted, the CDC announced an open contest for YouTube submissions of the most creative and effective videos covering preparedness for a zombie apocalypse (or apocalypse of any kind), to be judged by the "CDC Zombie Task Force". Submissions were open until October 11, 2011. [116] They also released a zombie-themed graphic novella available on their website. [117] Zombie-themed educational materials for teachers are available on the site. [118]

                          See also

                          References

                          Citations

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                          5. Niesse, Mark. "City of Atlanta's expansion to Emory and CDC approved". Atlanta Journal-Constitution . Retrieved December 5, 2017 .
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                          7. "Mission, Role and Pledge". Centers for Disease Control and Prevention . Retrieved January 16, 2017 .
                          8. ^CDC Home Page, cdc.gov retrieved November 19, 2008.
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                          The Ebola Scare, brought to you by WHO and CDC propaganda and a push for a mandatory vaccine

                          Over the past few decades the Center for Disease Control (CDC), the World Health Organization (WHO) and their insidious cohorts and lobbyists at big pharma have attempted several times to get a ‘pandemic’ off the ground that would include forced vaccinations, such as with Swine Flu and Bird Flu and even basic seasonal influenza. This is why all drug companies have been granted 100% immunity from lawsuits for faulty, dangerous, haphazard and untested vaccinations, immunizations, inoculations and oral vaccines like for Polio.

                          Most Americans have no clue that the CDC is a for-profit corporation listed on Dun and Bradstreet. The CDC promotes vaccines with full awareness that the vaccine manufacturers are immune from all liability should their products cause harm, or even death. What’s more is that the The CDC owns a patent on the Ebola virus, which would include patent rights and the rights to profit from an untested Ebola vaccine.

                          The CDC, the WHO and the media broadcasted fake ebola pandemic news and statistics, just as they did during the fake swine flu pandemic in 2009. The CDC does not serve the public, but implements political agendas and policies on behalf of those that control the White House, who also invest in Big Pharma stocks and vaccine industry profiteering strategies. That’s another reason why the CDC offers financial bounties to state public health entities.

                          CDC supports several corrupt industries, and has since 1946

                          The CDC is a federal agency under the Department of Health and Human Services, the same umbrella organization that couldn’t handle Obamacare technical nightmares with registering online according to laws and tax penalties imposed by the IRS. Headquartered in DeKalb County, Georgia, just northeast of Atlanta, the CDC is supposed to focus national attention on food borne pathogens and environmental health, but chemical agriculture goes unchecked in America, with more deadly pesticides sprayed on crops that are already containing genetically modified organisms that create pesticide inside the plants, thus the food. Since cancer and Alzheimer’s are diseases, the CDC should be heavily regulating pesticides and heavy metal toxins in the food supply, but they turn their heads instead to support corporate industries that lobby in Washington with big money and insidious agendas. The CDC is supposed to provide information on non-infectious diseases such as obesity and diabetes, but those statistics are skyrocketing in America. How far does cancer and diabetes date back in the US? After WWII, the U.S. began processing food and using chemicals for medicine, like prescriptions and vaccines. Coincidentally, this is when the CDC was founded, and the pharmaceutical conglomerate I.G. Farben from Nazi Germany would soon be a part of “Big Pharma” in America.

                          In fact, the CDC was founded just after WWII as was a branch of the US Public Health Service and the office was based in Atlanta due to malaria being endemic in that southern region of the USA. The CDC-to-be was called Communicable Disease Center in 1946. At the time, more than half of it’s personnel were engaged in mosquito “abatement” and habitat control to try and eradicate malaria in the USA. Although the main jobs at the CDC back then were entomology and engineering, more than six million homes were sprayed with DDT. How could they have NOT known the cancerous effects of DDT on humans or have run any laboratory safety tests on rats? The end game for the CDC is disease control, but the means of that “control” has a dark history. By 1957, the CDC also got involved in controlling sexually transmitted diseases (VD). They tailored their way over the years into focuses on chronic diseases, birth defects, E. coli, biological warfare and of course, the pandemic flu. Chronic diseases are preventable, but the CDC chooses to help run chronic care management and back-end “maintenance” instead of engaging preventative measures with nutrition.

                          By 1994, the CDC was forced to admit they sent biological warfare agents to the IRAQI GOVERNMENT for five years in the 1980’s. including Botulinum toxin, West Nile virus and Dengue fever virus. So instead of preventing disease and guarding the American public, the CDC engages biological warfare by supplying the agents to other Governments engaging unethical and terroristic behavior. Still, the CDC is there to “confront the challenges of the 21st-century health threats,” according to Dr. Julie Gerberding, who announced the “reorganization” of CDC in 2005. As disease and disorder grow exponentially in the United States, so does the power of the CDC and the pharma industries that are integrated with the work force manipulating data, research and controlling public information and opinion, especially that of the CDC.

                          Swine Flu Hoax, Wasting Money and Useless Flu Shots promoted by CDC

                          In 2014, the CDC’s budget approached $7 billion. Employing about 15,000 people, including 6,000 contractors in over 150 different occupations, CDC job titles include behavioral scientist to toxicologist, to computer scientist and statistician. Currently, the CDC is still headquartered in Atlanta, but has several other locations in Cleveland, Cincinatti, Puerto Rico, Washington, and a few others. They conduct “behavioral risk factor surveillance” and run the world’s largest survey system. Note that the CDC “Foundation” operates independently from the CDC as a private, nonprofit organization incorporated in the State of Georgia. It’s creation was authorized (as part of a public health service act) to support the mission of the CDC in PARTNERSHIP with the PRIVATE SECTOR, including businesses and individuals.

                          This year (2015), the CDC admitted the flu shot doesn’t even work and they still pushed people to get it, well aware of the neurotoxins in flu shots that lead to autism, central nervous system disorders, allergies to dairy and peanuts (peanut oil and casein milk are used to brew bacteria and viruses in the lab and trace amounts still exist in the vaccines), auto-immune disorders and reduction of overall immunity. (2) (3) Even the swine flu turned out to be a huge hoax and millions of vials of serum were auspiciously sold (for great profit) and stockpiled around the world as a result. (4) Americans are beginning to question exactly who should be making decision about vaccines as it becomes more evident these are not based on sound science or CDC research and proven safety, effectiveness and objective advice. The legislatures and the vaccine manufacturers are sharing the same wallet, and it puts doctors, parents and their children all at risk.

                          Profits, not science, motivate mandates coming from the CDC – according to Whistle-blowers from the INSIDE

                          In August of 2014, Alternative Health Newsaccross the world covered the CDC scientist Dr. William Thompson blowing the whistle on the MMR-II vaccine causing autism in African American boys under age three – this report was buried by the CDC and altered later. His guilt weighed so heavily on Dr. Thompson when he saw parents out in public with extremely autistic children and so Dr. Thompson “spilled the beans” on the CDC and vaccine fraud and chemical violence that continues today with the vaccine industry.

                          One of the head scientists at the CDC went public (via his law firm posting his letters) admitting to scientific FRAUD having taken place a decade ago and continuing to hold false merit for other dangerous drugs/vaccines approved and administered in the US market today. This seniior scientist, who has worked at the CDC, the Centers for Disease Control and Prevention since 1998, confessed to omitting statistically significant information in a 2004 article published in the journal of Pediatrics. That information showed that African American males who received the MMR vaccine before age 36 months were at INCREASED RISK FOR AUTISM. He also confessed that final study protocol was NOT followed after those findings were buried. (6)

                          Dr. Thompson confessed that the CDC was not honest about the risks associated with MMR vaccines, made by Merck, and to top things off, most vaccines contain many of the same neurotoxic ingredients as the MMR, including gelatin, human albumin, sorbitol (artificial sweetener) and bovine cow serum. (7) The M-M-Rvax, or Measles and Mumps LIVE Virus Vaccine has been exposed as toxic by one of CDC’s own head scientists, yet not one TV network covered the breaking news – not ABC, CBS, NBC, CNN, FOX, MSNBC – no mainstream media coverage at all not the New York Times, not the Washington Post – in fact, complete blackout of mainstream media coverage.

                          Natural News first broke the story by publishing secretive emails between Dr. Thompson and his CDC colleagues, and less than a day later Dr. Thompson went public with his full confession about medical fraud at the HIGHEST LEVELS of the CDC. Falsification of such research by the CDC opens a “can of worms” that several other recommended forms of medicine do not stand up to true efficacy tests nor ethical standards. Now the questions of efficacy and safety for pharmaceutical prescription medications, all vaccines and flu shots, and chemotherapy must come into question. Dr. Willaim Thompson condemned the CDC’s secrecy regarding vaccine risks and proves the CDC knowingly hides the truth about vaccine risks from the public. He says the CDC should “properly convey the risks associated with receipt of those vaccines,” including a moral obligation, he adds. This is the complete opposite of the mission statement on the CDC website.

                          One top physician who previously did work for drug giant Merck & Co.made groundbreaking admissions about the dangers of the Gardisil vaccine for cervical cancer. The only cancer that is contagious is said to often be defeated by the normal human immune system and the vaccination (only works for a few years, if it does) puts individuals at risk of paralysis, encephalitis, Guillain-Barre syndrome and a host of other debilitating ailments. (8)

                          Advisory Committee on Immunization Practices (ACIP) is the hand-picked “sales” team for the CDC’s vigorous vaccine enforcement mandates

                          The ACIP recommends, on the CDC’s behalf, which vaccines are administered (by law) to American children. The CDC then offers financial bounties to state departments of health for each “fully vaccinated” child. The Ohio Department of Health recieves such bonus payments to the tune of $1 million recently. At CDC national immunization conferences, Merck and other vaccine manufacturers “wine and dine” attendees who make their living promoting (and administering) vaccines. Even the American Academy of Pediatrics (AAP) supports mandatory chicken pox vaccines, even though the chicken pox is rather harmless but the vaccine contains known neurotoxins however, that becomes less surprising when one finds out that the AAP shares financial ties with Merck, having solicited funds from them ($100,000) to help build their new headquarters in suburban Chicago. These typical conflicts of interest between the CDC, advisory committees and vaccine manufacturers are leading more and more health enthusiasts to question vaccines and Western medicine in general, and look instead toward holistic healing, natural cancer prevention and natural immunity from whole, organic raw foods.

                          Hired consultants and media hacks like Dr. Paul Offit (9) speak at American Legislative Exchange Council meetings to stage mandatory vaccination initiatives that benefit them financially while compromising severely American health. From pushing hepatitis B vaccines on children to selling fake swine flu cures, MDs and paid shills sell the country on infectious disease fear and propaganda while pushing their business agendas.

                          CDC’s Ebola Haphazards and Importing Ebola to U.S. Soil

                          Oct 2014: Lacking any obvious principle of organization, the US federal government agency CDC exposed hundreds of Americans to Ebola, a deadly disease without cure, for no good reason. The CDC told “ebola” nurse Amber Jay Vinson she could safely fly from Cleveland, Ohio, to Dallas, Texas, because her fever was below the official mark set of 100.4 degrees. Arrogant US officials arrived at a certain temperature and these are their official Ebola-safety guidelines. Turns out the nurse had Ebola. Nurse Vinson had provided care for the now-deceased Thomas Eric Duncan, the “patient zero” – or first known case of Ebola on US soil since the major outbreaks in Africa. The CDC told her to fly on an airline, where the dirtiest seats and tray tables in the world exist and are not even regulated to be cleaned, ever. Airplanes can be as bad or worse than subways and buses for starting worldwide pandemics. The nurse had alerted the CDC several times before taking the flight that she had a temperature, and they knew who she was. The CDC declared that she was not a “high risk.” The CDC guidance in this “setting” outlines the need for controlled movement. How can one be controlled in an airplane, using the same seat cushions, tray table, bathroom and more with 100 other people for hours – – how can that be “controled movement?” That’s chaos. “She should not have traveled on a commercial airline,” said Dr. Thomas Frieden, the CDC ringleader dishing out conflicting information about Ebola risks since the outbreak started. (10)

                          CDC Supports Mandatory Vaccination behind other Agenda pushed by Special Interests

                          Mandatory vaccination for entire US states is underway right now. California has already passed legislation for all public and private school children to be force vaccinated or not attend school. The right to attend school has been taken away by the vaccine industry unless you believe that injecting known neurotoxins are the only way to prevent infectious disease, or you take the Government forced medicine and keep quiet about it. Ohio and Florida are pushing hard for other mandatory vaccines, and there is national support for a bill to force-vaccinate the entire country. Drug companies are running the show and the CDC is letting them push all the buttons and inject America with as many inoculations as they deem necessary to meet investor expectations and efficacy demands for marketing, such as the MMR vaccine that has been linked to autism and the highly controversial HPV vaccinethat has been linked to paralysis, coma and death.

                          Recalling the Swine Flu HOAX of 2008

                          Federal funding, expenditures, research and practices have all come under fire lately for the CDC. Under intense scrutiny by truth media, alternative media, alternative health news and health enthusiasts from coast to coast, the public is finding investigation after investigation revealing the CDC is rotten to the core, and soon there may be too much “dirt” for the White House to cover up completely. The swine flu turned out to be normal seasonal flu cases hyped as swine in order to sell millions of vaccines to panicked patriots. Eventually the CDC said they just couldn’t “track” swine flu cases anymore because it became too difficult, but in reality, the CDC got caught cooking the swine flu statistics. The swine flu, it turns out, wasn’t even as dangerous as the seasonal flu, so the pandemic panic created by the CDC unraveled at the seams and fell apart completely eventually. Millions of dollars worth of the “swine flu” vaccine were purchased and stockpiled around the world, never to be refunded or admitted to be a hoax and therefore illegally perpetrated upon the unknowing, believing US masses that worship Western chemical medicine. Now the US public is beginning to suspect that vaccines have been toxic all along, and that may be why the CDC and the vaccine industry are pushing so hard for national mandatory vaccination laws now, before everyone figures out the truth. (12)