When Republicans were talking about reopening the government piece by piece, certain very visible or emotionally-charged programs rose to the top. Especially emotional was a discussion about reopening the national parks and memorials. Many conservatives, who came out in full force this last weekend, felt the metal barricades were dishonoring to the dead. Similarly, the week before, there were cries to refund the National Institutes of Health to ensure children cancer patients were put on experimental treatments.
What was left out of the discussions was the Centers for Disease Control and Prevention. Without the CDC, we have no real-time tracking of disease outbreaks.
"To me the CDC and infectious-disease monitoring is to the military what a hostile enemy threat is," Gregory Poland, an infectious-disease expert at the Mayo Clinic, explains. "We don't furlough our military and say, 'Well, we won't just have any national security until the Congress gets its act together.' But why aren't we willing to save something that could cost just as many lives?"
When it comes to data, we already have a nationalized health care system. The CDC provides disease-tracking services that no other agency or private entity does. The CDC is the organization that makes the judgement call about what flu vaccines to distribute across the entire nation. Without the CDC, we have no real-time tracking of disease outbreaks. It monitors high-security labs that do tests on deadly pathogens like anthrax. It collaborates across international borders to stop outbreaks.
"That's what CDC does and we have no other agency to do it," Poland says.
So while the closing of the WWII memorial offends, the closing of the CDC could have serious consequences. Poland further explains the consequences, in this lightly edited interview.
How is the country's protection against disease outbreaks diminished during the shutdown?
The issue isn't really only for flu, but for a variety of infectious diseases, we don't have real-time surveillance. Hence, we lose a situational awareness, or intelligence about what's happening. Remember, CDC has [furloughed] 9,000 workers; they've got about 4,000 left. Imagine trying to do your job with two-thirds less resources.
They are responsible for putting together the information they get from individual states into a cohesive picture. We don't have that ability. They are responsible for monitoring what's happening internationally and what could be imported into the U.S. We don't have that capability. We can't follow flu outbreaks, we can't sequence viruses.
[The shutdown] really does put us at risk. In terms of influenza it puts us at risk from several points of view. Number one: We don't know what's happening nationally. All we can do is depend on what individual states report. Many of the state-level public health departments are underfunded and understaffed. We don't have the ability to sequence viruses and realize—whoops—suddenly a novel virus, like a new pandemic virus has popped up. We would have delayed recognition of that. We might not have the ability to determine whether any of the viruses circulating are resistant to any of the antivirals we have. That information is important to get out to physicians, so they can treat—let's say you have a young child or a pregnant woman on a ventilator due to complications of influenza.