NEW YORK — Disease investigators cannot be dispatched quickly. There will be no televised press conference to inform the public. There are no timely health alerts for doctors.
Many experts say the U.S. government’s top public health agency, the Centers for Disease Control and Prevention, is unusually inactive amid the hantavirus outbreak that has engulfed Americans and made headlines around the world.
“We seem to have things very well under control,” he told reporters Friday night against President Donald Trump.
Experts say the situation on cruise ships has not worsened because, unlike COVID-19, measles and influenza, hantavirus does not spread easily. Over the past week, health experts in other countries, not the United States, have been primarily dealing with the outbreak.
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“The CDC is not even a party,” says Lawrence Gostin, an international public health expert at Georgetown University. “I’ve never seen anything like that.”
It wasn’t until late Friday that CDC action accelerated.
Health authorities have confirmed the dispatch of a team to Spain’s Canary Islands, and the ship is expected to arrive early Sunday local time to meet the Americans on board. They said a second team would head to Offutt Air Force Base in Nebraska as part of plans to evacuate American passengers from the ship to a quarantine center at the University of Nebraska for evaluation and monitoring. The CDC also issued its first health alert to U.S. doctors, advising them of the possibility of imported cases.
At an initial conference held by telephone for invited reporters only on Saturday, officials promised to be transparent in updating the public, but said the media could not name speakers under rules set by Health Secretary Robert F. Kennedy Jr.’s aides. He did not directly answer questions about whether American passengers could leave the university’s medical facilities at any time.
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Some experts said the CDC’s diminished role in the outbreak shows it is no longer the global health force or national health protector it once was.
The hantavirus outbreak is a “surveillance event” that shows how prepared the country is for the threat of disease. And at this point, it’s very unfortunate that we’re not ready,” said Dr. Jeanne Marrazzo, CEO of the Infectious Diseases Society of America.
how the epidemic developed
Early last month, a 70-year-old Dutch man became ill with a fever while on a cruise ship from Argentina to Antarctica and some islands in the South Atlantic. He died within a week. Many more people fell ill, including the man’s wife and a German woman, who both died.
Hantavirus was first identified as the cause of illness in one of the cases on May 2nd. The World Health Organization sprang into action and called it an outbreak by Monday. There were about 24 Americans on board the ship, about seven of whom disembarked last month and 17 remaining on board.
WHO takes center stage
CDC has been collaborating with WHO in such situations for decades. The CDC served as the core of any international investigation, providing the staff and expertise to unravel the mystery of the outbreak, develop ways to control it, and tell the public what they should know and how they should worry.
Actions like this were a big reason why the CDC developed its reputation as the world’s premier public health agency.
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But this time, the WHO took center stage. The government has carried out a risk assessment to inform people that this outbreak is not a pandemic threat.
“I don’t think this is a major threat to the United States,” said Jennifer Nuzzo, director of Brown University’s Pandemic Center. But the way this situation played out “just shows how hollow and empty the CDC is right now,” she said.
Chaos under the Trump administration
The current situation comes after a turbulent 16 months in which the Trump administration withdrew from the WHO, at times limited CDC scientists’ ability to speak to international stakeholders, and embarked on a plan to build its own global public health network through one-on-one agreements with countries.
The administration has laid off thousands of CDC scientists and public health experts, including members of the CDC’s Ship Hygiene Program.
As this unfolds, President Kennedy said he is working to “restore CDC’s focus on infectious diseases, invest in innovation, and rebuild trust through honesty and transparency.”
Waiting to hear from CDC
The CDC hasn’t been completely silent on hantaviruses.
The agency issued a brief statement Wednesday saying the risk to the American public is “extremely low” and describing the U.S. government as a “world leader in global health security.”
“Not only was it not helpful, it was actually damaging, because a core principle of public health communication is humility,” Nuzzo said.
Dr. Jay Bhattacharyya, acting director of the CDC, posted a message on social media saying the agency is lending its expertise to coordinating with other federal agencies and international authorities. Arizona officials said this week they learned from the CDC that one of the Americans who disembarked the ship, who was asymptomatic and not considered contagious, had already returned to the state. WHO officials said the CDC is sharing technical information.
The CDC is also “monitoring the health status and preparing medical assistance for all American passengers on the cruise,” Bhattacharyya wrote.
But federal health officials have remained largely silent, declining requests for interviews. The CDC official’s first on-camera appearance came Saturday morning, when Bhattacharya appeared on a Fox News show and said, “My message to the American people is, don’t worry.” But he got some details wrong and overstated what was known about the outbreak.
He incorrectly said two passengers in their 80s died after contracting the virus while birdwatching in Argentina. The travelers are a 70-year-old Dutch man and his 69-year-old wife, and Argentine health authorities believe they may have contracted the virus while out birdwatching, but there is no confirmation.
Comparison with new coronavirus infection
In interviews this week, some experts drew comparisons to the 2020 incident involving the Diamond Princess cruise ship docked in Japan, which was the scene of one of the first major coronavirus outbreaks outside China.
The CDC sent personnel to ports, helped evacuate American passengers, conducted quarantines, shared genetic data about the virus, worked with the WHO and Japan, held public briefings and quickly released a report that “has become the world’s reference data on coronavirus transmission on cruise ships,” said former CDC Director Dr. Tom Frieden.
Several aspects of the international response to the Diamond Princess were criticized, and it failed to stop the coronavirus outbreak or stop its spread around the world. But some experts say it’s not for lack of effort by the CDC.
“The CDC was at the very top of it, very visible and very aggressive in control and containment,” Gostin said, but the CDC’s work is now being delayed and curtailed.
Instead of working with nearly every country in the world through the WHO, the Trump administration has pursued bilateral health agreements with countries for information sharing, public health assistance, and what it calls “the introduction of innovative American technology.” Currently, approximately 30 agreements have been concluded.
Gostin says that’s not enough. “You can’t cover a global health crisis by just making one-to-one deals with countries,” he says.
— Mike Stobbe
Associated Press writers Ali Swenson in New York, Darlene Superville in Washington, and Susan Montoya Bryan in Albuquerque, New Mexico, contributed to this report.
