Good morning. The C.D.C. acknowledged it had botched its Covid response. It is part of a broader set of failures. |
 | | Rochelle Walensky, the C.D.C. director.Pool photo by J. Scott Applewhite |
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The U.S. seemed ready for the monkeypox outbreak. It had vaccines and treatments that are effective and experts had studied the virus for decades. |
Yet the U.S. response has fallen short. The country cannot use millions of vaccine doses it owns because they were not bottled for distribution. The available vaccines and medications remain out of reach for a vast majority of Americans — a result of poor communication by federal officials and of other bureaucratic barriers. |
Monkeypox is not very deadly, so this is not a Covid-level catastrophe. But the flawed response suggests that, nearly three years after Covid first appeared, the U.S. is still unprepared for the next deadly pandemic. |
The C.D.C. director, Rochelle Walensky, acknowledged that much yesterday. She called for her agency to be overhauled after an external review found it had failed to respond quickly and clearly to Covid. She faulted the agency for acting too much like an academic institution that was focused on producing "data for publication" instead of "data for action." |
"For 75 years, C.D.C. and public health have been preparing for Covid-19, and in our big moment, our performance did not reliably meet expectations," Walensky said. |
In today's newsletter, I want to explain three vulnerabilities that Covid, and now monkeypox, exposed: unclear communication, a fragmented public health system and a tendency for public officials to be reactive instead of proactive. |
During the early days of the Covid pandemic, a lot of criticism focused on Donald Trump. He downplayed the threat, pushed the U.S. to reopen quickly after an initial lockdown and made outright false statements about treatments. |
Trump's poor performance sometimes made it seem as if he was the sole reason the U.S. had struggled more than other countries in combating Covid. But he wasn't; the broader public health system struggled, too. For its part, the C.D.C. said yesterday that its public guidance on Covid was "confusing and overwhelming." |
One memorable example was officials' initial, monthslong refusal to recommend that the public wear masks — not because they thought masks were ineffective, but because they worried that public demand would cause a shortage of masks for health care workers. |
Their hesitation represented what would become a pattern throughout the pandemic: a reluctance to communicate the truth clearly and directly. The resulting lack of clarity made it harder for Americans to act on expert advice. But it also damaged public trust, when people eventually found out they had been deceived. |
Similar problems have emerged with monkeypox. Some public health officials have been reluctant to acknowledge that the virus is mostly spreading among gay and bisexual men, out of fear of stigmatizing this group. But about 95 percent of known U.S. cases are among men who have sex with men (not all of whom identify as gay or bisexual). Failing to acknowledge that makes it harder to target and advise the most at-risk group. (I went into more detail in a previous newsletter about who should take precautions and why.) |
Effective public health messaging needs to be honest, said Ellen Carlin, a health security policy expert at Georgetown University. If officials do not trust the public with the truth, then the public will eventually stop trusting officials, too. |
 | | A monkeypox vaccination site in San Francisco this month.Jim Wilson/The New York Times |
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Another problem that made the U.S.'s Covid and monkeypox responses less effective: The American public health system is divided — among the federal government, 50 states, thousands of local governments and many more private organizations and workers both inside and outside the health care system. |
We saw the results when the U.S. first started distributing Covid vaccines. Poor planning and communication between the layers of government, along with limited supply, made it harder for front-line officials to plan for how many shots they could get in arms. Similar problems have appeared with monkeypox vaccine distribution. |
The C.D.C. is a key federal agency that is supposed to rise above this fragmentation and help coordinate the national response to disease outbreaks. But throughout the pandemic, as Walensky acknowledged, it has struggled. And it seems to be struggling with monkeypox, too. |
Many of these problems could have been avoided with better pandemic preparedness. The federal government could have, for example, bulked up mask stockpiles or manufacturing before the pandemic, easing early concerns about shortages. |
But the U.S. has underfunded public health for years, experts said. So when Covid first began to spread, officials suddenly had to shift limited resources to deal with a crisis that had caught them by surprise — making mistakes more likely. In the early days of the pandemic, experts often said that the plane was being built as it was being flown. |
Covid has worsened the problem. "Health departments have lost a lot of staff and have been very burned out," said Caitlin Rivers, a senior scholar at the Johns Hopkins Center for Health Security. "There's just not a lot left to bring resources to their full potential." |
To address the gaps, the Biden administration has called for tens of billions more in funding for pandemic preparedness. Congress has so far ignored those proposals, in what seems like history repeating itself. |
Nearly three years into Covid, the U.S. is still not ready for the next pandemic. The C.D.C. is moving to remedy some of the problems plaguing the country's public health system. Those changes, along with the broader lessons from Covid and monkeypox, could be the difference between another deadly pandemic and a crisis averted. |
 | | Liz Cheney after her concession speech this week.Kim Raff for The New York Times |
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Democrats' climate law is historic. Action on child care, elder care and paid leave must come next, writes Ai-jen Poo. |
Journalism like this is only possible with subscribers. |
 | | Randall Munroe |
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Lives Lived: Hanae Mori built a fashion house that popularized East-West styles and symbolized the rise of postwar Japan. She died at 96. |
| SPORTS NEWS FROM THE ATHLETIC |
Pressure's on: The Los Angeles Lakers' N.B.A. title window is clear after LeBron James signed a two-year contract extension yesterday. Can they get his supporting cast right, and in a hurry? That might mean Russell Westbrook out, Kyrie Irving in. |
Deshaun Watson decision still looms: Another day closer to the start of the N.F.L.'s regular season and we have no clarity on the Cleveland Browns quarterback's suspension status. A new ruling or a settlement could come at any time. |
An American soccer star on the move? Manchester United is considering bringing in the U.S. men's national team captain Christian Pulisic on loan from Chelsea. Would the move make sense? |
 | | via University of Michigan Library |
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The University of Michigan Library had described a manuscript from Galileo Galilei as "one of the great treasures" in its collection. On Wednesday, the university announced that the document — which purported to document his 1610 discovery of moons orbiting Jupiter — was a 20th-century forgery. |
Nick Wilding, an expert on forgeries who is working on a Galileo biography, first noticed that something seemed off. One clue: The ink at the top and the bottom of the page were remarkably similar, even though the two sections were supposedly written months apart. From there, he traced the manuscript to a Detroit businessman, an archbishop of Pisa and finally a notorious counterfeiter in Milan. |
 | | Paola & Murray for The New York Times |
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The pangram from yesterday's Spelling Bee was honeydew. Here is today's puzzle. |
Thanks for spending part of your morning with The Times. See you tomorrow. — German |
Matthew Cullen, Claire Moses, Ian Prasad Philbrick, Tom Wright-Piersanti and Ashley Wu contributed to The Morning. You can reach the team at themorning@nytimes.com. |
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