Why the CDC Should Never Have Gotten Involved in Manufacturing Consent
Epidemiologists are stuck in a real-time feedback loop with public health

By Douglas Rushkoff. Published in Medium on 6 August 2021

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I’ve been reading the critique. Everyone seems to hate the CDC these days. After telling vaccinated people in May that we can go maskless, they reversed course last week, instructing everyone to mask up wherever the virus is spreading rapidly.

One day, we’re told we’re almost completely immune to the virus, and the next we find out the “new” variant (really a few months old) actually spreads among immunized people as readily as chicken pox. At the same time, CDC Director Rochelle Walensky, MD, tells us the only real reason for vaccinated people to wear masks is to protect the unvaccinated. “It’s a pandemic of the unvaccinated,” she explained — a line apparently deemed rhetorically fit enough for the president to repeat at his press conference.

Like many of the reversals and clarifications from the CDC, health officials, and elected leaders since the beginning of the pandemic, all sides jump on any inconsistencies. Twitter leads the way, but the entire mediasphere goes on the attack. Conspiracy theorists hatch new plots to explain what’s “really” going on. Fearful parents blame the CDC for having put their children in harm’s way. Anti-maskers cry foul. Even our most respected science journalists can’t help but critique the CDC’s initial analyses and recommendations — with the benefit of a bunch of new information that the CDC didn’t have at the time.

I understand the aggravation. But it’s way too easy to attack the CDC for mishandling this whole thing, when they’re being charged with both solving the pandemic and communicating effectively to the American people. You’d think being totally transparent about the science would be the appropriate strategy, but this may not be the case.

For example, when the CDC told vaccinated people they didn’t have to wear masks, the science was most certainly correct. Masks are much more about protecting other people from our spit than protecting the wearer from aerosol particles of virus. Sure, if someone sneezes on your face, it’d be nice to be wearing a mask. But since the primary and effective purpose of surgical masks has always been to contain the user’s germs, the idea that vaccinated people could forgo wearing masks made sense. From a behavioral standpoint, it seemed to make sense, too, since the privilege of going maskless might encourage more people to get vaccinated.

The science was true, but the recommendation may have been wrong because unvaccinated people refusing to wear masks at all were indistinguishable from vaccinated people taking them off for the first time. “That was scientifically correct from a virology standpoint,” Carlos del Rio, MD, of Emory University told the New York Times. “It was wrong from a behavioral science standpoint.”

There’s the rub. The things the CDC says are not mere reporting after the fact. They make recommendations that some people follow, some people abuse, and still other people resist on impulse. (As a play on reverse psychology, last week I jokingly suggested we start the rumor that anti-vax disinformation was being spread to red states by Democrats who were hoping to kill off Republican voters.) Propaganda isn’t just about changing what people believe, it’s about changing what people actually do. And this is where the CDC may be over their heads.

For instance, shortly after the CDC began recommending vaccines for 12–18 year olds, some reports emerged from Israel showing that a small number of teen boys had developed myocarditis after receiving injections. The CDC stayed quiet as some journalists sounded the alarm—even if only in the form of asking questions. By the time the CDC acknowledged the link, it was “old news,” and the public’s trust level was further eroded. Why did they wait so long, we wondered? What else are they hiding? Maybe the guy on Facebook who says vaccinations make us infertile is telling the truth?

The CDC likely delayed making a statement about the potential side effect because of the debacle they had just been through after halting administration of the Johnson & Johnson vaccine pending review of some reports of thrombosis in women. The shot was eventually cleared of all charges, but then it was too late. No one wanted that vaccine after it was unpaused, and even the other vaccines were being met with more fear and trepidation.

That’s why the CDC was reluctant to tell people about a possible incidents of myocarditis. They don’t want to frighten us, increase vaccine hesitancy, and, in turn, lead to more spread of the virus. It’s not that they’re lying to us as a public so much as they managing us as they would manage the their patients.

As any doctor knows, a medical outcome is only as successful as the patient’s “compliance” with the prescribed protocols. Will they take all their medicine? Will they stop smoking? Will they do the painful but necessary rehab exercise? So when the CDC communicates something to the public, they’re not just thinking about telling us the absolute truth, but they’re considering how the information they’re releasing will influence our behavior, which will in turn change the course of the pandemic. It’s a feedback loop.

Jen Kates, of the Kaiser Family Foundation, articulated it best in her interview with the New York Times. “What’s happening is this is real-time public health messaging in a pandemic around data that is just emerging. That is just the reality, and that doesn’t necessarily provide comfort or always the kind of answers that people understand.”

This is a phenomenon I wrote about back in 2013 in my book, Present Shock. In the digital media environment, everything happens at once. So the CDC may be releasing messaging about newly published data after people on Twitter have already responded to the pre-published version — all while trying to anticipate how their messaging might change people’s behavior and the course of the disease through our society.

That’s a pretty complex communications task, even for seasoned public relations specialists. But for a group of epidemiologists? I’d venture that it’s impossible.

Maybe Walter Lippmann, the father of public relations, was right. Perhaps a “council of experts” should be determining the best, most scientifically grounded path forward, but then a totally separate group of people — the public relations specialists — should be in charge of “manufacturing consent” for those policies.

The assumption, in that case, would be that we regular people can’t quite handle the truth. I’m not sure I agree with that sentiment, but I’d sure love to live in a world where I don’t necessarily need to understand the whole truth about everything. I like making decisions for myself, but I also like having an auto mechanic, financial advisor, and school principal whom I can trust to apply their expertise in my best interest so I don’t have to know everything, myself.

The CDC can’t both do everything right and manage a real-time communications challenge of this magnitude in such a hostile environment. The best thing we can do moving forward is ask ourselves how every article we write, post we “like,” or sentence we tweet impacts the communications environment in which we are all enmeshed, and the poor folks at the CDC who are now so busy second-guessing everything they say lest it trigger one of our attacks. A little slack goes a long way.