Trump's Health Policies Hinder Federal Hantavirus Communication

The Hantavirus Outbreak and the Struggles of Public Health Communication

The recent hantavirus outbreak has highlighted the challenges faced by public health agencies in effectively communicating risks to the public. This situation has been exacerbated by the lack of experienced scientists and experts in key positions, leading to a reliance on political appointees for public messaging.

Impact of Leadership Changes

The Centers for Disease Control and Prevention (CDC) has experienced significant changes in leadership over the past few years. Career scientists have been let go or have left the agency, resulting in fewer people available to respond to outbreaks and communicate with the public. This has largely left political appointees in charge of updating the public about health threats.

Several top health officials who were previously critical of the COVID-19 response are now tasked with communicating the accurate level of risk posed by the hantavirus. They face serious challenges, including a loss of trust in public health, which critics say those key officials spent years contributing to, combined with a specific mistrust of the Trump administration itself.

The Hantavirus Outbreak on the MV Hondius

The rare hantavirus outbreak aboard the cruise ship MV Hondius in the Atlantic Ocean has resulted in three deaths. More than 140 passengers and crew members were on board the ship when it left Argentina on April 1. In the U.S., 41 people are being monitored for exposure, including the highest-risk passengers who are in specialized quarantine facilities in Atlanta and Nebraska.

Public health experts have criticized the CDC's slow response to the outbreak. U.S. officials did not give their first public briefing until May 9, almost a week after the World Health Organization confirmed hantavirus infections linked to the ship. While the agency had already notified states that American passengers had returned from the ship, a formal notice to clinicians, health departments, and laboratories was not published until late last Friday.

Since then, the agency has provided daily updates to the press with the consistent message that there is little risk to the public. Interim CDC leader Jay Bhattacharya stated, "The risk to the general public remains extremely low. Currently, in the United States, there are no cases of the Andes virus, the hantavirus that is causing this outbreak."

Bhattacharya, who was one of the most prominent critics of the Biden administration’s response to the COVID-19 pandemic, argued against many of the public health mitigation measures as being too heavy-handed.

Challenges in Public Health Communication

Experts emphasize that hantavirus rarely spreads among people, and only with close contact over a period of time rather than casual interactions. David Fitter, incident manager for the CDC’s hantavirus response, said, "This is not a novel virus. This is a known virus. We’ve seen this in the United States before, and we know how to respond to it."

During a viral outbreak, health agencies must balance the need to keep the public informed of an uncertain viral threat without generating too much alarm or downplaying the risks. However, they should not go radio silent, which some public health experts said was the case last week.

As news began to spread about the outbreak on the ship, the World Health Organization was the primary source of information, not the CDC. Online influencers sought to fill the void.

"It’s very rarely the case that silence from public health agencies is a helpful and effective communication strategy," said Glen Nowak, professor and Director of the Grady College Center for Health & Risk Communication at the University of Georgia. "It leaves people to the imagination regarding why that silence is happening or why a lack of communication is happening, that maybe officials are trying to hide something, or they’re worried about saying something."

Loss of Expertise and Trust

The messenger matters just as much as the message. You would want world top experts in hantavirus to provide the information, so that people would be more trusting. Nowak, who spent 14 years as a top spokesperson for the CDC, pointed out that it's mainly been political appointees speaking, showing the loss of agency expertise.

"When you want to have political officials commenting, regardless of their party affiliation, that’s always going to be a challenge," Nowak said. "I think the other thing it speaks to is the lack of expertise, or the expertise have been lost or not heard from at agencies like the Centers for Disease Control Prevention."

The agency lost the permanent head of the Division of High-Consequence Pathogens — which includes hantavirus — in December. The permanent director of the National Center for Emerging and Zoonotic Infectious Diseases, which leads CDC’s hantavirus response, also departed, leaving a new acting director in place instead.

"There’s been significant turnover of senior scientific leaders," said Debra Houry, formerly CDC’s chief medical officer. Houry was among three senior CDC leaders who resigned last August to protest what they described as the politicization of science at the agency under Health Secretary Robert F. Kennedy Jr.

"When you have people that may not have the same medical and public health training now in charge that haven’t listened to experts," that makes it difficult to establish trust, Houry said.