CDC Director fails first test of independence from RFK Jr.

Her promise to “speak truth to power” seems to have left the building. But it’s even worse.

Photo of Dr. Erica Schwartz by Finn Gomez/Getty Images

Dr. Erica Schwartz has failed her first major test as CDC Director. Yesterday, The New York Times and The Washington Post reported that the newly sworn-in Schwartz personally directed her staff not to include two likely measles-related deaths in Pennsylvania on the agency’s measles outbreak tracking webpage. For the CDC to go against a state’s determination is highly unusual, according to experts including Dr. Debra Houry and Dr. Anne Zink (two voices familiar to Inside Medicine readers) who provided analysis to The Times and The Post.

Prior to these reports, I had heard talk that CDC staffers who would normally be involved in updating the agency’s measles webpage had been iced out of the usual process—but I had not yet confirmed the provenance of that information. But given the Times and Post reports, those rumbling now seem even more credible.

Kennedy has entered the chat.

All of this began when HHS Secretary Robert F. Kennedy Jr. publicly questioned the two Pennsylvania measles deaths on social media last week. The CDC followed with its own embarrassing post sucking up to Kennedy by accusing Pennsylvania officials of withholding information while resurrecting an old conspiracy theory that Covid-19 deaths were overcounted. In contrast, just a day before, the CDC posted its “condolences to the families and communities affected by two measles-associated deaths in Lancaster County, Pennsylvania.” (As we’ve almost come to expect, the CDC is now two agencies. It’s still normal and effective when Kennedy is otherwise not paying attention.)

Now, under normal circumstances, it would not be inherently wrong for federal health leaders to insist upon adequate data before making public declarations. But doing so would be unusual when state officials have already made determinations based on CDC case definitions, which Pennsylvania officials explicitly say they followed.

However, even if contradicting local officials were necessary, such a move would certainly warrant striking a dignified, helpful tone. Given Kennedy’s batty views on vaccine-preventable diseases, however, it’s unsurprising that here he was unable to produce, say, a dispassionate admonition asking for forbearance.

Instead, he offered the only thing he seems to know: the seething language of political attack and thinly veiled anti-vaxxer talking points. Even if either of these two tragic deaths are eventually determined not to have been primarily caused by (or highly related to) measles—which in this case is possible in one of the cases— the tone of the messaging matters greatly here. Responsible, level-headed talking points, were they desired, would be extremely easy to write. But they’re nowhere to be found because that is just not who Secretary Kennedy is.

Read his unhinged rant for yourself. On what planet would this be a helpful public health approach? Indeed, the main thing it reveals is that Kennedy has a horse in this race and—just playing the odds here—that horse probably has some awful vaccine-preventable disease.

Schwartz is now performing worse than expected. Somehow.

Last month, I wrote that Dr. Schwartz’s promise to “speak truth to power” was the wrong goal. What mattered, I argued, is that she speaks the truth to the American public—especially when her overlords have it wrong or are overtly lying. I was especially worried because in her first address to her CDC colleagues, she admitted that she would not contradict Secretary Kennedy in public, but would do so in private. As if that would do any good. We can already see the abject failure of this approach in action.

New CDC director Dr. Erica Schwartz promises to “speak truth to power.” That’s the wrong goal.

Sadly, it’s already much worse—which is even more disappointing given her fine credentials prior to her disastrous confirmation hearing. Now, almost a month into the job, Dr. Schwartz is not merely doing as she promised by refusing to disagree with Secretary Kennedy in public. With the CDC’s measles page excluding the measles deaths reported by Pennsylvania—when the page could just as easily include the typical caveat that the data are provisional until confirmed—she’s clearly gone well beyond hiding behind a soldier’s commitment to maintaining public decorum. She is now explicitly doing RFK Jr.’s bidding. Dr. Schwartz is either taking orders from Kennedy or obeying in advance. Either is unacceptable. Any credibility she had when she walked into the CDC in August is circling the drain. Indeed, bad policy begets bad policy. That lesson usually takes a while to manifest. Not so here. I hope that Dr. Schwartz is a quick learner.

I’m not optimistic, not because of her skill set, but because of her mindset. I continue to worry that she simply has the wrong goal: outlasting Dr. Susan Monarez’s 29-day tenure in the job before being fired by Secretary Kennedy. She’s already almost there. But lasting 29 days (or 29 months) is not the goal. The goal is to improve—to save—our nation’s public health system. If Dr. Schwartz fails to realize this very soon, I can guarantee that she will far surpass her goal of outlasting Dr. Monarez. Worse than that, though, Dr. Schwartz will have a long and completely useless career at the CDC.

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