Roundup: Problematic COVID-19 Metrics and a Toxic Science Workplace 

April 13, 2022 | 3:06 pm
a discarded surgical mask lies on asphaltClaudio Schwarz/Unsplash
Liz Borkowski
Science Network Contributor

This post is part of a series of quarterly roundups on scientific integrity.

During the first quarter of 2022, CDC changed the metrics it uses to calculate county COVID-19 levels, resulting in a lagging indicator that’s unlikely to prevent future surges and has led to states dropping mask mandates. At the White House Office of Science and Technology Policy, revelations about a toxic workplace and ethics concerns resulted in its director’s departure while the agency is in the midst of essential work to strengthen the scientific integrity infrastructure across the executive branch.

Mask mandates fall as the BA.2 sub-variant takes over

As the U.S. nears the grim milestone of one million COVID-19 deaths, public officials seem to want to discount evidence of continued and inequitable risks in order to get back to something approaching normal. In February, CDC changed its framework for monitoring community levels of COVID-19. Instead of categorizing counties as being at low, medium, or high levels based on transmission, they now focus on preventing hospitals from being overwhelmed. So, if transmission in a county is high but hospitalizations are still at a manageable level, that county could still show up on CDC’s map with a green “low” level. The new guidance only recommends widespread indoor masking when counties are in the “high” category.

Hospital capacity has been an important metric throughout the pandemic, and the vaccines have proven highly effective at reducing the risk of hospitalization among those who get infected. However, the Omicron surge showed that even if a small proportion of infected people end up in the hospital, a large number of cases can still lead to overwhelmed hospitals. By relying largely on the “lagging” indicator of hospitalization numbers to calculate levels, the new framework will only indicate high risk after a surge is already underway. As National Nurses United explained in a letter urging CDC to reverse its shift to the new metrics, the framework “worryingly narrows the critical window during which the CDC and public health agencies can respond to and prevent further transmission, infections, hospitalizations, and death from Covid-19.” After CDC changed its focus from reducing viral spread to preventing hospital overwhelm, states that still had mask mandates in place dropped them in March.

The new guidance also recommends that at the “medium” level, those at high risk for severe illness talk to their healthcare providers about whether they should wear masks or take other precautions. While high-quality masks do provide protection to the wearer, protection is greatest with community masking. Immunocompromised people and those too young to be vaccinated can reduce their COVID risk by wearing masks, but they’ll be more protected if the people around them are also masked. The CDC framework is either discounting the evidence on the importance of community masking or placing a low value on the ability of immunocompromised people, young children, and their families to move about in their communities with confidence. And racial inequities could also increase as protections diminish; even as racial disparities in vaccination narrowed, COVID-19 hospitalization rates increased more among non-Hispanic Black adults than other racial/ethnic groups.    

CDC isn’t the only agency involved in the pandemic response. In January, the Supreme Court blocked the Occupational Safety and Health Administration (OSHA) emergency temporary standard requiring that large employers mandate that their workers either get vaccinated or take regular COVID-19 tests; however, the decision did acknowledge that COVID-19 is a hazard in high-risk workplaces and left the door open to a more comprehensive rule that bases required protections on the level of workplace risk. In March, EPA released a “Clean Air in Buildings” challenge with a set of guiding principles and actions that building owners and operators can take to reduce risks from all airborne viruses. FDA authorized a fourth dose of COVID-19 vaccines for those over age 50, and CDC signed off on the decision, without either agency convening the advisory committees that ordinarily advise them on such moves. After whistleblower disclosures by physicians serving as medical subject matter experts for the Department of Homeland Security warned of inadequate vaccination and other preventive measures in immigration detention facilities, several Senators wrote to Secretary of Homeland Security Alejandro Mayorkas and acting Immigration and Customs Enforcement (ICE) director Tae Johnson to request information about detainee vaccination rates and ICE’s plans to ensure that all detainees are offered COVID-19 vaccines and boosters.

The ventilation guidance from EPA was part of the National COVID-19 Preparedness Plan that the Biden administration released in March. It suggests that because we have effective COVID-19 vaccines, more tests, and better treatments than we did early in the pandemic, mask wearing is less important. However, the plan assumes continued widespread availability of vaccines, tests, and treatments, but Congress’s failure to provide sufficient COVID-19 funding threatens access to all of them; in some places, those without insurance have lost the ability to get free COVID-19 tests. This leaves the nation worse equipped than before for BA.2, a more-transmissible Omicron sub-variant that accounted for the majority of U.S. COVID-19 cases by the end of March.

Looking ahead: Congress will return to the question of a COVID-19 funding package after it returns from recess in late April.

“Toxic workplace” threatens scientific integrity

Eric Lander, former director of the White House Office of Science and Technology Policy (OSTP), tendered his resignation after he acknowledged mistreating OSTP staff. Politico obtained evidence that a two-month White House investigation had concluded that Lander bullied and demeaned those he supervised and violated White House policy. One of the employees who repeatedly raised concerns about Lander’s conduct was career civil servant Rachel Wallace, who was serving as General Counsel and Chief Operating Officer of OSTP when Lander arrived. A whistleblower disclosure filed on behalf of Wallace and other OSTP staff members by the Government Accountability Project (GAP) describes “three significant areas of misconduct: (1) repeated and knowing disregard of ethics rules; (2) toxic workplace; and (3) unlawful retaliation against our clients and other staff who raised legitimate concerns.”

After repeatedly raising concerns that Lander was violating ethics rules, Wallace was demoted to a Deputy Counsel role and excluded from meetings, conversations, and assignments—and she wasn’t the only one who suffered. She told Politico that Lander “retaliated against staff for speaking out and asking questions by calling them names, disparaging them, embarrassing them in front of their peers, laughing at them, shunning them, taking away their duties, and replacing them or driving them out of the agency. Numerous women have been left in tears, traumatized, and feeling vulnerable and isolated.” GAP reports that there were at least 15 abuse victims. In interviews with STAT News, ten Lander aides said that “Lander’s domineering presence and intolerance for push-back actively inhibited policy work.”

Since Lander tendered his resignation, details have emerged about the kinds of ethical concerns Wallace raised. Although Lander sold the bulk of his shares in BioNTech SE (the company that partnered with Pfizer to produce a widely used COVID-19 vaccine) shortly after his confirmation, he held on to many of them until months later, and sold them after the price rose for estimated total of more than $500,000. Although this move was within the terms of the ethics pledge he signed, the fact that a Cabinet member whose job included promoting the administration’s vaccine efforts was profiting from the widespread distribution of the Pfizer-BioNTech vaccine was ethically problematic. Under Lander, OSTP also gave a worrisome level of access to a foundation controlled by Eric Schmidt, the wealthy former CEO of Google. Schmidt Futures indirectly paid the salaries of two OSTP employees, and one of its senior officers worked as an unpaid consultant to OSTP for four months. Schmidt has advocated for a stronger federal role in the funding of 5G technology and artificial intelligence.

To replace Lander until another OSTP director is nominated, President Biden named Francis Collins, who recently retired from his position heading the National Institutes of Health, to serve as interim science advisor and Alondra Nelson, OSTP’s deputy director for science and society, to serve as acting interim director of OSTP. Science editor-in-chief H. Holden Thorp criticized the decision to split the role rather than giving both portions of the job to Nelson, saying it “reflects a chronic ill in America—inequity at the highest levels of leadership.” Neither Collins nor Nelson has been invited to become part of the president’s Cabinet, as Lander was. Dana Gold, GAP senior counsel and one of Wallace’s attorneys, emphasizes that Lander’s resignation has not resolved all of the problems that occurred under his tenure. She notes that the “culture and mechanisms that enabled Director Lander to create a hostile work environment and mistreat staff without check also need to be addressed.” She also explains that the White House’s refusal to restore Wallace to her former role as general counsel consistent with her whistleblower rights to raise serious concerns without suffering retaliation, instead insisting it has the right to hire a political appointee, is of particular concern given OSTP’s charge to lead on scientific integrity policies and practices for the federal government.  

Looking ahead: The leadership of the House Committee on Science, Space, and Technology has requested that the White House share a copy of its report on the investigation into Lander’s behavior and brief the committee on the steps OSTP is taking to improve the workplace environment. GAP attorneys for Rachel Wallace and other OSTP whistleblowers have been briefing House and Senate committee staff, and Congressional oversight is expected to be active and ongoing.

Steps toward a stronger scientific integrity infrastructure

In January, OSTP released the report of its Scientific Integrity Task Force on existing scientific integrity policies and practices across federal agencies. Reactions from Climate Science Legal Defense Fund (CSLDF), Jacobs Institute for Women’s Health, Public Employees for Environmental Responsibility, and the Union of Concerned Scientists praised some aspects of the report while expressing concerns about others. One common concern was that the report didn’t convey the scope or severe consequences of the long and terrible list of attacks on science that occurred during the Trump administration. An in-depth Nature article by Virginia Gewin makes a useful companion piece to the report; she tells the stories of several federal employees who faced reprimands and apparent retaliation after insisting on scientific accuracy, even though their agencies had scientific integrity policies in place at the time.

That report from OSTP was the first one required under President Biden’s “Memorandum on Restoring Trust in Government Through Scientific Integrity and Evidence-Based Policymaking,” which he signed during his first week in office. The next step is for OSTP to develop “a framework to inform and support the regular assessment and iterative improvement of agency scientific-integrity policies and practices.” OSTP requested feedback from the public to inform this process, in a 30-day public comment period that closed April 4. Former EPA scientist and current member of the Environmental Protection Network Elizabeth Southerland gave recommendations in an opinion piece. She urged OSTP to: adopt the definition of scientific integrity that CSLDF uses; provide “a default scientific integrity policy that would be in effect until an agency replaced it with its own customized policy approved by OSTP”; apply the default policy to inter-agency work, such as the US Global Change Research Program; specify serious consequences for scientific integrity violations; and “explain how whistleblower protections can be used for scientific integrity complaints if an agency’s scientific integrity process fails to investigate and remedy allegations of violations.”

Looking ahead: If OSTP follows the ambitious timeline in President Biden’s memorandum, it will publish its framework in May. The new report is expected to provide a detailed roadmap for strengthening scientific integrity polices and practices in all of the federal agencies with science programs, and to provide guidance for Congress in shaping legislative proposals to strengthen scientific integrity in government.

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