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HOUSTON -- The Biden administration should empower the CDC and put it in the forefront to continue fighting the COVID-19 pandemic, said Peter Hotez, MD, PhD, at a vaccine conference sponsored by the Baker Institute for Public Policy at Rice University.

"I think the answer is fixing the CDC, empowering the CDC, and putting them out in front -- together with the state and local health agencies, because I think the other thing the pandemic revealed was the chronic underfunding of state and local health agencies," Hotez said at the event Friday. "Until we do that, we're definitely not ready for another pandemic."

Hotez is a fellow in disease and poverty at the Baker Institute, and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston.

"I know some [people] are proposing to create a pandemic threat center in Washington," Hotez said during an hour-long interview. "I say that's probably the last thing you want to do, because that's what got us into problems in the first place -- having things run out of Washington. You want to get as far from Washington as you can, and I guess Atlanta is as good a place as any."

When it came to fighting the pandemic, "the CDC came up small every time," Hotez said. "They missed the entry of the virus from Southern Europe into New York ... [Instead], all eyes were on travel restrictions from China, and the virus came in from Southern Europe and caused that terrible epidemic in New York. The virus was circulating for weeks and nobody picked it up, and nobody led an effort to stop it in its tracks there and prevent it from coming across the nation."

There was also the issue of the CDC "never getting diagnostic testing up and running, never getting genomic sequencing adequately going, and never creating predictive models and [instead] relying on the universities like the University of Washington, UT Austin [University of Texas at Austin], Johns Hopkins, and a few others," he added.

"When you think about the big social and political determinants that we put in infrastructure to combat -- things like global terrorism or nuclear proliferation, or cyber-attacks, anti-vaccine activism by far is killing more Americans than all that other stuff combined," said Hotez. "And yet, we don't frame it as such, and nobody wants to go there."

He noted that Surgeon General Vivek Murthy, MD, MBA, who is a "very smart guy" that Hotez said he is "very fond of," "talks about the 'infodemic' and says he's going to meet with the leaders of Meta and Twitter and ... switch up computer algorithms so things don't go viral. Sure, that's helpful, but you know, it's going to get to about 10% to 15% of the problem. The real problem is this partisan rhetoric and what I call anti-science aggression coming from the far right, and that's what's killing people."

"A bigger part of the problem is we don't give young scientists the tools to know how to manage this," Hotez said. "We don't describe the anti-science ecosystem, we don't describe how the world has changed accordingly, and we don't really provide ... training in how to do science communication, and so the consequence of that is a vacuum, and what pours into it is all the anti-science stuff" -- not just about vaccines but also about COVID and virology generally.

Even though vaccines were widely available last year, "in the last half of 2021 alone, my estimate is that 200,000 Americans needlessly lost their lives because they refused the COVID vaccine," he said. "And the problem is that in general, people don't want to talk about the reasons for it because it means talking about unpleasant things." The problem "is usually characterized as an infodemic" or "misinformation .... as though it were some some kind of random set of events appearing on the internet. It's not. It's deliberate, it's organized, and it's linked to political power."

A big part of the issue, which has been documented by the Kaiser Family Foundation, the New York Times, National Public Radio, and other outlets "is that after May 1 last year, overwhelmingly those losing their lives from refusing COVID vaccines are in red states," Hotez said. "And the redder the county, the greater the loss of life." Doctors are uncomfortable talking about this issue because "as a physician or physician scientist, all of our training says, 'Hey, you're not really supposed to talk about Republicans and Democrats and liberals or conservatives.'"

"We're supposed to be beyond all that," he continued. "But what do you do when the deaths are coming so clearly along a partisan divide? And I say, 'Look, everyone's entitled to their conservative views, even extreme conservative views. But don't adopt this one, right?' I mean, somehow we have to find a way to uncouple it -- and we know why it's happening. It's happening because of the extremist elements in the Republican Party."

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