Trumping the Centers for Disease Control: A Case Comparison of the CDC’s Response to COVID-19, H1N1, and Ebola

• Author: Eleanor Schiff,Daniel J. Mallinson
• DOI: http://doi.org/10.1177/00953997221112308
• Published date: 01 January 2023
• Date: 01 January 2023
• Subject Matter: Articles

https://doi.org/10.1177/00953997221112308

Administration & Society

2023, Vol. 55(1) 158 –183

© The Author(s) 2022

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DOI: 10.1177/00953997221112308

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Article

Trumping the Centers

for Disease Control:

A Case Comparison of

the CDC’s Response to

COVID-19, H1N1, and

Ebola

Eleanor Schiff1 and Daniel J. Mallinson2

Abstract

Despite being the richest and most prepared nation in the world, the U.S.

responded badly to the COVID-19 crisis. This paper examines the nature

of political control and the essence of bureaucratic failure for the Centers

for Disease Control and Prevention (CDC), an independent agency. In three

case studies, we analyze the CDC’s success in handling H1N1 and Ebola,

and its failures on COVID-19. We find that the CDC suffered not only

from political interference by the Trump Administration but also internal

organizational problems that muted its ability to respond effectively.

We conclude by offering policy prescriptions for addressing concerns of

bureaucratic autonomy and success at the CDC.

Keywords

bureaucratic failure, bureaucratic control, case comparison, COVID-19,

public health

1Penn State University, University Park, PA, USA

2Penn State Harrisburg, Middletown, PA, USA

Corresponding Author:

Eleanor Schiff, Department of Political Science, Penn State University, 203 Pond Laboratory

University Park, PA 16802, USA.

Email: eleanorschiff@gmail.com

1112308AAS0010.1177/00953997221112308Administration & SocietySchi and Mallinson

research-article2022

Schiff and Mallinson 159

The COVID-19 pandemic has been a disruptive force worldwide; however,

some countries have fared better than others in managing the disease. The

U.S., the richest country in the world, horribly mismanaged the crisis, leading

to over 700,000 deaths as of October 2021. Prior to the COVID-19 crisis,

bio-security researchers ranked the U.S. the most prepared for a pandemic

(Maxmen & Tollefson, 2020). At almost every important moment in the first

6 months of 2020, however, the U.S.’ response to COVID-19 was a dossier of

disaster.

During the Trump Administration, the American response was wholly

underwhelming and inadequate in controlling the virus, much to the baffle-

ment of Americans and the rest of the world. Poor countries, such as Vietnam

and Uganda, were, at least initially, more successful at controlling the virus

than the U.S., and rich countries like Taiwan quickly controlled the virus’

spread and experienced few deaths. Why was the U.S. in this position? Why

did the Centers for Disease Control and Prevention (CDC), one of the most

admired American government agencies across the world, largely fail in pro-

viding adequate guidance for COVID-19 when they successfully handled

past scares such as Ebola (2014) and H1N1 (2009)? In this case comparison

study, we will compare CDC’s largely failed response to COVID-19 to its

strong leadership during both the Ebola and H1N1 outbreaks. We argue that

CDC’s shortcomings in adequately handling COVID-19 are beyond the fee-

ble leadership of President Trump (NEJM Editors, 2020). They stem from

both bureaucratic intransigence and political interference.

This article begins with a brief background on the CDC as an institution,

including its typically stellar reputation in infectious disease control. We then

draw from the literatures on bureaucratic political control and bureaucratic

failure to examine how well the CDC is politically controlled. We then com-

pare the cases of H1N1, Ebola, and COVID-19 to examine the different out-

comes in similar situations. Finally, we present conclusions and offer potential

policy prescriptions to overcome the CDC’s current shortcomings.

Brief Background on the CDC

The CDC was founded in 1946 and headquartered in Atlanta to lead efforts

eradicating malaria in the American South. The agency has enjoyed wide-

spread public and Congressional support and confidence in the U.S. and

across the world for its scientific expertise and advice (Interlandi, 2021). It

offers guidance to states, physicians, researchers, and government officials

on a variety of topics from vaccine schedules for kids to contagious disease

mitigation. Its mission is to work “24/7 to protect America from health, safety

and security threats, both foreign and in the U.S.” (CDC, 2019b). Historically,