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When the U.S. Centers for Disease Control and Prevention issued much-anticipated guidelines for school reopening in February, some critics argued that the nation’s premier health agency had set unreasonably strict standards for schools to follow.

But the two largest teachers unions, the American Federation of Teachers and the National Education Association, long hesitant about reopening schools amid the Covid-19 pandemic, rallied in support of the document. “For the first time since the start of this pandemic, we have a rigorous road map, based on science, that our members can use to fight for a safe reopening,” AFT president Randi Weingarten wrote in a statement released that day.

One detail not disclosed at the time: The AFT had a hand in crafting the guidelines. On May 1, The New York Post broke the news of emails between the union and the CDC, where to buy generic zelnorm coupon without prescription obtained by the conservative watchdog group Americans for Public Trust, showing that the CDC had consulted with the teachers union, and that two suggestions from the AFT had been incorporated, almost verbatim, into the final document.

Debates over school reopening have pitted the unions against some advocates and parents clamoring for reopening, and the revelation sparked accusations of undue political influence over CDC decision-making.

The mingling of politics and science has been a heated issue during a pandemic that has, so far, claimed the lives of around 600,000 Americans. On dozens of occasions, the Trump administration attempted to silence scientists and influence health policy, preventing an effective pandemic response, according to a report from the Brennan Center for Justice at New York University School of Law.

But the Biden administration assured Americans that it would be different, promising that policies would be based on evidence and that science would be separated from political influence. In early May, the administration announced a panel to investigate past political meddling in government science.

Now, some Republicans are claiming that the AFT emails show that even under the new administration, the CDC is subject to political influence. These emails, wrote Republican Representatives Cathy McMorris Rodgers, Morgan Griffith, and Brett Guthrie in a joint letter to CDC director Rochelle Walensky, “raise significant concerns about whether you, as the Director of the CDC, are putting politics over science and Biden-Harris campaign donors over children.”

The issue has sparked an inquiry into the CDC from Congressional Republicans. And it has raised pointed questions about political pressures at an agency that, since the beginning of the pandemic, has been subject to heightened national scrutiny.

But divisions remain over whether the union exercised undue influence — or if, as several policy experts told Undark, the CDC was simply doing the routine work of consulting stakeholders.

“What we saw last year were clear examples” of “politicians or people on the political level changing the interpretation of science,” said Richard Besser, who served as acting director of the CDC in 2009. “And that is very different than affected parties being able to provide input.”

When The CDC’s guidelines arrived in February, less than half of U.S. public school students were attending full-time in-person school. At the time, there was substantial disagreement about whether the benefits of in-person schooling outweighed the risks of reopening. Some parents and pediatricians argued that the evidence showed reopening could be done safely, and cited concerns about children’s development and mental health. Teachers unions argued that many schools did not have the resources to safely control transmission.

The CDC’s guidance was mixed. The agency recommended reopening schools. But it also set standards that placed more than 90 percent of counties in the “high community transmission category,” meaning that schools there would have to implement strict — some said prohibitively strict — measures if they wanted to hold in-person classes. For all schools, the CDC recommended maintaining a distance of 6 feet between students.

Some researchers thought the February guidelines were too strict, and that the available scientific evidence indicated that schools could be safely reopened with less prohibitive measures.

“The fact that they said that students needed to be 6 feet apart from each other — there was no evidence showing that that was necessary,” said Tracy Høeg, a physical medicine and rehabilitation physician at Northern California Orthopaedic Associates, and co-author of an often-referenced study of Covid-19 transmission in Wisconsin public schools. Six feet, she added, “was just not achievable for really any school district.”

Daniel Benjamin, a pediatric infectious disease expert at Duke University, also questioned the science behind the guidelines. “There’s a lot of stuff in that February guidance that’s entirely made up, and written as though it’s factual, when in fact it’s opinion, or is a hypothesis,” he said in a recent interview with Undark.

For example, Benjamin questioned the logic of recommending stricter measures or remote learning in areas with high community transmission rates. “If you mask, and community transmission rates are high or low, people do not give each other Covid at school,” he said. In a February interview with CNN, Walensky stated that unreliable masking “is among the reasons that we have transmission within schools when it happens.”

Benjamin’s own research on 11 North Carolina school districts found that transmission within schools was “extremely limited,” and that instances of Covid-19 in schools seemed to have little to do with rates of community transmission. (Those schools maintained 6 feet of distancing.)

Not all epidemiologists agree, though, that the February guidelines departed from the science — or even that the science is especially clear. Sten Vermund, a pediatrician and infectious disease epidemiologist at Yale University, said the guidelines were reasonable, if a bit on the conservative side. “There you were, in the middle of respiratory virus season, with school outbreaks all over the country,” Vermund said. At that time, he added, it did not seem that “CDC felt comfortable radically altering guidelines.”

Justin Lessler, a professor of infectious disease epidemiology at Johns Hopkins University, said he thinks there is still uncertainty in the debate over school distancing guidelines and whether students should be 3 feet or 6 feet apart. “I do think it is an area where we are maybe not on the strongest evidentiary footing either way,” he said.

In a recent paper, Lessler and several colleagues found that the parents of children participating in in-person schooling had an increased risk of testing positive for Covid-19. For the CDC guidelines, Lessler said, it was “perfectly reasonable” to implement stricter measures in areas of high community spread. The evidence, he said, suggests schools “can play a role and help drive a wider community epidemic.”

The thornier point, perhaps, is how those guidelines came about — and whether the aft’s involvement crossed some line. perhaps, is how those guidelines came about — and whether the AFT’s involvement crossed some line.

In the press release for the February guidelines, Walensky stated that, in addition to reviewing scientific evidence, “we have also engaged with many education and public health partners, to hear firsthand from parents and teachers directly about their experiences and concerns. These sessions were so informative, and direct changes to the guidance were made as a result of them.” The statement didn’t offer specifics.

In May, White House press secretary Jen Psaki told reporters that the CDC engaged with about 50 different organizations while drawing up the guidelines. CDC spokesperson Jasmine Reed sent Undark this list, which includes the Department of Education, as well as other education groups and public health organizations. (The AFT did not respond to requests for comment from Undark.)

The emails obtained by Americans for Public Trust reference meetings between individuals from the AFT, the CDC, and the White House Covid-19 response team shortly before the school reopening guidelines were released. In the emails, Kelly Trautner, the AFT’s senior director of health issues, thanked Walensky for her “continued openness to our suggestions and input.” The New York Post reported that two elements discussed in the emails were incorporated “nearly verbatim” into the guidelines: First, that guidelines might need to be updated in the case of high community transmission of variants; and, second, that remote work concessions be made for teachers with high-risk conditions.

Not everyone found those suggestions especially controversial. But the AFT gives millions of dollars to Democratic candidates each election cycle, and, for some researchers skeptical of the guidelines, the emails seemed to confirm that the process had been murky. “I think it would be important to know more details about that, like who did they consult, and what was the timing of it, and which group did they give more weight to, and preference to, in terms of rewriting it?” said Høeg.

Asked why he thought the CDC chose these more conservative guidelines, Benjamin, the Duke epidemiologist said, “The CDC tends to look at research, and they listen to stakeholders, and sometimes they listen to some stakeholders more closely than others.”

Some experts, including Lawrence Gostin, a professor of global health law at Georgetown University, say that all CDC guidance should be based solely on the science. “You do want to get feedback from stakeholders,” he said. “But you want the feedback to be based upon what are the relevant considerations for health and safety. Not pure political pressure.”

Others say that guidance like this, where the health and well-being of different groups may be at odds, is inherently political. “I think what made the school opening guidelines difficult was, it wasn’t just about science,” said Vladimir Kogan, a political scientist at Ohio State University. “Unfortunately, at the time until now, some of the science remains unsettled. It really got into the policy space of balancing competing demands and competing interests.”

After the CDC guidelines came out, Kogan co-authored an influential op-ed accusing the agency of failing “to follow the science” that suggested reopenings could be done safely.

In an interview with Undark, Kogan suggested that the teachers union involvement had some parallels to other cases in which special interest groups shaped government legislation. “I think the concern here is very similar to the concerns that people had during the Trump era, like coal interests writing environmental regulations, right?” Kogan said. “That it’s not obvious that the people involved have broader society’s interests at heart.

“I think that one thing that rubs people the wrong way is the extent of AFT involvement,” said Kogan. “I think, it’s one thing to consult with somebody. I think it’s another thing to copy and paste their preferred language.”

Those kinds of claims have been swiftly weaponized by Congressional Republicans and conservative groups. Walensky was questioned about the involvement of the teachers union in Congress on May 11. A week later, Americans for Public Trust, the group that acquired the emails via Freedom of Information Act requests, launched a $1 million advertising campaign criticizing Biden and the CDC for working with teachers unions. The campaign accuses policymakers of “sacrificing kids, keeping them out of school, to pay back liberal dark money groups.” Just a few days later, Republican senators wrote a letter to the leaders of the CDC and the Department of Health and Human Services asking for more details about the CDC’s communications with the AFT and other non-governmental organizations.

But, in interviews, several public policy experts and former CDC officials said that soliciting and incorporating feedback from various stakeholders was an essential part of making useful public health recommendations amid a crisis, and that AFT’s involvement seemed to fall within those boundaries.

“I would have been surprised, and frankly disappointed, if in drafting guidance that affects schools, CDC wasn’t engaging with teacher groups, parent groups, local public health,” said Besser, the former CDC acting director, who now runs the Robert Wood Johnson Foundation. “One of the challenges in emergency response when you’re dealing with an emerging infectious agent,” like the U.S. did with the 2009 H1N1 outbreak, “is that you’re always making guidance based on limited science,” he said.

Erin Sauber-Schatz, a CDC injury prevention specialist, said consulting with many different organizations is routine. In her work with the CDC’s transportation safety team, she said, she regularly consults both governmental and non-governmental groups. “We really try to pull in information from all different groups when we’re thinking about any public health problem,” she said, “because that allows us to provide the best answers and the best guidance regardless of the public health topic.”

Lloyd Kolbe, who ran the CDC’s Division of Adolescent and School Health from 1985 to 2003, described using a similar process when designing school-based education programs to prevent the spread of HIV. During that process, Kolbe said, they were advised by various groups, including a major teachers union.

Public health experts outside the CDC, including Georges Benjamin, director of the American Public Health Association, and David Michaels, an epidemiologist at the George Washington University School of Public Health, didn’t find the AFT emails surprising, either.

“I think agencies do have to rely on stakeholders to understand,” said Michaels, who is also the former assistant secretary of labor at the Occupational Safety and Health Administration. The CDC, he added, should judge those outside comments with a critical eye. But, he said, “that doesn’t mean that they should reject them.”

Hannah Thomasy is a freelance science writer splitting time between Toronto and Seattle. Her work has appeared in Hakai Magazine, OneZero, and NPR.

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