t has now been almost a week since the health risks surrounding the hantavirus – the virus identified onboard the MV Hondius that has claimed three lives among the passengers – have become the focus of intense attention.
On Friday, the United States Centers for Disease Control and Prevention classified the hantavirus outbreak as a “level 3” event. That is the lowest rung on the agency’s emergency ladder. It means active monitoring. It means someone is watching the numbers move.
What it did not mean, for most of the past week, was any visible sign that the nation’s top public health agency was actually doing something.
No rapid deployment of disease detectives to the Atlantic. No televised news conference to calm a nervous public. No timely health alert to the country’s doctors, who might have been the first to notice an imported case walking into an emergency room.
The CDC, for days, was mostly absent from a global outbreak that had already killed three people, sickened several more, and left nearly 150 passengers from 23 nations drifting off the coast of Africa aboard a cruise ship that had become a floating question mark.
President Donald Trump, asked about the situation Friday evening, offered the nation a single sentence: “We seem to have things under very good control.”
Experts who study public health for a living disagreed.
“The CDC is not even a player,” said Lawrence Gostin, a Georgetown University international public health expert. He said he had never seen anything like it.
This is the story of how the world’s former gold standard in outbreak response watched from the sidelines while the World Health Organization ran the show.
It is a story about the slow hollowing of an American institution, about the gap between what the government says and what the government does, and about a single word—“level 3”—that tells you almost nothing and everything at once.
The word “level 3” sounds technical. It sounds like someone is in charge. In truth, it is the public health equivalent of a fire department acknowledging that somewhere, in some building, a match has been struck.
The CDC’s Emergency Operations Centers were activated at that level Friday, which means the agency assembled a team. Epidemiologists. Scientists. Physicians. People who are very good at their jobs, sitting in a room, watching.
But watching is not the same as acting. And acting is what the CDC used to do.
To understand how far the agency has fallen, consider the Diamond Princess. In early 2020, a cruise ship docked in Japan became one of the first large clusters of COVID-19 outside China. The CDC sent personnel to the port.
It helped evacuate American passengers. It ran quarantines. It shared genetic data. It coordinated with the WHO and Japanese authorities. It held public briefings. It published rapid-fire reports that became the world’s reference data on cruise ship transmission of a novel coronavirus.
That was then. This is now.
The current outbreak began quietly.
In early April, a 70-year-old Dutch man developed a fever on a cruise ship traveling from Argentina to Antarctica and the South Atlantic. He died less than a week later. His wife died. A German woman died. Hantavirus—specifically the Andes strain, the only hantavirus known to spread person-to-person—was identified on May 2. The WHO swung into action within days. By Monday, the organization was calling it an outbreak.
The WHO made the risk assessment that told the world this was not a pandemic threat. The WHO coordinated with Spain, which agreed to receive the ship at Tenerife. The WHO’s director-general, Tedros Adhanom Ghebreyesus, wrote a personal letter to the people of that island, thanking them for their humanity. He said he would travel there himself.
Nearly a week after hantavirus was detected aboard the MV Hondius—resulting in three passenger deaths—the situation remains under close scrutiny.
With the imminent repatriation of five French cruise passengers still on board, and the identification of eight additional French contacts who traveled by plane with an infected individual, the focus has shifted to their management in France, including isolation, testing, and hospitalization. The ship is expected to dock in the Canary Islands on Sunday, May 10, prompting preparations by the French Health Ministry and crisis response teams.
Plans call for a designated “single point of entry” at an as-yet-undetermined airport in the Paris region, where health authorities will take charge.
The CDC, meanwhile, issued a short statement on Wednesday. The risk to the American public, the agency said, was “extremely low.” It also described the United States as “the world’s leader in global health security.”
Jennifer Nuzzo, who directs Brown University’s Pandemic Center, called that statement not only unhelpful but actively damaging. “A core principle of public health communications is humility,” she said.
She also said something else, something that should chill anyone who remembers what the CDC used to be. “This just shows how empty and vapid the CDC is right now.”
Empty. Vapid. Those are not words you want applied to the agency that once eradicated smallpox, that stopped Ebola in its tracks in West Africa, that built the global infrastructure for influenza surveillance. That agency has been systematically dismantled over the past 16 months.
The Trump administration withdrew from the WHO, restricted CDC scientists from talking to international counterparts, and laid off thousands of public health professionals—including members of the agency’s own ship sanitation program. In their place, the administration has pursued bilateral health agreements with individual nations, roughly 30 so far, one by one by one.
Gostin, the Georgetown expert, dismissed that approach as insufficient. “You can’t possibly cover a global health crisis by doing one-on-one deals with countries here and there,” he said.
The withdrawal from the WHO may already be hurting the response. NBC News reported Friday that without WHO membership, the United States might not have immediate access to surveillance data on hantavirus or contact-tracing information for cases linked to the cruise ship. That kind of tracking is how you prevent a spark from becoming a fire.
Not until late Friday did the CDC accelerate. Health officials confirmed the deployment of a team to the Canary Islands to meet the Americans onboard. A second team will go to Offutt Air Force Base in Nebraska, where the government plans to evacuate American passengers to a quarantine center. The agency also issued its first health alert to U.S. doctors, advising them of the possibility of imported cases.
That alert came a full week after the WHO declared an outbreak. A full week during which Americans who had been on the ship had already disembarked and returned home. Arizona officials said this week they learned from the CDC that one such person—asymptomatic and not considered contagious—had already returned to the state. No one had told them sooner.
Dr. Jeanne Marrazzo, chief executive of the Infectious Diseases Society of America, called the outbreak a “sentinel event”—a warning about how well the country is prepared for a disease threat. Her conclusion was not reassuring. “Right now, I’m very sorry to say that we are not prepared.”
Dr. Tom Frieden, a former CDC director, noted the contrast with the Diamond Princess response. That effort was not perfect. It did not stop COVID-19. But the CDC was visible, active, trying. This time, Gostin said, the agency’s work has been delayed and subdued.
There is a bitter poetry to this. Hantavirus is not COVID-19. It does not spread easily through the air. It is not a pandemic-level threat. The WHO has said so repeatedly. The risk to the American public genuinely is low. That is not the point.
The point is that the machinery of public health, built over decades and paid for with American tax dollars, did not engage. The point is that the WHO—the very organization the United States chose to leave—stepped into the void. The point is that when the next pathogen appears, and the one after that, and the one after that, the CDC may no longer be the agency that the world turns to. It may no longer be the agency that Americans turn to.
Seven hundred thirty million dollars, Israel just budgeted to convince the world it is not committing atrocities. The CDC, by contrast, seems to have budgeted nothing at all for the work of convincing anyone that it still knows how to do its job.
Friday’s level 3 classification was accurate, as far as it went. The lowest activation level. Active monitoring. Someone watching.
But watching is not the same as leading. And leading is what the CDC was built to do.
That building is still standing in Atlanta. The question—unanswered, unasked by the president, unmentioned in the agency’s careful press statements—is whether anyone is still inside who remembers how to fight.