Patricia August 27, 2013 11:27 am

I would say there was no mechanism at CDC for the connercs to have any effect. How could anyone 'push harder'? The article is written and goes out for clearance. It doesn't get cleared at lower levels, but gets sent out to JAMA anyway. How would you stop this from happening? Lower level people (even high level lower level people) don't have any mechanism they can use to stop a paper from going out. They can say over and over again that they think there are problems, but if no one is interested in discussing their comments, what are they supposed to do? Just repeat them over and over every single day? There was plenty of internal dissent at CDC over this paper. It didn't make any difference.