The restructuring of the CDC follows two reviews conducted in recent months, one by Health Resources and Services Administration Chief Jim Macrae of the CDC’s pandemic response and the other by Chief of the CDC’s cabinet, Sherri Berger, on the operations of the agency.
The reviews concluded that “traditional science and communication processes were not adequate to respond effectively to a crisis of the scale and scope of the COVID-19 pandemic,” according to an agency statement.
Specifically, Macrae’s review, which included 120 interviews with CDC staff and people outside the agency, recommended a series of improvements, including faster release of results and scientific data to improve transparency, translating science into practical, easy-to-understand policies, improving communication with the public, working better with other public health agencies and partners, and training and incentivizing public health staff. agency to better respond to public health emergencies.
There’s a consensus within the CDC that it “needs to make some changes to the way it communicates and how it works – to be faster, more nimble, to use simpler spoken language,” said one CDC official, who was granted anonymity to discuss the changes before they were announced.
“People work incredibly, incredibly hard and care deeply about trying to make sure the American people have the right information,” the official said. “Maybe the way a lot of [Covid-19] The response has been framed, and some of the incentives that people have here just aren’t aligned properly to really emphasize getting information to people quickly and how that information can benefit people’s health Americans.
An agency in difficulty
The CDC has been under intense pressure from Americans of all political stripes since the early days of the pandemic.
He pushed back on a battery of allegations during the crisis, from putting politics above his vow to ‘follow the science’ to clumsy messaging to put Americans’ lives at risk as pandemic restrictions eased. .
As public health officials have come under attack across the country, the agency’s authority to implement Covid-19 mitigation measures has also been cleared, with critics on one side blaming the federal overrun agency and critics on the other accusing the agency of not doing enough.
The CDC’s authority has been challenged in several court cases. Last year, the Supreme Court overturned its moratorium on evictions during the pandemic. The the government appealed the April decision of a federal district court judge in Florida to overturn the CDC’s directive that people wear masks on planes, trains and other public transportation.
This year, the agency has struggled to balance the competing interests of a virus that continues to find ways to evade vaccines and natural immunity, and a public that is weary of taking the genre. precautions that federal and state governments have imposed.
As the Omicron variant swept the country, the agency was criticized for shorten its recommended quarantine guidelines. This spring, its move to community-level risk assessment by weighing hospitalizations and healthcare system burden against the level of transmission was both confusing and putting Americans at unnecessary risk, according to many health experts. public health.
The CDC’s decision last week to lift quarantine recommendations for unvaccinated people exposed to the virus, including in schools, also drew criticism from doctors and public health experts who say the agency assumes individual responsibility for public health when responsible for it.
Several school districts, including those in New York and Philadelphia, are taking more precautions than the CDC now recommends. when students return.
Walensky has repeatedly pointed out that the agency was underfunded before the pandemic began, noting that the public health workforce was severely stretched and the agency was crippled by structural issues, including limited access to data. States.
In a interview with POLITICO earlier this year, she said the CDC alone would not be able to bring Covid-19 under control and called for broader investment in public health at the national and local levels.
“In fact, I really think a lot of people thought it was the CDC’s responsibility, to fix public health [and] the pandemic,” Walensky said. “The CDC alone cannot solve this problem. Business needs to help, government needs to help, school systems need to help. It’s too big for the CDC alone.
Nonetheless, Americans’ approval of the work of the agency leading the nation through a pandemic that has killed more than a million Americans has plummeted.
In March 2020, 79% of Americans said public health officials, including those at the CDC, were doing a good job responding to the pandemic, according to a Pew Research Center survey. By May 2022, only 52 percent of Americans thought so, Pew found.
The agency’s most recent handling of the monkeypox outbreak, which worries many epidemiologists, is now passed the containment point in the country, has again drawn widespread criticism that the CDC is unable to meet the demands of a complicated public health crisis as it unfolds in real time.
A new roadmap
Among the structural changes resulting from the reviews are the appointment of former HHS Assistant Secretary Mary Wakefield to lead a team to oversee the overhaul, as well as the creation of a new executive board, built by Wakefield and reporting to Walensky, who “will determine agency priorities, track progress, and align budget decisions, with a bias toward public health impact.”
The agency did not offer a specific timeline for the creation of the council, but generally noted in a statement that “the work ahead will take time and commitment at all levels of the organization.”
Redesigning the CDC’s approach to communicating with the public has already begun and will include revamping and streamlining the agency’s website and creating simplified public health guidelines. The agency will also create a new office of equity, working across all functions of the organization, from hiring to policy to improve agency diversity.
The overhaul aims to change “the culture of the CDC” away from a “misaligned” approach of encouraging staff to publish their research in scientific publications and instead encouraging staff to produce research and data intended to public health policy and action, the CDC official said. .
The agency is also considering measures that will speed up the release of scientific data and findings, train more staff to be prepared to respond to public health emergencies, and put in place emergency personnel. to ensure there is no shortage of staff during a crisis.
Walensky will also seek more authority from the CDC, through Congress and the Biden administration, to mandate data collection from states, to move money faster to external partners in emergencies. and to offer more competitive salaries for recruitment, among other things.