Centers for Disease Control and Prevention (CDC) director Rochelle Walensky proposed a wholesale restructuring of her agency in a meeting Wednesday after an external review of its organizational process during the COVID-19 pandemic.
Walensky told CDC staff the agency “did not reliably meet expectations” during the pandemic, and that the CDC will restructure to produce data faster and inform the public more frequently about pressing public health issues, according to multiple media reports. The way the CDC handles its staffing will also be altered to reward impacts on public health.
Breaking News: The head of the CDC said the agency had failed to respond quickly enough to the coronavirus pandemic and would overhaul its operations. An external review concluded that its public guidance about Covid was “confusing and overwhelming.” https://t.co/XsZc2BDUUo
— The New York Times (@nytimes) August 17, 2022
“For 75 years, CDC and public health have been preparing for Covid-19, and in our big moment, our performance did not reliably meet expectations,” Walensky said. “I want us all to do better and it starts with CDC leading the way. My goal is a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication and timeliness.”
Her announcement was largely met with praise among media figures and public health experts, but some doctors who spoke to the Daily Caller expressed skepticism about the idea of fundamentally altering the CDC’s mission, particularly with the person who made so many of the pandemic-era mistakes at the helm.
“I agree that changes definitely need to be made, but I think it’s hard to think about how the contemporary design of the CDC can be altered to improve our response next time,” said Dr. Cody Meissner, the head of the Division of Pediatric Infectious Disease at Tufts University Medical Center and an advisor on the Food and Drug Administration’s expert vaccine panel. “How is she going to be able to clearly think outside the box if she’s the person who got us into this position?”
“I wholly concur that there needs to be change, and whether the current head of the CDC is able to do that, I think is going to be a big challenge.”
Walensky ordered an external review of the agency’s structure in April following widespread criticism of its handling of COVID-19, particularly its public messaging. The review found that the agency was too slow in publishing scientific findings that could be used to guide public policy, and recommended de-emphasizing academic research in employee performance reviews, according to Bloomberg.
The restructuring was reportedly set to begin earlier this summer, but was setback by the outbreak of monkeypox, which has led to further criticism of the agency. Some of that criticism was echoed by Walensky herself in a Wednesday video message to staff, in which she offered an eyebrow-raising critique of her own colleagues and their shortcomings.
“To be frank, we are responsible for some pretty dramatic, pretty public mistakes — from testing, to data, to communications,” she reportedly said.
Walensky’s changes will include an overhaul of the agency’s communications regime. The communications office will be restructured and the agency’s websites will be redone to offer clearer guidance to the public. Officials will also streamline a process for releasing pre-print studies to allow the public to get data faster, circumventing the peer review process.
Emphasis on conducting thorough, accurate academic research has hamstrung the agency when it needs to nimbly respond to developing public health emergencies, critics said. The external review suggests Walensky de-emphasizes research when granting employee promotions, instead opting to prioritize a more direct impact on public health.
“I welcome an overhaul of the CDC based on the COVID response. However, as an academic researcher myself, I am concerned about the idea that the CDC would de-emphasize academic research and publishing quicker communications,” said Dr. Monica Gandhi, a professor of medicine and infectious disease expert at the University of California San Francisco. ” It is imperative- with any new infection or disease – to conduct and publish rigorous scientific research in order to inform policy.”
“For instance, the CDC has been criticized during the least year on publishing research in their internal journal (the MMWR) that is not peer reviewed or methodologically sound on topics such as mask wearing in schools or a study showing a high rate of diabetes in children who contract COVID-19.”
Meissner concurred regarding the emphasis on quicker communications. “If the information is wrong, it doesn’t matter how quickly you get it out.”
A new office on equity will be created to improve the organization’s diversity, and new data tracking mechanisms will be developed. The CDC is also planning to ask Congress to expand its powers, namely to force state and local health jurisdictions to share health data with the agency in a standardized manner. The haphazard process of gathering data from across the country was a major obstacle for the agency during the pandemic.
Health officials have acknowledged that communication during the COVID-19 pandemic was poor. The CDC spent tens of thousands of dollars on media training for Walensky after a number of public speaking mishaps. (RELATED: Here’s How The Biden Admin Is Quietly Expanding The Government’s Control Over Health Insurance)
Some skeptics expressed concern that the CDC isn’t accurately diagnosing what its problems actually are. Dr. Jay Bhattacharya, a professor of medicine at Stanford University who has been a frequent critic of Walensky and other CDC officials, questioned whether these changes will actually restore public trust in the healthcare bureaucracy.
“It is good that the CDC director is finally acknowledging that the CDC made catastrophic mistakes during the pandemic, but I do not see any evidence from the public pronouncements about the proposed reforms that the CDC director understands what the most damaging mistakes were,” he said. “The proposed CDC restructuring aims to centralize control in the hands of the CDC Director. It directs the agency to actually have less rigorous oversight over its scientific pronouncements and emphasizes messaging simplicity over faithfulness to scientific findings.”
“Perhaps the biggest problem with the CDC’s proposed changes is that, now that the American public has lost trust in the CDC and its leadership, it is too much to expect the American people to have any faith that those same leaders are capable of reforming the agency back to a place where it is deserving of trust.”
“This attitude that everyone else is wrong and we’re right, that needs to be changed. I don’t know how you go about doing that,” Meissner said. ”
Churning out guidance and recommendations at a faster rate may result in more rapid changes in public policy. While the CDC doesn’t have the power to make law or enforce public health mandates outside of rare circumstances, CDC recommendations became de facto binding law in many jurisdictions during the COVID-19 pandemic. Democratic mayors and governors in particular often modeled executive orders and public health rules after CDC recommendations, with little room for variance.
Historically the role of the CDC hasn’t been to directly guide public policy. Rather, it’s been to conduct research and use that to inform the public as well as medical professionals. “The CDC was not designed to handle pandemics, the way it’s presently structured is certainly not optimally designed to deal with such a terrible pandemic,” Meissner said.
“We all used to have so much confidence in publications that came out of the CDC. They were so well done. Their statisticians were great, their scientists were great … they really did, and still do, a wonderful job at what they were designed to do. It’s not designed to handle a pandemic.”
Ultimately, Walensky wants the agency to play a more active role in guiding responses to public health crises. She wants “data for action,” not “data for publication,” she said Wednesday.