As the coronavirus spread across the world last year, the Centers for Disease Control and Prevention sank into the shadows, undermined by some of their own mistakes and stifled by a government determined to minimize the nation’s suffering.
Now, a new director of the CDC is arriving for a gigantic task: reaffirming the agency while the pandemic is in its deadliest phase and the largest vaccination campaign ever carried out in the country is plagued by confusion and delays.
“I don’t know if the CDC is broken or just temporarily damaged,” but something must be done to bring it back to health, said Timothy Westmoreland, a law professor at Georgetown University with a focus on public health.
The task falls to Dr. Rochelle Walensky, 51, an infectious disease specialist at Harvard Medical School and Massachusetts General Hospital, who took an oath on Wednesday. It takes over at a time when the death toll from the virus in the United States has now exceeded 400,000 and continues to accelerate.
While the agency has retained some of its top scientific talents, public health experts say, it has a long list of needs, including new protection from political influences, a comprehensive review of its mistakes during the pandemic and more money to reinforce basic functions like disease tracking and genetic analysis.
Walensky said that one of his top priorities will be to improve CDC’s communications with the public to rebuild trust. Within the agency, it wants to boost morale, largely restoring the primacy of science and setting politics aside.
The speed with which she is taking on the job is unusual. In the past, the position was generally vacant until a new secretary of health and human services was confirmed and officially appointed a director of the CDC. But this time, Biden’s transition team named Walensky in advance, so she could take over the reins of the agency even before her boss took office.
Walensky, an HIV researcher, did not work at the CDC or a state or local health department. But she emerged as a prominent voice in the pandemic, at times criticizing certain aspects of the state and the national response. His targets included the unequal transmission prevention measures that were in place last summer and the endorsement by a prominent Trump adviser of a “herd immunity” approach that would allow the virus to run freely.
She recognized the weaknesses in her resume. “When people write about me as the selection for this position, they will say, ‘But she has no practical experience in public health,'” she said during a podcast with the Journal of the American Medical Association.
The podcast’s presenter, Dr. Howard Bauchner, who is also the editor of the newspaper, effusively praised her. “I can’t imagine the CDC and the country being any luckier … mainly because you can communicate, which is such an important task for the head of the CDC,” he said.
Walensky did not respond to requests for interviews from The Associated Press.
She will succeed Dr. Robert Redfield, 69, who came to CDC with a similar resume as a stranger at the academy. Redfield remained discreet during his first two years in office after being appointed by the Trump administration in 2018. Veteran CDC scientists have dealt with crises such as a deadly increase in hepatitis A cases among homeless and illicit drug users and an increase mysterious serious illness in people who smoke electronic cigarettes.
The agency’s treatment of the COVID-19 outbreak began in a similar way. The team’s scientists took the lead, holding regular news conferences to update the public on the emerging problem.
But the agency stumbled in February, when a test for the virus sent to the states proved to be flawed. Then, at the end of the month, a leading infectious disease specialist at the CDC, Dr. Nancy Messonnier, disturbed the Trump administration by speaking frankly at a news conference about the dangers of the virus when President Donald Trump was still minimizing it.
Within weeks, the agency was removed from the stage. Redfield made appearances, but was often a third-level speaker after comments dominated by Trump, Vice President Mike Pence and others.
The CDC “was marginalized, defamed, a punching bag for many outgoing government politicians. And that had a detrimental effect on the agency’s ability to carry out its mission, ”said Dr. Richard Besser, a former CDC employee who now runs the Robert Wood Johnson Foundation.
White House officials also took steps to try to control the CDC’s scientific reports and guidelines on its website. For example, the agency removed the guidance that advised to limit the activities of the church choir, although studies have shown the danger of prolonged transmission of internal chants. The agency also abandoned the guidance that advised anyone who came into close contact with an infected person should get tested – then adopted it again after criticism from health experts.
“People from across the political spectrum have reason to doubt the veracity and accuracy, sometimes, of the CDC’s messages,” said Adriane Casalotti of the National Association of County and City Health Officials.
Although public health veterans say they don’t know everything that happened behind the scenes, they say that Redfield apparently failed to defend the agency’s scientists, refused to contradict Trump and those around him and passively allowed the Trump administration to post his messages on the CDC websites.
“He was not willing to resign when it was necessary or to be fired for defending his principles,” said David Holtgrave, a former CDC official who is now dean of the school of public health at New York State University in Albany.
Redfield refused to be interviewed.
The pandemic also exposed some of the CDC’s shortcomings and weaknesses unrelated to the policy. The test kit problem was related to contamination of the laboratory at the agency’s Atlanta headquarters – a sign of neglect. The CDC also lost its position as the country’s main source for case counts and other measures of the epidemic after university researchers and others developed better systems for tracking infections.
Much of this has to do with funding cycles in the national public health system that increase in response to a crisis and then fall, hampering efforts to prevent the next crisis.
Last week, Biden said he would ask for $ 160 billion for vaccinations and other public health programs, including an effort to expand the public health workforce by 100,000 jobs.
Westmoreland of Georgetown called for a law or other measure to prohibit political nominees from having an editorial review of the CDC’s science and to prohibit them from controlling when the agency discloses information. He also recommended a review of the CDC to determine whether the agency’s problems can be attributed to poor management by Trump’s political appointees or whether there are deeper flaws in the organization.
Some experts suggest that an administration that values science and increases funding could restore the CDC to pre-eminence. Biden has pledged to put scientists at the forefront of COVID-19 issues, Besser noted.
“I think it will be fixed on the first day,” he said. “One of the things that gives me hope is that I didn’t see a big exodus from the CDC last year. I saw professionals doing their job. I saw the mental price they were charging, but I didn’t see them giving up. “
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