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NEW YORK (AP) – As the coronavirus swept the world last year, the Centers for Disease Control and Prevention fell into the shadows, undermined by some of their own mistakes and stifled by an administration determined to minimize the suffering of the country.
Now a new CDC director arrives at a mammoth task: to reaffirm the agency as the pandemic is in its deadliest phase to date and the largest vaccination campaign ever in the country is ravaged by confusion and delays.
“I don’t know if the CDC is broken or just temporarily injured,” but something needs to be done to bring it back to health, said Timothy Westmoreland, a Georgetown University law professor specializing in public health.
The task falls to Dr Rochelle Walensky, 51, an infectious disease specialist at Harvard Medical School and Massachusetts General Hospital, who is expected to become director of the CDC this week – a time when the death toll from the virus in the United States has eclipsed 400,000 and continues to accelerate. .
While the agency has retained some of its best scientific talent, public health experts say, it has a long list of needs, including new protection from political influence, a full review of its missteps during the pandemic. and more money to strengthen basic functions like disease monitoring and genetic analysis.
Walensky said one of his top priorities would be to improve the CDC’s communications with the public to restore trust. Within the agency, she wants to boost morale, in large part by restoring the primacy of science and putting politics aside.
The speed at which she takes on the job is unusual. In the past, the post was generally vacant until a new secretary for health and social services was confirmed, and that official appointed a director of the CDC. But this time, Biden’s transition team named Walensky ahead of time, so she could take the reins of the agency before her boss was even in place.
Walensky, an HIV researcher, did not work at the CDC or in a national or local health department. But she has established herself as a leading voice on the pandemic, sometimes criticizing aspects of the state and national response. His goals included the uneven transmission prevention measures that were in place last summer and the endorsement by a senior Trump adviser of a “herd immunity” approach. this would allow the virus to run freely.
She recognized the weaknesses of her CV. “When people write about me as a selection for this position, they’ll say, ‘But she has no public health experience in the field,'” she said during a podcast with the Journal of the American Medical Association..
Podcast host Dr Howard Bauchner, who is also the newspaper’s editor, congratulated her effusively. “I can’t imagine the CDC and the country being luckier … mainly just 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 an interview from The Associated Press.
She will succeed Dr Robert Redfield, 69, who came to the CDC with a similar resume as an alien from academia. Redfield has kept a low profile 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 national outbreak of hepatitis A among the homeless and illicit drug users; and serious illnesses among people who have vaped e-cigarettes.
The agency’s handling of the COVID-19 outbreak began in a similar fashion. Staff scientists have taken the lead, holding regular press conferences to educate the public about the emerging problem.
But the agency stumbled in February when a test sent to states for the virus was found to be flawed. Then, later that month, CDC infectious disease expert Dr. Nancy Messonnier shocked the Trump administration by speaking candidly at a press conference. on the dangers of the virus as President Donald Trump further downplayed it.
Within weeks, the agency was pushed off the scene. Redfield made appearances, but he was often a third-tier speaker after remarks dominated by Trump, Vice President Mike Pence and others.
The CDC “has been sidelined, has been maligned, has been a punch bag for many politicians in the outgoing administration. And that had a detrimental effect on the agency’s ability to fulfill its mission, ”said Dr Richard Besser, a former CDC official who now heads the Robert Wood Johnson Foundation.
White House officials have also taken steps to try to vet the CDC’s science reports and the guidance on its website. For example, the agency removed the advice which advised limiting the activities of the church choir even though studies had shown the danger of prolonged singing transmission indoors. The agency also dropped guidelines advising anyone who had close contact with an infected person to get tested and then re-adopt them after criticism. health experts.
“People from all political walks have had reason to doubt the veracity and accuracy, at times, of CDC’s messages,” said Adriane Casalotti of the National Association of County and City Health Officials .
While public health veterans say they don’t know everything that went on behind the scenes, they say Redfield apparently did not stand up for agency scientists, refused to contradict Trump and his entourage and passively allowed the Trump administration to post its posts on CDC websites.
“He was not ready to step down when necessary or be fired for defending the principle,” said David Holtgrave, a former CDC member who is now dean of the university’s school of public health. New York State in Albany.
Redfield declined to be interviewed.
The pandemic has also exposed some CDC failures and weaknesses unrelated to politics. The test kit issue was related to contamination of the lab at the agency’s headquarters in Atlanta – a sign of neglect. The CDC also lost its status as the country’s benchmark source for case counts and other measures of the outbreak after university researchers and others developed better systems for tracking infections.
Much of this has to do with funding cycles for the national public health system that increase in response to a crisis and then decrease, hampering efforts to prevent the next crisis.
Last week, Biden said he would ask for $ 160 billion for vaccines and other public health programs, including an effort to expand the public health workforce. 100,000 jobs.
Georgetown’s Westmoreland has called for a law or other measure to ban politically appointed people from having an editorial review of CDC science and to ban them from controlling when the agency publishes information. He also recommended a CDC review to determine whether the agency’s problems can be attributed to mismanagement of those Trump appointees or whether there are deeper flaws in the organization.
Some experts suggest that an administration that values science and increases funding could bring the CDC back to preeminence. Biden has pledged to put scientists first on COVID-19 issues, Besser noted.
“I think that’s something that will be sorted out on day one,” he said. “One of the things that gives me hope is that I haven’t seen a big CDC exodus in the past year. I have seen professionals do their job. I saw the mental toll they were going through, but I didn’t see them give up.
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The Associated Press’s Department of Health and Science receives support from the Department of Science Education at the Howard Hughes Medical Institute. The AP is solely responsible for all content.
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