CDC will undergo comprehensive review and evaluation
By Roni Caryn Rabin
The Centers for Disease Control and Prevention will undergo a monthlong comprehensive review and evaluation, a first step in modernizing its systems and processes and transforming it for the future, Dr. Rochelle Walensky, the agency’s director, announced earlier this week.
The move follows an unrelenting barrage of criticism regarding the agency’s handling of the pandemic over the past few months. The review will be conducted by Jim Macrae, who served as acting administrator of the Health Resources & Services Administration for two years and has held other senior positions at the federal Department of Health and Human Services, of which the CDC is a part. Macrae will start his assignment April 11.
“The lessons from the COVID-19 pandemic, along with the feedback I have received inside and outside the agency over the past year, indicate that it is time to take a step back and strategically position CDC to support the future of public health,” Walensky said in an email to agency employees.
Three senior CDC officials — the acting principal deputy director, Dr. Deb Houry; the chief operating officer, Robin Bailey; and the chief of staff, Sherri Berger — will gather feedback on the structure of the agency and “solicit suggestions for strategic change,” Walensky said.
At the end of what she described as a “collective effort,” the agency will develop new systems and have a plan for how the agency should be structured.
A CDC spokesperson said that the agency has worked to speed up data reporting and scientific processes over the past year, but that more needs to be done, including finding “new ways to adapt the agency’s structure to the changing environment.”
Walensky said the review will focus on the agency’s core capabilities: the public health workforce, data modernization, laboratory capacity, health equity, rapid responses to disease outbreaks and preparedness, both in the United States and worldwide.
“Over the past year, I have heard from many of you that you would like to see CDC build on its rich history and modernize for the world around us,” Walensky said in her email. Thanking her employees, she said, “I am grateful for your efforts to lean into the hard work of transforming CDC for the better.”
The CDC has long been revered for its methodical, scientific approach to improving public health around the world. Scientists outside the United States were trained by agency experts, and its standards have been embraced and emulated globally.
But the agency’s infrastructure was neglected for decades, like the nation’s public health system generally, and the pandemic has posed unprecedented challenges. Early on, the CDC made key mistakes in testing and surveillance — for example, famously fumbling design of a diagnostic kit sent to state laboratories.
Officials were late to recommend masking, partly because agency scientists didn’t recognize quickly that the virus was airborne. In May of last year, Walensky announced that vaccinated people could take masks off indoors and outdoors; just weeks later, it became clear that vaccinated people could not only get breakthrough infections but also could transmit the virus.
In August, Walensky joined President Joe Biden in supporting booster shots for all Americans, before scientists at the Food and Drug Administration or her own agency had reviewed the data on whether they were needed.
More recently, the highly contagious omicron variant has led the CDC to issue recommendations based on what once would have been considered insufficient evidence, amid growing public concern about how these guidelines affect the economy and education.
In December, the CDC shortened the isolation period for infected Americans to five days, although it appears that many infected people can transmit the virus for longer. Over the past few weeks, some experts have criticized the agency for changing the metrics used to assess risk and determine appropriate local measures, in order to appease business and political interests.
Supporters of Walensky say that the agency has been handed an extraordinary task, and that the CDC is doing its best under extremely difficult circumstances — not least that most employees have been working remotely.
In a separate statement issued to the public Monday, Walensky said that “never in its 75 year history has CDC had to make decisions so quickly, based on often limited, real-time, and evolving science.”