NEW YORK (AP) – As the coronavirus swept around the world last year, the Centers for Disease Control and Prevention sank into the shadows, undermined by some of its own mistakes and suffocated by an administration determined to minimize the suffering of the nation.
Now, a new CDC director is getting to a huge task: reaffirming the agency while the pandemic is in the deadliest phase to date and the confusion and delays the country’s largest vaccination campaign.
“I don’t know if the CDC is broken or just temporarily injured,” but something needs to be done to get it back, said Timothy Westmoreland, a law professor at Georgetown University who focuses on public health.
The job is for Dr. Rochelle Walensky, 51, an infectious disease specialist at Harvard Medical School and Massachusetts General Hospital, who is expected to be director of the CDC this week, a time when the figure for virus deaths in the US has eclipsed 400,000 and continues to accelerate.
Although the agency has retained some of its greatest scientific talent, public health experts say, it has a long list of needs, including new protection against political influence, a thorough review of its missteps during the pandemic, and more money to strengthen basic functions such as disease monitoring and genetic analysis.
Walensky said one of his top priorities will be to improve CDC communications with the public to rebuild trust. Within the agency, it wants to raise morale, largely by restoring the primacy of science and putting politics on its side.
The speed with which he takes on the job is unusual. In the past, the position has generally not been filled until a new secretary of health and human services is confirmed, and that officer appoints a CDC director. But this time, Biden’s transition team appointed Walensky in advance, so he could take the reins of the agency even before his boss was in place.
Walensky, an HIV researcher, has not worked at the CDC or a state or local health department. But he has emerged as a prominent voice on the pandemic, sometimes criticizing certain aspects of the state and national response. Its goals include unequal transmission prevention measures that were implemented last summer and the adherence of a prominent Trump adviser to a “herd immunity” approach. this would let the virus run free.
He acknowledged the weaknesses of his resume. “When people write about me as a selection for this site, they’ll say,‘ But she has no public health experience on the ground, ’” she said during a podcast with the Journal of the American Medical Association.
The podcast’s host, Dr. Howard Bauchner, who is also the magazine’s editor, praised her effusively. “I can’t imagine the CDC and the country being luckier … especially so that it can be communicated, 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.
Dr. Robert Redfield, 69, who came to the CDC with a similar resume as an academic outsider, will be re-elected. Redfield maintained a low profile during his first two years in office after being appointed by the Trump administration in 2018. Veteran CDC scientists treated crises as a national fatal increase in hepatitis A cases among homeless people and illicit drug users, and a mysterious spike in serious illnesses in people who smoked e-cigarettes.
COVID-19 outbreak agency treatment began in a similar manner. Staff scientists took the initiative and held regular press conferences to inform the public about the emerging problem.
But the agency stumbled in February when it was shown that the virus test sent to the states was defective. Then, at the end of the month, one of the CDC’s leading infectious disease experts, Dr. Nancy Messonnier, annoyed the Trump administration by speaking candidly 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 scene. Redfield made appearances, but was often a third-rate speaker after statements dominated by Trump, Vice President Mike Pence and others.
The CDC “has been sidelined, it has been denigrated, it has been a punching bag for many outgoing administration politicians. And this has had a detrimental effect on the agency’s ability to fulfill its mission,” he said. Dr. Richard Besser, a former CDC official who now heads the Robert Wood Johnson Foundation.
White House officials also took steps to try to monitor the CDC’s scientific reports and guidelines on its website. For example, the agency removed the guidelines this advised limiting the activities of the church choir even though studies had shown the danger of transmission of expanded singing inside. The agency also abandoned guidelines advising that anyone who comes into close contact with an infected person should be tested, and then re-adopted after criticism. of health experts.
“People across the political spectrum have had reason to doubt the veracity and accuracy, at times, of CDC messages,” said Adriane Casalotti, of the National Association of County Health Officers and the city.
While public health veterans say they don’t know everything that happened behind the scenes, they say Redfield apparently didn’t defend the agency’s scientists, refused to contradict Trump and those around him, and passively allowed in the Trump administration posting their messages on CDC websites.
“He was unwilling to resign when necessary or be fired to defend the principle,” said David Holtgrave, a former CDC member who is now dean of the public health school at New York State University in Albany.
Redfield refused to be interviewed.
The pandemic also exposed some non-policy CDC failures and weaknesses. The test kit problem was related to laboratory contamination at the agency’s Atlanta headquarters, a sign of carelessness. The CDC also lost its position as the nation’s leading source for counting cases 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 of the national public health system that increase in response to a crisis and then fall, and hamper 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. per 100,000 jobs.
Westmoreland, of Georgetown, called for a law or other measure to prohibit designated politicians from editorially reviewing the science of CDCs and banning them from controlling when the agency publishes information. He also recommended a review by the CDC to determine if the agency’s problems can be sought in mismanagement by Trump’s designated politicians or if there are deeper flaws in the organization.
Some experts suggest that an administration that values science and increases funding could restore the CDC’s preeminence. Biden is committed to putting scientists at the forefront of COVID-19 issues, Besser noted.
“I think this will be fixed on the first day,” he said. “One of the things that gives me hope is that I haven’t seen a big CDC exodus in the last year. I saw professionals doing their job. I saw the mental toll they were going through, but I didn’t see them give up. “
___
The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.