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August 19, 2022
CDC Gets an Overhaul
Apparently, the Centers for Disease Control & Prevention (CDC) has been listening to experts at the American Action Forum (and about a million others) on the need for serious change at the agency. On Wednesday, CDC Director Rochelle Walensky announced that the long-running “gold standard” of public health agencies would be undergoing a renovation, largely in response to the agency’s missteps during the COVID-19 pandemic.
What missteps were those? First, the patchy and ineffective communications strategy. The CDC’s communications efforts failed in three ways: They were slow, unclear, and inflexible. Regarding the lack of speed, the CDC routinely waited to push out documents and data until they were ready for official publication. But by the time these were published, it was often after state and local decision-makers had already made decisions without the benefit of the data. In the first year of the pandemic, our understanding of COVID-19 was rapidly changing, but the CDC’s slow pace left a vacuum that was filled by the less-than-qualified Twitterverse – leading to a raft of misinformation and conflicting advice. On the issue of clarity, the most infamous example would be the masking fiasco at the start of the pandemic. Despite knowing little about how COVID-19 spread and in a misguided attempt to prevent a run on supplies, the CDC confidently asserted that masks would not prevent or slow the spread of COVID-19. The back-and-forth confused the public and helped to turn mask-wearing into another culture war fight. Finally, the CDC’s inflexibility when issuing guidance – everyone everywhere was subject to the same rules – turned schools into another battleground as the agency refused to modify its in-person schooling guidance despite mounting early evidence in the United States and Europe that in-person schooling didn’t contribute to community spread.
The CDC’s solution to these and other issues is sweeping reform, and it comes on the heels of two reviews conducted in the wake of the pandemic. First, it will involve a major culture change: The agency will attempt to reward action over publication, meaning it will incentivize staff to produce actionable research and data and quickly get that data out to the public, rather than waiting to have it published in official journals. This also means the agency will work to speed up its ability to produce and make public its findings. Additional changes will involve seeking authority from Congress and the White House to mandate data collection from states, move money around to external partners more quickly, and offer better salaries and working environments for pandemic staff to reduce burnout. Additionally, the CDC is putting more emphasis on the clear communication of information in a way that is understandable to the public and demonstrates the CDC’s trust in the public to do the right thing with this information.
The CDC’s proposed changes are promising and should help address the various challenges that plague the agency. After two years in which trust in our public health system declined precipitously, and now with monkeypox on the rise, the CDC badly needs an overhaul of this nature. Changes of this magnitude will take time and have fits and starts, but with any luck, they’ll restore the agency’s luster to the “gold standard” of public health.