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CDC director orders agency overhaul, admitting flawed Covid-19 response

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The CDC’s restructuring follows two assessments conducted in recent months, one by Health Resources and Services Administration officer Jim Macrae of the CDC’s pandemic response and another by CDC Chief of Staff Sherri Berger of the operations of the CDC. the agency.

The reviews concluded that the “traditional scientific and communication processes were not adequate to respond effectively to a crisis of the magnitude and scope of the COVID-19 pandemic,” an agency statement said.

Macrae’s review, which included 120 interviews with CDC employees and those outside the agency, recommended a range of improvements, including faster release of scientific findings and data to improve transparency, translating science into practical and easy-to-understand policy, improving communication with the public, collaborating better with other agencies and public health partners, and training and encouraging agency personnel to better respond to public health emergencies.

There is consensus within the CDC that it “needs to make some changes to the way it communicates and how it works — to be faster, to be more agile, to use more clear spoken language,” said a CDC official, who protects anonymity. got to discuss the changes before they were announced.

“People work incredibly, incredibly hard and care about making sure the American people have the right information,” the official said. “Perhaps the way many of the [Covid-19] response was structured, and some of the incentives that people have here are just not well aligned to really focus on getting information to people quickly and how that information can benefit Americans’ health.”

A controversial agency

The CDC has been under intense pressure from Americans of all political colors since the earliest days of the pandemic.

It has thwarted a range of allegations over the course of the crisis, from placing politics above its vow to “follow the science” to bungling messages to endangering Americans’ lives as pandemic restrictions are eased. .

As public health officials across the country have been attacked, the agency’s powers to implement Covid-19 mitigation measures have also increased, with critics on the one hand accusing the agency of federal overspending and critics on the other blaming the agency. accuse of not doing enough.

The CDC’s authority has been challenged in multiple lawsuits. Last year, the Supreme Court lifted the moratorium on evictions during the pandemic. The government has appealed the decision of a federal court in Florida in April to override the CDC’s directive that people wear masks on airplanes, trains and other public transportation.

This year, the agency has struggled to balance the competing interests of a virus that continues to find ways to evade vaccines and natural immunity, and a public tired of taking the precautions federal and state governments have imposed. .

As the Omicron variant swept across the nation, the agency came under fire for: shorten the recommended quarantine guidelines. This spring, the shift to assessing risk at the community level by weighing hospital admissions and the burden on the health care system against the level of transmission has been both confusing and unnecessarily endangering Americans, many public health experts say.

Last week, the CDC’s decision to lift quarantine recommendations for unvaccinated individuals exposed to the virus, including in schools, was also criticized by doctors and public health experts who say the agency embraces individual responsibility for public health when it comes to public health. responsible for the latter.

Several school districts, including those in New York City and Philadelphia, are taking more precautions than the CDC now recommends when students return.

Walensky has repeatedly pointed out that the agency was underfunded before the pandemic began, noting that its public health workforce was severely depleted and that the agency was hampered by structural issues, including limited access to state data.

in a interview with POLITICS earlier this year, she said the CDC alone would not be able to control Covid-19, and called for broader public health investment at the state and local levels.

“I really think a lot of people have thought that this is the CDC’s responsibility, to restore public health.” [and] the pandemic,” Walensky said. “The CDC alone cannot solve this. Businesses must help, governments must help, school systems must help. This is too big for the CDC alone.”

Nevertheless, American approval for the agency’s job of leading the nation through a pandemic that has killed more than a million Americans has plummeted.

In March 2020, 79 percent of Americans said public health officials, including those at the CDC, were doing a good job in responding to the pandemic, according to a Pew Research Center survey. By May 2022, only 52 percent of Americans thought so, Pew thought.

The agency’s more recent approach to the monkeypox outbreak, which many epidemiologists are now concerned about, is now beyond the point of containment in the country, has again sparked widespread criticism that the CDC is unable to meet the demands of a complicated public health crisis unfolding in real time.

A new step-by-step plan

Among the structural changes that will emerge from the reviews include the appointment of former HHS Assistant Secretary Mary Wakefield to lead a team overseeing the overhaul, as well as the creation of a new executive council built by Wakefield and reporting to Walensky, who will “set the agency’s priorities, monitor progress and align budget decisions, with a bias towards public health implications.”

The agency did not offer a specific timeline for when the council would be established, but noted in a statement that, broadly speaking, “the work ahead will require time and commitment at all levels of the organization.”

The review of the CDC’s approach to communicating with the public has already begun and includes revamping and streamlining the agency’s website and creating simplified public health guidelines. The agency will also create a new stock office, working across all functions of the organization from hiring to policies to enhance the agency’s diversity.

The overhaul aims to change the “culture of the CDC” by moving away from a “wrong” approach to encouraging staff to publish their research in scientific publications and instead encouraging staff to contribute research and data. produce aimed at public health policy and action, the CDC official said.

The agency is also considering measures to speed up the publication of data and scientific findings, train more staff to be ready to respond to a public health emergency and establish emergency personnel to ensure there are no staff shortages. are during a crisis.

Walensky will also seek more authority for the CDC, through Congress and the Biden administration, to include obligations to collect state data, move money to outside partners more quickly during an emergency, and provide more competitive salaries for recruiting.

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