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CDC, under fire for covid response, announces plans to revamp agency

Outsider named to conduct one-month review with an eye toward modernizing

Rochelle Walensky, director of the Centers for Disease Control and Prevention, emailed staff April 4 about her plan to revamp the public health agency. (Shawn Thew/Pool/EPA-EFE)

Centers for Disease Control and Prevention Director Rochelle Walensky announced plans Monday to revamp the agency that has come under blistering criticism for its performance leading the U.S. response to the coronavirus pandemic, saying, “it is time to step back and strategically position CDC to support the future of public health.”

In an agencywide email sent shortly after 1 p.m., Walensky said she has hired a senior federal health official outside of the Atlanta-based agency to conduct a one-month review to “kick off an evaluation of CDC’s structure, systems, and processes.”

“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,” she wrote in the email. “I am grateful for your efforts to lean into the hard work of transforming CDC for the better. I look forward to our collective efforts to position CDC, and the public health community, for greatest success in the future.”

A copy of the email was shared with The Washington Post.

Since the pandemic began more than two years ago, the once-storied agency has been under fire for its pandemic response, from initial delays developing a coronavirus test, to the severe eligibility limits to get the test, to missteps often attributed to Trump administration meddling. But even under the Biden administration, the agency’s guidance on masking, isolation and quarantine, and booster doses has been repeatedly faulted for being confusing. A consistent criticism has been the agency’s failure to be agile, especially with analysis and release of real-time data.

Walensky seemed to acknowledge those criticisms in brief public remarks about the reasons for the reorganization.

“Never in its 75-year history has CDC had to make decisions so quickly, based on often limited, real-time, and evolving science,” she said in the statement. “ … As we’ve challenged our state and local partners, we know that now is the time for CDC to integrate the lessons learned into a strategy for the future.”

After briefing the agency’s leadership team, Walensky sent staff the email, saying the one-month effort, set to begin April 11, would be led by Jim Macrae, associate administrator for primary health care at the Health Resources and Services Administration, or HRSA. HRSA and CDC are part of the Department of Health and Human Services.

She also tapped three senior officials to gather feedback and solicit suggestions for “strategic change.” They are Deb Houry, acting principal deputy director; Robin Bailey, chief operating officer; and Sherri Berger, chief of staff and a longtime agency veteran who oversaw the agency’s budget for many years and is close to Walensky.

Walensky said the revamp would focus on the agency’s “core capabilities,” including beefing up the nation’s public health workforce, data modernization, laboratory capacity, health equity, rapid response to disease outbreaks and preparedness within the United States and around the world.

“At the conclusion of this collective effort, we will develop new systems and processes to deliver our science and program to the American people, along with a plan for how CDC should be structured to facilitate the public health work we do,” she wrote.

The review will occur while CDC streamlines its coronavirus management structure, which pulls teams from across the agency to manage the day-to-day covid response, and instead, will return more activities to existing offices, she said.

Some experts applauded the outside review, but faulted the Biden administration for failing to provide Walensky with the support she needed to modernize CDC before now.

“I think there needs to be a detailed accounting of why things failed so epicly … and that should have happened during the transition,” said Peter Hotez, dean for the National School of Tropical Medicine at Baylor College of Medicine in Houston. Walensky has “done as good a job as pretty much anybody could have,” Hotez added, noting she was saddled with inadequate infrastructure, and no information about what was broken.

But one outside adviser to the administration, who spoke on the condition of anonymity to be frank, said the CDC needed to do far more than hire an outside adviser, noting the agency has had one misstep after another for the past two years. The CDC was woefully unprepared for the pandemic, the adviser said, and has been too slow to respond at almost every turn, warranting a more drastic overhaul.

The email from Walensky to staff went out at a time when many of the agency’s more than 13,000 scientists, epidemiologists and public health experts were on vacation. But one CDC official welcomed the rethinking of CDC’s structure and processes. “It is NOT a bad thing, as covid has exposed some real weaknesses,” the individual wrote in an email on the condition of anonymity to share thoughts candidly. “I do think substantive change will require legislation, and I don’t know if this Congress or the next will be capable of doing that.”

A wide-ranging pandemic plan that would make the CDC director a Senate-confirmed post and make other changes to the agency passed a key Senate health committee with strong bipartisan support, but is awaiting a floor vote.

CDC spokesperson Kristen Nordlund wrote that the reorganization would build on changes already underway at the agency to speed up data reporting, among other things. Walensky has sought to speed up publication of data and guidance, and to share more frequent updates with the public, officials have said.

“Work is needed to institutionalize and formalize these approaches and to find new ways to adapt the agency’s structure to the changing environment,” Nordlund said.

Yasmeen Abutaleb contributed to this report.

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot designed to target both the original virus and the omicron variant. Here’s some guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

Variants: Instead of a single new Greek letter variant, a group of immune-evading omicron spinoffs are popping up all over the world. Any dominant variant will likely knock out monoclonal antibodies, targeted drugs that can be used as a treatment or to protect immunocompromised people.

Tripledemic: Hospitals are overwhelmed by a combination of respiratory illnesses, staffing shortages and nursing home closures. And experts believe the problem will deteriorate further in coming months. Here’s how to tell the difference between RSV, the flu and covid-19.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.

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