Having conceded the CDC made mistakes and errors in the pandemic response — then launched an ambitious effort to reinvent the agency — director Rochelle Walensky, MD, has announced she will resign at the end of June 2023.1
Appointed by the Biden administration in January 2021, Walensky took the reins of an agency battered by early mistakes, facing a politicized, sharply divided public. Walensky is credited with bringing a sense of normalcy and a boost for ebbing morale at the CDC. But it was a difficult time, and Walensky struggled.
“To be frank, we are responsible for some pretty dramatic, pretty public mistakes, from testing, to data, to communications,” Walensky said in a video to CDC staff last year.2
However, Walensky began an ongoing revamping of the agency, dubbed Moving Forward, with key goals that include:
- Faster sharing of data and scientific findings;
- Prioritizing public health communications;
- Translating science into practical, easily understandable policy;
- Creating a workforce prepared for future emergencies.
- Promoting results-based partnerships;
In addition to a mutable virus, Walensky had to battle a relentless misinformation campaign on multiple platforms, which led to a large swath of the population refusing to socially distance, wear masks, or take the vaccine. If there was a weak link for Walensky, it was probably communication and handling of an aggressive press, which published the federal costs of her media training as she tried to get up to speed.
Past CDC directors Julie Gerberding, MD, (2002-2009) and Tom Frieden, MD, (2009-2017) are highly skilled communicators, although they made a few mistakes of their own. For example, during the November 2001 anthrax mail attacks, the CDC made some assumptions that proved to be fatally false. The agency posited that postal workers who processed mail using high-speed sorting machines were at risk of cutaneous exposure to anthrax, but the deadly spores would not be re-aerosolized and become an airborne threat. (As the attacks began, Gerberding was at the CDC revamping the old hospital infections program and was soon to be promoted to agency director.)
The CDC anthrax dogma was “wrong,” Gerberding said at an open-forum analysis of the bioterrorism response in 2002. “That was brought home when the postal workers at Brentwood [post office] died of inhalational anthrax and other cases in the Washington, DC, area were identified,” Gerberding noted.3
For his part, Frieden’s tenure was marked by the first cases of Ebola in the United States, with both U.S. caregivers and infected travelers coming in from a record outbreak in West Africa in 2014. CDC guidelines for infection control ran into some perception problems — and perception can become a reality when dealing with the outsized fear of Ebola.
The CDC first emphasized a combination of contact, droplet, and airborne precautions for aerosols, essentially saying that any U.S. hospital should be able to admit and isolate an Ebola patient. These recommendations were skeptically questioned when the first cases of American care workers infected in Africa returned under heavy barrier precautions and were treated in virtually failsafe biocontainment units. After two nurses were infected at a Dallas hospital in 2014, Frieden dropped the “any hospital can handle Ebola” message and pledged to bring in CDC rapid response teams if alerted to a case.4
There is scarcely a federal agency or organization involved in the pandemic response that can claim anything close to a mistake-free record. Walensky was dealing with a changing pathogen, as SARS-CoV-2 kept evolving into more transmissible variants. This mutability eventually outpaced the CDC’s tactics and raised questions about its leadership. That, and bad luck. Shortly after the CDC told the vaccinated public they could shed their masks and not socially distance indoors, the delta variant hit with a fury and caused breakthrough infections in the vaccinated.
REFERENCES
- Centers for Disease Control and Prevention. Walensky announces departure from CDC. May 5, 2023. https://www.cdc.gov/media/rele...
- Evans G. Special report: Humbled CDC seeks reinvention, culture change. Hospital Employee Health. Oct. 1, 2022. https://www.reliasmedia.com/ar...
- Evans G. Won’t get fooled again? SHEA meeting sheds harsh light on anthrax response. Hospital Infection Control & Prevention. 2002. https://www.reliasmedia.com/ar...
- Evans G. Ebola in America: Reign of fear ending, will science prevail? Hospital Infection Control & Prevention. Dec. 1, 2014. https://www.reliasmedia.com/ar...
After conceding the CDC made mistakes and errors in the pandemic response — then launching an ambitious effort to reinvent the agency — director Rochelle Walensky, MD, has announced she will resign at the end of June 2023.
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