CDC director announces agency overhaul, says it must ‘do better’ after COVID-19 review

Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky said Wednesday that the agency “did not reliably meet expectations” and would overhaul its operations after an external review found shortcomings in the COVID-19 response.

The review, begun in April, comes after the CDC faced heavy criticism for its stumbles both in the early days of the pandemic and more recently, with critics pointing to confusing guidance and slow responses.

Walensky effectively acknowledged that at least some of the criticism is valid, and the agency announced a series of steps on Wednesday seeking to modernize and improve its responses.  

The review, led by Jim Macrae, an official in the Department of Health and Human Services (HHS), included findings such as that the CDC should “share scientific findings and data faster,” according to a top-line summary released by the CDC, and “be transparent about the agency’s current level of understanding.”

The CDC said Wednesday that it is taking a number of steps to change its culture and prioritize direct public health impact over a more academic mindset.  

The agency said in a summary of potential changes that its “guidance documents are confusing and overwhelming; the website is not easy to navigate.” 

It said it is considering restructuring its website and producing “plain language” guidance.  

The agency also said it “takes too long for CDC to publish its data and science for decision making.” It is considering steps to expedite publication.  

“For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations,” Walensky said in a statement.  “As a long-time admirer of this agency and a champion for public health, I want us all to do better, and it starts with CDC leading the way.” 

The CDC first faced heat for its COVID-19 response in the early days of the pandemic for problems plaguing testing that left the country unaware of the full extent of the virus’s spread. 

But even more recently under President Biden, the agency has faced criticism for shifting or confusing guidance in areas ranging from masking to isolation. At the end of last year, for example, the CDC faced questions when it did not include a requirement to test negative before leaving isolation after it cut the isolation time for many people infected with the virus from 10 days to five days.

While the new review focused on the response to COVID-19, the CDC has also faced criticism for its response to monkeypox, which some experts say shows the public health system has not learned lessons from COVID-19.  

Former Food and Drug Administration Commissioner Scott Gottlieb wrote in The New York Times that the CDC had once again failed to expand testing fast enough in the early days of monkeypox.  

“Our country’s response to monkeypox ‌‌has been plagued by the same shortcomings we had with Covid-19,” he wrote. “Now if monkeypox ‌gains a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures in modern times not only because of the pain and peril of the disease but also because it was so avoidable.” 

The steps the CDC announced on Wednesday also include appointing former Deputy HHS Secretary Mary Wakefield to help respond to the recommendations and creating a new executive council to implement changes.

“My goal is a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication, and timeliness,” Walensky said. 

–Updated at 12:31 p.m.