WASHINGTON — Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, on Wednesday delivered a sweeping rebuke of her agency’s handling of the coronavirus pandemic, saying it had failed to respond quickly enough and needed to be overhauled.
“To be frank, we are responsible for some pretty dramatic, pretty public mistakes, from testing to data to communications,” she said in a video distributed to the agency’s roughly 11,000 employees.
Walensky said the CDC’s future depended on whether it could absorb the lessons of the past few years, during which much of the public lost trust in the agency’s ability to handle a pandemic that killed more than 1 million Americans. “This is our watershed moment. We must pivot,” she said.
Her admission of the agency’s failings came after she received the findings of an external examination she ordered in April amid scathing criticism of the CDC’s performance. The report itself was not released; an agency official said it was not yet finished but would be made public soon.
Walensky laid out her basic conclusion from the review in candid terms: The CDC must refocus itself on public health needs, respond much faster to emergencies and outbreaks of disease, and provide information in a way that ordinary people and state and local health authorities can understand and put to use.
In an interview Monday, Walensky stressed that hundreds of Americans are still dying each day from the coronavirus and that while the country has not yet seen deaths from the outbreak of a new disease — monkeypox — it has presented some of the same challenges for the agency.
The CDC has been criticized for years as being too academic and insular. The coronavirus pandemic brought those failings into public view, with even some of the agency’s staunchest defenders criticizing its response as inept.
It remains unclear whether Walensky, an infectious disease expert whom President Joe Biden picked to lead the agency in December 2020, can bring about the changes many see as necessary.
“Can she do it? I don’t know. Does it absolutely need to be done? Yes. Is it just a reorganization that is required? I don’t think so,” Dr. Jennifer Nuzzo, a public health researcher and director of the Pandemic Center at Brown University School of Public Health.
Others said it was difficult to judge Walensky’s moves without more information, including the external report she commissioned. The review was led by James Macrae, who has held senior positions at the Department of Health and Human Services, which oversees the CDC. He interviewed about 120 people inside and outside the agency.
“Just saying we’re strengthening this and that — the devil is in the details here,” said Dr. Howard Markel, a professor of the history of medicine at the University of Michigan who has advised the CDC.
The CDC has been under fire since the outset of the coronavirus pandemic 2 1/2 years ago. It bent to political pressure from the Trump White House to alter key public health guidance or withhold it from the public — decisions that cost it a measure of public trust that experts say it still has not recaptured. It also made its own serious errors, including deploying a faulty COVID-19 test that set back the nation’s efforts to curtail spread of the virus.
While it has steadied itself since Walensky assumed control about 18 months ago, the agency has continued to fall short.
Walensky outlined in broad terms how she hopes to transform operations by emphasizing public health needs, especially with a quicker response to emergencies like infectious disease outbreaks. One of her top priorities is to deliver clear, concise messages about public health threats, in plain language that can be grasped without sifting through voluminous pages on a website.
“I think for a long time, CDC has undervalued the importance of direct communication to the public with information the public can use,” said Dr. Richard Besser, who served as acting director of the CDC during the Obama administration.
Dr. David Dowdy, a public health researcher at Johns Hopkins Bloomberg School of Public Health, said messages to the general public need to be “very clear, very simple, very straightforward,” not framed for scientists. “I do think that culture is changing, but we need it to change faster,” he said.
Other planned changes are more bureaucratic but could have a big impact. A new executive team will be created to set priorities and make decisions about how to spend the agency’s annual $12 billion budget “with a bias toward public health impact,” according to a media briefing document. Two scientific divisions will now report directly to Walensky’s office, a move that appears aimed at speeding up delivery of data.
Walensky hopes to cut down the review time for urgently needed studies, emphasizing production of “data for action” as opposed to “data for publication,” the briefing document said.
Some of the CDC’s problems are beyond its control: Much of its funding is tied to work on specific diseases and cannot be shifted to address public health threats. The agency also lacks legal authority to compel state and local health departments to deliver public health data.
The pandemic itself is another impediment. The CDC’s massive complex outside Atlanta sits mostly empty, while employees, including Walensky, work remotely.
“The actions that are being taken all strike me as actions that make sense and would make CDC a more effective public health agency,” said Besser.
But he said it was hard to see how Walensky could execute wholesale changes when she only sees most of her staff at a distance. “I don’t know how you motivate and inspire culture change when people aren’t together,” he said.