Make the CDC an Infectious Disease Epidemic Fighter Again
Dr. Walensky's proposed bureaucratic reshuffling is too timid.
The Centers for Disease Control and Prevention (CDC) did neither control nor prevention when confronted with the COVID-19 coronavirus outbreak over the past two-and-a-half years. The agency's many shortcomings began with its spectacularly botched rollout of tests for monitoring the spread of the coronavirus in early 2020. This was followed by the agency's failure for many months to recognize that the disease was chiefly spread via respiratory droplets. And let's not forget the agency's comprehensive ineptitude concerning the swift evaluation of the effectiveness of its proposed mitigation strategies such as masking, social distancing, and quarantining. In addition, the agency was dilatory in releasing relevant data concerning boosters, hospitalization trends, and wastewater detection of the virus.
"For 75 years, C.D.C. and public health have been preparing for Covid-19, and in our big moment, our performance did not reliably meet expectations," admits CDC director Dr. Rochelle P. Walensky in a statement this week announcing the reorganization of the agency. According to Bloomberg, she also acknowledged, "To be frank, we are responsible for some pretty dramatic, pretty public mistakes — from testing to data, to comms." Those are understatements.
According to The Washington Post, Walensky plans to speed up the agency's response to future disease outbreaks by using preprint scientific reports to get out actionable data as opposed to waiting for peer review; revamp its communications office and websites to make agency guidance clearer and more accessible; and require agency bureaucrats responding to outbreak emergencies to remain in their positions for at least six months. That's not nearly enough.
When the CDC was founded on July 1, 1946, as the Communicable Disease Center, its chief mission was to control and eliminate the scourge of malaria from the United States. By 1951, the efforts overseen by the agency succeeded in eradicating the mosquito-borne illness from the 13 southeastern states in which it was endemic. The agency was further tasked in 1948 with investigating typhus, polio, rabies, hookworm, tuberculosis, and viral encephalitis. The CDC played a major role in the global eradication of smallpox and the elimination of endemic polio, measles, and rubella in the United States.
Over the decades, the agency lost its focus on monitoring and fighting epidemic infectious diseases as it accumulated new branches and offices that aimed to combat "epidemics" of obesity, smoking, and violence. All of these issues have public health implications but not nearly the same urgency that actual epidemics caused by novel infectious diseases do. The manifold failures of the agency during the COVID-19 pandemic show that the CDC needs radical reform—not just Walensky's goals of improved communications and less bureaucratic turnover—that returns the agency to its infectious-disease fighting roots.