Public Health

New CDC director outlines 6 big fixes needed to crush COVID-19

Tanya Albert Henry , Contributing News Writer

As newly appointed Centers for Disease Control and Prevention (CDC) Director Rochelle P. Walensky, MD, MPH, steps into her new role leading the agency, the to-do list is long.

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Help get a pandemic under control. Create an equitable health system. Bolster public health infrastructure. Improve communication and combat misinformation circulating on social media and elsewhere. Build relationships with people at the state, community and tribal levels. Boost internal morale for scientists at the agency. Assess the collateral damage of the past year, including falling behind on childhood immunizations. And more.

Dr. Walensky, who heads to the CDC after serving as a professor of medicine at Harvard Medical School and practicing as an infectious disease physician at Massachusetts General Hospital and Brigham and Women's Hospital, is ready for the challenge.

"I'm calling it my midcareer residency. I'm going to dive in. I got called during a code and when you get called during a code, your job is to be there to help," Dr. Walensky told viewers during a JAMA Network™ livestreamed interview on the eve of her officially taking over as the CDC's new director.

Combating COVID-19

On her first day on the job, Dr. Walensky announced that as a protective public health measure, she will extend the order that temporarily halts residential eviction until at least March 31. She said in a statement that the pandemic is a historic threat to the nation's health and that it has "triggered a housing affordability crisis that disproportionately affects some communities." Learn more with the AMA about why eviction moratorium key weapon in the pandemic fight.

In the livestreamed interview led by Howard Bauchner, MD, editor-in-chief of JAMA and senior vice president of AMA scientific publications and multimedia applications, Dr. Walensky talked about key areas that need improvement to help crush the pandemic and secure longer-lasting public health gains.

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Vaccines. President Joe Biden is aiming to have the nation reach 100 million doses administered within his first 100 days in office, a goal she believes is attainable. Dr. Walensky said more thought should be devoted to vaccine eligibility to hit the sweet spot between supply on the shelf and the number of people eligible.

Vaccinators. Dr. Walensky said the U.S. must ensure there are enough people who can administer vaccinations, which means looking broadly for help from medical military, Public Health Service Commissioned Corps members, medical students and nursing students, dentists, veterinarians and more.

Vaccination sites. A four-pronged approach to reach people is being worked on: Community vaccination centers, such as stadiums and gymnasiums; mobile units to do the outreach to communities that otherwise wouldn't be reached; federally qualified health centers; and a pharmacy program.

Collaboration. The federal government needs to work with the states, offering support and resources available from the national level to help get vaccines distributed. Dr. Walensky said the role of the federal government will be to step in and ask each state "What is the help you need?"

Public health investment. The pandemic has laid bare the nation's frail public health infrastructure.

"We need to fix that public health infrastructure and we need resources to do it," Dr. Walensky said. "One of my challenges is to make sure Congress knows and understands that we are in this because we had warning for many, many other public health scares over the last 20 years and we didn't fix our public health infrastructure and our data infrastructure."

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Agency morale. Internally, Dr. Walensky said she needs to figure out how to make sure the CDC's many talented scientists—who fortunately have not left in a mass exodus—understand and feel the value that should be given to them.

"They've been diminished. I think they've been muzzled. Science hasn't been heard. This top-tier agency, world renowned, hasn't really been appreciated over the past four years … I have to fix that," she said. "I need to make sure that those voices get heard again—that I'm leading with trust."

Read more from AMA President Susan R. Bailey, MD, about why the effort to restore trust in science must begin now.

Public communication. Lastly, the CDC must better communicate with the American people: "I want to be able to convey in layman's terms what the science shows, when guidelines change. ... And not just me, but subject-matter experts who can convey that."

Subscribe to the "Conversations with Dr. Bauchner" podcast. Each week, he interviews leading researchers and thinkers in health care about their recent JAMA articles.

The AMA has created a COVID-19 vaccine resource center that features an array of information relevant to physicians about the development and distribution of COVID-19 vaccines. The AMA also partnered with the CDC and the Food and Drug Administration to provide a series of educational webinars that help explain the process of vaccine development and offer a deeper dive into the data to understand safety and efficacy results. These webinars are also available on the AMA COVID-19 vaccine resource center.