With the COVID-19 pandemic and its polarizing public health measures now largely in the political rearview mirror, the Biden administration is reworking its two highest-profile health agencies in hopes of improving future performance.
The Centers for Disease Control and Prevention has announced plans for an overhaul, belatedly acknowledging a failure to meet expectations in its response to COVID-19.
“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,” CDC Director Rochelle Walensky said in a mid-August statement.
Walensky took over the Atlanta-based health agency the same day President Joe Biden took office. But public relations headaches soon befell Walensky, who previously was chief of the Division of Infectious Diseases at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. That included CDC’s efforts to extend an eviction ban that was later overturned by the Supreme Court.
More broadly, critics accused the CDC of issuing confusing and conflicting guidance on issues such as vaccines. Suspicions of political favoritism by the CDC also crept into public debate. In one case, Freedom of Information Act requests revealed that the agency’s school reopening guidance was heavily influenced by teachers unions that pushed for mask mandates.
Without getting into specifics, Walensky admits the agency was not prepared to handle the country’s response to the pandemic, saying it was responsible for “some pretty dramatic, pretty public mistakes — from testing to data to communications.” She wants the agency, which has an annual budget of $12 billion, to share findings faster and develop a workforce to prepare for future emergencies.
The week after CDC announced its restructuring, longtime National Institute of Allergy and Infectious Diseases Director Anthony Fauci revealed he would step down from his position at the end of this year.
Fauci is the face of the pandemic for many people and became a divisive figure revered on the Left and reviled on the Right for his stringent embrace of lockdowns and mandates.
Fauci’s resignation represents a sea change for an agency he has led since 1984. In his place will likely be a bureaucrat enjoying a much lower profile, University of Georgia health and risk communication professor Glen Nowak told the Washington Examiner.
“His high visibility had a lot to do with where he was prior to the pandemic, his access to the media, and the media’s access to him,” said Nowak, a former CDC spokesman. “It’s hard to predict if someone will ultimately fill that particular role or whether it will go unfilled.”
Nowak compared the situation to that of C. Everett Koop, who became a household name while serving as surgeon general in the 1980s. The bearded-and-bespectacled Koop was well known and influential, with a grandfatherly aura that helped build his public health authority. Yet no surgeon general since has enjoyed so high a profile.
“Fauci’s replacement could be much more focused on the internal management of NIAID and much less visible,” Nowak said. “I’d guess that is the most likely scenario.”
While Fauci praised Biden when he became president, saying it was a “liberating feeling” in comparison to working under former President Donald Trump, he was gradually phased out as the administration’s top spokesman for COVID-19. Dr. Ashish Jha briefed reporters during Biden’s own infection.
As such, Fauci’s stepping down may be more symbolic than substantive for most of the public. Republicans tend to see the timing of his exit as an attempt to sidestep investigations that will take place if they win control of the House, and they vowed to hold him accountable.
Many Americans, especially conservatives, view the CDC and NIH as too political and dedicated to promoting narratives rather than issuing data-based guidance. John Feehery, a Republican strategist, said he hopes the Biden administration “brings in more transparency to the decision-making process and less spin.”
Even while the CDC is reorganizing, it is dealing with another public health challenge in the form of monkeypox, a viral disease first identified in 1958 that began spreading rapidly in the United States earlier this year.
The CDC is facing some of the same criticisms over its handling of monkeypox as it met with COVID-19 — that it’s sending mixed messages and failing to acknowledge all of the available information. For example, even though more than 95% of cases are spread by men having sex with men, the CDC was panned for releasing a graphic titled “How to have sex if you have monkeypox” that featured only heterosexual couples.
Nowak, who led the CDC’s media relations team during the 2009 swine flu pandemic, said the agency would need to reorganize to be faster and clearer, with primary messages focused on the people at the highest risk of contracting a disease.
“When you hear messages like, ‘Anyone can get monkeypox,’ that’s an unclear message,” Nowak said. “People want to know, ‘Who is most at risk, and why are they most at risk? If I wanted to reduce my risk, what would I need to do in order to reduce my risk?'”
