CDC Director Calls for Agency Reorganization After External Review

ATLANTA — Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, is calling for a dramatic reorganization of the agency in the wake of an external review of the agency’s handling of the coronavirus pandemic.

In a meeting with senior staff, Walensky said the CDC’s structure needed to be reorganized to prioritize public health needs and efforts to curb continuing outbreaks.

In April, Walensky asked Jim Macrae, associate administrator for primary health care at the Health Resources and Services Administration, to conduct a review of the agency’s COVID-19 response efforts.

She also directed three senior CDC officials —  Acting Principal Deputy Director Dr. Deb Houry; Chief Operating Officer Robin Bailey; and Chief of Staff Sherri Berger — to scrutinize operations and recommend strategic changes.

A final draft of Macrae’s review will reportedly be released later on Wednesday, but a brief of its findings said he concluded the agency’s performance during the COVID pandemic was “confusing” and “overwhelming.”

Particularly irksome, apparently, were public statements of masking and other mitigation methods that were abruptly modified without explanation.

But there were internal problems with the agency’s response as well. For instance, when the most experienced members of the CDC’s COVID team rotated to other assignments after a few months, other federal officials were left to figure out with whom to deal.

At other times, the revolving structure of the CDC’s COVID team led to information vacuums. 

Among other things, the review suggested the agency place less emphasis on the publication of scientific papers about rare diseases when the nation is in the midst of a public health crisis.

“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 provided to The Well News. “My goal is a new, public health, action-oriented culture at CDC that emphasizes accountability, collaboration, communication and timeliness.”

In a separate statement, a CDC spokesperson said, “Never in its 75-year history has CDC had to make decisions so quickly, based on limited and evolving science.

“Prior to this pandemic, public health was known by few, and woefully under-resourced,” the spokesperson continued. “[D]urable investments have not been made in our key public health care capabilities, including: diverse public health workforce, timely and accessible data for decision-making, laboratory capacity, the ability to rapidly respond to emerging threats, along with both domestic preparedness and global health security.

“A review of the agency’s operating posture illustrated that traditional scientific and communication processes were not adequate to effectively respond to a crisis the size and scope of the COVID-19 pandemic,” the spokesperson said.

“None of these challenges happened overnight, and the work ahead will take time and engagement at all levels of the organization. … The ultimate goal of this effort is a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication, and timeliness,” the spokesperson added.

Walensky wants to remake the culture of the agency and plans to bring in former Health and Human Services Deputy Secretary Mary Wakefield to oversee the reorganization.

She also wants to make it easier for other parts of the government to work with the CDC, and wants to simplify and streamline the website to get rid of overlapping and contradictory public health guidance.

Organizational changes announced Wednesday include having the center’s Division of Laboratory Sciences and the Office of Science report directly to the CDC director; the creation of a new office of intergovernmental affairs to serve as a hub where state health departments and other federal agencies will interact with CDC; and the creation of a new executive council, reporting to the director, that will determine agency priorities, track progress, and align budget decisions, with a focus on public health impact.

CDC staff were to be told of these and other changes via an email circulated Wednesday afternoon.

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