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Among other flaws, the public guidance during the coronavirus pandemic was “confusing and overwhelming,” the agency said.
Dr. Rochelle P. 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.
In a meeting with senior staff, Dr. Walensky outlined in broad terms a plan to reorganize the agency’s structure to prioritize public health needs and efforts to curb continuing outbreaks, and to put less emphasis on publication of scientific papers about rare diseases.
The steps announced on Wednesday grew out of an external review Dr. Walensky had ordered in April, after months of scathing criticism of the C.D.C.’s response to the pandemic. Its public messages on masking and other mitigation measures were sometimes so confusing or abruptly modified that they seemed more like internal drafts than carefully considered proclamations.
The public guidance has been “confusing and overwhelming,” according to a briefing document provided by the agency.
Leaders of the agency’s Covid team rotated out after only a few months, leaving other senior federal health officials unsure about who was in charge. And important data were sometimes inexplicably released too late to inform federal decisions, including some data on breakthrough infections that could have influenced a recommendation on whether to authorize a round of booster shots.
“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,” Dr. Walensky said in a startling acknowledgment of the agency’s failings. “My goal is a new, public health, action-oriented culture at C.D.C. that emphasizes accountability, collaboration, communication and timeliness.”
Her plan, which was also described in a video to the agency’s more than 11,000 employees, was short on specifics. But it was welcomed by at least some of the agency’s two dozen senior staff members, as well as by outside public health specialists.
The agency has been criticized for years as too insular and academic. Many of its experts are accustomed to conducting narrowly focused research that undergoes lengthy reviews, and they are uneasy with the kind of urgent action needed to address the coronavirus, and now the monkeypox outbreak.
In an interview on Monday, Dr. Walensky said she had repeatedly pushed staff members to turn around Covid-19 data as fast as possible. “Some of the data are messy, and some of the data take time,” she said. “I’ve really tried hard to push data out when we had it.”
The external review Dr. Walensky ordered was led by James Macrae, who has held senior positions at the Department of Health and Human Services, which oversees the C.D.C. He interviewed about 120 people inside and outside the agency. His report was not released; one official said it was being completed.
The changes Dr. Walensky described include the appointment of a former Obama administration health official, Mary K. Wakefield, to lead the C.D.C.’s shift to a stronger public health focus. Two scientific divisions will now report directly to Dr. Walensky’s office, and the agency will cut down review time for urgently needed studies. The agency is also altering its promotion system so that it rewards efforts to make an impact on public health and is less heavily based on the number of scientific papers published.
The briefing document said that Dr. Walensky wanted staff members to “produce data for action” as opposed to “data for publication.”
Importantly, the agency will beef up the team that responds to public health emergencies and require those officials to remain in their positions for at least six months, aides said. Previously, they were allowed to rotate out after only a few months, a system that senior federal officials said sowed confusion and took up valuable time during the pandemic.
A new executive team will be created to set priorities and make decisions about how to spend the agency’s annual budget of about $12 billion, “with a bias toward public health impact,” the briefing document said.
And the C.D.C. is working on improving its public messaging. Dr. Walensky, who has already shaken up the agency’s communications division, wants to make sure guidance is issued in “plain language, easy to understand,” the document said.