Via The Lancet: US CDC begins agency-wide changes after pandemic failures. Excerpt:
The US Centers for Disease Control and Prevention (CDC) is on a mission to reorganise and modernise itself, so that its mistakes during the pandemic will not happen again. The aim is to make the nation's leading disease detective more nimble and accountable, and fortify its role as public health protector. But although some changes have been made, progress will be limited without support from the US Congress.
The CDC's Director, Rochelle Walensky, an infectious disease physician and research scientist appointed by President Joe Biden in January, 2021, commissioned an independent review of the CDC's pandemic record in April, conducted by James McCrae, Associate Administrator for Primary Health Care in the Department of Health and Human Services’ Health Resources and Services Administration. “To be frank, we are responsible for some pretty dramatic, pretty public mistakes, from testing to data to communications”, Walensky told her roughly 11 000 staff when she unveiled a summary of the review's findings in August (panel).
Panel
Key findings and recommendations from the CDC review
It takes too long for the CDC to publish its data and science for decision making
• Create an online mechanism for pre-publication delivery of science
• Expedite the review or approval process for scientific publications and data (including laboratory data) to match the needs of the emergency
The agency's turnover of staff during the COVID-19 response created gaps and other challenges for partners
• Increase the number of CDC leaders trained and ready to deploy to a response
• Require a minimum of 6-month rotation for leadership positions on the response; build a redundancy model of emergency staffing (ie, backup or co-lead staff in all key positions) to prevent response burnout and assure continuity in operations
The agency's guidance documents are confusing and overwhelming, and the website is not easy to navigate
• Produce plain-language, easy-to-understand implementation guidance documents that apply over multiple settings; reduce the number and length of guidance documents; include a brief scientific rationale or background in the implementation guidance with a referenced or accompanying Morbidity and Mortality Weekly Report, Science Brief, as necessary
• Restructure the agency web site and digital communication platforms to eliminate unnecessary content and focus on key target audiences with a primary emphasis on the public
COVID-19 uncovered the need for flexibilities that do not exist today at the CDC
• Establish new authorities that will allow the CDC to be more nimble and work faster, such as public health and regulatory authorities mandating data collection from local jurisdictions, and human resource authorities with authority to hire faster, and ensure competitive salaries to recruit and retain for hard-to-fill positions like data scientists
