Recently, CDC Director Walensky described a set of proposed reforms of the CDC (boldface mine):
Dr. Walensky laid out her basic conclusion from the review in candid terms: The C.D.C. must refocus itself on public health needs, respond much faster to emergencies and outbreaks of disease, and provide information in a way that ordinary people and state and local health authorities can understand and put to use….
The C.D.C. has been criticized for years as being too academic and insular. The coronavirus pandemic brought those failings into public view, with even some of the agency’s staunchest defenders criticizing its response as inept….
While it has steadied itself since Dr. Walensky assumed control about 18 months ago, the C.D.C. has continued to fall short.
Its public guidance has often been confusing, even to public health experts. Leaders of its Covid team rotate so frequently that other senior federal health officials have at times been unsure about who is in charge. And important data was sometimes released too late to inform federal decisions, including studies on breakthrough infections that could have influenced a federal recommendation on authorizing a round of booster shots…
Other planned changes are more bureaucratic but could have a big impact. A new executive team will be created to set priorities and make decisions about how to spend the agency’s annual $12 billion budget “with a bias toward public health impact,” according to a media briefing document. Two scientific divisions will now report directly to Dr. Walensky’s office, a move that appears aimed at speeding up delivery of data. Mary Wakefield, a former deputy health secretary in the Obama administration, was appointed to lead the reforms.
Dr. Walensky hopes to cut down the review time for urgently needed studies, emphasizing production of “data for action” as opposed to “data for publication,” the briefing document said.
Disappointingly, I haven’t seen much about ‘silo-ization’–the inability of different parts of the CDC to work coherently together. But there’s a larger problem: none of the poor decisions made, such as relaxing masking, in the first half of 2021 would have been made any different had these reforms been in place. And I don’t think they would have had any useful effect in stopping Trump et alia’s campaign of misinformation. The balkanization of our public health system wouldn’t be affected by this either.
That requires political consequences, and, as some asshole with a blog keeps pointing out, said political consequences aren’t happening.
If we don’t do something to “repair” the failure of State and Local Public Health Departments, it really doesn’t matter how much effort we put into “fixing” the CDC. State and Local Public Health Departments literally operate as over 50 serfdoms, Although the federal government has provided billions in funding since 9/11 to these serfdoms, they are not accountable, nor are they held responsible for their failures to provide for the safety, health, and welfare of their citizens.
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