As the distance between Americans and the COVID-19 pandemic grows, the American people still lack an honest assessment of the Centers for Disease Control and Prevention’s performance– leaving meaningful reform further out of reach. The “independent” review of the CDC was anything but.
CDC leadership assessed their own performance and the agency’s structure in conjunction with other federal bureaucrats, concluding that the CDC needed to focus on communicating with the American public and share data faster. The million dead Americans, and the thousands of nurses and doctors who served on the front lines, deserve better.
Citizens must demand and Congress should honor those who died by undertaking the hard work of CDC reform, starting with rejecting “more of the same” policy recommendations and instead transform the agency’s workforce in order to transform its culture.
Despite prior successes fighting Ebola and H1N1 influenza, the agency’s mission and culture have drifted from its roots as a public health readiness and response-oriented agency to an academic, siloed organization focused on publishing papers. As New York City hospital morgues overflowed and bodies started piling up in refrigerated trucks, CDC bureaucrats worked from home – issuing outdated public health guidance, promoting school closures, and engaging in unchecked economic regulation through an eviction moratorium.
Two years later after the worst pandemic in a century, much of the agency is still working remotely. This is not the public health agency that America needs.
The country needs a nimble, action-oriented public health agency. Staff at the agency must be “ready to go” – or ready to deploy to assist in a public health emergency. This includes epidemiologists, physicians, and technical staff. The agency also needs a clear command structure, instead of an unwieldy leadership team of over ten direct reports.
Luckily, we have an existing and neglected uniformed service that can do just that: the U.S. Public Health Service Commissioned Corps (USPHS). By integrating this workforce as the primary staffing vehicle for the CDC, the agency would gain a uniformed service that is ready to deploy at a moment’s notice in emergencies, be it Ebola, an outbreak of foodborne illness, or another pandemic. With a bias for action – instead of publishing papers – the USPHS would help the CDC regain its focus on readiness and response.
Such an undertaking would require an honest accounting of the CDC, including an assessment of which roles are needed, and whether they should be filled by civilians or those in a uniformed service. Changing the CDC’s workforce could fight the organizational sloth, whose great costs we saw during the last two years.
Recent efforts from Washington insiders do not represent real reform and paper over deep, existing problems. A dangerous public health echo chamber has produced self-reinforcing recommendations, trying to foist upon regular Americans along with local and state governments a mandate to share public health and health care data. This is a direct contradiction to recent history: the CDC succeeded in modeling other disease outbreaks without a data mandate and when it failed during the pandemic, private sector entities like the Johns Hopkins University Coronavirus Resource Center took up the data mantle.
This is a classic example of ignoring the real problem: what is needed is the creation of standards for data reporting. The technology and cellular industry work together to set wireless standards like Bluetooth, enabling our phones to connect with our cars and computers. A similar effort is needed in public health, as public health reporting should not rely upon fax machines.
But before we throw more money to modernize health data systems, we need accountability. The CDC has spent hundreds of millions on data systems over the past decade with very little to show for it.
As the CDC and Washington insiders fail to hold the agency accountable for its blunders with an inappropriate fixation on a data mandate, Americans see the real problem: its languid culture. Reform won’t be an easy undertaking, but we can’t let the government agency that fumbled its founding mission to fight communicable disease to set the stage.