The CDC’s scientists have been “diminished” and “muzzled” under the Trump administration and a top priority of incoming director Rochelle Walensky, MD, MPH, will be restoring their stature in global public health.
“This top-tier, world-renowned agency hasn’t been appreciated over the last 4 years, and markedly over the last year,” Walensky said during a JAMA Live interview with editor Howard Bauchner, MD, on Tuesday. “The good news, in my mind, is that there hasn’t been a mass exodus of talent. I want to make sure those voices are heard again.”
Walensky is a professor at Harvard Medical School in Boston and is an infectious disease physician at Massachusetts General Hospital and Brigham and Women’s Hospital. She has also been chairing the National Institutes of Health’s Office of AIDS Research Advisory Council.
Part of that strategy will include a focus on social media, Walensky said. She’s already talked to CDC’s communications team to ensure that “we have a social media plan for the agency.”
“Science is now conveyed through Twitter. Science is conveyed on social media, through podcasts, and in many different ways,” she said, adding that having a social media presence will help fight medical misinformation.
“If you search vaccine hesitancy on Twitter, you see mostly hesitancy,” she said. “With the scientific response to that community, there’s a massive void. The right information is not getting out there.”
As part of pulling the U.S. out of its COVID-19 crisis, Walensky said both she and President-elect Joe Biden are devoted to equity, which will be borne out in the agency’s vaccination strategy.
She’s also aiming to fix the nation’s tattered public health system. “Part of the challenge with COVID was that we had a frail public health infrastructure to start with. It wasn’t ready to tackle what it was given, then it was given more than what it could have [handled],” she said.
“I’m going to make sure Congress knows and understands that we’re in this because we had warnings from many other public health scares in the last 20 years and we didn’t fix our public health infrastructure or our data infrastructure.”
In addition to the immediate threat of COVID-19, Walensky said there will be a lot of work in fixing the collateral damage from the last year in particular in terms of childhood vaccinations, hypertension control, HIV control, mental health challenges, and the impact of climate change on health.
Bauchner asked about the potential threat posed by new COVID-19 variants; Walensky responded that Biden plans to bolster funding for surveillance of new mutants. Work is “already being done to create connections with industry, academia, and public health labs” to ensure good national surveillance, she said.
She was unconcerned that the new variants might resist current vaccines: “The efficacy of the vaccine is so good, and so big, that we have a little bit of a cushion,” she said.
Monoclonal antibodies, on the other hand, won’t be the answer to the pandemic, she said. While some institutions have been able to give thousands of doses, the therapy is generally difficult to deliver, and “equity just really worries me there.”
“The concern in the back of our minds is, are they going to work on variants if they are truly monoclonal? Maybe if you have a cocktail, that’s better,” she said. “These may be a step in the path to get us to a better place, but I don’t think anybody envisions this is going to be a panacea for outpatient treatment. It’s just too hard.”
When Bauchner pressed on supply constraints as a challenge to Biden’s plan to deliver 100 million doses of COVID-19 vaccines in 100 days, Walensky said she didn’t “think the president-elect would have suggested [it] if we didn’t have the vision that we have that supply.”
Other constraints include balancing supply and eligibility in different parts of the country, and ensuring there are enough professionals to deliver vaccines. The incoming administration will be looking at retired medical professionals, medical students, nursing students, dentists, and veterinarians to boost vaccine administration.
The new administration will also be focused on vaccination locations, particularly community vaccination centers like stadiums and gymnasiums, mobile units, and pharmacies, and boosting existing vaccination programs at federally qualified health centers.
It also plans to reach out to states on a more strategic level: “The federal government isn’t going into Phoenix and asking if it needs help with [the football] stadium. They’ve done a great job. The question becomes, what does Arizona need? Do they need mobile clinics? Do they need more collaboration with pharmacies? The real vision is for the federal government to step in on a state-by-state level and ask, what is the help that you need?”
Walensky acknowledged criticisms that, in her current position as chief of infectious diseases at Mass General, she doesn’t have on-the-ground public health experience. But that’s why the administration hired her, she said: “I have the benefit of coming in from the outside, looking in and saying, ‘This feels really broken. As an end-user of that guidance, we couldn’t make that work.’ I think that will be really helpful.”
Source: MedicalNewsToday.com
