Midday today, January 20, Dr. Rochelle Walensky will take over as director of the Centers for Disease Control and Prevention—and one of her top priorities will be to try to undo all the harms done to the agency by the Trump administration.
“How is it that I make sure that the people who are there—these incredible scientists, these incredible civil servants for their entire career—understand and feel the value that we should be giving them? They have been diminished. I think they’ve been muzzled, that science hasn’t been heard,” Walensky said in a brief, but wide-ranging interview with JAMA Tuesday. “This top-tier agency—world renowned—hasn’t really been appreciated over the last four years and really markedly over the last year. So, I have to fix that.”
Part of her plan to do that is unmuzzling those scientists and getting their science out to the public where it can make a difference. And that blends into the next challenge: “We obviously need to get this country out of COVID and the current pandemic crisis,” she said. And that will also entail increasing communication with the public, as well as state and local health authorities and members of Congress.
Walensky—a professor of medicine at Harvard Medical School and chief of the Infectious Disease division at Massachusetts General Hospital and Brigham and Women’s Hospital—will be new to government health work when she takes over the federal agency of over 10,000 staff today. “I will have all of the benefit of coming in from the outside and being able to look in and say ‘This feels really broken,’” she said. For any institutional knowledge she’ll need, she’ll rely on long-standing career staff, she added.
Like President-elect Biden, Walensky will immediately focus on helping smooth out and speed up the COVID-19 vaccine rollout—and reaching the administration’s goal of getting 100 million shots into arms in the first 100 days. According to CDC data as of January 19, the government has distributed more than 31 million doses, but less than 16 million have been administered.
A bit of a cushion
Picking up the pace will involve helping states set the right eligibility conditions for vaccination—conditions that aren’t so restrictive that vaccine doses end up sitting unused in refrigerators, or so loose that there are long lines outside overwhelmed vaccination sites, she said. The Biden team also aims to boost manufacturing for vaccine supplies, increase the number of people who can provide vaccines, and increase the number of places where vaccines are administered.
Addressing one of the most pressing topics in recent days, Walensky also said she and the Biden team have their eye on the concerning coronavirus variants that are popping up in various places around the world—including the US. The team is working to “dramatically” bolster surveillance efforts, including partnering with industry and academic labs, so that they can track any variants that develop in or enter the US and begin to spread.
The main things to worry about with variants are if they spread more easily, if they cause more severe disease and deaths, and if they make therapies and vaccines less effective, she noted. We’ve seen variants that seem to spread from person to person more easily. But we have yet to see evidence that variants are increasing disease and death or that they’re evading vaccines and therapies.
“I think the good news with regard to the variants is that the efficacy of the vaccines is so good and so high that we have a little bit of a cushion,” she said. Even if lab studies show vaccines aren’t quite as effective against a variant as the initial strain, “we’ll probably still end up with quite a good vaccine.” Her point has been echoed by many other experts who predict it will take years before the coronavirus evolves to completely outwit immune responses.
“I just want to remind people: almost no vaccine we have is 95 percent effective” like the COVID-19 vaccines, she added. “So, before we panic and say ‘well, should I really get the vaccine if it’s not going to work against the variant?’—It’s going to work against the variant. Will it be 95 percent? Maybe. Will it be 70 percent? Maybe. But our flu vaccines aren’t 70 percent effective every year and we still get them. So, I’m really optimistic about how these variants are going to go.”