Transcripts For CSPAN CDC Director Discusses Preparing For T

CSPAN CDC Director Discusses Preparing For The Next Pandemic August 31, 2022

For joining us here at csis. Were going to be hosting a fireside chat with dr rochelle walensky, the cdc director to really focus in on cdcs preparedness and the road ahead. Im Julie Gerberding and i serve as the ceo of the foundation for the National Institutes of health. Im also co chairing with my colleague, former congresswoman susan brooks, this csi commission on strengthening samara because health security. I also served as the cdc director from 2002 to 2009. So you can imagine this topic is pretty near to my heart. Im delighted to be hosting dr walensky here today. Shes been the cdc director since 2021 but i bet it feels a bit longer than that before her tenure and government, she was the chief of Infectious Diseases at the massachusetts general hospital, a professor at harvard and has an amazing track record of contributing not only to the events in the covid pandemic there, but also a long history of contributions to combating he is cochairing here on the future of cdc and cdc repaired nest, welcome tom, thank you very much for joining us. I think it would be fair to say that we are at a Pivotal Moment in the cdcs future. On one hand, i know, and i think that anyone knows whos watching closely recognizes that the cdc has to had a tremendous impact on the course of the pandemic and has done a spectacular job in many dimensions. They are showing signs of strength. Scientific rigor has been challenged. Education competency has been challenged. And political assaults have intensified. It has been a tough time. When i was a cdc director, we faced similar challenges. But what was similar then, from my point of view, the context in which these challenges were adjudicated was much different. They were operating in exceptional environment. And other major issues beside the pandemic. We have a citizenry that is frightened. Sometimes confused. And is not able to tolerate the kind of ambiguity and uncertainty that a chronic pandemic has created for them. So its really eroded the trust in all of the institutions and clearly cdc is no exception i think we want and believe that cdc remains the Gold Standard od investments so that the agency can really move ahead and not have the crisis fretting that weve experienced in the past. So maybe like tap at your two cents before we get into the heat of the discussion. You been watching it from the same place ive been watching a, from afar. Thank you, julie. Great to be with you. Thank you for all that youve been doing. I absolutely agree that this is a pivotal time for Public Health hit america and particularly cdc. Its a time where we should strengthen the cc work to secure its own future and for the country. We all know how important is to do this in a bipartisan way, and that we will only make progress if we have the support of the administration and congress. Emily also know how important this commission, and in this working group are working on similar issues and eager to learn more from you today and to hear about your plans for the future. We have a lot of ground to cover this afternoon, so we want to get right into it and make this an informal interaction with you and we are really eager to do that. We also have a small group of experts on our commission who are here with us today, who people turn to for later in the conversation. We turned back to you to get us going. Im just sitting here realizing that a lot of people dont really understand what cdc is and what it really includes. The focus right now has been on the urgent Emergency Preparedness part of the cdcs responsibility, but actually, it has a very important and much broader agenda. Maybe you can start us off at the fundamentals. What is the cdc and what is its mission . Again, a pleasure to be with all of you. Its a Public Health agency in public help means caring for everybody. That is what we do. We protect the health, security and safety of all that come from domestic threats or from or from abroad. We are an agency with 12,000, 13,000 people, and i think that those people are our biggest assets, and they have been incredible. As you know, cdc became the work that we do there has not really recognized what we can do beyond the pandemic. I can tell you that she repelled all of the officer to alex hoff master led a team on outbreak investigation of amyloidosis, which im certain many people have not heard of when it started to strike in numerous disparate states and it is generally endemic in a world away and he found the source of his team found the source. We had 63 foodborne outbreaks in 2021 that most people didnt hear about, but that we were charged with addressing. Weve deployed 400 people to five Different Countries to address marburg hemorrhagic fever in uganda and cbcs polio cdcs polio effort in afghanistan and pakistan. And you know, numerous covid outbreaks around the world. So theres theres so and then of course that many of the infectious threats, but the non infectious threats are a really key component of what we do. As we think about covid 19. We think about it as an infectious threat. But the people who were most impacted by covid 19 had in fact many noninfectious comorbidities. So as we think about mental health, environmental health, opioid crises and then of course chronic conditions, chronic Heart Disease and obesity. So we do have a wide vast menu of things that we are tackling in the news, youre going to hear about covid and monkeypox and polio. But what we do every day, our subject matter expertise does every day is what leverage is leverages our ability to do that. And in fact, we know so much about monkey pox because we have decades of work going on within the cdc about monkey pox specifically. Now when i see dr bester here in the audience. Dr rich besser lead our center for Emergency Preparedness and response. When i was at the cdc and we went deep on preparedness in terms of planning and exercising and investing and so forth. But i think looking back on it, we thought of it as a Health Crisis and we approached it as a Health Crisis. We concentrated on the medical and the Public Health dimensions of it. We didnt think so much about the economic crisis and we didnt think so much about the social consequences and in equities that were part of what were experiencing right now in the context of this pandemic, what that really says to me is its a whole of government responsibility. And so i guess part of the issue is how does cdc fit into this much broader governmental context and how do you negotiate your unique role and yet at the same time participate in the intraagency process. Yeah. That i think has been something that i have to learn quickly and is so key because we will say we lead with science and we do lead with science but as we make policies we cant ignore the fact that these are interagency policies. So how does our School Guidance intersect with the plans of department of education. How does our Infection Control and prevention guidance intersect with what labor is doing . Department of labor is doing . How does the Eviction Moratorium intersect with the housing and urban development. And so almost every decision that we have made in the context of a pandemic in the of the pan in the in in our guidance in our Decision Making has brought and has broad interagency collaboration important policy intersections that we have to take into account as were making these you know these guidances and recommendations. Yeah. So rochelle, just picking up on what you said a little earlier about your deployments overseas. Ive heard you say before that when an Infectious Disease crisis hits many parts of the world, the first call people make is to cdc you want to say any more about your International Work that youre doing . Yeah. I think that actually people recognize cdc for its domestic work. But i think i had my first opportunity to go abroad and weve had a lot of campaigning domestically. So i havent been able to go as broad as much as i would have liked. But i had my first opportunity to go abroad and it has been and ive been doing outreach to our 60 country directors. We have a presence in 60 countries. And truly meetings dont start in many of these countries without minister of health meetings dont start unless cbc is at the table to provide that cdc is at the table to provide that advice. When when theres a minister of health who is giving advice to a government, they want cdc at their side to give that technical support. We do an incredible amount of work in the training of the Public Health leaders, the epidemiologists, the laboratory ins the disease detectives in these International Sites in uganda. I got to see you know a staff of 160 that were called to do a leptospirosis outbreak investigation. So i think that the here in the United States its underappreciated how important it is. Our domestic our International Footprint and of course you know we now know that no one is safe until everyone is safe. Right . And so i do an International Threat very much is one that could, you know from a Global Health security standpoint be a domestic threat. And i am particularly proud of the incredible work that we do internationally. I try and stay in touch with our International Offices to our to make sure that they know headquarters is with them. And rochelle, you noted a minute ago that people may not know about the International Work. Are there other things about cdc misperceptions or things that you see every day that the American Public may not see things that youre particularly excited about . You know i think i think the science of the agency is really its just incredible and and there have been when i started and i started really learning and and mind you i am an before i got here i was an avid consumer of cdc like i knew more than the average person about the cdc and yet when i got to the cdc and i started really doing a tour of all the divisions and and centers and the work that they were doing that it was a bit of a kid in a candy store. We do that here . Vital statistics and an Environmental Justice and you know cardiovascular disease i of course knew about but the deep subject matter expertise that you know when there was this first case of monkey pox i could talk to somebody whos literally spent decades of her career working in monkeypox. I was the first person to say, gosh i dont know if theyre ever gonna find where this came from. And sure enough they did so that is the incredible work of the people every single day. And mind you we will never know their names. I gave you their names but they are not doing it for credit. Theyre not doing it for recognition. Theyre doing it because they believe in protecting our health and safety and security. So can we keep going in that direction around the work that cdc is doing for epidemic preparedness and response. Pandemic preparedness and response. Obviously in this pandemic many things have been happening and when things dont work they may be called out but theyre not always called out when things are working. And so can you say a little bit more about the things that at cdc. Even when youre looking at your reform agenda and what i think d just acknowledge that in the last 19 months, we have delivered 600 million vaccines to americans. Thats kind of extraordinary, with the vaccine safety and Effectiveness Program profile that has been rigorously studied from moms, babies and infants. That in a of itself is something is underappreciated. What it took to vaccinate, we can call it 75 of america. So, so, that i think is something we should acknowledge in terms of the work that were doing and have been doing. There have been numerous things when i came when i started as an as a admire of cbc from the outside. Cdc from the outside. I could also say that these were challenges that i perceived as the outside, our signs needed to move faster. Cdc had been long criticized for our science not moving fast enough. So how can we get things out faster . Our clearance process out faster. That was something i addressed early on equity. Clearly a challenge in the pandemic. And this was something that i know all of cdc actually believed in but we have this moment to do more for Health Equity and and actually it was one of the things that worked to boost them around most of the agency when i got there was to talk about equity to mobilize around social determinants of health around a core strategy for equity around addressing Diversity Inclusion within the agency and outside of it. Data. Im a data geek. So data has always been important to me. We launched the center for forecasting and outbreak analytics which was really important to think about innovation. Data sources. How we can project how we can forecast how we can work with our partners, what do they need in terms of forecasting. And im really excited about this new this new center also in data. You know i dont know that everybody recognized in in as an Infectious Disease doc when you report something to the cdc it was a handwritten form that you send and say this patient has measles that this patient has tuberculosis in covid it was a million a day. We were getting reports to the tune of a million a day and some of them were literally coming in by fax machine thats not a data system. And so we really went from case reporting of 187 places to 15,000 Healthcare Facilities that were now reporting data electronically. So weve really scaled up our data systems and then maybe one final because really mentioned communications and that is i started and we had a Communications Director position that had been opened and vacant for four years. We posted christ we posted it twice, we just had that higher. Kevin griffin, im really excited is now with us, but thats been challenging, theres no question. You are mentioning this data systems problem, but a lot of people dont really understand what your authorities are from the state and local level, i think its really worth emphasizing that you get data by being a good partner, but you dont really have the authority to require it. Dir. Walensky thank you, so there are two major challenges, i would say, with data right now. When is the pipe stone connect. Data coming in from one county does not connect to its own state, doesnt connect to the cdc. It doesnt match the pipes from a different state. If one jurisdiction was to send data to us, we cant send a similar jurisdiction back to see how they are doing comparatively. Thats problem number one. Problem number two is, even if all the pipes connect it, theres nothing falling through it. So, having come in in the middle of the pandemic when we had the Public Health emergency, many of those systems started coming in because, through the Public Health emergency got through the authority for the data to come in. But you are exactly right, we do not have the capacity to compel data to come in. We get it voluntarily, we did not get it from monkeypox, we are just now able to get vaccine data from jurisdictions from 64 legal teams working on data use agreements each time so that we can get these data and they are now just starting to flow. We cant make real live nimble decision when three months after a first case we are first starting to see data. So, its both of those issues. We can work on the systems issue, we need the authorities issue and we need the partnership. Because i really do want to say is what im not interested in is mandating data from jurisdictions. Im interested in a bidirectional highway where if data was to come in, we have a responsibility to get it back in a way thats helpful to the jurisdictions as well. I think thats tough because, as you said, the pipes dont match up, and just linking one Institution Health care institutions data to their local Public Health department is a huge challenge, let alone trying to construct the system for the entire country. But the idea of a data, and public houses, i think an idea dir. Walensky we are actively working on it. Its really important and you need congressional help. That that leads us to the topic of the reform agenda. I think many people are familiar with the basic framework of the reform agenda. Maybe you could just highlight what youve already done, because i know that you did not wait around for time to pass. You got started right away. Dir. Walensky we did a lot of work on the data side, we did a lot of work on the equity equity side and weve done a lot of work on the Community Side communication side. Weve done a lot of work on the laboratory side. Laboratory has been a challenge. Weve read that in the news. One of the first things that we did when i came in was to do this and try to understand, but also have our Advisory Committee and the director reconvene. One of our first workgroups is on lab. Also, a lot of work on Quality Assurance and lab, our laboratory science, our director sat down. So, we needed to have a replacement, but also being in that role, which im delighted about, and really do a lot of work on Quality Insurance Quality Assurance. Importantly, and this really will get to the core Public Health capability. We need to raise our core Public H

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