‘Understand the greater good’: Walensky reflects on time as CDC director

Dr. Rochelle Walensky on Friday will leave her post as director of the US Centers for Disease Control and Prevention, where she served for a relatively short but eventful 2 1/2 years.

When she started in January 2021, more than 23,000 Americans were dying of Covid-19 each week. The next year, the mpox outbreak hit, eventually infecting more than 30,000 people in the US. Then there was the first case of polio in the US in nearly a decade. Ebola struck parts of Africa during her tenure, and just this week, there were five cases of locally acquired malaria in the US, the first such infections in 20 years.

In a wide-ranging interview with CNN on Tuesday, Walensky said she remembers dark days over the past few years.

Among them was May 3, when Amy St. Pierre, who helped lead the CDC’s maternal mortality prevention team, was killed in a mass shooting in Atlanta.

“I have received some pretty awful phone calls in the last two and a half years,” Walensky told CNN, her eyes filling with tears. “That was just awful.”

Even before St. Pierre’s death, Walensky had championed the cause of reducing gun violence, marking a distinct change after decades of near-silence on the topic from the CDC. Under her leadership, the agency funded studies to try to curb the ever-growing number of deaths from firearms.

She said she’s proud of her agency’s work in that area and of efforts to improve data collection on infectious disease outbreaks, to restructure the agency and to improve health equity.

When asked whether there’s anything she would have done differently, Walensky smiled and said, “I spent a lot of time thinking about that.”

“Some of the hardest decisions” during the Covid-19 pandemic, she said, came at times when “we did not have enough science to inform the perfect decision. The science wasn’t perfect. It was not yet fully developed.”

“We could have done better in saying to the American people, ‘watch this space. This is going to change,” Walensky said.

“And as it changes, you will get updated recommendations. That is because our science is changing, and the variant is changing.’ ”

Challenges from the start

Immediately upon assuming office on January 20, 2021, Walensky was faced with the enormous challenge of low morale among agency employees who were exhausted after dealing with the pandemic for nearly a year under the Trump administration.

A few months later, she was criticized for issuing mask guidance that was hard to follow, with late night TV host Trevor Noah taking aim at the agency’s “too complicated” messaging in a self-described “viral rant” that made waves among CDC workers.

As the pandemic wore on through the fall of 2021, in what was described by one expert as “a sea change,” Walensky tried to get the agency to change its ways and release data quicker.

January 2022 was another tough month for the CDC director.

There was criticism of agency messaging on Covid-19 isolation guidelines and other mitigation measures that some considered to be unreasonable and unrealistic.

There was also backlash to an interview in which Walensky referred to “encouraging news” about deaths caused by the Omicron variant among people with underlying health conditions. Walensky said her comments were taken out of context.

That month, it was revealed Walensky was working with a prominent media consultant.

Dr. Paul Offit, an external vaccine adviser to the US Food and Drug Administration, said Tuesday that Walensky had been “put in a very difficult situation [where] it was hard to shine.”

“It’s political, and that’s not who she is,” said Offit, a pediatric infectious disease expert at Children’s Hospital of Philadelphia. “She’s a wonderful person, a phenomenal teacher and researcher and clinician. And we were lucky to have her.”

New initiatives

As 2022 continued, Walensky announced a series of initiatives. In April, she kicked off a top-to-bottom review of the agency, which has long been considered overly layered and bureaucratic, later announcing changes based on that review to “remake the culture to help the agency move faster when it responds to a public health crisis.”

She also launched the Center for Forecasting and Outbreak Analytics, like the National Weather Service, to track infectious disease outbreaks.

This year, she announced an overhaul of the agency’s 100,000 webpages to make them more user-focused.

“She’s taken the CDC from an agency that had been somewhat rudder[less] and leaderless into what it is now, where she’s created organizational coherence,” Dr. Megan Ranney, the incoming dean of the Yale School of Public Health and an emergency physician, said Monday. “The organizational restructuring was just tremendous and deeply needed.”

Harassment and threats

Ranney also noted the hate that Walensky and other public health leaders have received since the Covid-19 pandemic began.

“I just have to give her a huge credit for sticking with this despite the near constant online – both virtual and real – harassment and threats that she and other federal public health officials have experienced during the pandemic,” Ranney said.

In her interview with CNN, Walensky recalled “situations where somebody looked like they needed a doctor, and I would try and work to rush to their need, and their expression was one of disdain for me.”

“It has been trying to have people attack me personally when what my goal is is to care for them,” she added. “What I’ve recognized is, I’ve had to put my head down and understand the greater good.”

Looking to the future

Walensky declined to say whether leaving the CDC was her idea or if the White House asked her to go.

“I’m leaving because this was the right time to leave,” she said.

She added that she “will never have a regret” about taking the job, which she calls “the honor of a lifetime,” but that there is “some relief that those day-to-day, really hard decisions will not be mine for a little while.”

Those decisions will now go to her successor, Dr. Mandy Cohen, whom Walensky describes as “an incredibly capable, smart woman who has her own incredible track record in health and public health.” The new CDC director “is going to receive a place that is full of people who care deeply, who are deeply expert in the work that they are doing, and that she will have great pride in,” Walensky says.

Moving forward, Walensky said, she has “very intentionally left my next chapter blank.” Instead, she’s looking forward to spending time with her husband and children and “reading a good book, heading to the gym, and really processing and thinking about what I want to do next.”

But she remains “deeply devoted to health, medical care, public health [and] access to care and equity.”

“Whatever it is that I will do, it will be with those north stars,” she said. “You’ll see me championing those issues from whatever my next perch.”

CNN’s Ben Tinker, Carma Hassan, Amanda Sealy and John Bonifield contributed to this report.

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