Rochelle Walensky, director of the Centers for Disease Control and Prevention (right) reflected on her tenure at the federal agency during a Public Health Conversation at Boston University’s School of Public Health on Thursday, March 30. She was joined by Sandro Galea, SPH dean and Robert A. Knox Professor. “Our job is successful when nobody hears about public health,” Walensky said during the event. Photo by Michael Saunders

Coronavirus

CDC’s Rochelle Walensky Visits BU’s School of Public Health

Director of Centers for Disease Control and Prevention reflects on agency’s pandemic mistakes and successes

When President Biden selected Rochelle Walensky to take the reins of the US Centers for Disease Control and Prevention (CDC), the former infectious diseases division chief at Massachusetts General Hospital and professor of medicine at Harvard Medical School asserted in her nomination speech that “leading with science is the only way to deliver breakthroughs, to deliver hope, and to bring our nation back to full strength.”

During a recent visit to Boston University’s School of Public Health, Walensky said she stands by that statement—with one caveat.

“I assumed, which was not appropriate, that the people who were listening understood that science would change,” she said during a wide-ranging Public Health Conversation moderated by Sandro Galea, SPH dean and Robert A. Knox Professor, on Thursday, March 30. “Scientists and academics understand that, but not everybody understands that. [I] should have said, ‘science—and it will change,’ or ‘science, for now, and we will update you and give you more information as we have it.’”

Walensky reflected on the agency’s oft-criticized COVID-19 communication missteps, as well as a number of other topics, in front of the more than 1,100 people who attended the hybrid event in person and via Zoom.

The discussion spanned the public health gamut, exploring the CDC’s mistakes, successes, and lessons learned during the first pandemic in the age of digital media, and identifying pathways for the 76-year-old agency—and broader health and science fields—to regain the trust of the American people, develop clear and effective messaging, and confront other urgent national crises, such as climate change, gun violence, and maternal mortality.

Confronting the rampant misinformation on social media is difficult, but necessary, Walensky said. “We like that kind of active discussion and disagreement, but at the same time it’s not always used for productive purposes,” she noted, adding, “It’s a really interesting, but really difficult space right now for social media.”

Over the course of the pandemic, the CDC has adjusted the way it develops certain recommendations, currently applying a more layered strategy that “can apply to Manhattan, and tribal country, and Guam, and rural Idaho,” she said. “We need to provide options for what you can do in your place when you have these resources, and this capacity, and this sort of political will.”

“Do you place value on your economy being open over your risk of health?” Galea asked.

“Those are values judgments, and we don’t get to decide how everybody else places those values—and at that intersection is politics,” Walensky replied.

“Do we have a role to play in shaping values?” Galea followed.

“I think we have a role to play in helping to understand risk [and provide] accurate science to help shape those values,” she answered.

Noting that she inherited a “frail public health infrastructure,” Walensky stressed that evaluating and improving the systems and processes within which the agency collects, analyzes, and disseminates public health data will be critical to the CDC’s future—a future that will continue to encounter numerous infectious diseases, she predicted.

These challenges necessitate faster production of data without compromising the accuracy and clarity of information, she said. Strengthening the agency’s laboratory infrastructure, modernizing data systems, and supporting data analytics training will improve monitoring capabilities, such as wastewater and genomic surveillance. And all of this work must be done through an equity lens, aiming to close racial and socioeconomic gaps in access to adequate healthcare and community resources.

Walensky also touted several public health accomplishments during her tenure, such as the agency’s successful efforts to publish the first technical briefs worldwide on the performance of the mpox (formerly known as monkeypox) vaccine, following the rapid and unexpected spread of the mpox virus across the US last year.

In other public health successes since she took the helm at the CDC, the agency formally named racism and firearm violence public health issues, established the agency’s Center for Forecasting and Outbreak Analytics, and administered more than 673 million vaccines in the last two and a half years.

Walensky noted that some of the successes were small and mostly unheralded, such as when US government officials dropped test kits from a helicopter to stranded passengers aboard the luxury Diamond Princess cruise ship during the first COVID wave.

And during last year’s Operation Allies Welcome, the federal government coordinated support to resettle vulnerable Afghans and welcomed 80,000 people into the US in August 2022, she said. Unknown to many outside of the agency, there were 44 active measles cases and 14 active mumps cases among the refugees, and neither disease spread to the broader community, thanks to the swift containment efforts by the CDC.

“Our job is successful when nobody hears about public health,” Walensky said.

During the event, Galea selected several questions that members of the audience submitted electronically. In responding to a question about the CDC’s role in developing policies to curb gun violence—as the nation reels from the latest mass school shooting, which took the lives of three children and three adults in Nashville, Tenn.—Walensky made an appeal for unity on an issue that continues to destroy families in every corner of the nation.

First acknowledging the Nashville tragedy as a parent, she said the administration has expanded research on firearm violence prevention, but noted the additional need to collect data and address firearm injuries and other lasting effects of gun violence on shooting survivors.

“We do have to come to terms on what we agree on across the aisle because we have to get to ‘yes,’” Walensky said. “Can we agree for firearm owners and [non-firearm owners] that we do not want to have loved ones die unnecessarily of a firearm death? Let’s just agree on that. I’ve been to a firearm training facility where they were teaching eight-year-olds to shoot. What is it that you should also be teaching your eight-year-olds about safe storage—about how we engage in prevention of community-based violence? Let’s get everybody to the table so that we can agree.”

Watch the full conversation with Rochelle Walensky here.