Reforms vital after CDC's fumbling

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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A North Dakota native has been named to a new and vital health care post. The nation ought to wish her well because the task before her is daunting: overseeing the overhaul of the U.S. Centers for Disease Control and Prevention (CDC) after its frustrating response to the COVID-19 pandemic.

Mary Wakefield, who was born and educated in Minnesota's northwest neighbor, is a nurse and veteran health care administrator who served as acting deputy secretary of the U.S. Department of Health and Human Services under former President Barack Obama. Last week, Wakefield was tapped to serve in a new role at the CDC: leading a team that will determine fixes to problems identified by two reviews of the agency's flawed COVID approach.

Wakefield will bring a pragmatic Midwestern sensibility to the role, according to those have worked with her. Even so, the task she faces is monumental.

Long considered one of the world's premier public health assets, the CDC turned in a fumbling performance at a time when the agency's best work was needed. The stumbling began early with the bungled development of COVID testing — a failing the Star Tribune Editorial Board sounded the alarm about on Feb. 6, 2020.

Unfortunately, the CDC failed to find its footing after that. While the agency is staffed with world-class scientists, they never gelled as a team.

Early chaos surrounding supplies of personal protective equipment for health care workers was one result. But communication to the public was particularly problematic. For much of the pandemic, COVID trackers built by the New York Times and nonprofit organizations filled in information gaps about cases, hospitalizations and deaths.

The information the CDC did provide was often slow and written for a scientific audience. Adequate explanations were missing when public health recommendations evolved. While these changes reflected expanding knowledge of the virus and other developments, too often they felt arbitrary.

Masking is one example. There was early equivocation about the value, but later the agency embraced masks as part of the strategy to stop COVID's spread. It felt like a switch had flipped, and the abruptness helped feed the rebellion against their use.

The agency's communication struggles have continued during the Biden administration. Officials seem to have a tin ear when it comes to pleas for a second booster shot from those who aren't currently eligible — essentially, healthy adults under 50. Many are concerned about variants and worry about previous shots' waning protection.

The first step toward improvement requires acknowledging there's a problem. For that, CDC Director Dr. Rochelle Walensky merits praise. She stepped into that role in early 2021 as a presidential appointee, and it's to her credit that she recognizes the need for reform.

"I thought she called it out like real leadership does," Andy Slavitt, a former Minnesota health care executive who served on President Joe Biden's COVID response team, told an editorial writer. Slavitt also was the acting head of the Centers for Medicare and Medicaid Services during the Obama administration.

Slavitt applauded the move to have Wakefield oversee reforms at the CDC. He worked with her at the federal level and said she's focused, practical and "listens before she talks."

Minnesota infectious disease expert Michael Osterholm also lauded Walensky's reform efforts. Implementing change will be challenging though, he said, adding that the "devil is in the details."

In an interview, Osterholm called on Congress to ensure the CDC has the funding and other resources it needs to carry out its vital mission.

The Star Tribune Editorial Board agrees and would like to see Minnesota's congressional delegation at the forefront of this. The CDC has many critics. With that comes a responsibility to right this ship. Everyone has an interest because disease threats continue, as monkeypox's spread and polio's re-emergence illustrate.

As to the importance of getting CDC reforms right, Osterholm said, "If this were on a scale of 1 to 10, this is about a 12."