The loss of two longtime CDC leaders combined with Walensky’s overhaul of the Covid-19 response strengthens the CDC chief’s power, giving him control over some of the most critical political conversations related to the pandemic. The changes she made also reinforce the independence of his agency vis-à-vis the White House. As POLITICO reported, several senior White House officials – including some in the White House Covid-19 Working Group – said the CDC did not warn them until the morning of the announcement that those vaccinated could forgo masks in most situations.
Another senior administration official with first-hand knowledge of the situation said Walensky had limited news of the coming change to a small group of CDCs. so the agency could better monitor the messages and failed to notify local and state public health officials and public policy groups across the country.
Walensky decided to overhaul the structure of the agency’s Covid-19 response after several listening tours within CDCs revealed pandemic task forces no longer fulfilling their original mission or could be streamlined under a central leadership structure, a senior health official with knowledge of Walensky’s thinking. As the number of new infections has plummeted, the CDC has focused on offering advice to help Americans get back to normal – like telling people who have been vaccinated they can forgo masks in most situations. .
A senior health official from Biden described the CDC reshuffle as “a long time ahead.”
“When Biden took office there were conversations very early on about how the CDC was going to be run … who was going to run it and what it took to get back on track,” the senior official said. of health. “Dr. Walensky was chosen for the top post and was in high demand. But I think it’s fair to say that there have been hiccups over the past few months that have created tensions within the agency. And I think we’re starting to see the CDC director taking action to change things.
In a statement, CDC spokesman Jason McDonald said the agency had “revamped the incident management structure to better fit each phase of the country’s response to COVID-19.” He added that “previous reorganizations have improved efficiency and improved collaboration. Another senior CDC official said Walensky “is aware of the changes but is not directly involved in decision-making” on restructuring within the agency.
The first clue that a major reorganization was underway came at the end of April, when Messonnier – then head of the Covid-19 vaccine working group – went on leave. At the time, CDC officials described it as an unplanned vacation. Behind the scenes, Walensky had decided that the vaccine task force should be placed under the direct supervision of the agency’s senior management, rather than reporting to both CDC leaders and the White House, they said. said three senior health officials.
Messonnier, who had operated semi-autonomously, was told that the vaccine working group would now report to the CDC Incident Response Team overseen by Henry Walke, director of the Division of Vaccines. preparation and emerging infections of the agency, which reports to Walensky. Two weeks later, Messonnier resigned after about 20 years at the agency. It was one of the first high-profile departures from the CDC during the pandemic, despite months of pressure and attacks the agency had suffered from the Trump administration.
As Messonnier announced his release, several CDC officials said the vaccine the working group had been reshaped because the vaccine rollout was going smoothly and the group’s mission was changing. Placing the group under the Incident Response Team was a positive sign, CDC officials said, because it meant there was less need to monitor the vaccine. The vaccine working group oversaw distribution, administration and implementation.
More recently, Walensky reassigned agency workers who were previously part of the Ministry of Health and Human Services’ Covid-19 interagency working group, the ‘Joint Coordination Cell’, which was recently disbanded. Some of these officials have returned to their normal full-time jobs at the CDC or are part of CDC working groups.
Growing criticism of vaccine guidelines
Through all of these changes, the agency was drafting and rewriting its guidelines on safety protocols for those vaccinated.
The CDC drafted the first version of this notice in early March. After two days of meetings and appeals with senior officials from the White House and HHS Covid-19 task force, the CDC was asked to “not publish” the recommendations, as POLITICO previously reported. A senior White House official denied any interference and said the CDC just needed time to read officials, not change guidelines.
The agency finally released the guidelines on March 8 – notifying those vaccinated that they could congregate without masks or stay 6 feet away. The recommendations also said that vaccinated people could congregate indoors, without a mask, with unvaccinated people from another household. Then, on April 2, the CDC said fully vaccinated Americans could resume domestic and foreign travel as long as they wear masks in public.
Three weeks later, the agency released a major update: vaccinees no longer needed to wear masks indoors or outdoors when in small groups with other friends and fully vaccinated family – and in some circumstances they could do without a mask with unvaccinated people.
This version of the guidelines has been widely criticized. People in the Biden administration complained that the language of the CDC was confusing. Republicans on Capitol Hill and across the country argued the agency was being overly cautious and prescriptive in a way that limited the activity of those vaccinated.
CDC officials have long argued that vaccine guidelines only evolve as science becomes available and supports change. But a senior administration official with knowledge of the situation said officials in the CDC, White House and HHS often disagreed over whether to ease restrictions on those vaccinated.
In late March and early April, several CDC officials argued that science did not support the cancellation of things like mask warrants, especially because the guidelines could indicate that it was safe for all Americans to give up adhering to public health measures. Other senior officials have argued that the country has vaccinated enough individuals to give those people the choice to visit other fully vaccinated Americans.
A change of leadership
Walensky decided to give Walke responsibility for the next phase of vaccine guidelines just days before Messonnier officially resigned. On May 13, a week after Messonnier’s official resignation, the CDC said those vaccinated could remove the masks in any type of group gathering – large or small, indoors or outdoors, no matter who is present.
The move marked a significant change in tone for the health agency, which for months slowed down the rollback of public health measures, even for those vaccinated. CDC officials had feared that an acceleration of the movement would encourage the spread of new, highly transmissible Covid-19 variants that would reverse the country’s progress towards ending the pandemic.
“My feeling is that there has been more and more real-world data that has emerged that has guided the CDC in its decision-making, especially on these recent guidelines,” said John Moore, virologist and professor. of Microbiology and Immunology at Weill Cornell Medicine. “There will be confusion over the next few weeks. Everyone needs to develop their own comfort zone with counseling. “
Health officials and experts across the country have denounced the CDC’s new advice, saying the agency’s recommendations would be difficult for national and local authorities to implement and enforce.
“I would expect the CDC to recommend to local and state public health departments that when your immunization coverage is at this level, when your cases are at that level … this is when you can locally recommend lifting.” mask requirements for people who have been vaccinated, ”said Celine Gounder, infectious disease expert at New York University and former advisor for Biden’s Covid-19 Transition Advisory Committee. “This is not what happened in this case. “
A senior health official working on the vaccine said the agency had neither the capacity nor the means to develop local public health guidelines and that it was up to local authorities to find ways to guide their communities. .
“The CDC just can’t win. First, they are told they are too careful, too careful with masks and travel, ”a senior HHS official told POLITICO. “Then they recommend getting rid of masks for people who have been vaccinated and they are targeted for doing too much too soon. I mean, what is it? I think what is clear is that there is now a much clearer process for these things.