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The CDC has struggled with clear messaging and COVID-19 guidance during the pandemic, and the agency will aim to do better, Rochelle Walensky, MD, director of the CDC, told The Wall Street Journal.
The pandemic threw curveballs that she should have expected, she said, and she should have made it clearer to the public that new guidelines could change quickly as the pandemic shifts.
“I think what I have not conveyed is the uncertainty in a lot of these situations,” she told the newspaper in an exclusive interview as the 1-year mark in her tenure as CDC director approaches this week.
Walensky said she is committed to communicating CDC policy more clearly. She is being coached by a media consultant and plans to hold more media briefings in coming months that are separate from the briefings with the White House COVID-19 Response Team. Public health experts have recommended separate CDC briefings to highlight the agency’s role as an independent, scientific voice in the pandemic, according to the Journal.
Walensky and the CDC have been criticized by public health experts for communication around pandemic guidelines for mask-wearing and isolation requirements in recent weeks. Some officials in the Biden administration have also said the agency’s updated guidance can be hard to interpret at times, the newspaper reported.
In the past month in particular, the CDC put out guidelines that were confusing as the contagious Omicron variant drove up infections across the country. On Dec. 27, the agency cut the isolation time in half for people without symptoms, but public health experts said that ending isolation after 5 days without a negative COVID-19 test could pose a risk if people were still contagious.
On Jan. 4, the CDC updated the guidelines, adding new instructions for people who want to test before leaving isolation — but it didn’t require people to get tested. The guidelines were updated again on Jan. 9 with more details about monitoring symptoms and how to calculate isolation days.
Walensky said the isolation guidelines were based on more than 100 papers that researched the Alpha and Delta variants, as well as recent reports from health care facilities. But the main research was done before the Omicron variant surged across the world.
“We felt the need to take action before we had Omicron-specific data,” she told the Journal.
The CDC decided to add information about testing in January after Walensky and other officials saw that people wanted guidance on using rapid tests to check whether they might still be contagious, she said. The rapid tests authorized by the FDA aren’t intended for testing to get out of isolation, she noted, since they should be done repeatedly over several days. But the American public wanted guidance.
“If you’re positive, you should probably stay at home,” she said. “But a negative — that doesn’t mean you’re not contagious. And we needed to be very clear about that.”
Walensky also said she plans to address the gaps in national public health data collection. The CDC receives reports from state and local systems, which can be inconsistent, and public health officials have said the lack of a centralized system has led to a slow response to the Delta and Omicron surges during the pandemic, the newspaper reported.
Fewer than 200 health facilities across the country had their electronic health records linked to the CDC’s data collection systems before the pandemic, Walensky said. Some states couldn’t provide electronic reports of positive COVID-19 cases at the beginning of the pandemic and had to send faxes. Some states sent positive results before negative results because they didn’t have the capacity to enter all the cases.
Now, tens of thousands of facilities have upgraded their electronic record systems, Walensky said, in part due to federal funds. But more work needs to be done. Modernizing the national public health data infrastructure for both the federal government and the country’s 3,050 health departments would cost about $30 billion over 10 years, according to the Journal.
“This will not end with COVID,” Walensky said. “This is not a one-and-done effort.”
SOURCES:
The Wall Street Journal: “CDC Director Aims to Improve Covid-19 Messaging, Data Collection.”
CDC: “COVID-19 Quarantine and Isolation, updated Jan. 9, 2022.”
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