Aug 18, 2022 - Health

CDC takes a small step toward fixing America's public health system

Illustration of an 8-bit syringe, firing up at rows of 8-bit viruses.

Illustration: Megan Robinson/Axios

Public health experts say the Centers for Disease Control and Prevention's new plan to reform itself is generally a good plan — but that without much bigger, more fundamental changes, the U.S. might continue to be caught flat-footed by new threats.

The big picture: Systemic failures at the CDC have sown public distrust in health experts over the past three years, but America's public health problem is much bigger than any one agency — and the politicization of the COVID pandemic only made things worse.

Driving the news: The CDC yesterday vowed to change course after COVID thrust its shortcomings into the spotlight.

  • The agency's diagnosis of itself as too slow, too academic and too confusing to the public is spot on, experts told Axios.
  • "It is undeniably right that a system that is set up to deal with a relatively stable status quo is not equipped to handle rapid change. This recognizes that. And it is one step on the way to making things better and learning lessons from the last couple years," Harvard epidemiologist Bill Hanage said.

State of play: The country's public health problems are piling up.

  • COVID-19 still kills around 400 people a day in the U.S., and around 100,000 new cases are still being reported each day. The virus is likely never going away.
  • Meanwhile, experts are losing hope that monkeypox can be contained, at least in the short term, after the U.S. fumbled its initial response.
  • A polio case was recently detected in New York, the first reported case since 2013 and only the second identified instance of community transmission of polio in the U.S. since 1979, per the CDC. Wastewater samples indicate the virus may have been circulating since as early as April.
  • Vaccine rates for other diseases plummeted during the pandemic, anti-vaccine sentiment is on the rise and less than half of eligible Americans have received a even one COVID booster dose.
  • On top of all that, the country's public health workforce is short-staffed and burned out.

Between the lines: The CDC's missteps date all the way back to the origins of the pandemic — when it failed to quickly produce accurate diagnostic tests — and have spanned both the Trump and Biden administrations.

Yes, but: Messaging problems have been exacerbated by the rise of misinformation and the political weaponization of COVID, resulting in deep partisan fissures over the pandemic response.

  • And much of the country's public health response isn't run at the federal level.
  • "I commend CDC for taking this on. But if you could really do a wonderful job of fixing the CDC challenges, that’s only fixing a part of the problem in this country. So much of this is still at the state and local health departments," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

The bottom line: How the CDC's reforms are implemented will be crucial, experts say, and there's plenty of work outside of the agency to be done.

  • But “we should not make the best the enemy of the good," said Zeke Emanuel, vice provost for Global Initiatives at the University of Pennsylvania. "Forward progress is important, and it’s really really needed."
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