Former CDC director Rochelle Walensky, MD, MPH, Shared Insights with the Triological Society

Dr. Walensky said that one big issue is data collection. “There’s some assumption that we at CDC receive data in real time,” she said. “In fact, we don’t have the authority to do so. All data that we get at CDC is voluntary.” As the public health emergency came to an end, the data being collected lost some of their granularity, she said.

“What I will say about another pandemic is, everyone assumed the one-in-100-year pandemic would be influenza. And it was coronavirus. And what is true is that just because we got one doesn’t mean we won’t get another,” cautioned Dr. Walensky. “And so we have to be in a position of preparedness. We have a deficit of 80,000 public health workers in this country. 

We have data systems that still come to CDC by fax. And then we have a laboratory infrastructure that’s quite frail. So, we do need an investment in public health infrastructure to tackle whatever comes next.”

Toughest Moments at the CDC

Dr. Walensky said that on one Friday in July, when the CDC had just told the country that it was OK not to wear masks if you were vaccinated, she got a call that, in an outbreak in Barnstable County in Massachusetts, vaccinated people were transmitting the virus to others.

“That likely meant that we were going to need to put masks back on,” she said. “All things happen on Friday afternoon. That was a big gut punch. And we spent the weekend talking to colleagues around the world to see if we were seeing the same thing with those more experienced with [the] Delta [variant].”

The CDC had to make a dramatic policy decision, hoping they would have the data to demonstrate the reasoning, she said. “We knew we were ultimately going to need to put masks back on. Could we distribute the science in a way that everybody would quickly understand our need? We were able to do it within a week.”

We don’t need to continue to document [health disparities]; what we need to do is implement solutions. —Rochelle Walensky, MD, MPH

The other moment she highlighted came after the CDC’s Advisory Committee on Immunization Practices voted 9-6 not to endorse booster shots for frontline workers.

“That was unprecedented,” Dr. Walensky said. “We had to ask, ‘What do we do in a split vote? Can a director overturn it?’ And as you can imagine, just as the votes came in, my phones exploded with everybody who had an opinion about what I should do.”

In the end, she overruled the committee, and booster shots were made available to frontline workers. “There was no mechanism by which healthcare workers could get a booster dose,” she said. “At that time, I remember one story of a pregnant emergency department doctor who was saying, ‘I’m on the front lines; I really would like a booster dose.’ It would have actually been illegal for her to receive a booster dose. Those were some of the things that were influencing my thinking.”

Words of Advice

Despite the burdens imposed by the job, Dr. Walensky encouraged the audience to seek out the difficult course of action.

“I would say, just from this position that I’m in now, lean in,” she said. “If you think the job is too big for you and somebody else is offering it to you, it’s probably the right kind of job. I never had director of CDC on my bucket list, and, in fact, I can’t tell you how many times I said to my husband, ‘Do you really think I can do this?’ So if you’re just comfortable with your next job, you haven’t strived high enough.”

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Thomas R. Collins is a freelance medical writer based in Florida.