Mandy Cohen, the new director of the Centers for Disease Control and Prevention, has only been on the job for two weeks. However, she can already hear the clock ticking.
Cohen, the successor to Rochelle Walensky, who resigned at the end of June, will have approximately 18 months at the helm of the world’s foremost public health agency before the inauguration of the next U.S. president. Depending on the outcome of the 2024 election, her tenure could be extended, pending Senate approval. If the opposite occurs, it is likely that someone else will assume her place.
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Cohen compared her new position to running a leg in a relay in an interview with STAT on Tuesday, which was only her second since assuming the job. She assumed the reins from Walensky, whose work Cohen considers an excellent beginning to the CDC’s long-overdue reform. Her plan? “I’m going to run as hard and as fast as I can for as long as they’ll let me,” said the former North Carolina secretary of health.
Clearly, the agency will undergo adjustments. Cohen has already instructed staff, who have been working remotely since the onset of the COVID pandemic, to return to the CDC’s Atlanta campuses more frequently.
It is also evident that she is already working on both sides of the aisle to prevent budget cuts that could affect the CDC’s new Center for Forecasting and Analytics. According to her, the CDC is a national security asset that requires funding to safeguard American health.
People want us to be prepared to recognize hazards and respond swiftly. To accomplish this, we require data and visibility, she stated flatly.
This conversation has been gently edited for clarity and length.
Are you going to encourage or even require CDC employees to return to the office? I assume that many individuals continue to work remotely.
I believe that in-person engagement is crucial. I believe this is how one builds relationships. I spoke at my first all-hands meeting, which I conducted in my first week; 9,000 people were present. And one of the very first topics we discussed was establishing trust. And this begins within our own team. And the only method I am aware of to cultivate trust is through relationship building.
But it must serve a purpose. Therefore, I do not want Atlanta commuters to sit here alone in a cubicle. So what I’ve been requesting from my team is a plan stating, “Can we establish core days when we bring people here?” How can we ensure that the time we spend with visitors is purposeful?
Currently, this procedure is underway. And I am extremely focused on ensuring that our in-person work is purposeful. It does take us some time to ensure the quality of our performance. But it is foremost in my consciousness.
Are you physically relocating your family to Atlanta? You have small children.
I do have young children, so it does require a bit of time. So they are currently immersed in summer activities. When I received this call, my summer plans were already set. However, I am in Atlanta. I intend to be here whenever I am not in Washington, D.C., or, candidly, traveling across the nation or the globe to observe our work.
But what about your family? Will they also relocate to Atlanta?
I’m working on it. I have two children. So we have some matters to resolve. So allow me some time while we work on that segment.
I am aware that you have met with former CDC directors. Have you reviewed the entire list?
I believe I’ve exhausted the list; from Bill Foege to Jeff Koplan to Julie Gerberding, who am I overlooking? Tom Frieden, Bob Redfield, and others are obvious. Yes, they have been extremely helpful.
I believe it is essential to comprehend what has occurred in the past in order to learn from what went well, what did not go well, and where you need to go in the future. The leader who eradicated smallpox was Bill Foege. I was desperate to comprehend his perspective on the work. However, it is also important to comprehend Bob Redfield, who was present when COVID struck, and how he approached this task. Therefore, everything has been extremely useful.
The CDC has much work to complete. I believe the world will be significantly different in 2023 than it was in 2019. I believe that the situation has changed. Consequently, I believe it is time for a new chapter. And this is what I am contemplating. How can we operate as efficiently as possible to accomplish our mission?
Did any of them provide you with particularly sage advice?
So many recommendations! Be here. Be present. Get to know the fantastic staff that is present. We have some of the most remarkable experts, and significant scientific work is being conducted here.
In addition, it is vitally important for the CDC to keep in mind that it is only one component of a larger U.S. government strategy to protect public health.
This is where my experience becomes useful. Obviously, I worked at the federal level at [the Center for Medicare and Medicaid Services] for seven years, and I also worked at the state level. Considering the CDC’s role within the U.S. federal government as well as with our state and local partners, how can we ensure that we work as a team?
Obviously, we discussed faith extensively. This is a prevalent topic I’ve discussed with former CDC administrators, but I’ve heard a lot about trust from Hill members and others.
As a result of the pandemic, the CDC has sustained significant damage. And confidence in the CDC’s competence has been questioned. Do you believe that to be just?
During a truly unprecedented pandemic, I believe the CDC has lost credibility. But I believe there is a strategic approach to rebuilding that trust. And that is what we’ve been discussing here.
I believe this begins with openness and communication that is plain and straightforward. The second is proper execution, or ensuring that we follow through on our commitments. The third step involves establishing relationships.
These are all skills I observe at the CDC. We simply need to ensure that we are concentrated on them each and every day and that we are a unified team at the CDC so that we can achieve what we desire in the world, which is excellent collaboration. Because protecting the public’s health requires a team effort, Clearly, the CDC is a major participant in this, but it is not the only one.
A House subcommittee examining the CDC budget recently proposed that the new Center for Forecasting and Analytics receive no funding. They also proposed eliminating funding for the Initiative to End the HIV Epidemic. I am aware that the budget procedure is a process that is not yet complete.
But are you concerned that individuals may be attempting to undermine the CDC’s capacity to safeguard the nation from the next outbreak of an infectious disease?
The CDC has a vital role in protecting the nation’s health. It is a vital asset to national security. Thus, we must consider it in this manner. Consequently, it requires resources to perform its duties. I’ve begun speaking with members of the House and Senate to ensure that they are aware of the CDC and the resources necessary for it to serve as a national security asset.
Let’s discuss the Center for Prediction and Analytics. People want us to be alert and quick to respond to threats. For this, we require data and visibility. Thus, this funding will allow us to detect and respond to dangers more quickly. And I believe this is what the American people desire and deserve. But doing so requires resources.
Another of the terms we discussed as a group was stewardship. We are aware that we must be responsible custodians of taxpayer funds. Therefore, we want to demonstrate to the public that the money they invest in the United States is benefiting the American people every day.
Is the CDC considering staff reductions? I have heard that redundancies may occur. Is that accurate?
What I would say is that, as you are well aware from the federal budget process, there are programs with funding cycles that begin and end. We currently do not anticipate this in the immediate future. However, resources are required to ensure that we have the necessary workforce to complete our task.
So I don’t want to rule out the possibility, but nothing is imminent.
Regarding infectious disease concerns, I believe that the nation is extremely exhausted. People want COVID to be a tempest that occurs once every century so that we do not have to worry about it for the next century. Obviously, this is not the case. How do you feel about the nation’s ability to respond to something else if it were to occur in the near future, as well as the CDC’s capacity to respond?
I am aware of everyone’s exhaustion due to the pandemic. Unfortunately, pathogens never become exhausted. Therefore, we must maintain vigilance.
The good news is that we have more tools than ever before to protect ourselves from the viruses that are currently circulating. Therefore, we will see COVID, influenza, and RSV as autumn and winter progress. We will meet with them all at once. However, we have instruments for every scenario. Vaccines, treatments, and effective protocols Therefore, we are able to respond.
And we must utilize these resources. To prevent illness, all that is required is for people to use instruments such as vaccination, get tested when they feel unwell, and take the available antiviral medication. Therefore, we currently have the necessary instruments for the viruses we are aware of.
But additional investment is required to be able to respond to something novel. During the pandemic, there was undoubtedly room for improvement in how things were handled.
And our capacity to do so the next time will necessitate investments in data as well as in our workforce in order to have the people who can actually respond.
As we move forward, we must also ensure that our communication is improved and that our guidance is clear. Currently, we are building that. We are hard at work on it.
In reality, there is a limited amount of time until the next election. And after the next election, the CDC director must be confirmed by the Senate. Are you considering this position for the next 18 months? How much can one accomplish in 18 months?
I’ve held similar positions at the federal and state levels, and I’m well aware that we’re always running a segment of the race. So I took the baton from Dr. Walensky, who put in a great deal of effort to consider how she could place the CDC on a path to success in order to fulfill its mission. I believe a great deal of that work was accurate. I have no plans to alter this piece of work.
Consequently, I took the initiative. I will run as hard and as quickly as possible for as long as they allow me to. However, I must consider it in terms of chapters to ensure that we remain focused.
However, I do have a sense of urgency, regardless of whether the timeframe is 18 months or five and a half years. I sense the passage of time. We must set priorities. We cannot do everything at once. Consequently, I am collaborating with the team to determine how we can focus and prioritize our efforts to ensure that we are doing the most important tasks for the American people.
