CDC wants to change ‘outdated’ rules that hamper agency’s ability to fight Covid, polio and other diseases


This summer, when the shocking news emerged that there was a case of polio in New York, the US Centers for Disease Control and Prevention immediately turned to Shoshana Bernstein.

The agency urgently needed to increase polio vaccination rates in Rockland County, New York. And though Bernstein is neither a doctor nor a public health official, she is exactly what the CDC was looking for: a local vaccine educator who is part of the Orthodox Jewish community, one of many groups with a low vaccination rate.

Over the next few months, Bernstein spent hours and hours in meetings with CDC officials, including agency director Dr. Rochelle Walensky, and then more time preparing presentations on campaign ideas. of education.

She wasn’t paid a penny for her time.

“If I won the lottery, I would do it for free because I have a passion for public health,” Bernstein said. ” But I can not. I had to put other projects on hold to do pro bono work for the CDC. I have a family with bills to pay. I had to tell them, ‘I can’t keep doing this if you don’t pay me.’ ”

It’s an old problem for the CDC: Despite a multi-billion dollar budget, the agency lacks the authority of Congress to hire consultants in a timely manner when an emergency situation arises.

Walensky plans to appeal to Congress to allow some flexibility to do this type of hiring in a crisis, similar to the authority given to some other federal agencies.

“I want to be very clear that [we] don’t ask for a blank slate to free up resources. What we’re saying is that in certain situations we need to be nimble and act urgently in a culturally sensitive way that we don’t currently have the capacity to do,” Walensky said.

She told CNN that the agency’s “inability to act quickly and with agility when needed” was “frustrating.”

“We don’t have the ability, even in times of emergency or emergency, to say ‘we have to act fast here,'” Walensky said. “We need to provide resources to people who can actually do the job [to] get this message across quickly.

Dr. Tom Frieden, CDC director from 2009 to 2017, said he felt Walensky’s pain. He experienced the same inflexibility during the Ebola outbreak in 2014.

“If we want the CDC to get better at fighting disease, we need to stop tying their hands behind their backs,” he said. “It’s kind of torment to work within the government system.”

Their names are Duvi and Rochel, and they could be the key to stopping polio in its tracks in the United States.

Over the years, some members of the Orthodox Jewish community have fallen prey to well-orchestrated campaigns of lies about vaccines. To counter this, Bernstein is working on several projects, including an animated video with his brother and sister Duvi and Rochel and a vaccine hero named Super V.

The characters sprinkle their conversations with Yiddish expressions. Duvi wears a yarmulke, or headgear, and Rochel wears a long-sleeved robe, typical clothing of their community. Singing to the tune of a popular Jewish song, Duvi thanks “Hashem” – or God – for vaccines.

The project is funded by the New Jersey Department of Health, and Bernstein offered to the CDC that versions of the cartoon could be made for other communities. She also told the CDC about a post she wrote called “Tzim Gezint” — “To Your Health” — that helped raise awareness of the measles vaccine during a 2018 virus outbreak.

Walensky said the CDC liked Bernstein’s ideas but couldn’t afford her.

“Shoshana is known to the CDC for her work in this same community several years ago with measles and her extraordinary work to successfully reach this community,” Walensky said. “One of the things that is frustrating from my perspective [is] that we don’t have the capacity to be able to finance it or to be able to provide it with resources.

This financial rigidity was also apparent during the Covid-19 pandemic, when the CDC wanted to develop culturally specific vaccine education programs for communities with low vaccination rates.

A senior CDC official called it an “outdated” system that “hasn’t evolved over time.” The manager spoke on condition of anonymity so she could speak freely on the matter.

The CDC is preparing a submission to urge Congress to address this issue, Walensky said.

She said she hoped to “move the needle” by using “real-time examples of how public health has been hurt due to our failure to act” during the pandemic.

One of Congress’ main arguments will be that other federal agencies have the authority to contract with aliens during emergencies, according to the unnamed senior CDC official.

Spokespersons for the Federal Emergency Management Agency (FEMA) and the United States Agency for International Development (USAID) told CNN that their agencies may enter into certain types of contractual arrangements with outside organizations.

The CDC will ask Congress for flexibility for several types of financial arrangements, Walensky said.

For example, during the Ebola outbreak in 2014, the agency tried to encourage people in West Africa to stay in Ebola treatment units, but it proved difficult, a said the anonymous senior official.

“You want to be able [arrange for food] for these families and children so that they can remain confined [treatment units] and don’t wander off when they just need a meal,” the manager said.

“The lack of flexibility to be able to help on the pitch is so difficult. … It’s heartbreaking.

CDC workers in West Africa have faced financial stiffness for even the simplest things, like printing Ebola educational materials, the anonymous official added.

“I think people would be surprised how hard it is to do anything,” she said.

Ed Hunter believes him.

Hunter retired from the CDC in 2015 after 40 years with the agency. His last position was legislative director in the agency’s Washington office.

He said every CDC director he worked with experienced “the same story: that there are such limits to what you can do. [given] the specificity of appropriations that come from Congress; and the delays and complexity of the federal procurement system.

“This is something that has been a focus of the CDC for years and a real challenge to solve,” he said.

Walensky said she hopes things go differently this time.

“We are not asking for money. We are asking for capacity. We ask the authorities to be able to do our job,” she said. “[But] I don’t know if I will be more successful than my predecessors.

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