Fifteen Questions: Rochelle Walensky on Pandemics, Public Health, and Reading for Fun
Rochelle P. Walensky served as the director of the U.S. Centers for Disease Control and Prevention from 2021 to 2023. She is currently a fellow at Harvard Law School, Harvard Kennedy School, and Harvard Business School. Walensky, a Harvard School of Public Health graduate, was a faculty member at Harvard Medical School from 2001 to 2021.
FM: What was it like transitioning to a role that especially during the Covid-19 pandemic entered a very public, often politicized role?
RPW: That was hard. There’s no way around that. There were so many things around the time that were hard. It was hard because 3,000 people were dying a day. It was hard because, essentially, aside from the essential workers at CDC, people were asked to stay home.
The agency had been, I’ll say, thrown under the bus for numerous things, some of which they didn’t handle as well as they might have or didn’t have the resources to handle as well as they might have, and some were really politicized.
When you walk into that, what you really need to do is right the ship and importantly, also recognize that there was extraordinarily selfless, tireless work being done by people within the agency and you have to reward and respect that as well.
I said in my nomination speech we were going to lead with science. I did my absolute best to make that happen and I always stood by the fact that if that wasn’t going to happen, I was not going to be there anymore, and we were able to get through some really particularly hard times.
FM: And what was the decision like to step down?
RPW: It was time. I came in to right a ship. I left the place so much better, I think, than I found it, I left the country better than I found it.
The public health emergency was ending, I had set forward a path on the things that CDC really needed to do to reform. It was very clear to me that those things were going to take years and that we needed to set forth that map but that I alone was never going to be the one to see it all through.
It had been an exhausting, particularly brutal several years, and so I always wanted to leave the agency better than I found it, and that was the appropriate time to do so.
FM: In June, you told CNN that after leaving the CDC, one of the ways you hoped to spend time was reading a good book. What have you been reading lately?
RPW: I have read several books. “Women in White Coats” — that was the beginning of women in the field of medicine. I read a book called “Shock,” which is the history of [electroconvulsive therapy] through both the eyes of somebody who looked at the history, Larry Tye, and Kitty Dukakis, who actually experienced ECT.
I’ve read a few fun novels. I read “Lessons in Chemistry.”
So, I’ve been doing a lot of reading.
FM: What does it feel like to be back at Harvard after spending the last few years in Atlanta?
RPW: Oh, it feels like home.
It’s interesting because I have intentionally picked places at Harvard that are less familiar to me. So while Boston feels like home, like the Crimson feel, I am definitely in places that are more foreign to me than I left.
FM: You’re serving in fellow positions at Harvard Law School, the Kennedy School, and Harvard Business School. What does that day-to-day look like?
RPW: What I really wanted to do is foster networks.
I thought — as I’m thinking about what I want to do next — that what I should do is really explore and talk to a lot of different people who have touched pieces of the healthcare world in places that are different than the ones I’ve touched.
FM: What do you like most about teaching?
RPW: The students are so much fun and so bright and I get as much as I give. There’s always a different perspective that I can offer potentially and that they’re offering me.
FM: In August 2022, following a review of the organization, you said that the CDC needed to be reorganized and launched the CDC Moving Forward initiative to act on the review’s findings. What did you hope to achieve in that process? And do you think it’s been successful so far?
RPW: The agency was founded in 1946. The last pandemic was in 1918. So, the agency has never actually had to tackle a pan-respiratory pandemic the way it did during Covid-19 and I think we learned a lot of lessons along the way.
We did a massive number of interviews with people within the agency, outside the agency, external stakeholders, folks on the Hill to say, “What did you see from us and what could we have done better?”
We did need to get rid of some layers of bureaucracy.
We needed to have a workforce that was ready to respond. Our CDC responses typically were a dozen people. In our responses during Covid, we had up to 2,500 people working in the Covid response. So, were we an agency that could mobilize 2,500 people at once? What did that look like and how would we become that agency that could do that faster the next time?
We talked about our need to communicate better and we learned a lot in our communications. When I left the agency, we had 200,000 web pages on CDC. That’s a lot of web pages. So, we had a lot of work to do to comb through to understand which ones were necessary, which ones were full of data that needed to be archived.
FM: During the pandemic, the CDC took on a more prominent role in the lives of most Americans, especially from a communications standpoint. How did you approach that task?
RPW: First of all, most of America didn’t know what CDC was before the pandemic. It’s the case that when public health is working really well and working for you, it’s working in the background, right? You don’t necessarily know all of those things that public health averted.
I did podcasts with new moms, I did farm television, I did Black and African American newspapers. Intentionally reaching people so that they knew I was talking to them. I took over Jennifer Garner’s Instagram account. So, we did those sorts of things so that we could reach all demographics.
We spent a lot of time and energy thinking about how we could anticipate what the next piece of mis- or disinformation would be and how we would combat it.
What’s the information that we need to put out there today, and can we anticipate some of those? We call that prebunking. Can we anticipate some of those and get that information out there earlier, sooner, and in a digestible manner to work against that anti-vax movement?
FM: What was it like dealing with things like vaccine skepticism and misinformation?
RPW: I had a very wise social worker who taught me how to deliver an HIV diagnosis. She would say, “After you give an HIV diagnosis, you then wait and you don’t say anything next.” That is because the thing that comes out of your patient’s mind is going to be the most important thing to them and you’re not going to be able to guess whether it’s “Can I afford my medicines?” or “Is my baby infected?” or “Will I lose my job?”
I credit Susan Larrabee for teaching me that but also for teaching me that in the context of vaccines.
You have to spend time listening rather than talking. I’m a data-driven person. If you said to me “I don’t want to be vaccinated,” the first thing I would say is “Well, let me show you all the data.” Everybody doesn’t respond to that.
FM: You were one of the first CDC directors to address larger issues outside of just public health. What was it like to be blazing that trail?
RPW: I imagine you’re talking about racism as a serious public health threat. So, that needed to happen. I’m a bit surprised that I was the first person to do it.
Anybody in public health could see that this was an issue and a challenge.
It was also the case that we were trying to address the Covid pandemic through an equity lens. So, it was synergistic with the work that we were trying to do.
What I asked every single division and center to do is say, “Stop only documenting the problem. We know wherever we look there are racial inequities. Let’s start implementing solutions.”
FM: What do you think we can take away from Covid-19 when it comes to preventing future pandemics?
RPW: We started the Covid-19 pandemic in this country with a particularly frail public health infrastructure and it claimed over a million lives. And it is really easy now for us to say, ‘Thank goodness, that’s over,’ but we haven’t actually made the necessary investments, long-term standing investments, to improve the public health infrastructure.
From a workforce standpoint, we know that there have been estimates that our public health workforce is about 80,000 persons in deficit. There are real challenges in upskilling the current public health workforce and enticing people to go into public health. We saw a mass exodus of people in public health during Covid-19. So, what are we doing today to bolster that public health workforce so we can be ready for tomorrow?
Our data highways. I mean, the fact that CDC was receiving data by fax, by email? Not okay. You can order a Starbucks coffee with a QR code but we are receiving our national data by fax machine? That’s just not okay.
And then, laboratory. CDC has the responsibility of developing new tests for new pathogens.
CDC does not have the responsibility of scaling up those tests to a million a day. So, where is that infrastructure that happens at the CDC in collaboration with state and local health departments, in collaboration with state and local labs and academia and industry, so that when we need a test in a heartbeat, we can have one?
FM: What was your favorite part of your time leading the CDC?
RPW: I had some really extraordinary times and the public saw some really tough times. I loved meeting the people and understanding the breadth and scope of what CDC did.
Meeting the guy who works at the Uganda-Congo border who was trained by a CDC field epidemiology training program to recognize people who come in with Ebola. He recognized a mom and baby who came in with Ebola from an Ebola treatment center of the Congo and had escaped. Because of the training that we had done, isolated them as soon as he saw and probably saved an Ebola outbreak in that country. I mean, extraordinary.
Talking to the person who rappelled out of an airplane to drop Covid test kits onto the Princess Diamond cruise ship, people who work on the southern border and do tireless work trying to screen people for infectious diseases before they come across the border.
I don’t know that America appreciates how the people of CDC, the 12,000 people of CDC, work tirelessly, quietly. You never know their name. But knowing the truly selfless work that they do to benefit not only people in the United States but around the world.
FM: How do you think people should think about Covid-19 in mitigating its spread today, now that it’s endemic?
RPW: Everybody has a different risk assessment, right? Their own personal risk, their willingness to take risk. I think we have to individualize it. People know what they need to do if they want to protect themselves.
Obviously, that means getting vaccinated. Obviously, if you want to take an extra measure, it’ll be testing if you are going to visit a loved one who might be at risk — certainly testing if you have systems. And then wearing a mask. All of those things are on the menu; we know those things are on the menu. This is about risk and about your own personal risk preferences.
FM: I’m sure you’re really busy as a fellow, but it’s definitely going to be a lot more free time than running the CDC. Have you picked up any hobbies since?
RPW: So I have been spending time with my kids, I have been going to the gym a little bit more than I used to at CDC, that has been fun. I’ve been reading books and novels, which I hadn’t done before. It’s more catching up with family, doing some travel, dropping my kids off at school, which I had the luxury of being able to do this year.
FM: It’s been a busy last few years and this year, you’re here for the semester. Do you know what you want to do after?
RPW: I do not. That’s actually part of what I am hoping this next several months is going to offer me.
Somebody had mentioned to me before I left the administration, “You may not even know the job exists that you are supposed to be in.”
I’m just talking to a lot of people and learning a lot and doing my best to give back.
— Magazine writer Neil H. Shah can be reached at neil.shah@thecrimson.com. Follow him on X @neilhshah15 or on Threads @kne.els.