Fireside Chat: I. Glenn Cohen and Rochelle Walensky

I. Glenn Cohen: I’m Glenn Cohen. I’m the Faculty Director of the Petrie-Flom Center, the James A. Attwood and Leslie Williams Professor of Law, and the Deputy Dean of Harvard Law School and your host. You’re listening to Petrie Dishes, the podcast of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. 

Today, we are sharing a conversation I had with Dr. Rochelle Walensky. Dr. Walensky was the 19th Director of the Centers for Disease Control and Prevention during the darkest days of the COVID-19 Pandemic. She’s also been a Professor of Medicine at Harvard Medical School and was Chief of the Division of Infectious Diseases at Massachusetts General Hospital from 2017 to 2021. This semester, Dr. Walensky has been a Senior Academic Fellow at the Petrie-Flom Center at Harvard Law School. And I asked her to share her reflections on the intersections of medicine, law and policy, and as leader of the CDC at such a critical time.  

I. Glenn Cohen: Welcome everybody. I’m Glenn Cohen. I’m a professor here at Harvard Law School and I’m so glad today to be joined by Dr. Rochelle Walensky, the 19th director of the CDC who’s been joining us this year at Harvard. We’re so glad to have you. 

Dr. Rochelle Walensky: Thank you, I’ve been delighted I’ve had so much fun this semester. 

I. Glenn Cohen: So, thank you for sitting down with us today to talk a little bit about the life you’ve led before the CDC, but also the life at the CDC, and the life after the CDC, these three distinct kinds of periods. I wonder if you could tell us a little bit about what you did before the CDC and how that got you kind of noticed for that job. 

Dr. Rochelle Walensky: Yeah, that’s a great question. So, I will say 1991, I won’t be in such detail, but in 1991 I was a med student when I remember pouring over the newspaper, when magic had HIV. Magic Johnson had HIV. In 1995 I was a house officer and everybody we admitted in that year was dying of AIDS. And actually, it was that year, December of 1995, that the “cocktail” became available. And I was hooked on being an HIV doc. That’s what I wanted to do. And what you saw was this intersection of really critical science that was happening, new and novel therapies that potentially gave people a lifetime ahead of them when they you know had been otherwise had a death sentence, and these social vulnerabilities that where everybody didn’t have access. And so, I became an HIV Doc, and my research actually was in HIV policy and cost-effectiveness of how we bring people who don’t have resources, anti-retroviral therapy and other HIV related prevention interventions. So that was really what my career was, I was working in the field of cost effectiveness both in the United States and abroad. And in 2017 I became the Chief of Infectious Diseases at Massachusetts General Hospital, then 2019 of course first cases of Wuhan in China of SARS COVID and so was really sitting as the chief of the division of infectious diseases when we had our first cases here in the state on March 6th and spent that first year working with a division that was completely dedicated during really challenging hard times of their first year of COVID. 

I. Glenn Cohen: I mean what an amazing story to be there really on the front lines as you say. You know this switch from being on the front lines to policy: I’m curious if you could say a little bit about when you were on the front lines, we’ll get to the policy part first, how you thought about the policy making process and what it looked like to you from the outside. 

Dr. Rochelle Walensky: Well, you know from the front lines, I was managing the division and there was a lot that we had to do on the policy front as well. We were invoking crisis standards of care and thinking about that, what was that going to look like, we had been given a handful of remdesivir, but we had way more patients than we could use all the remdesivir for. We had to think about masking policy in the hospital when we weren’t sure that we had enough masks to actually create a masking policy. So, it was a microcosm of what we needed to do for the country. One of the things that we did as a chief of ID and chief across all the different systems in Massachusetts, was to come together every week on Thursdays and sit down and say what’s happening in your hospital, what’s happening in your hospital, what are the policy and challenges that you’re facing? So that we can kind of trade secrets and see what everybody else was challenged with. We wrote numerous op-eds together as the division chiefs of infectious diseases across the state, to sort of have a unified message of what the people of Massachusetts should be doing. And that was actually something that um I think was really important to the state and something that I took with me to CDC. Of course, that first year was you know not being director of the CDC, but it was one of those most challenging years because there was so much uncertainty. You were seeing your colleagues as patients in the ICU it was really really a scary time. It was pre-vaccine, we didn’t know when and if a vaccine was coming and how good it would be. From the CDC lens, it was a much larger scale, and the diversity of those who you had to care for was very different. We were caring for people across the United States there were global health issues that were involved. There were regulatory things that we were in charge of. And creating policy for a country that is so markedly diverse in what they need, what they want, and what resources they have, was really among the biggest challenges. 

I. Glenn Cohen: So you’re here in Massachusetts you’re dealing with this crisis, on a day-to-day basis right and then there’s this moment of transition to Washington right. So first of all, just tell us what that call felt like, when you got the call. But also tell us a little bit how you think you got on the radar of the people making the decision to fill the CDC director’s slot. 

Dr. Rochelle Walensky: Right so in my work previously, I had done a lot of work in HIV policy. I had done a lot of work in thinking about how we blanket the limited resources that we have especially among those who are socially vulnerable and advocating for those resources in an economically efficient way, that was the work that I did. Through that work I had gotten to know Dr. Fauci and had worked closely with him and and had been in touch with him when there were certain HIV related policies that needed vetting. So fast forward, it’s my son I was actually gowned and gloved in a patient room when my son called my phone about six times, to let me know that Biden had officially won. It was a Saturday afternoon. And about two weeks later I was in my office at Mass General. I was actually in my chair’s office we were having a meeting and I got a voice message saying Ron Klain called with the 202 area code and I thought, I know that name. I called first my husband and I said Ron Klain called, and he said “whatever he asks don’t say no.” 

I. Glenn Cohen: That’s a good husband. 

Dr. Rochelle Walensky: He’s a great husband. But he knew that I would be like I’m sorry what? The CDC? So I actually anticipated it would be a job in Washington, I didn’t anticipate it would be a job in Atlanta, that might have even been a little easier for me my family’s in Washington I know Washington pretty well. But he called and said would you consider a job as chief chair director of the CDC. And I said I would have to think about it and then the vetting started. 

I. Glenn Cohen: And I mean the have to think about it is a real thing because you know this is a tough job, but also a job that had been caught a little bit in the political crosshairs in prior administrations and prior periods of history and certainly we saw how politicized covid was already becoming at that point right. 

Dr. Rochelle Walensky: It was a lot in the political crosshairs. 

I. Glenn Cohen: Right this must been a moment of big trepidation too right to some extent? 

Dr. Rochelle Walensky: Yes I mean I, everybody had who I had talked to about it, and I didn’t talk to very many people, had said this is going to be the hardest job you ever will have. And while that did give me pause, I think the thing that kind of took me over was somebody thinks I’m the right person for the job in this moment, and there was this call to service in you know and what I said in my nomination speech was when you are the chief resident in the ICU and your code pager goes off, you answer the code. Whether you think you’re prepared for whatever it will be. And it felt like at 4,000 deaths a day, the country was coding, and somebody called and said your code pager is going off. You answer the code. 

I. Glenn Cohen: Okay so you’re now at the CDC so you’ve had this huge change in perspective from looking at the agency and its directives from the outside to now being an Atlanta and being on the inside. Any reflections on how the public gets things wrong about the agency or what you even, a very informed person about the agency, didn’t really know from the outside that you saw moving to the inside? 

Dr. Rochelle Walensky: Yeah I mean I think of the agency in a couple of different ways. First is prior to the prior administration, CDC is and was the gold standard for all things infectious disease. It was a site that, I mean if I put C in my Google search bar CDC came up. That’s the place that we went for all sorts of surveillance data where, what is our sexually transmitted infection outbreak status. You know that’s where we went. As an infectious disease doc I went there mostly for infectious disease related statistics and policies and guidances and recommendations. But I knew it to be much broader scope. The prior administration tarnished that a bit. And so that was really a challenge because I always knew it to be the gold standard but what was happening is under the prior administration, the logo was being used for things that sort of the agency and its incredible people didn’t stand for, and that was a real challenge. So when I got to CDC I saw the great people who were there, I saw the people who I knew whose voices wanted to be heard. It was a tough place from a morale standpoint. I recall an anecdote that somebody told me that he said he doesn’t go to the supermarket and tell people he works at CDC. I recall somebody telling me that they were told by security to scrape off their parking stickers on their car for fear of vandalism. So it was a really tough place despite the fact that it was full of 13,000 public servants who are really doing their best to convey the science in really difficult and challenging times. The size and scope of what CDC does I knew it existed, but it was really incredible to see firsthand. So the country knew of covid and the CDC’s mark in what it did in covid, but there were so many other infectious diseases that were even sent my direction during my tenure. COVID, mpox, two Marburg outbreaks around the world, one Ebola outbreak in Uganda, a new paralytic polio case, several measles outbreaks, 63 foodborne outbreaks. I could go on and on, a glasto micosis outbreak in Michigan. So that is what we did that nobody really even heard about because it didn’t, we tackled those right. The other thing I think people don’t realize are twofold one is all of our incredible, the CDC’s incredible work in the non-infectious space: maternal mortality, opioids, firearm violence, mental health, tobacco cessation, cardiovascular disease, cancer screening. All of those things are a really important part of what we do at CDC and then finally the global piece. We have a presence, an active presence in 60 countries. I visited our team in Uganda that has over a hundred people working there which is why we were able to work so much on the ground in Mubende when the Ebola outbreak happened. So the size, scope of what CDC does the number of offices around the country was really just extraordinary and fun for me to watch. 

I. Glenn Cohen: And you’re absolutely right that I think because so much of the attention focused on Covid for understandable reasons, it’s very easy to lose track of how broad the mission of the CDC is and has been right not just in the United States but globally. 

Dr. Rochelle Walensky: And I think what you know the curse of public health in terms of funding, is that it’s only known about when it it fails. So the one of the incredible examples that I like to give is during operations allies welcome 80,000 afghanis were brought to the United States. All of them needed medical screening. None of them spoke English. All of them needed medical screening. And in that medical screening I believe there were 44 active measles cases that didn’t get into the community. I mean there was active tuberculosis, active syphilis, active hepatitis A. None of those got into the communities because of the incredible work of people at the CDC. 

I. Glenn Cohen: Now I can say this because I’m a law professor from the outside, right so nobody’s going to take umbridge if I say it, which is to say we also have a form of public health federalism in this country that I think does nobody any favors in the sense that people think of the CDC as very powerful but actually a lot of the implementation work and a lot of the policy work is given to local and state governments such that in the early days of covid we saw huge variations in policy and the like. Must be very challenging to run a federal agency where everybody’s focused on you, but you know that actually a lot of what whether it go right or wrong will be about the partnership with state and local governments. 

Dr. Rochelle Walensky: Yes thank you so much for saying that. So you know what I have frequently said is we have the responsibility but not the power. And one of those is really manifested in data. I think people just fail to recognize, headline after headline reads CDC is going to not report, or CDC didn’t report, or CDC didn’t tell us. And I keep saying does CDC have the data to report CDC receives data from 3,300 counties, 50 states, nine big cities, five territories, and 574 tribes. And they come all in voluntarily. They come in in a not standardized fashion. And so one can imagine if one decides to report one way versus another, some of them come in in antiquated version ways like fax machine. And so that is some of the work that we really need to do because you are right it is it is really hard to run a response, when you know those data exist you know you could make a better decision if you had those data, and yet you don’t. Mpox was actually a key example here, we had our first case of mpox reported here in Massachusetts in on May 17th we had our Peak number of cases on August 1st. We know this in retrospect. We had the public health emergency declared on August 4th. 

I. Glenn Cohen: That’s amazingly quick. 

Dr. Rochelle Walensky: Right, and with that public health emergency we then took a month with many lawyers to navigate data use agreements on how and when vaccines were delivered and administered. And we got those agreements signed around September 1. So how can we be fast when we can’t even see the data until a month after a peak number of cases? 

I. Glenn Cohen: So we heard a little bit about the challenges about implementing the policy at a local and state level. I don’t want to ask you the other direction which is the global piece. So as you described with Ebola with other outbreaks there’s so much going on the CDC does globally. Can you tell us a little bit about that piece? 

Dr. Rochelle Walensky: Yeah I mean we have offices in 60 different countries and in six different regions and those regions are actually expanding and that is really key and critically important for global health security globally as well as here in this country. When we work with our International Partners in our offices, some of our offices are over 25 years old. We really have partnership we have locally employed staff and we have subject manner expertise, and we have we call them FPS field epidemiology training programs where we are doing the work to develop the local staff, so that this is really a partnership where the ultimate goal of course would be to put ourselves out of business in that country, that they have developed all the skill sets, and laboratory and technical expertise that they need such that our presence is no longer needed there. But we work it’s incredible to visit to visit these countries I have the great gift of being able to visit some of them and to see that partnership in action. I met a 20 year old gentleman who works at the Uganda/Congo border he had been trained by our CDC staff and he had recognized a woman and her baby who had left the Congo and had signs and symptoms of Ebola. As he screened her, he isolated her and her baby, and she in fact succumbed to Ebola. But he probably saved an outbreak of Ebola in that country. And so you see that work and the impact on the ground saving that country, but then also potentially saving a global scare. 

I. Glenn Cohen: So we’re at Harvard Law School I would be remiss if I didn’t ask you a little about the role of lawyers here in lawsuits. So you know I just finished a book editing a book with some others on covid-19 and the law. Of course is always going to be a lot of Monday morning quarterbacking on this, but as you were in the role, to what extent did thinking about lawsuits, thinking about litigation, affect kind of the decision- making you were doing and how does that interplay work? 

Dr. Rochelle Walensky: So I’m a trained physician and epidemiologist. My North Star was what is the right thing to do for health in this moment. We then always had to understand what is the policy impact of that, and maybe everyone doesn’t consider health the most important parameter that they’re trying to make a decision under. And we needed to understand where the law was going to fit in, where were we going to be potentially at risk of the law, and where the law might not be on our side and especially if and when it was the right thing to do in a public health emergency. So I found myself it’s actually why I’m here this semester, I frequently found myself on a zoom screen of an ID Doc,and six lawyers. And so I really thought, and I really do believe that sort of magic happens at this intersection of disciplines. And so I learned a lot from my legal colleagues. I would like to say that they learned something from me as well and it was always part of the discussion but not necessarily the most important part of the discussion. Fortunately, when we had these conversations we could get to the why. Why do we need to be in this space? And where is the gray zone where the law will help support our our cause for what we need to do. 

I. Glenn Cohen: You’re very gracious to say magic is what happens when you’re surrounded by six lawyers. People often use a different word that’s very kind of you. So you know, lawyers sometimes think of themselves as all powerful. We’re certainly not all powerful, but it is true the law has a big role to play in the public’s health. We’ve talked a little about this in terms of Covid, but I want to just give you an opportunity to say a little bit of how you see law playing out and laws effect in other public health domains. 

Dr. Rochelle Walensky: Yeah this is a really important question and I think people don’t necessarily recognize how ingrained these laws are and how it can affect other infectious threats for example. So I spent 25 years of my career working in the field of HIV. Right now, that HIV epidemic in this country is generally focused on black gay men of the South that’s where we see the most. And when you think about the policies in the areas where we have the hardest challenges, it is sexual health and learning in the elementary schools. It is incarceration laws so many black men in those states are incarcerated. It is their inability to vote after they come out. It is their inability to access meds. It is with incarceration, there’s a lot of concurrency of many different partners at once in those communities. It is lack of Medicaid expansion. So inability to get meds. So when you put all of those together it is not a surprise that that is where the epidemic is concentrated. And so I think that when we think about these policies we really do need to understand and as an infectious disease doc, I will say infectious diseases tend to hit the vulnerable. With covid it was people who could travel on airplanes and travel on cruise ships who brought it here, and then it quickly went to people who are vulnerable. So we will see this with infectious disease threat after infectious disease threat. 

I. Glenn Cohen: Right, I’m going to ask you now a little bit about how CDC sits within the administrative law context of the HHS as a you know Department in general and that you are one sub agency, there’s other players, there’s FDA, there’s CMS, of course. Can you say a little bit about what the relationship is like from a day-to-day level?  

Dr. Rochelle Walensky: Yeah, I mean so much of the work that we needed to do, it’s a passing the baton. So much of the work around HHS was passing the baton. If we take this action, you’re going to need to pick it up with this action, and how is that all going to piece together, so it serve the American people well, so we had frequent conversations. I did a lot of one-on-one conversations with other agency heads. We did a lot of meetings especially around when a new policy would come up, so for example, when there would be a new vaccine or a new booster that would be either authorized or approved, what was the implication, what was the action that FDA was going to take, what was a follow-up action that we at CDC were going to take, where did HRSA need to integrate with the federally qualified Health Centers and then Medicare, Medicaid, and CMS, so it really was a finely tuned, you know, there was a lot of, there was a lot of baton passing and a lot of integration, and I’ve just had a great gift of working with amazing people while I was there.  

I. Glenn Cohen: So you talked a lot about making decisions under conditions of uncertainty, which was the reality of the COVID-19 pandemic for really for all of us but also for government officials. When you look back at your time as CDC director, you said you know one or two do-overs that you could have a again or decisions you could make differently, is there anything that comes to mind in particular?  

Dr. Rochelle Walensky: I learned a lot about communications. I think people don’t necessarily realize that I came to the agency and the director of communications position had been empty for four years, so you can imagine stepping into a position where we were doing three times a week press conferences without a communications director. I had amazing people working in the acting role and that was wonderful, but I didn’t have the stability of a communications director. I will also say that because the prior administration was not actually putting the best agency face forward I will say there was a lot of other ways that communication was happening not through standard processes and so a lot of leaks were happening, leaks of early documents, leaks of things, and that disturbed me a lot I came from a background where we like we had HIPAA constraints right like leaking doesn’t happen, and so it really disturbed me when I came in that there wasn’t that trust there that that linking didn’t happen, and I that really bothered me early on it probably bothered me more than it should, and so among the things I will say in sort of the major big pictures where we had to make decisions under uncertainty, there were places that we had to pivot and I stand by where we had to pivot cause the science and the virus changed. In the big pictures as we made those decisions, I feel like scientifically we generally did the right thing, and science was on our, like science always was on our side. The challenge was how we, how we communicated some of that and so especially after doing our agency review in April of 22 where I really heard the importance of partnerships, I think probably my biggest challenge was when we removed the masks in May of 2021, I was so worried about the leaking that I sort of was less worried about the partnerships, and I should have reversed that. I should have been more worried about how are people going to implement this on the ground if you so quickly take off masks rather than being worried that that somebody was going to say it first.  

I. Glenn Cohen: I want to switch now to think a little bit about the trajectory of public health. Right, so we’re at a period where I think trust and institutions in the United States is not an all-time low, quite a low, and also to some extent trust in public health, mistrust in medicine and medical authorities right. Do you see us on a trajectory where there it gets better? Do you see us some trajectory where that gets worse? How do you think the future is going to unfold on this topic of public health?  

Dr. Rochelle Walensky: I’m deeply worried about it. I do think that it is very, it is very hard to challenge when somebody con considers their fact a fact when in fact it is not a fact, and we have to understand that science evolves and we will learn learn more every day and this is the state of the science and that this paper that has been heavily vetted in Nature or New England Journal probably has way more credibility than your white paper that you refuse to put authors on, right, so and that’s but the people are sort of counting them as the same. We also are in a time where science is now being put out there in met archive prior to peer review and that always, that allows it to get out faster, but it’s not fully vetted, and so I think we’re in a really interesting time, but I do worry about conveying truth and the trust in health and public health, and I think part of that too is while CDC has the name and the federal recognition as you talked about its effector arms, which is state and local health departments, do not have have not had the resources. They’ve been incredibly frail in terms of the resources that they’ve had to operate. People have estimated that public health workforce is about 880,000 in deficit. I mentioned our data systems that still come in, you know you can order a Starbucks by QR code, but the data systems come in by fax machine in this country, so there’s something that’s backwards about that. Even our. laboratory systems if you go to a state-of-the-art laboratory and then you go to our state lab here, we have we have great people working in those labs and a lot of infrastructure, but our labs across the country really need more infrastructure, so I think there is the trust component and then the fact that we do need investments because forgetting that it is those effector arms that are doing some really hard work to support CDC I think will be a disservice to us.  

I. Glenn Cohen: So it’s interesting you talk about this lack of resources. I often tell people that when it comes to COVID-19 that was a terrible pandemic, there were many ways in which we were very lucky, including the speed with which we got these vaccines, like unprecedented if you compare it to prior vaccination efforts right.  

Dr. Rochelle Walensky: By years.  

I. Glenn Cohen: By years. If you think about the next pandemic that might be coming our way, it’s a crossover, whatever it is, what would you like to see the powers that be whether that’s Congress, state governments, philanthropic funding, global health funding, what would you like to see us do in a ramp up in the next five years, let’s say, to try to be more prepared.  

Dr. Rochelle Walensky: It is that infrastructure, and because I think that there’s a lot that needs to be done both in the investments of the public health infrastructure, let’s face it, three years ago was a time that was too painful for us to want to recall and want to remember, but we will be back to that if we have another infectious threat because we haven’t fixed all the systems that need to be fixed. I have said before we anticipated a 100-year influenza pandemic. We didn’t get it. We got COVID, and they’re not mutually exclusive, so it is the case that we still have you know influenza risk and other other global zoonotic risks. Our Data systems, we made massive investments in our data systems, over a billion dollars in investments.There are single health departments that need those kinds of resources. Single health systems spend more than that to convert to Epic, single health system, so when you think about that investment for the entire country when COVID started, we had 187 health care facilities that were able to electronically report data to the CDC. By the time I left that was 25,000, so those Investments have gone a really long way and that’s about 25% of the health systems in the country, so we still have a lot of work to do.  

I. Glenn Cohen: You know HLS stands for Harvard Law School, but I often think it’s about Harvard Leadership School too. We try to prepare a generation of leaders right. What was it like stepping into an agency where morale was low. What did you learn about leadership and what lessons about leadership do you think you could tell us a little bit about that you might pay forward.  

Dr. Rochelle Walensky: Yeah this was, this was not the public challenge. This was the challenge within the agency, so morale was really low, really really low. We talked a little bit about some of the challenges people not wanting to even claim that they worked there, and so there were several things that I did to start. One was I met one-on-one with my division, with my center leaders, but then I did what I called skip meetings and went one level down and met one-on-one with I think 120 division directors many of whom said they had never met with a CDC director before, so just trying to touch people one-on-one and to say if you ever need me, knock on my door or send me an email, I will be here for you, so that was one thing these skip meetings and trying to touch more people. The second thing which was the right thing to do although I didn’t necessarily think it would improve morale in the way that it did was declaring racism a serious public health threat. This was, I think it was April 6th that we made that announce so I was just 10 weeks into the job. CDC had received a letter, my predecessor had received a letter saying they thought CDC was a racist place, and that hadn’t been acted on, and we were actively trying to get vaccines to socially vulnerable communities, so it all aligned. It was the important message to send. Since then, 200 public health departments have done the same thing, which is really incredible, and it mobilized people who were really down to work to this common cause, and they were already working super hard, and they would put in extra hours to try and see what they could do there, so it was really a mobilizing morale boosting announcement that I didn’t recognize at the time would boost morale, so one other thing maybe I’ll just mention that I did was I did what I called unsung hero calls. I had my team, people know CDC for the epidemiology that we do, the science that we do, but I had my team give me five names a week of people who had just gone above and beyond, and I called them on the phone, and you know it’s an agency of 13,000, you don’t necessarily think that five names a week you’re gonna make a difference, but I talked to the woman who stayed up all night to book airline flights for people who deployed to operations allies welcome sites. I spoke to the person who knocked on doors at the Ohio train derailment, or you know those kinds of things people they’re the connective tissue of what makes the the agency work. All the logistics, people who who were deployed to the Border, it was really meaningful to me to really understand the ban and scope of what the agency was doing. I had people in tears when I called them they saying they’d never spoken to a director. I asked them to thank their teams, and that actually you know it touched way more people than five a week.  

I. Glenn Cohen: So I know that I think it was in April 2022, you did a review of the CDC as an agency. Tell me a little bit about that process but also the results and what the findings were and what you thought about it.  

Dr. Rochelle Walensky: Yeah I felt like finally by that time, this was at the end of Omicron or at the end of that big Omicron surge, it was time to sort of put the mirror up and to do some tough love and say the agency’s been around for 76 years, never before in the time of a pandemic, what did we learn, what did we do really well, and what are things that we need to do better and prepare ourselves for. Communication was a key piece of that. Moving our data and science faster was also a key piece. The agency is well known for moving science and its academic work that it does, but in public health emergencies, we need to move our data faster and sometimes that means we have to put it out there before the ink is dry in the paper. We need to put it out on on our website or in white paper form to say this is what we know now and we’re going to take policy action right now, so we needed to move it faster. We needed to change our guidance so it read more for the American people. Most people hadn’t heard of the CDC and therefore people who came to our website were not the American people. It was epidemiologists and health care providers, but increasingly the American people were coming to our school guidance and so you will see over time that how those read were markedly different. We had 200,000 web pages on our CDC website, and we really needed to call those down. We needed to you know have the language be more accessible language, and we needed to maybe sunset some websites, but also put some websites in places where others could find them, archive them but not have them as our forefront. We needed to be about our partner. We needed to listen more than we were talking sometimes and that was really important, and then we need a public health workforce that’s ready to respond, so we learned that you know if there’s a foodborn outbreak, we can send a dozen investigators to that foodborn outbreak. During COVID, we had 2,500 people at the CDC working in an outbreak and on our response and we needed to have everybody able to work on a response, so those were some of the really important themes that we heard and part of what we initiated in a process of moving forward to say these are all the things that we we need to do, some of the things are outside of CDC’s control, and we we did make a list and published a list of some of the authorities that we need. We talked about the federalism component that we need. If we did all of this really hard work at the agency, we still couldn’t do everything that we needed to do because we didn’t have authorities, human resource authorities, and data authorities, so it was a really comprehensive piece of work that I think is really important and action being taken.  

I. Glenn Cohen: So we’ve been lucky to have you here at Harvard Law School and at the Petrie-Flom Center. You also have connections with other parts of the University this year. What’s it been like coming back to an academic institution after this very high pressure, difficult, but also fulfilling job.  

Dr. Rochelle Walensky: Well it’s been extraordinarily fun. This is sort of you know I consider Harvard my home although I am not in sort of my home space, and so while it feels homey, it is still a bit foreign for me, and that’s actually was by design. It was intentional. It’s really fun for me to work at the intersection, we talked about this, the intersection of disciplines, and so as I think about, and it’s been fun for me to work with students, I love working with students and mentoring and sort of paying that forward. As I think about what’s next, I still don’t know, I’m still sort of doing I’m in the exploratory phase, but I will say that some of the problems that really plague me are our data system problems in this country because I do think we as a health system and a public health system need to have more intersection and our workforce challenges both in the public health workforce and in the healthcare workforce and so I intend in whatever I do to help work on and think about those problems, and I don’t exactly know what shape that’ll look like just yet.  

I. Glenn Cohen: Of course COVID-19 is still with us and of course the challenges of public health are very much with us if you could leave the American public with one message or one thought, what would it be? 

Dr. Rochelle Walensky: Just one? First it was just a gift and an honor of a lifetime to be able to serve in that role.I will say that we have not been very good as a country about protecting one another during periods of this public health crisis. We’ve had several public health crises and so much of what we do I think in public health is to work to improve not only our own individual health, but the health of our community and to protect one another, and then to be critical about the places that you get your information and your data and making sure that they are scientifically correct and they are actually working in your favor.  

I. Glenn Cohen: Dr. Walensky, thank you so much for sitting down with us.  

Dr. Rochelle Walensky: Thank you it was a pleasure. Thanks for having me here at Petrie-Flom. 

I. Glenn Cohen: We’ve enjoyed having Dr. Walensky as a fellow here at Petrie-Flom, and appreciate her reflections on her experiences.  

If you liked what you heard today, check out our blog ‘Bill of Health’ and our upcoming events. You can find more information and sign up for our newsletter at our website, petrieflom.law.harvard.edu. And if you want to get in touch with us, you can email us at petrie-flom@law.harvard.edu. We’re also on Twitter and Facebook @petrieflom. 

Today’s show was produced by Susannah Baruch with assistance from Nicole Egidio. Nicole Egidio and Vaughn Samuels were our audio engineers.  

I’m Glenn Cohen and this is Petrie Dishes.