The pandemic has provided us an opportunity to reflect and evaluate our behaviors as people, employees, citizens, parents, caregivers. Meanwhile, the trust in government and their services has declined significantly, and that was true even before the start of the pandemic. The trust in science-based agencies and our collective-community has also eroded over the last 3 years. It was refreshing to see the leader of CDC Dr. Walensky order an evaluation and publicly acknowledged the less than stellar  response, in her own words a botched response to the pandemic leading to the conclusion that the agency needs major restructuring alignment.

It is ironic, that when you search for the report, or when you go to the landing page of CDC you do not find any links to the executive report.  The program evaluation page that I use often as an evaluator and researcher has no mention of the evaluation that is surely foundational. This is emblematic not just of government but of most agencies. We are quick to issue and conduct evaluative studies, write lessons learned, provide recommendations to be effective and efficient, and learn from the past. However, the reality is that the people that ask for evaluations, hopefully with good intentions, are often unable to enact change or do not have successful change implementers in their teams, thus leaving the status quo unchanged.

One of the findings of the report is that CDC is too academic. Perfection can (in publications and other realms of life) become the enemy of good, so the first order of business for the CDC is to communicate and demystify scientific information, so that public can understand it and trust it.  This means that an integrated leadership team needs to be in charge, and it should include a variety of professionals — not just doctors. About a year ago I had this discussion with a leader (a physician) of one of the largest public health departments in the country.  The response was you don’t understand, we know best. My response is the same today, you may know how best to treat the disease, but are you the right person to implement and deliver the service and operations effectively and efficiently? As a result of the brave acknowledgement by the CDC leader about the shortcomings of the CDC as it responds to COVID today and in the future, I am hoping for a few quick changes.

First, these findings likely apply to most public health departments, so I am hoping that we can learn from this study, and not start spending millions more to conduct expensive studies, because we each need our own findings. Some focused in-depth specific studies may be needed but let’s not replicate common-sense findings over and over.

Second, be action-oriented, do not get paralyzed by the scope of change needed, make small incremental changes. Identify three priorities that you and your team agree need immediate action. These could be, upgrades to infrastructure (within list prioritization), investment in workforce skill-training while pursuing staff-augmentation and use data (with its limitations) for intelligence and continuous quality improvement.

Third, hire people that are good managers and implementers for your agency to implement the response. Do not drive away talent because they are not MDs. Create a team with diverse skills as an integrated team is better than a group with one single focus and training.

Lastly, encourage a culture of honesty. This provides the freedom and an opportunity to innovate. Remember every innovation is not successful, admitting to mistakes quickly is smart and one can change course without incurring high costs, and keep a journal for both, things that work and the things that didn’t work.  And share these experiences publicly, as “Collective cooperation will help us build infrastructure that is stable, scalable, flexible, equitable, efficient, cost-effective, person-centered, and standards-based that can support small and large public health departments alike.”