These have been difficult years for the Centers for Disease Control and Prevention. After facing a barrage of criticism for repeatedly failing to respond to the COVID-19 pandemic and most recently to monkeypox, the agency has admitted it has failed and needs to change.
CDC Director Dr. Rachel Wallensky has tapped Mary Wakefield — an Obama administration veteran and nurse — to lead an overhaul of the sprawling agency and its multibillion-dollar budget. Making changes will require winning over the CDC’s wary career scientists, militant members of Congress and the general public, which in many cases has stopped looking to the agency for guidance.
“If she can’t fix it, she’s going to say, ‘It can’t be fixed, here’s why, and here’s what to do next,'” he said. Eileen Sullivan-Marksdean of NYU College of Nursing Rory Meyers, who has known Wakefield professionally for decades.
Other former colleagues said Wakefield’s experience as a nurse, congressional staffer, politician and administrator gives her the perspective and leadership tools to rise to the top, even as they acknowledge the scale of the job ahead.
“She has high standards, and she will expect people to follow through,” he said Brad Gibbons, former staff member and acting director of the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences. “She’s very fair, but you have to know what you’re doing.”
Wakefield will have to navigate turbulent waters after a series of agency blunders. The CDC screwed up rollout of COVID testing at the beginning of the pandemic, ed confusing guidance on preventive measures such as masking and quarantine, and not rushing to publish scientific findings about the fast-moving coronavirus.
Walensky emphasized that as part of the reboot, she wants the CDC to provide Americans with clear, accurate and timely guidance on public health threats.
“I am confident that Mary Wakefield’s appointment will further our goals to modernize and streamline CDC,” Walensky said in a written statement. “Mary is clearly an action-oriented leader who can drive effective change.”
After an internal audit, Valensky announced the plans restructure the way the agency communicates with the public, eliminate red tape, and help CDC better interact with other parts of the federal government.
Wakefield’s first day on the job was in mid-August. She declined to speak to KHN for this article, but those who know her paint a rich picture of her philosophy and management style.
New York University’s Sullivan-Marks said Wakefield’s experience as a nurse makes her well-suited to handle the complex set of challenges facing the CDC, which she likened to a patient needing stabilization.
“When you look at someone in an ICU bed, all you see are beeps and lines and monitors going away — people coming in and out like a train station,” Sullivan-Marks said. “The nurse is central to that for the patient, bringing it all together.”
Sullivan-Marks also said Wakefield’s perspective as chief medical officer can help the CDC better understand how clinicians will receive and interpret its recommendations and recommendations.
Wakefield headed the Health Resources and Services Administration for most of the Obama administration. HRSA, a division of the Department of Health and Human Services, is responsible for a wide range of programs — those that serve people living with HIV, provide compensation to people injured by vaccinations, and document disciplinary actions against health care workers.
Former HHS Secretary Kathleen Sebelius called Wakefield an “agent of change” who managed to win the trust of HRSA staff, many of whom are full-time employees rather than political appointees.
“People realized they were there before she came in and they’re going to be there after she’s gone,” Sebelius said. “They had to be convinced that she is a good leader and they will follow her. It’s very important that she has done so well at this agency.”
(Sebelius is a member of the KFF Board of Trustees. KHN is an independent newsroom of KFF.)
Sebelius said that kind of experience could be helpful for Wakefield at the CDC, which employs just over 12,000 people, some of whom may be skeptical of change. Covid has been a major stress test for the CDC, leading some staff to wonder if it has lost its way.
Sebelius also pointed to Wakefield’s experience with the CDC as acting deputy secretary of HHS as a plus. She was appointed to the position of deputy secretary, but was never confirmed because of political squabbles over abortion.
The details of the changes that will come to the CDC are still being worked out, though top management has said they will need congressional support to implement them.
Sheila Burke, head of public policy at the law firm Baker Donelson, met Wakefield while working in Congress. She said Wakefield’s experience on Capitol Hill will come in handy when working with lawmakers who serve on committees that oversee the CDC.
“She will be well aware of the role of members who care deeply about these issues,” Burke said.
Top health officials have had a hard time justifying the federal government’s response to the pandemic to some members of Congress. Walensky and Dr. Anthony Fauci, the Biden administration’s soon-to-be-retired chief medical adviser, have faced tough questioning from lawmakers on several occasions.
“I think she’s uniquely positioned to understand how you navigate these relationships,” Burke said of Wakefield.
Several former employees noted what Gibbens of the University of North Dakota described as Wakefield’s “relentless amount of energy.” He said that it is not unusual for him to come to work on the phone messages that she left him at 4:30 in the morning.
He described Wakefield as someone who knows “when someone is trying to play her”. But he also said she doesn’t take herself too seriously. He remembered the kitsch animatronic singing fish on her office wall, a sign of her love of fishing. And the time she refused to fly on Air Force Two from Washington, D.C. to North Dakota, opting to take a commercial flight “like a regular person.”
“She said, ‘You have to be very careful with these things. You don’t want to get used to it,’” Gibbens recalled.
The job ahead of Wakefield could be a stress test of her faith in the human value of public policy. Walensky said the changes she hopes to implement at the CDC won’t happen overnight and likely won’t be easy.
Like the CDC now, in 2005 Wakefield found itself at a possible tipping point. That year, Wakefield’s brother and two of his children were killed in a car accident that seriously injured her daughter-in-law and young nephew.
“Health policy, which had been one of the main areas of my work before, was now of little importance,” Wakefield wrote in the Journal of Forensic Nursing at the time.
Then she got word that her former boss, Sen. Kent Conrad (DN.D.), had joined with others to introduce the Wakefield Act, a bill aimed at improving emergency medical care for children. Although it didn’t pass, it reminded Wakefield that pulling the levers of government can have real-life consequences.
“They recognized my family’s loss and supported legislation that could affect the lives of children in other families who may have a chance to survive,” Wakefield wrote. “Public policy is important, isn’t it?”
This article was originally published in Kaiser Health News.
WORDS: Sam Whitehead: firstname.lastname@example.org, @sclaudwhitehead
IMAGE CREDIT: US House of Representatives – Dan Sullivan’s Office.
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