CDC leader faces precarious political moment

Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky is under fire for failing to adequately communicate agency guidance as the U.S. enters the third year of the pandemic and the Biden administration struggles to control the rapidly spreading omicron variant.

The criticisms, most recently about the agency's guidelines on isolation and quarantine, are coming from people both outside and inside the agency, reflecting rising frustration during a precarious moment for both Walensky and the CDC.

Coronavirus infections are rising exponentially as the omicron variant spreads, and there's growing concern that Walensky and the agency's stumbles are contributing to Americans' confusion about the path forward.

During an interview on "CNN Newsroom" Monday, Health and Human Services Secretary Xavier Becerra defended Walensky but acknowledged she's not the best at selling the agency's actions to the public

"Dr. Rochelle Walensky is an infectious disease expert. She has a medical license, and she also has a degree in public health. She doesn't have a degree in marketing," Becerra said. "Who do I want running CDC? Someone who knows infectious diseases. Someone who understands this stuff. So while we may have issues with some of the marketing that's been done, I guarantee you Dr. Walensky is someone we need at the CDC."

In prepared remarks shared ahead of a Senate hearing with Walensky and other officials on Tuesday, Sen. Patty Murray (D-Wash.) said her constituents are frustrated.

"People back in Washington state, and across the country, are frustrated and worried about the course of this pandemic, and its persistent challenges - like how hard it still is to get a test. ... I've also heard from people who have found the communication about new isolation and quarantine guidance confusing and frustrating," Murray will say.

Public health messaging during a global pandemic is complicated enough, but experts say Walensky and the Biden administration as a whole need to be better at making clear that the situation is evolving constantly.

On Friday, Walensky held the agency's first solo press briefing since taking the helm, despite a promise from the Biden White House to put career scientists first.

"We're in an unprecedented time with the speed of omicron cases rising and we are working really hard to get information to the American public and balancing that with the realities of what we're all living with," Walensky said.

She noted that over the last year she has taken reporters' questions in more than 80 briefings. However, most of them have come as part of the White House's COVID-19 task force press conferences, where she appears with other administration officials rather than with agency scientists.

The agency decided to hold Friday's briefing, Walensky said, because "we had heard clearly over the last week that there was interest in hearing from us independently."

Walensky started the CDC job with a reputation as a savvy communicator, tasked with salvaging the reputation of an agency that took a beating under the Trump administration.

But there have been some very public missteps. Just after Christmas, the CDC cut in half the recommended isolation period for someone who tests positive for COVID-19. The update came from a press release, with no accompanying data or media briefing.

Confusion and criticism ensued, as public experts said the agency erred by not specifying the need for a negative test before leaving isolation. Walensky and the administration spent the next week fielding criticism, and top officials hinted that a change was coming.

But Walensky did not back away from her initial guidance, and last week said a negative test was not necessary to leave isolation - a person could take a test if they wanted, but should extend isolation if they continue to test positive.

To some, the agency's explanation only served to muddy the waters further. Walensky's clarification was slammed as convoluted and mocked by late night hosts.

Tom Frieden, a former CDC director during the Obama administration, said there needs to be a briefing any time there's a policy update.

"We will all be better off when we're hearing more from the CDC directly," Frieden said.

"Currently, CDC really is kind of a scapegoat where a bunch of people from outside public health or outside of governmental public health can criticize, because the airwaves have been empty when they issued new guidance. You can't just post new guidance on the website at 10 o'clock at night and think people are going to understand it. Even if it was the best guidance in the world. It's not going to go well," Frieden said.

Experts said Walensky is still the best person to be delivering the administration's message, but she needs to recognize the consequences of unclear guidance.

"CDC's loss of trust is real. It's no longer just anti-vaxxers and Trump supporters who mistrust the agency. People who are worried about omicron and determined to do the right thing are public health's 'home team' - and they too are losing trust in the agency," Peter Sandman, a crisis communications expert, said in an email.

"It's not too late for CDC to rebuild trust. It's never too late. But a precondition for getting another chance is telling the truth about your prior screw-ups," Sandman said.

Judith Auerbach, a professor in the University of California San Francisco School of Medicine who previously worked with Walensky on HIV research, said Walensky hasn't been clear enough that uncertainty is the rule.

The message from the CDC needs to be that "we're experiencing viral evolution in real time. It's complex, and it's nuanced. And what we know about it changes on a daily basis," Auerbach said.

"We'll continue to provide the best information we have at this moment based on the scientific evidence, clinical experience, and even epidemiologic modeling. But please understand that this information may be moot the next day as we continue to learn more," Auerbach added.