‘CDC is a critical national security asset’

Mandy K. Cohen, MD, MPH, director of the U.S. Centers for Disease Control and Prevention, raises her hand before her testimony with the Oversight and Investigations Subcommittee of the House Energy & Commerce Committee on Nov. 30, 2023. This image was taken from a webcast of the event.

The U.S. Centers for Disease Control and Prevention is a national security asset that is requesting congressional support, its new director said.

On Nov. 30, Mandy K. Cohen, MD, MPH, appeared on Capitol Hill before the Oversight and Investigations Subcommittee of the House Energy & Commerce Committee. Titled “Unmasking Challenges CDC Faces in Rebuilding Public Trust Amid Respiratory Illness Season,” it was Cohen’s first meeting with Congress members since taking the reins at CDC in July.

Cohen and the lawmakers spent almost 2 ½ hours talking about the fall flu and season, compounded by COVID-19 and respiratory syncytial virus (RSV), lessons to take from the agency’s response to the COVID-19 pandemic, and the larger restructuring of CDC. There was criticism about the CDC’s actions, or inactions, during the pandemic, and some partisan jabs.

“CDC is a critical national security asset, putting data and evidence into action to protect this country's health and safety, and I am privileged to lead this dedicated team,” Cohen said in the hearing, which was webcast online.

“I step into this role acknowledging, acknowledging the unprecedented challenges the agency and the country faced during COVID and that the health threats are going to continue to impact the security and safety of Americans,” she said. “As CDC is that trusted and has the tools to effectively and quickly respond to the next public health challenges and it's foundational to combating these threats.”

From the director

Mandy K. Cohen, MD, MPH
_{Photo courtesy of the U.S. Centers for Disease Control and Prevention}

The fall and winter respiratory season is an opportunity to focus on CDC’s core capabilities across three domains, Cohen said.

• Rapidly detect and respond to health threats.
• Provide timely, common-sense, evidence-based solutions to protect and improve public health.
• Build toward a broader, integrated, effective system that protects public health.

CDC has launched a new respiratory season website with a combined view of COVID-19, flu, and RSV, with updates to help people make informed decisions for themselves and their loved ones, Cohen said. This week brought the launch of an updated wastewater data dashboard for public health practitioners and the public to watch for spread of infectious diseases in communities, she said.

This season has immunizations available for RSV, COVID-19 and influenza, and vaccinations remain the best defense against severe illness and death, Cohen said.

The end of the COVID-19 public health emergency has limited CDC’s ability to show county-level data for that disease, but the agency hopes new policies and resources from Congress will enhance data collection and analysis, she said. The nation also needs a better system to distribute and administer vaccines to uninsured adults.

Cohen asked for Congressional help to take on the agency’s goals, Cohen said.

COVID-19 and other challenges

There are lingering effects of the COVID-19 pandemic that go beyond health, said Subcommittee Chair Rep. Morgan Griffith (R-Virginia) and full Committee Chair Cathy McMorris Rodgers, (R-Washington).

School closures to slow the spread of COVID-19 are still hurting young Americans, they said.

The average testing scores for US 13-year-olds has hit the lowest level in decades

Griffith said, citing the National Assessment of Educational Progress. The New York Times this month reported school closures led to 50 million children, “being out of the classroom, causing these students to miss an extremely crucial time in their lives since they were forced to attempt to learn from home,” he said, including his own children.

“The damage wrought by school closures was enormous and our children will be living with its consequences for decades,” Griffith said in his prepared remarks.

Rodgers told Cohen her predecessors “acted on bad advice due to political pressure and misled the American people,” folding to demands of teachers’ unions, losing Americans’ trust, and now leaving children with generational learning loss and mental health troubles.

“This is a chance to restore transparency and public trust in our health institutions and ensure that the CDC’s issued guidance is clear, practical, and consistently relevant and up to date with the latest science,” Rodgers said in her opening statement. “Sometimes, this may include telling the American people what the CDC does and doesn’t know.

“The gravity of the situation is clear,” she added. “If we fail to restore trust in public health institutions and correct past missteps, the consequences for our children and country could be dire.”

Supporting CDC

Committee Ranking Member Frank Pallone (D-New Jersey) touched on another controversial COVID-19 preventive – use of face masks – in his opening statement. He added he is “astonished and disappointed that we still can’t agree on the hard lessons learned during the pandemic.”

COVID-19 is not the only public health issue that CDC deals with. The agency needs money, data, public health infrastructure and communication to assist Americans with issues including maternal mortality and morbidity, the opioid epidemic, mental health, rates of sexually transmitted infections, and shortages in our health care workforce, Pallone said.

Subcommittee Ranking Member Rep. Kathy Castor (D-Florida) noted CDC figures show American life expectancy improved slightly in 2022, but the United States is struggling in health compared with other wealthy nations.

Earlier this year, CDC experts helped quash a malaria outbreak in Florida, the nation’s first in 20 years. That shows the importance of timely information for the public, a point that “became entirely too political during COVID” when some officials conceal information the public needed, Castor said.

She squarely blamed Republicans for undermining public health efforts that Democrats support.

“The Republican majority has actively opposed strengthening public health and failed to use the lessons learned to better position America to respond to a future health emergency,” Castor said. “Republican budgets in Congress tell the story. Instead of working to keep our neighbors safe and avoid higher health care costs, Republicans want to take us backwards through harmful cutbacks, shutdowns and budget showdowns.”