The pandemic broke the CDC. New director will try to fix it.

The incoming CDC director has a lot of work to do, and she knows it. Dr. Rochelle Walensky said on Tuesday (Jan. 19) that over the last four years, scientists with the Centers for Disease Control and Prevention (CDC) "have been muzzled" and "science hasn't been heard."

Walensky, formerly a professor of medicine at Harvard Medical School and chief of the division of infectious diseases at Massachusetts General Hospital, will be sworn in on Jan. 20 — exactly one year since the first officially reported COVID-19 case was reported in the U.S. "The good news in my mind is there hasn't been a mass exodus of the talent, the talent is still there," Walensky said during a livestream interview conducted by The Journal of the American Medical Association (JAMA). "What I need to do is make sure that those voices get heard again."

The CDC has faced backlash from public health experts over the course of the pandemic, after having botched early testing and published questionable public health messaging. "It is unconscionable that recommendations, which should follow only the science, are being modified to enable [maybe even ensure] underreporting of COVID-19 cases at this critical juncture," Krys Johnson, an assistant professor of instruction in the Department of Epidemiology and Biostatistics at Temple University in Pennsylvania previously told Live Science over an abrupt switch in CDC testing guidelines.

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One of Walensky's major challenges will be to lead the U.S. out of the grip of the pandemic — and also fix the public health system so that the U.S. is better prepared for the next big one. When the COVID-19 pandemic hit, the U.S. had a "frail" public health infrastructure to start with, she said. "It wasn't ready to tackle what it was given."

More than 400,000 people in the U.S. have died as a result of  COVID-19, according to the Johns Hopkins dashboard; public experts are worried that new, more transmissible coronavirus variants may only add fuel to the fire, leading to more overwhelmed hospitals and thus more preventable deaths. 

However, Walensky is optimistic that COVID-19 vaccines will work against the new variants. Even if a new variant comes along that decreases vaccine efficacy slightly (of which there is currently no evidence), the current vaccines will likely still be effective, she said. The U.S. has also struggled to distribute vaccines on a large scale, though President-elect Joe Biden has promised to deliver 100 million doses of vaccine in his first 100 days in office.

The "real vision" is that the federal government will step in and ask each state "what is the help that you need?" Walensky said.

She also hopes to improve communication both within the CDC and outside of the CDC, for example by developing a social media plan for the agency. "The right information I think is not getting out there," she said. For example, if you search "vaccine hesitancy" on Twitter, you'll mostly find tweets from people who are hesitant to get the vaccine, rather than posts from the scientific community or the CDC, she said.

But the CDC isn't just an emergency response agency; rather, they do a lot of public health work in times without crisis or pandemics, she said. All those programs are in flux.

"We're going to see a lot of collateral damage from the last year in terms of hard-won gains that have been lost," due to the pandemic, she said. These include a decrease in child vaccinations, more uncontrolled hypertension, less HIV control and mental health challenges, she said. "I have a lot of work ahead."

Originally published on Live Science.