The Centers for Disease Control and Prevention is running out of ways to be creative with its limited pandemic funds and needs more flexibility from Congress, Director Rochelle Walensky told CQ Roll Call in an exclusive interview Wednesday.
The White House last month requested nearly $10 billion more for short-term needs related to COVID-19 and to stave off a winter surge, including money for vaccines, therapeutics, accelerated research and long COVID-19 treatment.
Walensky is hoping for more funding, in addition to more authority to improve data reporting from states and medical providers.
But this is the fourth time the White House has sent an emergency COVID-19 funding request to Congress this year. Lawmakers, especially Republicans, are so far refusing to include any more COVID-19 funding in an end-of-year government funding bill, and prospects for data authority also look slim.
When both Democratic and Republican members tanked a $15 billion funding request in March, the White House repurposed funds and paused a program to get free testing kits to Americans. When the GOP blocked a $22.4 billion request for COVID-19 and mpox in the September short-term spending law, the CDC reallocated funds from other agency programs.
Then, last week, Energy and Commerce Republicans chastised the administration for using $475 million in Provider Relief Fund dollars for a COVID-19 vaccine campaign.
Now Walensky says the CDC is running out of money to shuffle around.
“Not all of it is really re-allocatable. We’re constrained in a lot of ways in our ability to do that,” she said.
“I will just say that this is not a sustainable or preferred approach,” said Sherri Berger, the CDC’s chief of staff, who pointed to prior “fits and starts” in funds for Ebola as an example of how not to adopt a long-term approach to improve public health.
Where’s the data?
Nearly three years into the pandemic, COVID-19 is no longer the focal point of Americans’ daily lives, as cases, hospitalizations and deaths decrease. But public health experts warn that cases could creep up again this winter because of new variants and a lack of booster protection.
Roughly 5 percent of U.S. jurisdictions are reporting high levels of COVID-19 community transmission, and Walensky said the agency expects that number to continue to increase.
Additionally, high levels of flu and respiratory syncytial virus, or RSV, are crowding hospitals and straining resources.
Despite the predicted surge, public health experts anticipate the Biden administration will wind down the ongoing COVID-19 public health emergency in the coming months. This could drastically impact the agency’s ability to respond to the virus.
After the public health emergency ends, the CDC can continue to ask for state data on surveillance, testing, hospitalizations and deaths for a period of time after the emergency — but it does not have the authority to do that forever. Instead, Walensky said, it will need congressional approval to collect that data.
She predicted the agency may not be able to report out COVID-19 community levels in a year.
“If we don’t get surveillance data, testing data, at the pace that we have been getting it, at the transparency that we’ve been getting, we may not be able to report on those sorts of things,” Walensky said, noting the lack of data flow also could prevent the CDC from churning out long COVID studies.
So now the agency is hoping Congress will help the agency access the data it needs.
She said many lawmakers aren’t aware that the agency cannot just collect the data as it would like.
“People have no idea we didn’t have the authorities,” she said.
A bipartisan bill from Senate Health, Education, Labor and Pensions Chair Patty Murray, D-Wash., and ranking member Richard M. Burr, R-N.C., includes data-sharing incentives aimed at improving the nation’s broader pandemic response, but not enough authority to collect the data in the first place, Walensky said.
The bill, known as the PREVENT Pandemics Act, is one of several health policy riders lawmakers are attempting to attach to government funding legislation.
Walensky also voiced concerns about the bill’s requirement for Senate confirmation of future CDC directors, pointing to the delay in getting Food and Drug Administration Commissioner Robert Califf confirmed.
“One could imagine, especially with the politicization of CDC at the time, that that could have taken a really long time,” she said.
Her concerns will likely have little sway with Republican leaders on the Hill.
“Tough shit,” Burr said. “We desperately need to reform CDC,” he added. “This is minor compared to what we should do.”
There are currently no changes to the data provisions in the PREVENT bill, Burr said, though he acknowledged that the CDC needed data more quickly.
“After all we have gone through, Sen. Murray knows there are so many lessons we have learned from the pandemic and we need to make sure we never make those mistakes again at the federal, state, and local level,” a Murray aide said. “The PREVENT Pandemics Act represents a bipartisan set of common-sense reforms to our public health system including the CDC —and Senator Murray remains committed to getting it across the finish line.
“The provision requiring the CDC director be Senate confirmed would not apply to the current CDC director — and going forward, it would simply treat CDC director the same as other key positions at the department, which are all Senate confirmed already.”