ATLANTA — Earlier this year, senior leadership at the Centers for Disease Control and Prevention began a monumental task: transforming the sprawling, labyrinthine organization known for its highly specialized, study-driven scientific research into a health intervention agency. elegant and flexible audience ready to serve the American public. This is an attempt to prevent the CDC from repeating the mistakes it made in responding to covid-19.
But agency veterans, outside public health officials and workplace organization experts said the current workplace structure could be a major obstacle to that goal. Like directors before her, agency director Dr. Rochelle Walensky spends a lot of time away from CDC headquarters in Atlanta. The agency has also adopted a workplace flexibility program that has allowed most of its scientists to remain remote.
As of October, 10,020 of the CDC’s 12,892 full-time employees — 78% of the full-time workforce — were allowed to work remotely all or part of the time, according to data KHN obtained through a request. of the Freedom of Information Act.
Experts said the lack of face-to-face work would likely be a substantial impediment to senior management’s efforts to overhaul the agency after its failures during the pandemic – a botched testing rollout, confusing security advice, slow publication of scientific research and a loss of public confidence.
They also wondered if Walensky, who frequently works remotely while on the move, could drive this change remotely, and if a virtual workforce might find it more difficult to fight infectious diseases than someone working together. in person.
“One of the things that a really strong new leader would do is be visible, walk the halls, have the door open,” said Pamela Hinds, a science teacher at management and engineering at Stanford. University. “It’s a lot harder to accomplish when nobody’s around.”
Key to the CDC’s reform effort is changing its institutional culture, which the agency says is at the heart of all its work — from how it interacts with other agencies to how it shares its research. Walensky said the CDC needs to be faster and more agile in dealing with emergencies and more communicative, both internally and with the public.
A flexible, responsive and collaborative culture flourished not too long ago – under the Obama administration, when the agency handled crises such as the H1N1 flu pandemic and the Zika virus outbreak, the Dr. Stephen Cochi, who worked at the CDC for four decades. before retiring this year. “I would like to see every effort made to try to restore that culture as much as possible, because the CDC will potentially lose some of its excellence if it can’t,” he said.
Changes, such as the transition to a largely remote workforce and a burgeoning bureaucracy, he said, made it “almost impossible to do anything” in his final years at the ‘agency.
Chris Collins, a professor at Cornell University’s School of Industrial and Labor Relations, said institutional culture includes ‘unwritten rules about how work gets done’ and these are hard to learn. in a remote work environment.
A largely remote workplace, Collins said, can lead to weaker social bonds between staff members, which can ultimately lead to less understanding and less investment in the institution’s values. A loss of personal interaction can also suppress innovation. “If you think great new ideas come from people bumping into ideas, you want to try to create an environment where that happens as often as possible,” he said.
A document outlining CDC policy that was last updated in April says remote work can help recruit and retain staff, keep workers happy, and reduce the cost of workspaces. office rented. He followed updated guidance from the U.S. Office of Personnel Management encouraging federal government agencies to consider remote work options for staff, given their usefulness during the covid-19 pandemic.
At the start of 2020, much of the FDA and National Institutes of Health workforce was working remotely. Today, the NIH is mostly back in the office, but the FDA said many of its employees continue to work remotely when possible. And while the White House COVID-19 task force met early in the pandemic and held in-person press conferences, its briefings became largely remote events.
Still, Walensky has recently faced sharp skepticism about the workforce flexibility policy from lawmakers, who have questioned his ability to remake the CDC with a dispersed staff.
During a congressional hearing in September, U.S. Sen. Bill Cassidy (R-La.) quoted remarks a former acting CDC director made to the New York Times: “I don’t know how you motivate and inspire culture change when people are not together.’
“The CDC people are good, they work hard, and they don’t necessarily have to be on site in Atlanta,” Walensky replied. “In fact, often they are more productive offsite.”
Walensky added that agency staff deployments are common, and many lab staff, who cannot work from home, are showing up at CDC offices.
Running the agency isn’t a traditional office job either.
“The role of CDC director has historically involved a significant amount of official travel around the world; requiring the director to be mobile and able to work from anywhere,” CDC spokesperson Jason McDonald said in a statement. “Dr. Walensky divides his time between CDC national sites across the country, Washington, D.C., state health departments, and internationally where the CDC has a presence in 60 countries.
KHN spoke with several CDC employees working remotely. They declined to speak publicly due to job security concerns.
They said the remote work policy had no impact on their work, but acknowledged that reduced opportunities for in-person interaction could make some CDC staff feel less connected to their managers. and their peers – and the agency’s mission.
This lack of personal connection can lead to a lack of trust, which can prevent important conversations from happening, said Stanford professor Hinds. “We’re much more willing to be open, to ask tough questions, to raise issues when we’ve actually sat down with someone face-to-face and got to know them a little better,” she said. declared.
A remote work environment also makes it harder for a new leader who has no experience within an organization to really understand its quirks, Hinds said. Walensky was an outside hire and worked at Massachusetts General Hospital before her appointment as CDC director. And setting aside time for a video or a phone call with a new boss to help them learn more about an institution is “a big hurdle,” Hinds said, compared to bumping into them in the hallway or at the trolley. coffee.
Early in her work at the CDC, Dr. Anne Schuchat said, she relished the informal interactions with colleagues and called this unscheduled time creative and productive. “I think you lose some things when you don’t have the informal mentorship and the visibility, maybe the greater sensitivity to who’s struggling, who needs help,” Schuchat said.
She spent more than three decades at the agency, including two as acting director, before retiring in the summer of 2021. Her departure follows that of another senior CDC official, Dr. Nancy Messer.
Schuchat said part-time remote work was encouraged at the CDC before the pandemic due to a lack of office space. She said she imagined that many staff were indeed more productive when working remotely, despite the possible costs to agency culture.
Many people have fled US public health workers in recent years, exhausted by the covid-19 response. Public health experts have said retaining talent requires offering benefits such as remote working – especially when it’s difficult to offer competitive salaries – and getting employees to believe in the mission of an agency.
But, experts said, face-to-face interactions can lead to strong allegiances and investment in an organization, which can translate to better retention.
“They generally want to feel that their work is important and that they are valued,” said Dr. Manisha Juthani, who has led the Connecticut Department of Public Health since July 2021. “And the workplace allows that a little more . than sitting in front of the computer.
Walensky said transforming the CDC’s culture from a methodical, academic culture to one focused on quick action won’t be easy. Other experts agree on the need for the pivot.
“They tend to be an agency that studies things and then, at their own pace, responds, as opposed to an emergency response agency,” said Dr. Georges Benjamin, executive director of the American Public Health Association.
Overhauling that culture will be a big challenge, with high stakes, for the agency tasked with protecting the public health of all Americans. Benjamin said the CDC likely would have tripped up its pandemic even if staffers hadn’t been working remotely. But coming to terms with those mistakes — and rebuilding the agency to prevent them from happening again in the future — might be easier and more sustainable if more people worked together in person, he said.
“How are you part of a culture, how are you part of a holistic organization, if you’re not together?” he said. “While I’m not bothered that they aren’t back, my advice is to get there as quickly as possible.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polls, KHN is one of the three main operating programs of the KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.