Science Not Politics: How Dr. Rochelle Walensky is Saving the CDC

SHE CRIES as she gets the vaccine. “It’s amazing, it’s amazing,” Rochelle Walensky, M.D., M.P.H., murmurs as a nurse at Massachusetts General Hospital pierces her deltoid with a needle. “Usually it takes 10 to 15 years. The fact that we have it in one.…” Walensky shakes her head in wonder.

“Yay for science,” the nurse says.

“Yay for science,” Walensky agrees.

After vaccination, patients are monitored for an allergic reaction for 15 minutes, so Walensky—who had been chief of infectious diseases at Mass General until a few weeks ago—takes a seat in a makeshift clinic set up in the now-shuttered museum of medicine at the hospital. “It has been so hard,” she says, dabbing her eyes over her mask. “So much of what we do as doctors has to do with touch. With COVID all you can see are the eyes, and these patients have been so alone, without their families.” It is not the first time she’s become emotional over the toll of this pandemic. When she spoke recently at the announcement of her new job as the director of the Centers for Disease Control and Prevention, she also teared up. “My kids were like, ‘You quivered.’” She laughs at herself. “I did! I can’t help it. I want to be strong, but when you look at all the people affected and the collateral damage, it’s heavy.”

There’s no doubt that Walensky, 51, has the scientific and intellectual chops for her new job. Besides her now-former position at Mass General, the teaching hospital of Harvard, she is a prolific author of papers on the epidemiology of HIV and, at 43, was among the youngest women ever promoted to full professor at Harvard Medical School. As Julie Gerberding, M.D.—who led the CDC from 2002 to 2009—says, “Her credentials and reputation are impeccable. It’s clear that the Biden administration played an ace in this decision.” It’s also clear Walensky will bring much-needed compassion to a nation reeling from the trauma of the last year. “She’s an interesting choice,” says Ingrid Bassett, M.D., an associate professor of medicine at Harvard Medical School, who counts Walensky as one of her mentors. “It shows that they understand the messenger is just as important as the message. She’s warm, she’s kind, you feel she wants to make the world a better place. People are ready to feel that sense of trust in the messenger.”

The CDC was founded in 1946 to combat malaria in the South, which is why the main campus is located in Atlanta. In the years since, it has evolved into a revered institution entrusted with protecting the country’s health. “I know it doesn’t roll off the public’s tongue,” Walensky says, “but I rely on it for everything I do. If you type c in my Google search bar, the first thing that comes up is the CDC website.” For all those reasons, its missteps in this pandemic year have been acutely painful for the scientific community. First the CDC stumbled by producing a flawed COVID-19 test early on. More recently, whistleblowers have revealed the extent to which politics have interfered with the agency’s delivery of medical advice. Health memos from the CDC were being edited by the likes of Kellyanne Conway and Ivanka Trump. Lifesaving practical advice was simply ignored—when the agency sought to issue a nationwide requirement that masks be worn on all public transportation last September, the White House blocked it without discussion.

Among the agency’s 13,000 or so employees, these have been dark days. Former chief Gerberding has received phone calls from employees she once worked with wondering if they could maintain their sense of integrity in such an environment. “I am not concerned about what’s going on underneath the politicization,” she says. “These are the same heroic scientists who did such a fantastic job on SARS and containing Ebola. They are still there.” Walensky concurs. “I am not going to say there weren’t missteps, but for the most part [the scientists] have been incredible.” Nevertheless, getting politics out of science will be her first goal. “Political people cannot influence science,” she says simply. “If they do, I won’t be there.”

WALENSKY grew up in Potomac, Maryland, the daughter of a father with a Ph.D. in mathematics and a schoolteacher mother who later worked in human resources. As a child, she excelled at math. “It’s in my genes,” she says. Her great-grandparents emigrated from Russia in the early part of the century, entering the United States through Ellis Island. Her parents divorced when she was 14, an experience she calls painful but one that left her with an indelible message—whatever happened in her life, she would need to be independent. She remains close to both parents, who are impatiently awaiting the pandemic’s end so they can start traveling and see their grandchildren (Walensky and her husband, Loren, have three sons, ages 16, 19, and 21). To keep her mother’s spirits up, she tries to talk to her daily.

Being good at math and wanting to work with people made doctoring an obvious choice. With a guaranteed acceptance at Washington University in St. Louis, she applied to only two medical schools—Harvard and Johns Hopkins. Harvard, she readily admits, rejected her. In fact, she readily admits to a lot of failure in her life. “My CV makes it look easy, but it hasn’t always been. For every paper or grant I have submitted, 80 to 90 percent of them have been rejected, which is why I tell my students they have to love the pursuit of the question.” At Hopkins, she met her husband, a pediatric oncologist at the Dana-Farber Cancer Institute. She calls him “an amazing husband in every way” (except, perhaps, for that Star Wars obsession). A close-knit family, they and their boys spend their evenings at home in Newton, Massachusetts, watching the news (Tivo’ed), followed by Stephen Colbert. If the family tries to make her sit through another episode of The Mandalorian, the answer is no. The Walenskys seem to take special pleasure in egging one another on in friendly competition. There was the FitBit challenge Walensky set with her kids to see who could take more steps in a day. She knew that as a doctor doing rounds at a hospital, she would have an edge: “I’m winning!” she texted them.

Taking the CDC job will mean moving to Atlanta, where she will rent an apartment while leaving the family up north. Two of her boys, Seth and Matthew, will be in college, and one will be finishing his junior year of high school. She is a woman who has always put family first; is she bothered by the separation? “My entire life has been turned upside down in the last four weeks,” she agrees, “but this isn’t about me. This is about public service and getting us out of this hot mess.” In any case, she adds, “My children know I am always there for them.”

Walensky’s worldview was shaped by her residency in Baltimore during the 1990s, when HIV/AIDS was ravaging the population. It could have been an irredeemably depressing experience, but her tenure coincided with the discovery of a new class of antiretroviral drugs. The resulting combination therapies would prove to be a medical miracle along the lines of the COVID vaccine. “You were going to die in September,” she recalls, “but by February we could say, ‘Maybe you won’t.’ ” A generation of doctors was inspired by this era—some 30 percent of Walensky’s class at Johns Hopkins would go into infectious diseases, she estimates, even though it is one of the medical specialties with the lowest salary. “It’s a cerebral field,” she explains. “We don’t do procedures. When someone has been in the hospital for two months and then they spike a fever, that’s when they will call in infectious diseases. We will pore through every culture that was done, and it may take two hours, but you can’t bill for that work as well as you could if you had done a colonoscopy.” Not that she’s complaining. “It makes for a happy, fulfilled group of doctors.” Indeed, a new generation of physicians may be similarly inspired by the miracle of COVID vaccination—applications to med school are up an unprecedented 18 percent this year. (If so, they will likely be Democrats—Walensky likes to cite a Yale study that found infectious-disease doctors are the most blue of any specialty. Surgeons were the least.)

Walensky’s work with drug addicts in the ’90s taught her some fundamental truths about long-standing inequities in our culture and the limits of medicine. She could write a prescription, but getting a patient to change his or her life was something else. “When you ask someone to stop doing drugs, you are essentially saying, ‘You know all those contacts in your phone? Throw them out. In fact, throw out your whole phone because all those people know your number, and they are going to be calling you.’ It’s hard.”

To make individual choices easier, she began to view her science through the lens of advocacy. As an example, she tells me about her first bylined paper in The New England Journal of Medicine. By the early 2000s, the treatment for HIV was changing lives, but the disease was still spreading, due to a lack of routine screening in the medical community. The people spreading it were unaware of being infected. “The CDC actually had routine screening as policy, but it was one of its most ignored,” Walensky points out. “So I used my tool kit of epidemiology, math modeling, and cost effectiveness to make the case for it. There were other papers, but ours was among those that show the science to make such screening possible. It was a thrilling moment because I knew things were going to be better.”

One of the challenges she will face at the CDC is persuading vaccine-reluctant people to get the shot. Does this hesitancy frustrate you? I ask. “I don’t think it matters if it frustrates me,” she answers. “We need to understand the ‘why’ behind the hesitancy. In medical school we were taught to stay quiet after giving someone a new HIV diagnosis. It’s a painful, awful pause, but you need it so you can learn what they’re thinking. That diagnosis means different things to different people. Maybe they’re wondering, ‘Am I going to die?’ or ‘Is my kid infected?’ ‘Will I lose my job?’ Until you know what the diagnosis means for that person, you can’t address the next question. I think it’s similar with vaccine hesitancy. Are you worried about the side effects? Is it because you have no place to leave your kid while you get vaccinated? Are you worried about the science? We can’t address the noes until we understand them.”

Of course, even the people who give an enthusiastic yes to the vaccine have faced difficulty getting it, something she attributes to an initial misallocation of resources. “The budget for Operation Warp Speed was in the billions; the budget for the rollout was in the millions,” she says. “This isn’t something you just drop off at the front door.” From the moment she accepted the job, she has been meeting with President Biden and a multidisciplinary group including FEMA officials and supply-chain, data, and community experts to figure out the optimal way of distributing the dose. “We are,” she said, “treating this like the emergency it is.” She admits the way forward is going to be difficult, but at least it will be transparent. “The states haven’t been able to plan, because they haven’t known how much vaccine they’re going to get. How do you open a stadium if you don’t know what you have? We have a vision for making it better.”

I went looking for someone who might be skeptical of Walensky in her new position. She is, after all, going from overseeing a staff of 100 to a staff of more than 10,000. No small jump. But I couldn’t find a single naysayer. By contrast, her predecessor, Robert Redfield, M.D., was strenuously opposed by the consumer-advocacy group Center for Science in the Public Interest. Even Twitter swooned over the appointment. As one doctor wrote, “This has sent me into a sort of public health euphoria!” The only person expressing trepidation might be Walensky herself. “A female mentor once said to me, ‘Any job you’re not a little afraid of isn’t big enough.’ The enormity of this job is not lost on me. It’s a big job, but I don’t think the fundamentals of leadership change with the number of people working under you. You’ve got to credit those people and understand that they are trying to do the right thing. The personal touch matters. Feeling valued is so important.”

At Mass General, the stories of that personal touch are commonplace. “Everybody remembers their first impression of Rochelle,” says Jacqueline Chu, M.D., another doctor Walensky has mentored. “She fills the room. Her investment in me has made me think that if she believes in me, then maybe I can step into this role. And she doesn’t just do it for me; she does it for everyone she meets with. I often wonder where she gets the time or energy, but I think caring about people is what fills her tank. At least, that’s how she makes you feel.” She was so adept at being both friend and mentor—“I’m wearing my friend hat now” is one of her signature phrases—that a colleague once gifted her a baseball hat emblazoned with the word friend. It hung prominently on a hook in her office. And now the nation is going to get a chance to be her friend. Says Chu, “Her light and energy are going to be great for this country.”