We have a public health leadership crisis writ large

It should have been obvious but to me it was not.

I have long held the view that the CDC has been operating way beyond its remit for at least a couple of decades or more.  By treating social health conditions (gun violence, obesity, smoking, etc.) as if they were transmissible illnesses, a position bolstered by social network theory, the CDC has taken its eye off the infectious diseases ball and played about in the muck of social engineering.  Entirely logical for people of a statist bent but not what they were actually authorized to do.

With the Covid-19 pandemic, I have lazily ascribed the poor US government response to bad or ineffective policy originating from the CDC and FDA.  And certainly to a large degree that is true.  At every turn, they seem to have abandoned long established public health knowledge in order to use strategies (such as masking, lockdowns, disease passports, etc.) which were totalitarian in nature, unsupported by rigorous research, and ineffective in practice.  They enthusiastically pursued that which was already known not to work.

I have anticipated that post-Covid, we might get some reforms at the CDC which are long overdue.  Reforms which are compellingly needed.  Covid-19 will not be the last infectious disease in our lifetimes.  There will be others and our response will need to be dramatically more effective in the future.  We dodged a bullet this time with a relative low all-causes excess mortality concentrated among the most elderly and the sickest.  

Covid-19, as it turns out, was not a particular danger to most the population.  A circumstance which cannot be guaranteed to happen again.  We have been warned and we need to do dramatically better.  Which can be done if we hold the CDC accountable and undertake the reforms so clearly required.

But in thinking this morning about Drs. Anthony Fauci, Deborah Birx, and Rochelle P. Walensky, the three witches of public health failure, it suddenly struck me that only Walensky is CDC.  Fauci is head of the National Institute or Allergy and Infectious Diseases and Birx's background is in AIDS/HIV.  

I already knew that, I was just hazily mushing them together.  

Yes, their respective organizations are highly interlocked with one another, but CDC's institutional failures are not those of NIAID (and NIH of which it part) nor are they the failures of  United States Military HIV Research Program (Birx).  

Given how dramatically this triumvirate of public health leaders from three distinct enterprises within the US government have failed, it suggests that our post-Covid-19 repairs to our public health will need to be much more encompassing than just fixing the CDC.  We have a public health leadership crisis writ large, not just a CDC mission crisis.