September 12, 2024 — Mandy Cohen, MPH ’04, has been going nonstop since being appointed by President Joe Biden to head the Centers for Disease Control and Prevention (CDC) in 2023. Here, the physician and former North Carolina Secretary of Health and Human Services takes time out to share some thoughts on looming health threats, lessons learned from COVID-19, and why public health is a team effort. The conversation has been lightly edited for clarity and length. You can also watch a recent video of Cohen speaking with Harvard Chan Dean Andrea Baccarelli about a wide range of pressing public health issues.
Q: We’ve seen headlines about bird flu, mpox, dengue, measles and other infectious outbreaks in the U.S. in recent months. What diseases concern you most?
Cohen: There are quite a number of health threats out there [beyond infectious diseases]. We know it is extremely hot in the summer, and that is a threat to our health. We also know that the [top killers] of folks are still heart disease, stroke, cancers. As CDC director, I think about how we as a country make sure that we are as healthy and strong as we possibly can be. We need to be ready for any health threat, and that requires us to invest in systems that allow us to both identify those threats early and respond to them quickly.
You can’t solve problems and respond quickly if you don’t have the data that allows you to see those threats, understand the severity of the signal, and then respond appropriately. So, we’re very focused on our underlying data systems.
Of course, we can’t do any of this without talented people who have the expertise. This is where it’s so important to partner with academic institutions, like Harvard and many others. The important work of public health is not something that CDC can do alone. We also collaborate with a network of people who do this work each and every day.
Q: Four years after the COVID pandemic, what major lessons has the CDC learned about managing a runaway infectious disease outbreak?
Cohen: We have certainly all learned a lot, not just CDC. All of us have learned about how a virus can turn our lives upside down and how important it is to be ready.
What I think is different now is that we are really focused on better and faster communications. We have learned a lot about the importance of that simple, clear, common-sense message, so that folks understand what we know and what we don’t know. I hope folks are already seeing that in how we are responding to avian flu.
We are also making a ton of progress in [collecting] the data that drives our actions to protect health, and making sure that that data turns into action much more quickly. Again, you can’t solve problems you don’t see. And the faster you see it, the faster you can respond. [For example,] we have a new heat-and-health tool that both tracks what’s going on heat-wise in your community, but also maps that to clear, simple things that folks can do to protect themselves.
Lastly, I see us doing more to break down silos and partner together. We are really working hard at CDC to be one team … across all of public health.
Q: What are some of your near-term and long-term priorities for the agency?
Cohen: We have three major priorities. The first is being ready to respond to any health threat. So that is making sure we have the capacity—data, lab, workforce, and response capabilities—so that we can respond no matter the health threat, whether that’s infectious disease, whether that’s something vector-borne, whether that’s heat-related, whether that’s opioids, whether that’s heart disease.
Second is improving mental health, specifically, reducing suicides and overdoses. We lost 100,000 folks to overdose and 50,000 to suicide last year and we can do better. What CDC brings to the table is data and expertise, as well as evidence for what works in terms of best practices. We want to [share those] all over the country.
The third area of focus is supporting young families. This is recognizing that our lifelong health patterns start when we are young, so making sure that mom has a healthy pregnancy, that our kids get vaccinated, that they’re not food insecure, that they’re having positive childhood experiences and that we’re mitigating adverse childhood experiences. Again, CDC is bringing data and evidence and investment in best practices to keep our country healthy.
Q: There has been a growing lack of trust in medicine, public health, and government. How are you building back public trust in the CDC?
Cohen: I think trust is built by showing up and doing good work every day, and that’s what we’re trying to do: to show how CDC is working for folks. We’re also making sure we’re being very transparent in our communications, explaining what we know, what we don’t know. And building relationships. Data and evidence are incredibly important to power our work, but we also have to make sure we’re connecting to each other as humans. CDC alone cannot fulfill our mission of protecting health and improving lives. This has to be a team effort.
Photo: Michael Brochstein / Sipa USA via AP Images