美国国家公共电台 NPR--A shake-up at the CDC is intended to make it a more nimble organization

A shake-up at the CDC is intended to make it a more nimble organization

Transcript¹

NPR's Leila Fadel speaks with Dr. Ali Khan, public health expert at the University of Nebraska Medical Center and a former CDC official, about the effects of an announced CDC reorganization.

LEILA FADEL, HOST:

Over the course of the COVID-19 pandemic, we've become accustomed to hearing recommendations that sound like this.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED PERSON #1: Today, CDC is releasing updated guidance for K-12 schools.

UNIDENTIFIED PERSON #2: We've done a reevaluation.

UNIDENTIFIED PERSON #3: Now we have new science that is just happening from our outbreak investigations² that has demonstrated that...

UNIDENTIFIED PERSON #4: But we are at CDC updating our guidance for the particular settings in light of the newer science.

FADEL: For more than two years, the science shifted, the guidance changed, and now the head of the Centers for Disease Control and Prevention wants to reorganize the CDC to do better. Dr. Rochelle Walensky calls it a reset³, saying her agency was responsible for pretty dramatic and pretty public mistakes in response to COVID-19. Dr. Ali Khan is dean of the University of Nebraska Medical Center Department of Public Health. He's also a former director of the CDC's Office of Public Health Preparedness and Response. Welcome back to the program, Dr. Khan.

ALI KHAN: Always a pleasure, Leila.

FADEL: So I want to start with this announcement. I mean, a lot of Americans lost trust in the CDC over its response to the pandemic, the constantly changing guidance, a perception that the CDC was bending to political pressure from the Trump⁴ White House. What's your reaction to this announcement?

KHAN: I think that assessment⁵ of yours is spot on, and the first step in solving a problem is actually admitting you have a problem. So it's really critically important that the CDC director admitted to the American people and has, importantly, the rank and file of the agency, that they made numerous mistakes during the botched COVID response, including the fact that people didn't go to CDC to get data on how many cases there were in the United States, which is their raison d'etre. She left obviously unsaid that CDC's woes⁶ weren't just, you know, due to partisanship⁷. So we do know that's an issue. But for the rank and file and for the American people, CDC itself needs to reform.

FADEL: Let's do a quick summary of the ways in which you believe the CDC might have failed during the pandemic.

KHAN: Sure. And Dr. Walensky was very transparent⁸ about this. So you talked about, without a doubt, botched communications. They could have done much better in communications. But it starts right at the beginning, using the wrong response model - this was not a influenza⁹ disease; this was more like the original SARS-1 - not having enough testing, the wrong case definition, a wrong test that initially¹⁰ went out, not compiling the data, making it available to individuals. So those are some of the things that - and the messaging obviously has continued, but some of the mistakes that were made by the agency.

FADEL: Now, you say this is a big step, recognizing there's a problem, but what are your concerns maybe with this reset? Is this the solution?

KHAN: It's not the complete solution. So there's lots to like about the reset - the focus on better sharing of early information, better communications - it's hard for me to believe that for years, CDC hasn't had a person in charge of communications - and the clear recognition that data is the core of what public health does, and a request for more mandates¹¹ around data sharing and obviously flexibility¹² in using dollars. But I think this misses the mark on a couple of places. One is, I think, the recognition of the underlying¹³ culture of CDC. So, you know, CDC, you know, prides itself on saving polio vaccination¹⁴ in 1955 from a nimble - you know, nimble, fast response when people got infected from an inactivated¹⁵ polio vaccine¹⁶. So when I hear about creating a culture of nimble response, I think no, that is the inherent culture of CDC. What's happened to it over the last couple of administrations that they've lost that culture? So, you know, response to measles¹⁷, anthrax, natural disasters, global emergencies like SARS - CDC got all those right, so what's wrong now? What were the leadership issues that put them in this position?

So I think it misses the mark on that, and I think it misses the mark on less focus on publications without recognizing that CDC is a science creation entity¹⁸, unlike many other federal entities¹⁹. And the reason people trust CDC and respect CDC is because of their best science. And I think it gets framed like - framed as too academic, too many publications, but the too many publications is because CDC creates science, and that's why you trust CDC, and we can't get away from that. And then finally, too much focus on reorganization - when I was at CDC, I underwent three separate organizations based on whatever the director's pet project happens to be. And I'm not sure they'd necessarily lead to more, you know, operational administrative²⁰ efficiencies, to be honest with you. And what we don't want to do is create a FEMA for public health emergencies. We still need that excellent science-based organization that is CDC.

FADEL: You know, we can't talk about the CDC and public health officials without talking about the politicized environment in which they're working, where public health officials have gotten death threats over public guidance, over masking and testing. So I've got to ask, how much of this organization is in response to politicized criticism and how much it reflects real problems inside the agency?

KHAN: This reflects real problems inside the agency. And so it's important - why I started off by saying it's important to the rank and file to say an amazing workforce²¹ - some of the best scientists worldwide in public health - but there are issues that need to be solved at the agency. And an internal review, which is essentially²² what this is, is not going to talk about the politicization and the difficulties, not just at CDC, but local and state health departments. And I think we still need a truly external review like we did, for example, during the original 9/11 events that looks broadly across the federal government. I do not want to compartmentalize the difficulties - national difficulties with the public health response to what the challenges were just at CDC. And I think we need to look at this broadly across every agency, across the government and say, how do we do better to be ready for the next pandemic?

FADEL: In the little time we have left, a big question - how can the CDC become more effective in its public health responses going forward?

KHAN: I believe CDC can become more effective by going back to its roots, which is about a rapid, nimble response at trying to identify how it's become so bureaucratic²³ and how to address that bureaucracy where anybody at CDC can identify a problem, bring it to the fore²⁴ for the CDC director and the leadership and say, this is what's wrong. This is what we need to do to move forward. And that'll get us back to the CDC we all know and respect.

FADEL: Dr. Ali Khan of University of Nebraska Medical Center, a former director of the CDC's Office of Public Health Preparedness and Response - Dr. Khan, thank you.

KHAN: It's a pleasure.

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 investigations   

（正式的）调查( investigation的名词复数 )； 侦查； 科学研究； 学术研究

参考例句：

• His investigations were intensive and thorough but revealed nothing. 他进行了深入彻底的调查，但没有发现什么。
• He often sent them out to make investigations. 他常常派他们出去作调查。

3 reset   

v.重新安排，复位；n.重新放置；重放之物

参考例句：

• As soon as you arrive at your destination,step out of the aircraft and reset your wristwatch.你一到达目的地，就走出飞机并重新设置手表时间。
• He is recovering from an operation to reset his arm.他做了一个手臂复位手术，正在恢复。

4 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

5 assessment   

n.评价；评估；对财产的估价，被估定的金额

参考例句：

• This is a very perceptive assessment of the situation.这是一个对该情况的极富洞察力的评价。
• What is your assessment of the situation?你对时局的看法如何？

6 woes   

困境( woe的名词复数 )； 悲伤； 我好苦哇； 某人就要倒霉

参考例句：

• Thanks for listening to my woes. 谢谢您听我诉说不幸的遭遇。
• She has cried the blues about its financial woes. 对于经济的困难她叫苦不迭。

7 Partisanship   

n. 党派性, 党派偏见

参考例句：

• Her violent partisanship was fighting Soames's battle. 她的激烈偏袒等于替索米斯卖气力。
• There was a link of understanding between them, more important than affection or partisanship. ' 比起人间的感情，比起相同的政见，这一点都来得格外重要。 来自英汉文学

8 transparent   

adj.明显的，无疑的；透明的

参考例句：

• The water is so transparent that we can see the fishes swimming.水清澈透明，可以看到鱼儿游来游去。
• The window glass is transparent.窗玻璃是透明的。

9 influenza   

n.流行性感冒，流感

参考例句：

• They took steps to prevent the spread of influenza.他们采取措施
• Influenza is an infectious disease.流感是一种传染病。

10 initially   

adv.最初，开始

参考例句：

• The ban was initially opposed by the US.这一禁令首先遭到美国的反对。
• Feathers initially developed from insect scales.羽毛最初由昆虫的翅瓣演化而来。

11 mandates   

托管（mandate的第三人称单数形式）

参考例句：

• Individual mandates would require all people to purchase health insurance. 个人托管要求所有人都要购买健康保险。
• While I agree with those benefits, I'm not a supporter of mandates. 我同意上述好处，我不是授权软件的支持者。

12 flexibility   

n.柔韧性，弹性，（光的）折射性，灵活性

参考例句：

• Her great strength lies in her flexibility.她的优势在于她灵活变通。
• The flexibility of a man's muscles will lessen as he becomes old.人老了肌肉的柔韧性将降低。

13 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

14 vaccination   

n.接种疫苗，种痘

参考例句：

• Vaccination is a preventive against smallpox.种痘是预防天花的方法。
• Doctors suggest getting a tetanus vaccination every ten years.医生建议每十年注射一次破伤风疫苗。

15 inactivated   

v.使不活泼，阻止活动( inactivate的过去式和过去分词 )

参考例句：

• Molluscicides are quickly inactivated by sunlight and adsorption to mud organic matter. 灭螺剂因阳光作用、泥土及有机物质的吸收会很快失效。 来自辞典例句
• Viruses were inactivated by BPL and the toxicity measured again. BPL对病毒进行灭活，测定残存毒力。 来自互联网

16 vaccine   

n.牛痘苗，疫苗；adj.牛痘的，疫苗的

参考例句：

• The polio vaccine has saved millions of lives.脊髓灰质炎疫苗挽救了数以百万计的生命。
• She takes a vaccine against influenza every fall.她每年秋季接种流感疫苗。

17 measles   

n.麻疹，风疹，包虫病，痧子

参考例句：

• The doctor is quite definite about Tom having measles.医生十分肯定汤姆得了麻疹。
• The doctor told her to watch out for symptoms of measles.医生叫她注意麻疹出现的症状。

18 entity   

n.实体，独立存在体，实际存在物

参考例句：

• The country is no longer one political entity.这个国家不再是一个统一的政治实体了。
• As a separate legal entity,the corporation must pay taxes.作为一个独立的法律实体，公司必须纳税。

19 entities   

实体对像； 实体，独立存在体，实际存在物( entity的名词复数 )

参考例句：

• Our newspaper and our printing business form separate corporate entities. 我们的报纸和印刷业形成相对独立的企业实体。
• The North American continent is made up of three great structural entities. 北美大陆是由三个构造单元组成的。

20 administrative   

adj.行政的，管理的

参考例句：

• The administrative burden must be lifted from local government.必须解除地方政府的行政负担。
• He regarded all these administrative details as beneath his notice.他认为行政管理上的这些琐事都不值一顾。

21 workforce   

n.劳动大军，劳动力

参考例句：

• A large part of the workforce is employed in agriculture.劳动人口中一大部分受雇于农业。
• A quarter of the local workforce is unemployed.本地劳动力中有四分之一失业。

22 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

23 bureaucratic   

adj.官僚的，繁文缛节的

参考例句：

• The sweat of labour washed away his bureaucratic airs.劳动的汗水冲掉了他身上的官气。
• In this company you have to go through complex bureaucratic procedures just to get a new pencil.在这个公司里即使是领一支新铅笔，也必须通过繁琐的手续。

24 fore   

adv.在前面；adj.先前的；在前部的；n.前部

参考例句：

• Your seat is in the fore part of the aircraft.你的座位在飞机的前部。
• I have the gift of fore knowledge.我能够未卜先知。