I led the CDC. I know what greets a new director on day one: an inbox that never empties, urgent calls about health threats worldwide, a workforce at every level watching her every move, and a Congress that controls whether her plans survive the next budget cycle. Erica Schwartz, MD, MPH, JD, the newly confirmed CDC director, inherits all of this at a tougher moment than most of her predecessors faced. She will soon confront an agency that has lost more than a quarter of its staff, three infectious disease outbreaks running at once, and a public with rapidly waning trust in federal guidance.
I don't know Director Schwartz personally, but I know this job and what medicine taught me about doing it. Here's some advice, from someone who's been there.
She arrives with some real assets. She inherits a workforce that, despite the losses, still contains some of the best epidemiologists, laboratorians, and disease detectives in the world. That expertise doesn't rebuild itself quickly, but it also hasn't disappeared. It's waiting to be led. Chris Klomp, deputy administrator of the Centers for Medicare & Medicaid Services and the nominee for HHS deputy secretary, has brought real operating discipline back to the department and has recruited real talent, including Jennifer Shuford, MD, MPH, former commissioner of the Texas Department of State Health Services, who will serve as Director Schwartz's deputy. Director Schwartz also earned a Democratic vote in committee from Sen. Tim Kaine (Va.), proof that it's possible for her to find support across the aisle.
