In the aftermath of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) has evaluated its response to pandemic preparedness. The agency has reorganized and developed new programs and issued new grants to allow it to better monitor, identify and respond to emerging diseases.

The CDC is leveraging and expanding its systems and embracing new technologies for a comprehensive approach, Henry Walke, M.D., M.P.H., director, Office of Readiness and Response at CDC, said during a session at the IDWeek meeting this week in Boston.

“We’ve reflected on the shortcomings of our response to COVID,” Walke said. “The CDC Moving Forward Initiative was started to focus on key areas, which includes translating our science faster, and in a way that’s more understandable by the public, promoting more partnerships, integrating health equity, and strengthening foundational capabilities in data laboratory science and our workforce.”

In April 2022, the CDC began a review of the agency’s response to emerging diseases. That led to the CDC Moving Forward Initiative and CDC’s strategic plan to modernize the agency to be better prepared to protect health and safety. There are more than 160 individual efforts taking place at the agency, with 80% targeted to be finished by January 2024.

“It’s our priority to change in governance, to support new ways of thinking within public health and working, as well as data modernization that improves the timeliness and quality of the modeling and advanced analytics to enable timely and effective decision making,” Walke said.

One component of the Moving Forward Initiative involves helping states develop their public health infrastructure. In 2022, CDC issued more than $10 billion in grants to states for emergency health preparedness, epidemiology and laboratory capacity, and workforce and data systems. Last year, the CDC began a new program to develop a network of state health departments, universities and private sector partners, called the Outbreak Analytics and Disease Modeling Network. The CDC granted 13 awards totaling $262.5 million over five years to develop and implement new tools to detect, respond to, and mitigate public health emergencies.

Another area of focus is surveillance for early detection and early warning. One such surveillance program, Walke said, involves monitoring wastewater for emerging diseases. The agency currently has monitoring programs for COVID-19, influenza A and respiratory syncytial virus (RSV). Unlike other types of disease surveillance, wastewater surveillance does not depend on the vagaries of people having access to healthcare, people seeking healthcare when they are sick, or availability of COVID-19 testing, he said.

“Wastewater can be an early indicator for the number of people with COVID increasing or decreasing,” he said. “In a program monitoring influenza A and RSV in three major Wisconsin cities, higher concentrations of influenza A and RSV in wastewater were associated with higher numbers of emergency department visits.”

The CDC is also piloting a metagenomic sequencing and laboratory testing effort to analyze samples from people, animals and the environment. The Advanced Molecular Detection program is working with universities across the United States to form five centers of xxcellence. This effort aims to identify emerging pathogens, improve vaccines, make foods safer and develop faster tests.

The CDC is also expanding its capacity and partnerships, including with the FDA and private laboratories, for testing during public health emergencies. This national laboratory system aims to coordinate the program for testing at hospitals, drive through collection and testing, laboratories, and state and public health authorities.

Tying this all together, however, requires better data management and analytics. To that end, the tCDC has several programs, including modernizing technology, consolidating data and creating tools for analysis, forecasting and tracking outbreaks.

“Last fall, we published the first iteration of the DMI (Data Modernization Initiative) Strategic Information implementation plan, which is a guiding vision on how to implement key priorities,” Walke said. “The goal was to create scalable flexible systems that will work for any disease or condition.”

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