At the beginning of the pandemic, the CDC was slow to respond due to its usual pace of operation. This led to delays in testing and surveillance as the agency struggled with outdated methods and infrastructure. The agency also hesitated to recommend masking because it took too long for federal scientists to acknowledge that the virus could spread through the air. Now, the highly contagious omicron variant is forcing the CDC to make rapid decisions based on limited evidence, causing public concern about the impact of these guidelines on the economy and education. Dr Rochelle Walensky, the director of the agency, has at times bypassed much of the usual scientific review process, most recently by reducing the isolation period for infected Americans. Following the Trump administration's history of interference, President Joe Biden took office with a promise to restore the CDC's reputation for independence and rigorous science. Walensky's current challenge is how to communicate to the public that the science is not yet complete, but this is the best advice available. This shift has been difficult for a bureaucracy mostly made up of medical professionals. In recent interviews, some CDC officials privately expressed feeling demoralized by the decisions and concerned about Walensky's increasing reliance on a small group of advisers and what they perceived as heavy political influence from the White House. Others outside of the agency praised Walensky for her efficient handling of a national emergency, even when faced with unclear data and uncertainty among agency researchers. Dr. Richard Besser, who led the agency during the H1N1 outbreak, acknowledged that policy decisions during a pandemic are not solely the CDC's responsibility. However, he emphasized the need for more clarity when policy and economics influence agency recommendations. The New York Times reports that over 800,000 Americans are infected daily, leading to challenges for schools, businesses, and hospitals across the country. At the end of December, Walensky announced that infected Americans would only need to isolate for five days instead of 10 if they no longer had symptoms, and a negative test result would not be necessary to end isolation. Critics were concerned about the potential spread of the virus as contagious individuals were allowed to return to work and school. Despite limited research supporting the shortened isolation period for omicron infections, the recommendation was seen as beneficial in keeping hospitals, businesses, and schools operational during the omicron surge. Dr. Thomas Frieden, who previously led the agency under President Barack Obama, stated that the recommendations for isolation were essentially accurate. Walensky and the CDC have not commented on recent tensions within the agency's decision-making process, with Walensky often attributing recommendations to rapidly changing science. During a Senate testimony, Walensky defended the agency's new guidelines for shorter isolation periods as a response to potential staffing shortages. This approach has been a recurring theme for Walensky, as seen in the CDC's previous recommendation for students to sit 3 feet apart in classrooms instead of 6 feet, even without substantial research supporting the change. Nonetheless, this adjustment did facilitate the reopening of schools. In May, Walensky used scientific data to inform vaccinated individuals that they could remove their masks and socialize without restrictions, despite criticism from experts who believed this decision did not consider the risk of breakthrough infections, particularly with the delta variant. In August, Walensky supported booster shots for all Americans alongside Biden, before the FDA or her own agency had reviewed the data on their necessity. The recent instance of providing isolation advice caused turmoil within the agency due to the way it was decided and communicated. Following Christmas, Walensky convened an emergency meeting with the agency's COVID response leaders. She informed them that the agency would reduce the recommended isolation period and eliminate the need for a negative test result before leaving isolation. The new guidance would be announced the next day, and officials were instructed not to discuss it until then. The scientists were surprised and rushed to gather data to support the recommendations and revise the information on the agency's website related to quarantine and isolation. Normally, federal researchers thoroughly review data, draft recommendations, and make adjustments based on feedback before publishing new guidance. However, due to limited evidence for shortened isolation, primarily based on the delta variant, the accompanying "science brief" was reduced to a "rationale" document. Some researchers were upset about not being involved in the decision-making process and were angered by the agency's statement that the change was based on science. Although some thought the new five-day cutoff was arbitrary, they were aware of data suggesting that rapid tests may not detect all omicron infections, so they mostly agreed with Walensky's decision not to require a negative test before ending isolation. However, when Walensky announced the new recommendations at an emergency meeting on Dec 26, staff members were not prepared. In the following week, CDC scientists struggled to update numerous guidance documents on the agency's website. Approximately 2,000 health officials, public health lab directors, and researchers at the state and city levels participate in a weekly call with CDC officials. During the call on Dec 27, just before the CDC's statement was released, state and local officials had many questions for agency scientists about the isolation guidance for the general public. CDC staff members were quiet due to strict orders not to discuss the new recommendations. Scott Becker, CEO of the Association of Public Health Laboratories, expressed a desire for more input and advance notice. Supporters of Walensky believed the CDC's change in direction was necessary, as the agency's researchers typically work at a slower pace, while the pandemic required immediate action. Frieden noted that some individuals at the CDC were not understanding the urgency of the situation. He mentioned that during his time in office, he often encountered CDC staff who were unaware of the potential impact of their recommendations and statements. Many experts believe that Walensky has unfairly been blamed for the challenges faced during the ongoing pandemic, as leading the CDC is difficult even in normal circumstances. Taking over during a pandemic, in a politically charged environment, and at a time when the agency's credibility and staff morale were low has made her job even more challenging. Additionally, the fact that agency researchers are still working remotely is seen as a significant obstacle to overcome. Besser expressed concerns about the future of the CDC. Besser expressed his concerns about the public's trust in public health, stating that it is unfair to blame Dr. Walensky for this issue. Despite explaining her decisions at White House briefings, Walensky and other agency scientists recently held their own briefing to address criticism and clarify the CDC's decisions. This move was seen as a positive step towards rebuilding trust in the CDC and ensuring that public health considerations are separate from political considerations. "Through receiving briefings from the CDC, she will have the opportunity to highlight the expertise of CDC scientists and experts. The ongoing conflict within the CDC predates the pandemic and the leadership of Walensky. Tensions between the CDC and the National Institutes of Health, led by Dr. Anthony Fauci, have existed during previous public health crises. In a recent incident, Fauci and Surgeon General Dr. Vivek Murthy made public statements about the CDC revisiting its isolation recommendations, causing irritation among senior CDC scientists. Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, suggested that Health and Human Services Secretary Xavier Becerra should intervene to resolve the situation. Becerra recently defended Walensky in a CNN interview, highlighting her medical and public health qualifications." She lacks a marketing degree.