Updated at 8 p.m. with details of CDC Director Rochelle Walensky's visit to CareSTL Health
The coronavirus is in the U.S. to stay, and it will continue to affect the country's most vulnerable people the most, Centers for Disease Control and Prevention Director Rochelle Walensky said Thursday.
In a talk with Washington University medical students, Walensky advocated for more support for local public health programs at the forefront of the nation’s pandemic relief efforts, particularly for poor people without health insurance who are most at risk of getting sick.
“I think ultimately we’ll have good-level population immunity for variants that come our way, and even if surges come, the amplitude of those surges will be less," Walensky said. "We’ll have a coronavirus that will lead to death in every season, that we will tolerate in some way.”
Walensky came to St. Louis as a visiting professor in a Washington University program that brings notable infectious disease experts to lecture university students. She’s also planning to visit CareSTL Health, a federally supported health center in north St. Louis.
The coronavirus pandemic is similar to the early days of the AIDS epidemic in the U.S., said Walensky, an HIV specialist and Wash U graduate.
“We in infectious disease have long known that where infectious diseases go are not in places of wealth and places of poverty and places in lack of access,” she said. “We’re going to see it again with long COVID, where those who had been more afflicted with the disease had less access to care and more comorbidities are going to bear the burden of that disease.”
The CDC director’s visit came a week after the federal agency announced people in parts of the country with low numbers of coronavirus cases and hospitalizations could safely go without masks in public indoor spaces. That includes most of the country, including the St. Louis region.
The announcement is a notable milestone in the country’s recovery after more than two years of the coronavirus pandemic, Walensky said.
It’s also a moment to reflect on what the agency’s blind spots were as the pandemic unfolded. The agency showed “too little caution and too much optimism” when officials learned of the newly developed COVID-19 vaccine’s high effectiveness rates against serious illness, she said.
“So many of us wanted to say, ‘This will take it out, we’re done,’” she said. “Nobody said ‘waning’ or that 'It will work, but maybe it will wear off.’”
Public health officials should better educate the public about how understanding of science can change over time, Walensky said. Knowledge of, for example, the effectiveness of masks is always evolving.
“I think there will be things we’ve learned here,” she said. “If we had more health equity in this country I think we would all be healthier and we would be able to tackle [the next pandemic] better.”
In the afternoon, Walensky toured the CareSTL Health clinic in the Wells-Goodfellow neighborhood in north St. Louis.
Dr. Mati Hlatshwayo Davis, St. Louis' health director, invited Walensky to tour the federally supported health center, which offers health care to uninsured and poor residents.
Such safety net clinics have been the backbone of the nation’s pandemic response, Walensky said. However, federal investment in such clinics is low, and more funding is needed to train, hire and retain public health employees.
“What we've really learned through the frail public health system that we had coming into this pandemic is the need for long-term sustainable funding for public health,” she said.
Having the ability to voice concerns to a top federal official was a welcome opportunity, CareSTL President and CEO Angela Clabon said.
“We’re losing providers and nurses to places like Amazon and Walmart and McDonald's,” Clabon said. “And we just cannot afford to compete with those large organizations for minimum-wage jobs.”
Hlatshwayo Davis told Walensky it was difficult for local leaders to implement federal policies made for the entire nation.
For example, Hlatshwayo Davis said many people who are vulnerable to severe COVID-19 infections are dismayed by the new federal guidance on masks. Missouri has a lower vaccination rate than New York, California or Washington, D.C.
“She understood the complexity; she owned that,” Hlatshwayo Davis said. “I said we would love to work more closely at the small, local level with some of the federal people — to say, ‘OK, the guidelines have come out and they support science, we get that. How do you help the folks that are struggling the most to implement that?’”
Follow Sarah on Twitter: @petit_smudge
