ATLANTA \u2014 Earlier this year, top leadership at the Centers for Disease Control and Prevention began a monumental task: turning the sprawling, labyrinthine organization known for its highly specialized, academically focused scientific research into a sleek, flexible public health response agency primed to serve the American public. It\u2019s an attempt to keep the CDC from repeating the mistakes it made while responding to covid-19.<\/p>\n

But agency veterans, outside public health officials, and workplace organization experts said the current workplace structure could be a major barrier to that goal. Like directors before her, agency head Dr. Rochelle Walensky spends a considerable amount of time away from the CDC\u2019s headquarters in Atlanta. The agency has also embraced a workplace flexibility program that has allowed most of its scientists to stay remote.<\/p>\n

As of October, 10,020 of the CDC\u2019s 12,892 full-time employees \u2014 78% of the full-time workforce \u2014 were allowed to work remotely all or part of the time, according to data that KHN obtained via a Freedom of Information Act request<\/a>.<\/p>\n

Experts said the lack of face-to-face work will likely be a substantial obstacle to the top leadership\u2019s effort to overhaul the agency after its failures during the pandemic \u2014 a botched testing rollout, confusing safety guidance, the slow release of scientific research, and a loss of public trust.<\/p>\n

They also wondered whether Walensky, who frequently works remotely while traveling, can bring about that change from afar and whether a virtual workforce might experience more challenges battling infectious diseases than one working together in person.<\/p>\n

\u201cOne of the things that a really strong new leader would do is they\u2019d be visible, they\u2019d be walking the halls, they\u2019d have the open door,\u201d said Pamela Hinds<\/a>, a professor of management science and engineering at Stanford University. \u201cThat\u2019s much harder to accomplish when nobody\u2019s there.\u201d<\/p>\n

Key to the effort to reform the CDC<\/a> is changing its institutional culture, which the agency says is at the core of all its work \u2014 from how it interacts with other agencies to how it shares its research. Walensky has said<\/a> the CDC needs to be faster and nimbler in the face of emergencies and more communicative, both internally and with the public.<\/p>\n

A flexible, responsive, and collaborative culture thrived not too long ago \u2014 during the Obama administration, when the agency handled crises such as the H1N1 flu pandemic<\/a> and the Zika virus outbreak<\/a>, said Dr. Stephen Cochi<\/a>, who worked at the CDC for four decades before retiring this year. \u201cI would like to see every effort made to try to restore that culture to the extent possible, because CDC will potentially lose some of its excellence if it can\u2019t,\u201d he said.<\/p>\n

Changes, such as the transition to a largely remote workforce and a ballooning bureaucracy, he said, made it \u201calmost impossible to get anything done\u201d in his later years at the agency.<\/p>\n

Chris Collins<\/a>, a professor at Cornell University\u2019s School of Industrial and Labor Relations, said that institutional culture includes \u201cthe unwritten rules of how work gets done\u201d and that those are hard to learn in a remote work environment.<\/p>\n

A largely remote workplace, Collins said, can lead to weaker social connections among staffers, which can ultimately result in less understanding of and investment in the institution\u2019s values. A loss of personal interaction can also suppress innovation. \u201cIf you believe great new ideas come from people bumping ideas up against each other, you want to try and create an environment where that happens as often as possible,\u201d he said.<\/p>\n

A document that outlines the CDC\u2019s policy<\/a> and that was last updated in April says remote work can help recruit and retain staffers, keep workers happy, and reduce the cost of leased office space. It followed updated guidance<\/a> from the U.S. Office of Personnel Management encouraging agencies across the federal government to consider remote work options for staff, considering their utility during the covid-19 pandemic.<\/p>\n

As of early 2020, much of the workforce of the FDA and the National Institutes of Health was working remotely. Today, the NIH is mostly back in the office, but the FDA said many of its employees continue to work remotely when possible. And while the White House COVID-19 Task Force huddled in the early days of the pandemic<\/a> and held in-person news conferences, its briefings became largely remote events.<\/p>\n

Still, Walensky has recently faced pointed skepticism about the workforce flexibility policy from lawmakers, who questioned her ability to remake the CDC with a dispersed staff.<\/p>\n

During a congressional hearing in September<\/a>, U.S. Sen. Bill Cassidy (R-La.) quoted remarks that a former acting CDC director had made to The New York Times<\/a>: \u201c\u2018I don\u2019t know how you motivate and inspire culture change when people aren\u2019t together.\u2019\u201d<\/p>\n