Summary of guidance review
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Summary of guidance review

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    • Description:
      DATE: March 10, 2021

      TO: Rochelle P. Walensky, MD, MPH Director, CDC, and Administrator, ATSDR

      FROM: Anne Schuchat, MD (RADM, USPHS, Ret.) Principal Deputy Director, CDC

      SUBJECT: Summary of Guidance Review

      As part of your pledge to lead an effort to restore the public’s trust in the CDC, you asked me to begin a comprehensive review to ensure that all of CDC’s existing guidance related to COVID-19 is evidence- based and free of politics.

      In response to the dynamic circumstances of emerging infections and public health emergency responses, CDC has customarily issued “interim” guidance documents that are updated as new information and insights are gained, once novel interventions become available including through emergency use authorization, or once research reveals greater certainty that permits strengthening or rejecting earlier interim recommendations. CDC staff have developed thousands of documents during the COVID-19 response, including foundational guidance documents that address major areas of concern as well as numerous subsidiary tools and resources adapted from the foundational guidance.

      At your request, I led a process to rapidly assess the major or foundational guidance the agency had issued in order to identify primary documents that needed updating or removal. I also sought to identify practices that could strengthen the transparency of the evidentiary basis for CDC’s COVID-19 guidance. In addition to my own review, I sought review of the process and results from current and former Incident Managers and Principal Deputy Incident Managers of CDC’s Emergency Response, as well as key Center Directors. The review also included a general assessment of the approach to cross-clearance within the Incident Management Structure’s task forces (Appendix 1) as well as how the CDC website alerts readers to changes in guidance and relationships between the evidence-base and various guidance documents.

    • Content Notes:
      BACKGROUND -- PROCESS -- Next Steps and Recommendations -- Table 1. COVID-19 Guidance Documents Removed from CDC Website -- Table 2. COVID-19 Prioritized Major New or Updated Guidance based on Incident Manager System Leadership Review, October 2020 through January 2021 -- Table 3. COVID-19 Major Guidance Documents Released or Updated since January 20, 2021 as of March 8, 2021 -- Table 4. COVID-19 Science Briefs Containing Evidence-Base in Support of Updated Guidance -- Appendix 1: Task Forces within CDC’s COVID-19 Incident Management Structure, March 2021.
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