CDC director Rochelle Walensky says she is struggling to communicate with Americans about coronavirus

Rochelle Walensky said the patients she treated as a physician generally trusted that she was working in their best interests. As director of the Centers for Disease Control and Prevention, Dr. Walensky said she has learned the same isn’t always true of many people in the U.S.

"My job is to put my head down, ignore the criticism and do the right thing for the public and to do the right thing for health," Dr. Walensky said in an interview with The Wall Street Journal. "And so that’s what I did."

When Dr. Walensky assumed her post in January, she vowed to restore trust in an agency where some officials said they felt undermined and sidelined by the Trump administration during the first year of the pandemic. She has become a fixture at White House briefings on Covid-19, and President Biden has said her agency is in charge of key public-health recommendations.

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Dr. Walensky, in her first government post, has repeatedly been the target of public criticism as her agency has taken a central role in the federal response to the pandemic. The CDC’s shifting guidance on masks and schools has confused some public officials, and many Americans, and often put Dr. Walensky on the defensive. At times, some public-health experts say, she hasn’t sufficiently accounted for the way people think and behave. Some of the experts say she has failed to draw a clear connection for the public between policy and the data guiding the CDC’s decisions.

"Their communication has to be much better," said Eric Topol, a professor of molecular medicine at the Scripps Research Institute. "Just tell it like it is. They haven’t done that."

Some Biden administration officials said they were frustrated at the way the agency communicated some of the guidance changes. The people said the White House was caught off guard by the CDC’s pronouncement in May that fully vaccinated people could stop wearing masks in most settings, and was expecting the July reversal of that recommendation to apply to fewer people and circumstances. Although the administration backed the changes, White House officials had little time to prepare for how to explain them to the public.

Some West Wing aides said they anticipated a political fallout from the CDC’s decision last month to advise vaccinated people to again wear masks indoors in public places where the virus was spreading rapidly. Mr. Biden had set a goal that July 4 would mark a moment when Americans would be on a path toward normalcy.

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After Dr. Walensky said the changed mask guidelines were informed by a July outbreak on Cape Cod, where dozens of vaccinated people became infected with the Delta variant, some public-health experts said using instances of infection among inoculated people to address the threat to the unvaccinated risked undermining trust in vaccines.

Dr. Walensky defended the CDC’s messaging. She said it has been hard to distill complex science in the midst of a pandemic in which public-health measures including masking have been politicized. She said that some of her statements have been misinterpreted, and that the CDC has changed guidance to reflect evolving data.

"I am really struggling with how to communicate to people who are worried about politics, and I just want them to continue to be at their family’s dinner table," Dr. Walensky said.

Some Republican officials have defied the CDC’s latest recommendations and questioned the science behind them. Officials in Arizona, Arkansas and Oklahoma are among those who have barred schools from requiring that students or teachers wear masks or be vaccinated, steps the CDC has recommended.

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"Did you not get the CDC’s memo?" Florida Gov. Ron DeSantis, a Republican critic of the CDC, asked a mostly maskless crowd at a conservative conference in Salt Lake City in July, days after the revised guidance was released. "I didn’t see any of you guys complying."

When the CDC eased masking guidelines for vaccinated people in May, nearly half of Americans had received at least a first vaccine dose and Covid-19 cases were declining. While Delta was fueling infection surges in countries including India, the variant was responsible for fewer than 1% of new infections in the U.S. at the time, Dr. Walensky said.

"There was an enormous pressure for vaccinated people to be able to do things that they wanted to get back to doing," she said.

The change prompted many local officials and businesses to drop mask mandates altogether, relying on unvaccinated people to decide to protect themselves with masks. Dr. Walensky said that in the absence of a vaccine-passport system, which the Biden administration had ruled out, there was no better way to allow inoculated people to resume more public activities.

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"I couldn’t actually see a pathway that didn’t lead to an honor system," she said. "It was never a permission, although it was interpreted that way, for unmasking cities, unmasking jurisdictions."

The White House has stood by Dr. Walensky and the CDC. Anthony Fauci, Mr. Biden’s chief medical adviser, said he recommended Dr. Walensky to lead the CDC due in part to her expertise in infectious diseases.

"Yes, she does not have a lot of, or any, experience in the federal government, but I felt that she’d be a quick study and a quick learner," Dr. Fauci said. "It’s a very, very difficult role that she’s in… where you have changing science, changing information."

Andy Slavitt, who worked with Dr. Walensky while serving as Mr. Biden’s senior Covid-19 adviser until June, said it was a difficult adjustment for her to suddenly be in the limelight. He described Dr. Walensky as someone with "a real backbone" who knows she will ultimately bear the burden of major decisions, but was also effective at speaking with people on a more personal level.

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"She went from someone who was not a household name to someone where people hang on her every word," Mr. Slavitt said. "If cases are going down, people will think she’s brilliant. And when cases are going up, people will blame her."

Before joining the CDC, Dr. Walensky, 52 years old, was a researcher known for her analyses of the benefits of early treatment and generic-based drug regimens for HIV patients. She was chief of infectious diseases at Massachusetts General Hospital in Boston, which put her on the front lines of the first waves of the Covid-19 pandemic.

Stephen Calderwood, a physician at Mass General who held the chief of infectious diseases role before Dr. Walensky took over in 2017, said she was a strong communicator who maintained morale through the toughest months of the pandemic. He and other former colleagues said she cared deeply about her peers, remembering birthdays and leaving handwritten notes of encouragement for healthcare workers shellshocked from treating Covid-19 patients.

"She can really bring together people who are of disparate opinions," Dr. Calderwood said.

As director of the CDC, Dr. Walensky said she is still trying to figure out what messaging will prompt people to make the best decisions for their health, and to get vaccinated against Covid-19.

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She said the American public can still come together to determine the future course of the pandemic, but noted that kind of coordination isn’t a given.

"It’s not yet clear to me that we are going to unify together to claim that control," Dr. Walensky said.