Progress on the pandemic might appear to be embodied in the face of one elderly gentleman you see on TV all the time. But in fact many people were on to a then-nascent virus in late 2019. Among them is one of the nation’s leading infectious disease experts, a veteran of H1N1, West Nile, Ebola and Zika. Now she’s a finalist in this year’s Service to America Medals Program. Principal Deputy Director of the Centers for Disease Control and Prevention, Dr. Anne Schuchat, joined Federal Drive with Tom Temin.
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Tom Temin: Dr. Schuchat, good to have you on.
Dr. Anne Schuchat: Thanks so much, happy to be here.
Tom Temin: And your citation for your career award says that you are the Dr. Fauci of CDC. But maybe Dr. Fauci is the Dr. Schuchat of NIH.
Dr. Anne Schuchat: I wouldn’t say that, he’s a real giant. But I’ve been really privileged to work at the CDC for 33 years now and to be part of some really amazing experiences here.
Tom Temin: And in your work, discovering and learning and how to deal with all of these different infectious diseases that have struck the United States to a small degree or a larger degree – do you sense that our learning about these types of viruses is expanding and we’re getting better at it, do you think,
Dr. Anne Schuchat: I’ll come at this with humility. The microbial world is very devious. And what we’ve learned from one outbreak or public health emergency is critical. But it may not be completely relevant to the next one. Having an open mind and continually learning during a response is really important.
Tom Temin: Yes. And I guess I would ask if you could convey one thing to the public that seems to never quite understand exactly what’s going on, or have multiple understandings of what’s really going on? What’s the one thing you feel the public needs to know about infectious viruses and other microbes?
Dr. Anne Schuchat: These are a persistent threat. We’re all looking forward to being finished with this pandemic. But there will be more emerging infectious diseases, and we have to be ready. We really need to expect them, prepare for them, and respond effectively.
Tom Temin: Yeah, so be prepared this could happen again pretty easily, basically.
Dr. Anne Schuchat: Absolutely.
Tom Temin: And describe the work that you actually do in these things. What does an infectious disease expert – and now your principal deputy director – what do you do all day in this work, and how does it differ from what they do at the NIH?
Dr. Anne Schuchat: CDC is working 24 seven to protect Americans from threats, whether they’re infectious or non, whether they emerge here at home or come from abroad, whether they’re manmade or are natural. And what we do is combine a set of different scientific disciplines to prevent, detect and respond. Those disciplines include epidemiology, which is what I am, an internist and an epidemiologist. But they also include laboratory research and surveillance, monitoring, the early detection and trends looking at factors that lead to increased risk setting interventions like vaccines, or quarantine, or social distancing. And then a lot of communication, trying to get the interventions and the messages that help people know how to protect themselves out to the public and out to clinicians. So what I personally do has changed so much over the past three decades, from frontline in the field, research and studies, to more leadership and administrative roles. But I’m part of this big family at CDC that pulls together different strains of science to get the best information to the public to keep them healthy and safe.
Tom Temin: I was gonna ask in the job that you have now, do you ever get to wander down the hall and look into a microscope and take a look for yourself at some horrible microbe.?
Dr. Anne Schuchat: We have an amazing pathology unit here that if in fact the folks that recognize many new infections, many new pathogens have been identified by them from some of the samples that we’ll receive. And so looking in their microscopes is a fun experience, looking at the lens of what is being found, but that’s not what I usually do.
Tom Temin: We’re speaking with Dr. Anne Schuchat, she’s Principal Deputy Director of the Centers for Disease Control and Prevention, and a finalist in this year of Service to America Medals Program. And several people in your citation site your calmness and your demeanor that is soothing in these kinds of situations. It sounds like lack of panic is something that is really needed in someone looking at infectious diseases and possible epidemiological disasters.
Dr. Anne Schuchat: We try to lead with science and put the data first try to understand what’s going on and make sense of it. And so I think that I’m trying to bring some organization into what can be chaos in terms of an emerging threat or a confusing situation. But being part of the team and helping support them is really central to my identity and what I try to bring to the agency.
Tom Temin: And how did you come to this work? You said, you are an internist, so you could have been putting stethoscopes on chests for your career, but instead, you went this way.
Dr. Anne Schuchat: Yeah, I love the clinical work. That was part of my medicine training. But I came to the CDC really just for two years to be a disease detective, what we call an Epidemic Intelligence Service Officer. I was expecting to spend two years here in training and then go back into clinical practice. But I loved the agency when I arrived. I loved the work, the intellectual work, but really the impact that we could have being able to work on prevention studies that lead to a national standard of care that is keeping babies from getting a serious infection called Group B Strep. Working on vaccine introductions like pneumococcal conjugate vaccines and non-pneumococcal conjugate vaccines, working around the world on prevention and research. I just found it a career here has been more meaningful than I could ever have imagined.
Tom Temin: And do you also deal with bacteria as well as viruses?
Dr. Anne Schuchat: Yes, absolutely. The first 15 years of my time at CDC was in respiratory bacterial infections. Of course, when a new pathogen emerges, we don’t always know what it is. So when the SARS Coronavirus, the first one in 2003 was causing outbreaks in China and Vietnam and Toronto, that came in as an unknown respiratory infection. We didn’t know if it was viral or bacterial. I was able to go to Beijing to be part of the response there as a respiratory epidemiologist, agnostic to pathogen. But of course, that turned out to be a virus. Many of the vaccines I’ve worked on have been bacterial vaccines.
Tom Temin: Sure. And over the years, as you mentioned, these different emerging infectious potentials, do each have different qualities, different transmission methods, and so you can’t really necessarily apply what you learn here to the latest one. My question is, have the indicators and the sensors out there in the world, have they improved such that when something could be a potential emergent that could spread from continent to continent – do we know earlier than we did say a generation ago?
Dr. Anne Schuchat: Absolutely. The communication environment and the laboratory detection methods are completely different than a few decades ago. When I was an intern in New York City in 1984, that was the year that the HIV virus was actually identified. But the disease had been spreading for many years, and the syndrome had been recognized for a few years. With the SARS Coronavirus-2, we’ve basically from the clinical syndrome being recognized to the genetic sequence being posted was a matter of a couple of weeks, not several years. So we really have much greater ability to detect, which hopefully can lead to more rapid response and prevention. But we don’t always pick up on the signals. And we don’t always have open communication between countries or between researchers. And so we have work to do to really make sure that our data systems and our transparency are faster than the virus.
Tom Temin: And do people still study the polio phenomenon because that was about 50 years between the ID of the virus and the development of a successful vaccine, which people forget wasn’t all that smooth rollout either.
Dr. Anne Schuchat: Yeah, and polio is still with us in Afghanistan and Pakistan, the wild polio virus, and there’s vaccine derived polio virus in a number of countries. But we are still deeply involved in the global eradication of polio. The CDC is a critical partner with the World Health Organization, UNICEF, Rotary International, and the Bill and Melinda Gates Foundation, trying to really get the last polio case to be identified, and to get everyone protected so that polio will no longer circulate around the world. We’ve made a lot of progress, but we have had some setbacks during the pandemic, like with many other initiatives, and we really aren’t done. Here in the US of course, we haven’t had a case of polio for quite a while. And that’s due to the really strong immunization system that we have here.
Tom Temin: Sure. And just to get back to where we started, do you and Dr. Fauci chat from time to time now?
Dr. Anne Schuchat: He’s just wonderful. I have so much respect and admiration for him and have always enjoyed interacting with him. Whether it’s a media event or a congressional hearing, he’s someone that it’s wonderful to have by your side.
Tom Temin: What I meant was, do you ever call him or he called you and you say, hey Anne what do you think of this – or hey Tony, what do you think of that?
Dr. Anne Schuchat: For sure, yeah.
Tom Temin: Dr. Anne Schuchat it is Principal Deputy Director of the Centers for Disease Control and Prevention, and she’s a finalist in this year’s Service to America Medals Program. Thanks so much for joining me.
Dr. Anne Schuchat: Thank you.