Expecting the Unexpected - An Interview with CDC's Anne Schuchat

October 25, 2018|12:27 p.m.| ASTHO Staff

Rear Admiral Anne Schuchat, MDRear Admiral Anne Schuchat, MD, is CDC’s principal deputy director. Schuchat has worked at CDC since 1988 in the areas of immunization, respiratory, and infectious disease. During her career, she has also worked on the frontlines of disease emergency responses, including the SARS outbreak in China, the prevention of infectious streptococcal disease in children, the 2009 H1N1 response, and most recently last year’s flu season, the worst in nearly a decade. At ASTHO’s annual meeting in September, Schuchat received the Ed Thompson Lifetime Achievement Medal. Following the ceremony, ASTHO reached out to Schuchat, who reflected on her career in public health, her advocacy work around vaccination, and future public health priorities.

Throughout your career, you have played key roles in various public health emergencies, including the 2009 swine flu epidemic, the 2003 outbreak of severe acute respiratory syndrome (SARS), and the 2001 anthrax attacks in the United States. In fact, CDC Foundation notes that actress Kate Winslet’s role in the 2011 movie “Contagion” is based on your role as a disease detective at the agency. What lessons have you learned from your experiences working in public health preparedness?

The complexity of the issues we deal with is daunting, but the tools and abilities that we have to connect across geographic areas and across disciplines—whether through technology or other means—is pretty impressive. In addition, having good data is essential. It’s not always that easy, but better information makes for a better response. Early detection can often lead to a simpler and more effective response. Whenever possible, prevention is a lot better than even the best response. In my 30 years at CDC, I’ve seen a lot of changes in public health. One lesson that always stands out for me is: nature is always evolving, people are always evolving, and our understanding of science is always evolving. Take Zika, for example. We’ve seen mosquito-borne infections spread across the continents over the years, but what’s new about Zika is the fact that it’s a mosquito-borne infection that can cause a serious and devastating birth defect. And it can be spread sexually. We’ve continued to learn more about Zika throughout our response to the outbreak—and that is emblematic of the challenges we face in public health. We’re more interconnected than ever, and that can increase the pace of change. It also means a threat anywhere is a threat everywhere.

You are well-known as an advocate for vaccination, denying links between vaccines and mental or physical illness. How can public health leaders raise awareness around this important issue in the communities they serve?

Public health leaders must continue to educate parents, patients, and healthcare providers on the importance and effectiveness of vaccines. Data shows that the current U.S. vaccine supply is the safest in history and routine vaccination protects people against 17 vaccine-preventable diseases throughout their lifetime. We know national levels of childhood immunization are good, but there are pockets around the country where there is less protection, including in some schools and communities where vaccination rates are low. The risk of getting an infectious disease that is vaccine-preventable is not just based on whether you’ve been protected, but whether those around you have been protected. Simultaneously, your vaccination protects the whole community, including those who can’t be vaccinated. Vaccination is one of our strongest tools and a key component of public health. We risk outbreaks and the resurgence of many vaccine-preventable diseases if we don’t strengthen vaccination programs. The vaccination of children born between 1994 and 2016 will prevent an estimated 381 million illnesses and 855,000 deaths. We can all play a role in educating the public on the safety—and importance—of vaccinations.

From 2006-2015, you served as director of CDC’s National Center for Immunization and Respiratory Diseases, which includes its influenza division. You also presided over CDC during last year’s flu season, the worst in nearly a decade. What advice do you have for public health leaders looking to ensure public health preparedness for future events?

As scientists and leaders, it is important we learn from our experience. Don’t let your fear of making a mistake stop you from taking on difficult challenges. Assemble teams with diverse expertise and points of view. Get to know your counterparts across sectors and jurisdictions—it’s better to have met each other before the first emergency you face together. Public health needs to be ready for pretty much anything. We have to anticipate and respond to the unexpected. Planning, exercises, drills, and protocols are all important, but when the events don’t follow the playbook, flexibility is key.

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