KeepHealthCare.ORG – Acting CDC director Anne Schuchat good match for flu season
When Dr. Anne Schuchat stepped back in as acting director of the Centers for Disease Control and Prevention this month, few stories referenced her background in-depth.
It was perhaps not needed. Schuchat is a career CDC leader, and has been acting deputy director since 2015. Her expertise was clearly visible in the last two weekly conference calls with reporters on the 2017-2018 influenza season.
Predecessor Dr. Brenda Fitzgerald would be available in those calls, with the main CDC participant Dr. Daniel B. Jernigan, director of the influenza division in the National Center for Immunization and Respiratory Diseases.
In the Feb. 9 conference call, Schuchat took all the questions and talked in detail about the severity of this year’s season, comparing it to previous seasons and spoke in understandable terms about vaccine effectiveness.
“One of the areas that we’re really seeing unusual levels of hospitalizations is in non-elderly adults,” said Schuchat to reporters about the current season that began in October.
“So far this year we’ve seen 63.1 per 100,000 people in the 50- to 64-age group being hospitalized by flu. In 2015-16, that number was 35.1. So that’s our most recent severe season and we’re quite a bit higher than that.”
Of the data for week 5, Jan. 28-Feb. 3, she added, “The proportion of deaths attributed to pneumonia and influenza is 10.1 percent this week. That means one out of 10 people who died in the week that has passed died from influenza or pneumonia.”
It may be of interest in Western Massachusetts that Schuchat is a graduate of the Audrey and Theodor Geisel School of Medicine at Dartmouth College in Hanover, N.H. Geisel, the Springfield native known around the world as “Dr. Seuss,” the beloved author and illustrator of countless children’s books, was a 1925 Dartmouth graduate.
The long established medical school was named in his and his wife’s honor, in 2012, in recognition of the family being “the most significant philanthropist to Dartmouth in its history.”
Broader interest might be found in the fact that, as the country is facing one of the worst influenza seasons in a decade, with Massachusetts reporting yesterday its first death of a child from flu this season, Schuchat has decades of experience tracking and fighting infectious diseases both here and abroad.
She was quoted in yesterday’s release from the CDC on the importance of the Trump Administration’s request of $59 million in support of the Global Health Security Agenda in Fiscal Year 2019.
Schuchat had been serving as acting CDC director for seven months until Tom Price, the now former secretary of Health and Human Services, named Dr. Brenda Fitzgerald, Georgia’s public health commissioner and two-time Republican congressional candidate, to the position in July.
According to her CDC biography, Schuchat served as chief health officer for CDC’s 2009 H1N1 pandemic influenza response. In her Feb. 9 conference call, she noted the 2003-2004 season, like the current one, was early and severe, especially on children, and that is what prompted the agency to have state health departments report deaths of children from the flu virus.
Schuchat supported the Washington D.C. field team during the 2001 bioterrorist anthrax response, and led the CDC team responding to the SARS outbreak in Beijing in 2003. (Kate Winslet’s character in “Contagion” is based on Schuchat, who joined the CDC as an Epidemic Intelligence Service officer, and her experience tracking the SARS outbreak.)
Schuchat has worked on meningitis, pneumonia, and Ebola vaccine trials in West Africa, where there is currently an outbreak of lasso fever.
Schuchat also served as the director of the National Center for Immunization and Respiratory Diseases from 2006-2015. Her other CDC leadership posts include acting director of the Center for Global Health (2012-13), chief of the respiratory diseases branch (1998-2005) and the initial medical director of the Active Bacterial Core surveillance of the Emerging Infections Program Network.
Her return as acting CDC director was prompted by the Jan. 31 resignation of Fitzgerald.
Fitzgerald stepped down after it was reported that she – or those who manage her personal assets – had invested in tobacco stocks while she was CDC director.
Schuchat had been serving as acting director after Dr. Tom Frieden resigned from the post when Donald Trump was sworn in as president Jan. 20, 2017. An Obama-era appointee, Frieden had served since 2009.
Schuchat served until Fitzgerald was appointed in July 2017.
Fitzgerald had been serving as public health commissioner of Georgia since 2011, when she was tapped to head the CDC.
An obstetrician-gynecologist, she publicly endorsed vaccination for childhood illnesses as commissioner and her state played a role in addressing the Ebola crisis four years ago.
It was to Georgia’s Emory University Hospital where four U.S. health care workers were flown and successfully treated, after becoming infected with Ebola in Africa.
She has an undergraduate degree in microbiology from Georgia State University, a medical degree from Emory University School of Medicine and was a major in the Air Force.
Fitzgerald made a priority in the fall of 2016 to visit Georgia’s counties to talk about possible Zika-virus transmission from infected mosquitoes.
Still, it was Schuchat, as CDC’s principal deputy director, who appeared, with the CDC’s director of infectious diseases, at a media telebriefing on the the virus in January 2106 to discuss with reporters what was known about the outbreak of the disease in Brazil and the threat it posed to travelers there and to the U.S.
“Zika is spread to people by the Aedes mosquito. They are common in parts of the United States, particularly southern states. It’s possible, even likely, that we will see limited Zika outbreaks in the U.S,” Schuchat said.
“The same kind of mosquito has caused limited U.S. outbreaks of Dengue and chikungunya virus, but no widespread outbreaks or epidemics in the continental U.S. as a result. Other factors work in our favor here. Our urban areas are not as densely populated as areas in central and South America, and we have widespread use of air-conditioning and stronger mosquito control. Our experience with Dengue and chikungunya and the different living conditions lead us to believe that any outbreaks of Zika in the continental U.S. will likely be limited. Of course this virus is fairly new to the Americas and we will remain vigilant.”
When Schuchat was appointed acting director of the CDC, retired CDC director Dr. Jeffrey Koplan, who now is Emory’s vice-president for global health, praised Schuchat as a “highly skilled, talented health professional.” He told the Huffington Post a “real health professional” is what is needed in a CDC director as a “more lethal flu bug” or similar threat is always a reality “sooner or later in the course of the four-year period.”
Koplan’s words seem prophetic.
The death of the Massachusetts child reported this week in the Northeast region of the state, which has seen a spike in visits to outpatient centers for influenza like illnesses this month, brings to 64 the number of children who have died this season from the disease nationwide. Many of those confirmed deaths are in the three national regions that report to the CDC out of Atlanta, Chicago and San Francisco. There are two pediatric deaths so far in the New England region, according to the latest CDC statistics.
Influenza-like illness activity continues widespread across much of the country, with high rates of hospitalizations for confirmed cases, high rates of visits, in terms of percentage of visits to outpatient centers and emergency rooms, and high numbers of cases linked to the Type A viruses, particularly H3N2, against which this season’s vaccine offers the least protection.
During the Feb. 9 teleconference, Schuchat told reporters that “overall hospitalizations are now significantly higher than what we’ve seen for this time of year since our current tracking system began almost a decade ago in 2010 and the rate is approaching the final rate of hospitalizations that we observed at the end of the active 2014-2015 flu season. That was our recent severe season.”
“We have very high influenza-like illness activity. We have very high hospitalizations. Our pneumonia and influenza deaths are not yet very, very high compared to previous years, but unfortunately, more deaths are likely to happen,” Schuchat said.
She called this season a “wake-up call.”
“I think we have a lot to learn still about influenza including about this particular season,” Schuchat told reporters.
“It’s a wake-up call about how severe influenza can be and why we can never let down our guards against this virus – the virus is always changing.”
CDC estimates that influenza has resulted between 9.2 million and 60.8 million illnesses, between 140,000 and 710,000 hospitalizations and between 12,000 and 56,000 deaths annually since 2010.
According to CDC data for week 5, the proportion of outpatient visits for influenza-like illness was 7.7 percent, with all 10 regions at or above their region-specific baselines. The national baseline is 2.2 percent.
A cumulative rate of 59.9 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
There are 12 more weeks estimated to be left in the current season for which the CDC will give another weekly update on Friday.