The CDC's No. 2 Official Says The U.S. Isn't Ready For Another Pandemic

The United States was unprepared for the coronavirus, the response "wasn't a good performance," and there's still "a lot of work to do" to get ready for the next pandemic when it comes. That's the assessment of Dr. Anne Schuchat, the No. 2 official at the Centers for Disease Control and Prevention, who is retiring this summer after 33 years at the agency.

"This was a really complex, systemwide assault," she says in an interview on Morning Edition. "But another threat tomorrow, we're not where we need to be. We're still battling this one. And we have a lot of work to do to get better prepared for the next one. But I think there's political will that might have been missing before."

When she's asked about the political pressure she faced under former President Donald Trump, Schuchat declines to get into details.

"I would say that my work was mainly focused on directing our response to support state, local, public health, clinical partners, community groups," she says. "The political side of things, I was not — after a certain point, I wasn't doing."

Schuchat also says she supports further investigations into the origins of the pandemic. "There's a lot we really do need to know here," she says.
"So understanding where this came from and how it spread so easily, I think is important."

How Schuchat became a disease detective

Schuchat does not quite have the public profile of Dr. Anthony Fauci, but her work as a disease detective tracing outbreaks is a part of American popular culture. Kate Winslet's character in the movie Contagion was modeled in part on Schuchat. Schuchat's career as a doctor began in the 1980s in New York City, which was a challenging time and place.

"One out of five of my patients had AIDS and they were really sick," she says. "Many of them didn't make it. You know, people came in with shortness of breath and were intubated very soon after and got a diagnosis that they didn't know they had, which at the time was essentially a death sentence."

She emerged from that time as an internist looking for something new.

As she finished her residency, she remembered hearing about the Epidemic Intelligence Service, the CDC's disease detective program.

She thought: "Maybe that would be a fun thing to do. Maybe just spending two years learning how to investigate outbreaks would be interesting and a little less intense than what I had just been through before I spend my life in practice."

But instead of returning to a medical practice, she stayed with the CDC. "I just fell in love with what we do, how we do it, the people that we work with and the impact that we can have," Schuchat says.

Below are highlights of the interview edited for length and clarity.

Interview Highlights

Looking back, did the nature of COVID-19 make it inevitable that it would be as deadly as it has proven to be?

This virus is really difficult. I think that a severe toll was going to happen, but we have seen such variation in countries and in communities' ability to counter it. And so I wish that we had not had as much loss of life and ongoing loss of life as we've had around the world. But this virus was going to be difficult under the best circumstances of response. And of course, we've had very variable response to this.

I'd like to ask about something that was commonly commented on at the height of the pandemic. People would look at a country like South Korea, where testing and tracing seemed much more effective and people were much more aggressive and successful in containing the disease. Was that ever possible in the United States?

We were not ready for that, OK. There are many things that our colleagues in Korea did that allowed them to have a very effective initial response. Our public-private smorgasbord of clinical laboratories and testing, our regulatory environment for how new lab tests can be rolled out, the public health capacity [being] very weak in terms of ability to get the contact tracing done. You know, obviously, we had problems with our test, and the academics and others who had tests couldn't use them until FDA changed their enforcement discretion.

There were just many things that delayed us. That said, there was lots of great work in many communities. But I think as a nation, it wasn't a good performance.

If it were to happen again next year, five years from now, which is plausible, would we be ready then?

We have a lot of work to do. So I think I am really encouraged by the investments and the seriousness that we're seeing in the administration, in the agencies, in the communities. You know, this has been really bad and I just hope people continue to feel that commitment to do better.

Just the public health piece: We have a lot of work to do in terms of the workforce, the data, the laboratory, the community outreach. Our health care system was overwhelmed in many places. The supply chain is very interdependent internationally. This was a really complex, systemwide assault.

But another threat tomorrow, we're not where we need to be. We're still battling this one. And we have a lot of work to do to get better prepared for the next one. But I think there's political will that might have been missing before.

As a disease detective, with the experience that you have, what have you thought about as people have raised more questions about the origins of the virus?

I want all the questions to be answered. There's so much we need to learn about this virus and this pandemic so that we do better next time and prevent where we can. ... Sometimes scientists have questions because they're kind of curious, and more is better. But I think there's a lot we really do need to know here. So understanding where this came from and how it spread so easily I think is important.

As you step away, how seriously do you take the possibility that this virus may have in some form originated in a lab in China?

We need to do the investigations. I think they're important.

You don't rule it out.

I don't think we have all the answers that we need, and so I support the idea of additional investigations and, you know, getting to the bottom of that.

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