14 December 2015

Meet America's Anti-Anti-Science Crusader

Courtesy of the National Foundation for Infectious Diseases

The CDC's Anne Schuchat receives her annual flu vaccine

America's war on science is widespread and well documented: from climate-change deniers, to moon-landing doubters, to those who claim there is a link between vaccination and autism.

It's Anne Schuchat's job to take on this last group of misinformationists—and help the public understand the science of disease.

As deputy director at the Center for Disease Control and Prevention, Schuchat has battled the anti-vaccer position on Capitol Hill. When asked at a February 2015 Senate hearing if there exists scientific evidence between vaccines and what the deniers call clear links to mental illness, she flatly said, "No."

When the health committee cited a scholarly paper purporting to prove the link, and being widely circulated online, she called the research "fraudulent" and "totally discredited."

Schuchat sees the science doubters for what they are: a roadblock to public health. It's a field she knows well. She's worked in it for 27 years, tamping down the 2001 anthrax attacks; traveling to the front line of the SARS outbreak in 2009; sounding the alarm about influenza, which can kill as many as 50,000 people in the U.S. each year; and even agreeing to consult on a Hollywood film about her little-known work as a global virus hunter.

While advances in technology can't predict every outbreak, they, along with proper vaccines and surveillance, she says, can do a lot to help stop the next crisis before it spreads.

But the public needs to pay attention to science, not conspiracies.

Here, a few words of reason—and insight—from America's top disease detective.

How do you battle people who don't support vaccination or the science behind it?

It’s important to acknowledge that over the past two decades the public has been encouraged to become informed health consumers, and we think that that’s a good thing and encourage health care and public health professionals to embrace this information-seeking behavior by parents.

Sometimes, though, parents have access to a great deal of conflicting and often inaccurate information about vaccines. CDC encourages parents with vaccine questions or concerns to talk to their child’s doctor. Parents are also encouraged to consult credible sources when seeking information about vaccines.

How do we prepare for diseases that are hard to predict?

That’s my specialty: unpredictable diseases. We like to say the only thing predictable about influenza is that we can’t predict it. It comes every year; it’s one of the leading causes of illness and death; it’s much worse in the elderly; and currently we recommend everyone six months and over get a vaccine every year. But we know influenza can also cause pandemics, and those are unpredictable. We know we will have future pandemics, we don’t know how bad they’ll be.

Wikimedia Commons

USNH, Mare Island, California

Scene on the ward during influenza epidemic, November 1918

The other thing that’s hard to predict is emerging infections. The world is still dealing with Ebola in West Africa. We’re not quite to zero yet, and it’s been a really hard year and a half.

We know the Ebola virus was just an airplane away, and that airplanes are bringing all kinds of things all over the place like measles to Disneyland. These problems are not going to be solved with just one country working on their own. They need us working as an organized, coordinated team.

Aside from vaccines, what other protections are needed?

Just go back to 2003 and look at the SARS epidemic. Dozens of countries infected. After a $40 billion loss to the world’s economy, in just one quarter, that disease was stopped. Not with a new drug, not with a new vaccine, but with classic public health interventions: active surveillance for cases; isolating people when they were ill; having good infection control in hospitals to stop the spread to healthcare workers and to their patients; and quarantining people who had been exposed and might be incubating illness.

Those interventions have been around for hundreds of years. And they were able to stop that very new, scary threat.

With Ebola, we are excited about the vaccine evaluations that are ongoing. CDC is part of them. I’m optimistic that 40 or 50 years from now we’re going to have fantastic new tools for detecting problems, for diagnosing disease, for treating, and for preventing through vaccination.

In the 2011 film Contagion, Hollywood based the lead virus hunter on you, and you consulted on the film. What was that like?

Yeah, it was fun to meet some of the movie-makers and talk to them as they were developing the plans. And yes, to get to meet Kate Winslet was exciting.

Not a bad choice to represent you in Hollywood, huh?

I would say my husband thought it was an excellent choice.

Contagion, 2011

Anne consulted on the film and a character based on her was played by Kate Winslet.

Does Hollywood accurately portray outbreaks or does it wildly over dramatize?

Contagion actually was quite realistic. Features of it might seem hard to believe, but it resonated with me. I traveled to Beijing during the SARS epidemic. I saw the streets emptied of people. Schools closed. Businesses closed. Beijing is a city known for traffic and there were no cars in the street. Society had shut down in response to the outbreak. So some of the aspects of social breakdown that the movie portrayed we have seen in severe outbreak settings.

Some things we see in public health are stranger than fiction. There was a person who was ill with SARS in Hong Kong at a hotel. And people who stayed on the same floor as him—the only thing they had in common with this gentleman was being guests at the same hotel—became ill and started outbreaks in several other countries.

We saw this totally new disease spread from country to country with these very limited interactions. So that was a nightmare scenario.

How did you get involved with disease work?

I’m a physician and I came to the CDC for the epidemic intelligence service. I loved working on outbreaks, doing research, carrying out prevention projects, and really having impact. So I ended up staying. It's now been 27 years.

How has our ability to fight diseases changed in that time?

There’s a lot of advances in diagnostic tests. The molecular biology revolution has really improved our ability to characterize pathogens more quickly. And one of the things that we’re finding with the next generation sequencing or whole genome sequencing is that patterns are really evident that couldn’t have been found before.

What are the social elements in epidemics?

Diseases take advantage of the worst situations. We know poverty and war are huge drivers of infectious disease. So unfortunately we continue to have parts of the world that are really suffering with fragile states, major disruptions, large refuge populations. I hope 40 or 50 years from now, the world will have dealt with extreme poverty, but we will continue to have infectious diseases as long as there’s that kind of social unrest and inequality.

On the other hand, as the world gets richer more people are middle class and suffer from lifestyle diseases like heart disease and diabetes. This is where people need to understand the importance of physical activity, healthy eating, managing stress, staying connected, and preventing depression and other mental health issues that are potentially worsened by isolation.

"As the world gets richer more people are middle class and suffer from lifestyle diseases like heart disease and diabetes."

We have also seen an explosion of chronic disease challenges in countries like China and India as they get wealthier. We have seen changes in countries when environmental issues are neglected and air quality gets worse. Industrial improvements or technology improvements are not always without downsides.

In general the world is getting healthier. But as we live longer, we want to make sure we’re assuring quality of life as well. It’s not really just about the years but about what we’re able to do in those years.

With advances in technology could we ever be 100 percent immune to things?

There are always going to be threats out there. Even though we have some great vaccines, there are new bugs and there are new versions of bugs that keep coming. The microbial world will always be a threat.

Listen to Schuchat's interview on Popular Science's podcast Futuropolis.



from http://www.popsci.com/meet-america%27s-anti-anti-science-crusader
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