The United States wasn't ready for the pandemic "and we have a lot of work to do to get better prepared for the next one," says Dr. Anne Schuchat, who is retiring after 33 years at the agency.



Dr. Anne Schuchat is not yet finished cleaning out her desk. She is retiring after 33 years at the Centers for Disease Control and Prevention. She was the agency's No. 2 official as it faced the pandemic, and yesterday, from Atlanta, she came on a Zoom call.

Am I looking at your home office or your office office?

ANNE SCHUCHAT: This is my office office. I debated having the backdrop versus letting you see the real place. But, yeah, I'm in the office.

INSKEEP: I'm happy to see the real place. Are you, like, cleaning it out at this stage?

SCHUCHAT: Not yet. You're going to make me start feeling very anxious about all the stuff I have to do.

INSKEEP: Oh, I'm sorry.

SCHUCHAT: No - just teasing.

INSKEEP: Schuchat does not quite have the public profile of, say, 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" a few years ago was modeled in part on Dr. Schuchat. Her career as a doctor began in the 1980s in New York City, which was a punishing time and place.

SCHUCHAT: One out of 5 of my patients had AIDS, and they were really sick. 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.

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

SCHUCHAT: In thinking of what to do as I finished my residency, I remembered hearing about the Epidemic Intelligence Service, or disease detective program, that CDC has. 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, you know, obviously, that's not what happened. I didn't come down for two years and go back to practice, but I stayed. And 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.

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

SCHUCHAT: 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.

INSKEEP: I'd like to ask you 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 was much more effective, it seemed, and people were much more aggressive and, by the numbers, much more successful in containing the disease. Was that ever possible in the United States?

SCHUCHAT: 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. You know, 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 - very weak in terms of ability to get the contact tracing done. You know, obviously, we had problems with our tests, 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.

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

SCHUCHAT: 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, you know, 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. You know, 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. You know, the supply chain is very interdependent internationally. This was a really complex, systemwide assault. But another threat tomorrow, you know - 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.

INSKEEP: How much of your energy, if any, was spent during the pandemic fending off pressure from former President Trump, who wanted the pandemic to go away, or advisers around the former president who had a particular opinion of the pandemic?

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

INSKEEP: After a certain point, you weren't doing.


INSKEEP: Was that by choice that you backed away from that?

SCHUCHAT: It's sort of a complex answer that I probably don't want to go into.

INSKEEP: What's complex about it?

SCHUCHAT: Yeah. I'll just - I'll go on to the next part.

INSKEEP: (Laughter) I understand. I understand. 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?

SCHUCHAT: I want all the questions to be answered. You know, 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. So I think that - you know, sometimes, scientists have questions because they're kind of curious and, you know, 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.

INSKEEP: 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?

SCHUCHAT: You know, I think we need to do the investigations. I think they're important.

INSKEEP: You don't rule it out.

SCHUCHAT: I - you know, 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.

INSKEEP: Well, Dr. Anne Schuchat, thank you very much.

SCHUCHAT: A pleasure.

INSKEEP: She's retiring after 33 years at the Centers for Disease Control and Prevention.

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