Heroes unite: A different kind of year
September 11th. Anthrax attacks. Bioterrorism threats. It was a vastly different kind of year for CDC… and the CDC Foundation. It was a year when heroes united - on the front lines, behind the scenes, at home and abroad - to protect the public in challenging times.
It was, unquestionably, a different kind of year for CDC and the CDC Foundation. Priorities shifted. Responding to terrorism took center stage. The horror of September 11 was followed by alarming anthrax threats, and CDC mobilized rapidly to respond. Behind the scenes, the CDC Foundation quickly stepped forward to help CDC - first in small ways, and then through significant measures designed to arm CDC with powerful emergency resources if and when terror strikes again.
CDC’s swift response began minutes after the second hijacked plane struck the World Trade Center. “We had to mobilize a lot of people very quickly, and everyone was extremely willing to rally around the cause to help,” says Patrick Meehan, M.D., EIS ‘88, director of the Division of Emergency and Environmental Health Services at CDC, who was among those responsible for dispatching the first emergency medical supplies to New York City.
In New York’s surreal environment following the attacks, CDC employees faced tremendous challenges. “Everyone just rolled up their sleeves, dealt with the hardships they were facing, and got the job done,” says Meehan.
For example, CDC stockpile personnel were on hand to meet a 50-ton “push package” filled with pharmaceuticals, medical supplies and equipment. Teams were immediately deployed to area hospitals to assess injuries and monitor for bioterrorism-related symptoms. A rescue worker injury/illness surveillance system was quickly established to monitor rescue workers’ injuries and health problems. Working closely with the New York City Department of Health, CDC assessed hospital capacity and needs, addressed occupational health issues (like fitting workers for particulate masks and monitoring the safety of the food supply), and helped develop a comprehensive worker health and safety program.
As CDC staff worked under incredibly difficult circumstances, they faced all kinds of unforeseen problems. Federal regulations and guidelines made it impossible for them to purchase critical equipment and services quickly and efficiently. What could the CDC Foundation do to help CDC? The answers began to unfold in the weeks and months that followed.
An anxious nation on edge learned about the first case of inhalational anthrax on October 4, 2001. Reported by CDC and state and local public health authorities in Florida, the incident was the first of many in Florida, New York, Washington, D.C., and Connecticut that presented both a health threat and a crime scene. In the months that followed, 22 cases of anthrax were confirmed, five deaths resulted and over 2,000 CDC employees were involved in responding to the crisis - the largest, rapid mobilization of CDC staff for a single public health issue in the agency’s history. Was the anthrax “weapons grade” or not? Did it spread easily? Was each incident related to other attacks, or not? What could be done for protection? A jittery public wanted answers. Suddenly, CDC was thrust into the glare of media attention.
The anthrax investigation became CDC’s top priority as the agency mobilized to thwart bioterrorism. Within hours after the first case of anthrax was detected, CDC converted an auditorium into a 24-hour emergency operations center. A bevy of CDC employees worked there around the clock amidst a constant buzz of activity, tracking anthrax exposures, processing specimens, answering questions and providing technical assistance and support for those in the field.
Teams of scientists and epidemiologists were quickly deployed to conduct studies and collect samples in affected cities. CDC worked with elected officials at every level of government, as well as with media representatives, to disseminate the most up-to-date information concerning the health and safety of those affected. A laboratory designed to provide rapid response and advanced technology and an anthrax specialty laboratory rapidly identified thousands of biological and environmental samples. The National Pharmaceutical Stockpile program deployed critically needed caches of medical supplies to augment local stocks. A nationwide web-based network - Health Alert Network (HAN) and Epidemic Information Exchange (Epi-X) - enabled the rapid dissemination of information and laboratory and treatment protocols.
At the height of the anthrax crisis, the CDC Foundation rushed in to help in small ways - and that was just the beginning. Thanks to some generous donations from The Kroger Company and The Coca-Cola Company, the CDC Foundation made sure that workers at the emergency operations center always had a hot cup of coffee or an ice cold drink, day or night. It was a small, yet much appreciated, gesture of support for staffers who barely had time to field the calls coming in every 20 seconds, let alone leave the room in pursuit of a drink.
In those challenging days, it was hard for the CDC Foundation to get CDC’s attention - and rightly so. But the CDC Foundation kept asking questions. And it started learning more about where the gaps were in CDC’s bioterrorism response efforts.
“We found out about resources that would have been valuable for CDC to have,” says Charlie Stokes, president and CEO of the CDC Foundation. “At the emergency center, big video screens posted high on the wall with a CNN feed would have been ideal to keep workers informed about breaking news. In New York City, CDC staff really needed satellite phones to communicate, yet didn’t have them. There was a need to hire lab workers and other scientists more quickly than the 60- to 90-day window required at a federal agency. People needed help processing and interpreting environmental data, but just didn’t have the resources. All these stories started coming out.”
Preparing for the Unimaginable
In late fall 2001, the CDC Foundation announced a $2 million Emergency Preparedness and Response Fund. The Fund was created to give CDC a flexible, immediate resource during a national crisis. For instance, with help from the Fund, CDC staff will be able to purchase necessary supplies and hire people without going through lengthy standard government procurement and hiring processes.
“We worked with the CDC Federal Credit Union to arrange for credit cards for each of the 10 teams ready for field deployment in an emergency situation,” says Stokes. “Each card has a spending limit that can be increased as needed. When a crisis strikes, team leaders will be given a card. The CDC operations manual references the card and its capacity for emergency purchases not allowed through normal government regulations. Once a field team leader signs the card, it is ready to use.”
When individuals learned about the Emergency Preparedness and Response Fund, they stepped forward to help. Although CDC has 12 institutes, centers and offices, nearly 8,600 employees and a fiscal year 2002 budget of $6.7 billion, there’s something it does not have - the flexibility to allocate funds swiftly in a crisis.
Robert Yellowlees, a member of the CDC Foundation’s board of visitors, who, with his wife, was one of the first donors to the Fund, understands how critical it is to arm CDC for the next emergency. Yellowlees, chairman of Global Payments, one of the largest payment processors in the world, is also chairman of NDCHealth, the largest electronic health care trans-action network in the United States.
“CDC plays a critical role in containing the impact of disease in this country and others,” he says. “That affects people’s well-being and helps assure stable economies. The spread of disease by people with the wrong motivation could easily disrupt a country or region, leading to political and economic instability. The funding for CDC is modest compared with its needs - this Emergency Preparedness and Response Fund helps fill that gap. It provides the flexibility to respond to special funding requirements on a faster decision cycle than the federal government is capable of.”
Many other individuals have also contributed to the Fund, recognizing the importance of arming CDC with these flexible resources. “People want to have a way to help protect themselves and their families in an emergency. The Fund allows them to do that,” says Stokes.
What began as a fund became a sweeping Emergency Preparedness and Response Initiative in early 2002. As the CDC Foundation continued to explore how best to help CDC, it became clear that there was an opportunity to create something much larger than a fund. There were corporations, foundations and individuals who wanted to bolster the nation’s ability to respond to bioterrorism. CDC was a natural partner. The CDC Foundation went back to its board of directors and gained approval for a comprehensive initiative that would include not only the Fund, but also a new program that could help build strong partnerships between the private sector and CDC.
By forging these important partnerships, the CDC Foundation hopes to bridge gaps in federal funding to strengthen CDC’s level of preparedness for a major public health emergency. Through the program, concerned individuals, corporations and foundations now have a powerful way to bring their ideas, needs, concerns and resources together with CDC’s world-class public health and safety experts.
Flexibility in Challenging Times
On April 4, 2002 - six months after the first confirmed case of anthrax - Bernard Marcus announced a $3.9 million pledge from his Marcus Foundation to equip a state-of-the-art emergency response center at CDC. When Marcus, Home Depot co-founder and ex-chairman and CEO, learned that CDC staff members were working in a converted auditorium with limited resources during the anthrax crisis, he stepped in quickly to help. Announcing a multi-million dollar pledge to the CDC Foundation, Marcus appeared on CNN with a challenge for America’s corporate and philanthropic leaders to join him. “We cannot wait out the normal federal funding channels to make sure CDC has the equipment and technologies it needs to deal with the next emergency,” stressed Marcus. “We must act quickly to build world-class facilities, install state-of-the-art equipment and train a network of bioterrorism and other public health experts to ensure that we are prepared. I call on America’s corporate and philanthropic leaders to join forces with the CDC Foundation to help bridge funding gaps in our local and national preparedness efforts.”
Corporate America heard his challenge. And businesses responded with generous discounts and outright contributions of essential supplies for the new center. The Marcus Foundation, Inc. provided $1.1 million immediately to procure vital equipment for CDC. The remainder of the funds will equip the new emergency center, which will serve as the central control and coordination hub for epidemic outbreaks and other public health emergencies. The center will be equipped with cutting-edge communication and data collection technologies, including tools to bring together audio, video and data feeds from scientists in the field to facilitate real-time analysis and decision-making, and it will have a multi-window video wall to display images from remote video feeds, cable TV and computer feeds.
Already, suitcase-sized portable satellite uplink transponders are ready for immediate deployment to hot spots during a crisis. With the help of these units, CDC scientists in the field will be able to send and receive voice, data and video, making it possible to “virtually” send a greater number of experts to the field.
Building a Strong Infrastructure
By mid-2002, even as the anthrax crisis was waning, CDC and its many partners were taking fast action. The event proved that there were serious gaps in the public health infrastructure. What if there was a large-scale bioterrorism attack? Could America handle thousands of infections, an overwhelmed medical system and public health labs flooded with specimens?
A strong public health infrastructure is urgently needed - now more than ever. Many existing CDC Foundation initiatives are bolstering public health training and communications systems in the United States, while two recent CDC Foundation partnerships are contributing to a state of readiness abroad.
Eli Lilly and Company joined with the CDC Foundation to fund an international effort to support scientific training. The training will help improve surveillance for infectious diseases and biological threats. Through a $2 million gift from Eli Lilly, scientists from both developed and developing countries will train at CDC, using the latest laboratory techniques and technologies.
“The goal of the program is to train a network of laboratory leaders around the globe to provide a rapid, multinational response to infectious disease threats, whether they be naturally occurring or intentionally released,” says Gail Cassell, Ph.D., Lilly’s vice president of infectious diseases. “In doing so, we hope to reinforce the public health laboratory system and strengthen its relationship to infectious diseases surrounding prevention, research and control.”
The Nuclear Threat Initiative announced a partnership with the CDC Foundation to help CDC fund a two-year India Field Epidemiology Training Program. The program will help ensure that Indian field epidemiologists know how to investigate and control infectious disease threats, including agents of bioterrorism. Indian scientists will learn the proven epidemiology methods used by CDC “disease detectives,” and a CDC field epidemiologist will guide the program’s early phases at the National Institute for Epidemiology in Chennai, India.
A Different Kind of Year
“What can we do to help?” That simple phrase set the wheels in motion for the CDC Foundation during a year like no other. What started as small gestures of support, like refreshments for tired CDC workers, became a far-reaching plan with incredible potential to arm CDC with flexibility and resources to respond to unimaginable terror.
Before September 11, CDC was one of the few federal health agencies that had started planning for a bioterrorism attack. Even then, CDC understood that it was not a matter of if, but when, such an event would occur. But for most of us, it would have seemed farfetched if someone had suggested that terrorists could inflict damage on the United States by using a commercial airliner as a guided missile to crash into the Twin Towers or the Pentagon. Or that they had capabilities to attack our nuclear power plants, our transportation system, the water we drink, the food we eat or the air we breathe.
That was then. Today we know that our world will never be the same. In these times of rapid change and growing responsibilities, CDC is more committed than ever to safeguarding Americans. In the wake of the anthrax attacks, weaknesses in the public health system have been exposed. It has become abundantly clear that lack of flexibility is not acceptable when CDC is operating in an emergency mode.
The CDC Foundation exists to help CDC do more, faster. This year, the Foundation’s priorities may have shifted, but its focus remained laser sharp. As CDC heroes put their lives on hold, uniting to respond to unprecedented crises, the CDC Foundation’s heroic contributors also found innovative ways to unite with the CDC Foundation. As a result, the CDC Foundation is helping CDC prepare and respond to unfathomable emergencies faster, and with greater flexibility, than ever before.