Fri July 18, 2014
Head Scientist At CDC Weighs Costs Of Recent Lab Safety Breaches
Originally published on Sun July 20, 2014 10:40 am
The director of the Centers for Disease Control and Prevention is on the hot seat.
It all started in mid-June, when the CDC announced that dozens of its scientists might have accidentally been exposed to anthrax.
Since then, a number of other security risks in and via national laboratories have come to light: Ordinary flu virus was unknowingly contaminated with the deadly bird flu virus (sent from a CDC lab); vials of smallpox virus were found forgotten in a National Institutes of Health storage room; and just this week the FDA revealed that forgotten vials of other potential bioterrorism agents were discovered in the same storage room where the smallpox samples turned up.
These lapses, occurring in some of the nation's top government-run facilities, left many to wonder whether the CDC, which is charged with protecting the public from natural and man-made health threats, is capable of shielding Americans from the risks posed by its own research.
Under questioning by lawmakers on Wednesday, the CDC's director, Dr. Tom Frieden, testified that these errors represent a larger pattern of unsafe practices in government laboratories that must change.
This week Frieden sat down with NPR's Morning Edition host David Greene to discuss these breaches and what new steps are being taken to ensure the safety of lab workers and the public. Following are highlights of the conversation.
On the CDC's response to the anthrax and bird flu incidents
I've imposed a moratorium on transfer of all infectious or potentially infectious material out of all of our high containment labs until we trust but verify that they're changing their protocols. ... I've closed the individual labs associated with the two incidents and they won't reopen until we are certain that they can reopen safely. I've appointed a senior scientist to be the single point of accountability and we're going to work at every level of CDC to increase the culture of safety here.
On how the CDC is working to improve the safety of its labs
One of the things that we want to ensure in the strengthening of the culture of safety is that people understand that anytime there might be a problem — or there is a problem — report it, rather than try to figure it out first and then report it. CDC scientists are rightly famous around the world for being the top in the world in their field, and that same rigor that we've been applying to finding and stopping outbreaks — that's the rigor we are now applying to improving safety at CDC.
On how the CDC currently regulates labs that work with dangerous pathogens
Scientists don't regulate themselves. We currently have a select agent program run by both a separate division of CDC and the Agriculture Department's Animal and Plant Health Inspection Service. These two agencies ... oversee all entities that work with select agents. We make unannounced site visits; we have detailed reviews. We'll look at whether these incidents suggest that we should do other things in addition at those.
On whether we should establish an independent oversight team to regulate CDC facilities
We're certainly open to anything that will improve lab safety. One of the things that I will be doing this week is inviting an external advisory group that has no prior employment with CDC to ... look at what we are doing on lab safety and biosecurity and suggest any ways that we can improve that process.
One thing that all three of these incidents suggest is that we need to take a hard look at the risks and the benefits of the different types of research that are being done and make sure in every case that the benefits justify ... potential risks.
DAVID GREENE, HOST:
Dr. Thomas Frieden had a pretty tough week. He's the director for the Centers for Disease Control and Prevention, and he got a grilling on Capitol Hill Wednesday. Lawmakers wanted to know why samples of anthrax and smallpox were mishandled. And just hours after the director testified, there were more revelations. This time, hundreds of vials with other dangerous pathogens, dengue, and a bacteria linked to tyhpus, had been mishandled. We asked Dr. Frieden about those latest problems when we reached him yesterday.
THOMAS FRIEDEN: We'll check every location we can to make sure that we can identify any other stray vials like that. We've done inventories like that at CDC on multiple occasions, but we'll do it again, because safety has to come first.
GREENE: We also spoke to Dr. Frieden about the broader safety concerns at the CDC's labs.
I wanted to start with the anthrax incident at your lab in Atlanta back in June. Dozens of workers were exposed. How did this happen?
FRIEDEN: Well, our subsequent investigations find that in all likelihood, no one was actually exposed, but we can't rule it out. People are still taking preventive medicine. It's a tipping point. We recognize a need to improve the culture of safety, and are making sweeping changes at CDC to improve lab safety.
GREENE: What are a few of the sweeping changes?
FRIEDEN: I've imposed a moratorium on transfer of all potentially infectious material out of all of our high containment labs, until we're certain that nothing infectious leaves there when we think it's not infections. I've closed the individual labs associated with the two incidents, and they won't reopen until were certain they can reopen safely.
GREENE: The second incident you mention, are we talking about the bird flu virus?
GREENE: So just so our listeners know, that was back in the spring as well. A pretty harmless strain of the bird flu virus was contaminated by a much deadlier strain, and it took weeks for you to even learn about this. Which makes me wonder, is there some kind of cultural issue at the CDC that could explain why the head of the CDC doesn't learn about such a security lapse for so long?
FRIEDEN: Sometimes our scientists are so rigorous, they want to nail down every detail before they send information or tell anyone else about it. And, I think that's possibly part of the problem.
GREENE: You're suggesting that there are many scientists who might know there's something dangerous happening, but they want to, as you put it, rigorously investigate themselves before they actually report it up the chain. That sounds like a serious problem, potentially.
FRIEDEN: One of the things that we want to ensure, is that people understand that any time there might be a problem or there is a problem reported, CDC scientists are top in the world in their field. And that same rigor which we've been applying to finding and stopping outbreaks, that's the rigor we're now applying to improving safety at CDC.
GREENE: Can you give our listeners a sense of scope here? I mean, how many labs does the CDC have oversight of? How many pathogens are - are you dealing with?
FRIEDEN: CDC does work to protect us from natural and man-made diseases. Whether it's Ebola, where we have a large response going now in West Africa, or MERS, or a drug-resistant bacteria, we have more than 2,000 laboratory scientists who work at CDC here in Atlanta. Also in Colorado.
One thing that all three of these incidents suggests, is that we need to take a hard look at the risks and the benefits of the different types of research that are being done. But as another witness said at the hearing, it's not possible to make that zero. And, recognizing that the risks are present, and are difficult or impossible to completely eliminate, we need to make sure that the bar is high enough so that only if it's likely to protect people and help people stay healthy, is that something we should do.
GREENE: Is it a too big a responsibility? Should there be some sort of independent body overseeing all of this, and doing the oversight?
FRIEDEN: I think it's certainly worth considering anything that will improve lab safety, not just at CDC, but throughout the country. One of the things that I'll be doing this week is inviting an external advisory group to look at what we're doing on lab safety and bio-security, and suggest any ways that we can improve that process.
GREENE: Dr. Frieden, with all due respect, I mean, we listened on Wednesday to lawmakers from both parties asking you some very tough questions, suggesting that there's a culture that may have been place for some time now. Could you blame a lawmaker or someone else for suggesting, that perhaps, you lose your job over this?
FRIEDEN: Well, that's not my decision. What I'm doing is everything I can to ensure that we get back to work safely, so that we can keep protecting Americans from things like Ebola, and MERS, and drug-resistant bacteria. and potential bio-terrorism.
GREENE: But I just wonder is there an issue of accountability here? Do you feel responsible for what's happened?
FRIEDEN: I wish we had recognized the pattern of incidents in the past, and taken action earlier. But that's hindsight. What I'm focused on now is doing everything we can to make sure that we're working safely, and we're back to work protecting Americans.
GREENE: Dr. Frieden, thanks very much time for your time. We appreciate it.
FRIEDEN: Thank you.
GREENE: Dr. Thomas Frieden is director of the Centers for Disease Control and Prevention.
STEVE INSKEEP, HOST:
Great conversation there. Transcript provided by NPR, Copyright NPR.