Outgoing CDC leader Dr. Tom Frieden on ACA repeal, his biggest fears, CDC lab safety and more: 7 quotes

Outgoing CDC Director Tom Frieden, MD, has led the agency since 2009, holding the post longer than any other director since the 1970s, according to The Washington Post — but he is set to resign Friday as President-elect Donald Trump will assume the presidency.

The high-profile political appointee spoke with the Post last week about his tenure at the CDC, the current political climate and the future.

Here are seven quotes from Dr. Frieden.

1. On President-elect Trump's possible vaccine commission chaired by vaccine critic Robert F. Kennedy Jr.: "The CDC is ready to work with the incoming administration to protect American people from threats. In terms of immunization policy, we arrive at these recommendations through the Advisory Committee for Immunization Practices. ACIP is a model for transparency. It involves not just doctors and nurses but professional organizations, community groups and consumers. Every single deliberation of that committee is open to the public. All of the materials are available on the web."

2. On the potential impact of an ACA repeal on CDC's public health efforts: "Currently, more than a tenth of our budget comes from the [ACA's] prevention fund. It goes for programs which are broadly supported: the block grants for state governments, immunization programs, the epidemiology and laboratory capacity programs that find and stop threats, tobacco control programs. These are programs that save lives and save money. And they are at risk. It's a budget decision more than any other decision. Regardless of what happens to the prevention fund, it's extremely important to Americans' health and safety that those programs continue."

3. On the CDC's biggest successes under Dr. Frieden's leadership: "Ebola was the largest mobilization of CDC in history. We had 4,000 people work on this, including 1,400 people who spent 75,000 work days in West Africa... And in significant part, because of their work, we stopped Ebola, particularly we stopped it in Lagos [Nigeria] where it could have gotten out of control and become a global catastrophe. We sounded the alarm early and often on the opiate epidemic... [And] because of efforts by the federal government, including CDC and partners throughout society, there are 10 million fewer smokers than there were in 2009."

4. On what public health concern keeps him up at night: "The biggest concern is always for an influenza pandemic. Even in a moderate flu year, [influenza] kills tens of thousands of Americans and sends hundreds of thousands to the hospital. That increase in mortality last year may have been driven in significant part by a worse flu season compared to a mild flu season the prior year. So flu, even in an average year, really causes a huge problem. And a pandemic really is the worst-case scenario. If you have something that spreads to a third of the population and can kill a significant proportion of those it affects, you have the makings of a major disaster."

5. On frustrations with the "slow-moving" federal bureaucracy: "I'll mention one thing that was public. We were told not to do social media when there was the [2013 federal government] shutdown. But I was so pissed off that, [at] 10 o'clock at night, sitting at my desk working, I typed into my iPad that 'Today, CDC had to furlough 8,754 staff. Yesterday they protected you. Tomorrow they can't. We are less safe.' I hit enter... I went to our central lab — it's a whole floor in one of our huge buildings. It's usually bustling with people doing tests and producing diagnostic kits. It was empty. And there was a machine beeping, an alarm going off. It was terrible, like something out of a movie... There are real-life implications of what decisions are made here. If a tobacco program gets defunded, 16,000 more Americans will be dying from tobacco-related disease."

6. On CDC lab safety issues: "CDC has more than 150 labs with around 2,000 laboratory scientists. We do well over 1 million laboratory tests per year. We have the broadest range of pathogens and environmental risks that are tested for of any laboratory in the world... I think that the broader lesson on lab safety is that we must minimize, but it is impossible to eliminate, the risk of working with dangerous microbes. I think that this means that we should ensure both that we do everything possible to minimize risk and that we reconsider how many laboratories are doing research on these pathogens and how they are doing it."

7. On his next move: "I'm weighing the options. I've made all my career decisions by asking one simple question: How can I save the most lives? That's the question I'll ask in making my decision."

More articles on infection control: 
Top 10 infection control stories, Jan. 9-13 
Researchers create dengue-resistant mosquitoes 
Bloodstream infections most common HAI among children, European study finds

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