“CDC-1, cleared for approach” —
Drop-in surveillance on 9/11
W
Photo courtesy of CDC
hat started as a clear, sunny day in Atlanta for CDC’s
Captain Tracee Treadwell, D.V.M., M.P.H., ended in
smoke, soot and tension in New York City.
“I was at work
when the planes
struck the towers
and many of us
congregated in an
office with a TV,”
she said. Soon
after, Treadwell and her colleagues on the
main CDC campus in Atlanta were evacuated
because of evolving threat concerns expressed
by the FBI.
CDC leadership met in an alternate site and
began to develop the response. Treadwell was
assigned to lead a team to respond to New
York City.
Before that day, she had been working on bioterrorism preparedness projects at CDC. In 1999,
she had served as a team leader for surveillance
and response activities at the World Trade Organization Ministerial in Seattle. In 2000, she
did the same at the Democratic and Republican
Convention cities. “We were doing ‘drop-in’ surveillance in high profile events, looking for unusual disease clusters or symptoms being
reported within the population,” she explained.
Early warning system
The value of this “drop-in” surveillance, at the
time, was it could serve as an early warning system and supplement what was being done by
local and state health departments.
Despite the closure of airspace over the
United States, Treadwell and three others
raced to a local airport to board a small corporate jet. CDC had previously established a
unique FAA-issued Priority Flight Designation
that allowed people and materiel to be flown
to New York City. They would be looking for
suspect pathogens in the city.
While on the flight up to New York City,
Treadwell started to organize her team’s activities, anticipating what support the health
department might need. “There was a lot of
tension because we knew we were truly under
attack,” she said.
They called us CDC-1
Nearing the city, the pilot invited Treadwell to
come up to the cockpit. “It was early dusk,
night was approaching. Suddenly, in the distance was a black dot in the sky and it was moving rapidly toward us. Of course, my mind
jumped straight to someone is shooting us
down,” she admits. In seconds, she saw a
fighter jet come up near the plane. “They
were so close I could clearly see the face of the
pilot. They did a wing wave and moved on.
We were the only civilian plane in the sky.
They called us, CDC-1.”
With that welcome to New York, the team
landed. While in the movies everything works
smoothly, this was real life. They found themselves hampered by spotty phone service and
difficulty determining just where they needed
to meet up with the city health director. A sheriff finally got them where they needed to be.
“The city health department was fairly close to
ground zero. There was smoke and soot in the
air. A little past midnight we hammered out
what was needed for the bio-surveillance. The
concern was about what agents might be dispersed. We developed case definitions and created a rudimentary system of surveillance and
assessment. We were assessing hospital capacity
and clinics. We expected to be overwhelmed
with injuries. It was clear this was going to be
labor intensive,” Treadwell remembered.
CDC should send more
They decided the first night that CDC should
send more Epidemic Intelligence Service
(EIS) officers to New York and more than a
dozen arrived within days. Worker safety at the
site became a primary concern. Treadwell assigned her team across hospitals in the city to
collect information about the types of illness
FEDERAL RESPONSE
and injuries being seen in the ERs. “We wanted
to ensure medical supplies and personnel got
where they were needed and to see what sort
of public health recommendations and health
education would be needed onsite.”
The days for Treadwell may have blurred one
into another, but not the scene outside the
temporary site of operation for the health department: it remains starkly vivid. “We were
across the street from Bellevue Hospital. The
refrigerated trucks for the bodies being removed from the site were next to the hospital.
The constant noise from the motors, the rumble of the refrigerator cars and the sirens were
reminders of the magnitude of loss. It defies
description,” she admits.
I was going to turn back around
Treadwell had little time to adjust to her involvement in the 9/11 response, when she was
thrust into the response to the anthrax letters.
“I needed to return to CDC briefly for a specific
task and I traveled back to Atlanta thinking I was
going to turn back around to New York the
same night. Again, it was late at night and I
drove up to the CDC campus — the lights were
out [CDC had experienced a temporary black-
Photo courtesy of CDC
out on the campus] and it felt so strange. The
weather was still warm and I walked up to someone and they welcomed me back,” she said.
However, Treadwell did not get back on that
plane. She was again tapped, along with Jay
Butler, M.D., to co-lead the state liaison team.
This was the first team that received all of the
calls from state health departments or private
physicians concerned about a possible anthrax case. The team would literally start the
investigation over the phone and, if needed,
form the team to visit the site in person.
Treadwell has not left emergency preparedness. Today she is the associate director for infectious disease preparedness in the CDC
center responsible for emerging and zoonotic
diseases. “I’m proud to have been a small part
of an agency that dealt with a crisis of this magnitude with dignity and dedication,” she said.
When revisiting her early drop-in surveillance
work, she cautions, “we have created some sophisticated systems, but surveillance is best
done by supporting the capacity at the state
and local level. No one knows a city and
county better than the people who live there.
We need to invest in them.”