21st century disease detectives

The ideas and innovators shaping health care

Jul 05, 2023 View in browser   By Ben Leonard, Erin Schumaker and Evan Peng DATA DIVE The CDC Center for Forecasting and Outbreak Analytics chief technologist Eric Rescola and director Dylan George | CDC The CDC’s fledgling Center for Forecasting and Outbreak Analytics hopes to build on disease-monitoring systems pioneered during the Covid-19 pandemic. It’s ramping up with the hire last month of Eric Rescorla as chief technologist. Rescorla’s tech resume includes serving as chief technology officer at Mozilla, the maker of the Firefox web browser, and leading a review of California voting machines in 2007 for then-Secretary of State Debra Bowen. Rescorla says he’s been a fan of the Centers for Disease Control and Prevention since he read “Disease Detectives,” a book about the agency by Gerald Astor, as a child. Ben caught up with Rescorla to talk about the new center's goals. Dylan George, the center's director, joined the conversation. This interview has been edited for length and clarity.  The center officially launched in January. Where are you at now? George: We’re a startup in government. We’re building the organization, team, tools and partnerships to be successful. We need to work more effectively with the private sector. We started with five, and now we’re at a headcount of about 50. We’re targeting in our first buildout to be about 130 people. Rescorla: There’s an amazing amount of high-powered expertise in modeling and disease analytics at CDC. Where I can help is bringing some of the techniques that have been developed in industry to help bring that horsepower to bear faster and more efficiently. What obstacles remain? George: We need to have the data move at the speed of need, and that’s still a challenge. We need the data authorities to collect the data from states and localities and move it very quickly. Building out our team and tools is going to be critical. We need to have sustained funding. We’re aspirationally building towards working with state and local jurisdictions so you can have that weather forecast everyone uses to decide whether they need to take an umbrella, but it’s going to take a while. Rescorla: It’s important for us to not do it alone. We have the National Weather Service, which does amazing work, but we also have Apple Weather and things like that. What’s the biggest technical challenge?  George: One of the biggest is getting the data to move quickly and interoperably. The Data Modernization Initiative, a sister effort, is critically important for us to succeed. Our 10x value proposition is to provide advanced analytics to the CDC director and White House. I’m very confident we can do that. We’ve been doing it the past year or so. Our 100x value proposition is doing that for state and local jurisdictions, but to achieve that, we need the Data Modernization Initiative to succeed. What role will artificial intelligence play in this?  Rescorla: It’s probably too soon to tell. It's an incredibly powerful tool, so it’s important to take a look and see if it can be used to make analysis go faster. George: There is one area where we’re clear it will help us — machine learning operations. That’s the technology to generate lots of models in a machine learning approach. In the early stages of an outbreak, there’s going to be relatively few data. We want to throw models at that data, even if it’s small data, to figure out how we can improve.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     WELCOME TO FUTURE PULSE San Diego, California | Evan Peng This is where we explore the ideas and innovators shaping health care. Zespri International, the New Zealand-based marketer of kiwifruit, wants you to know that eating two green kiwis a day will help make your constipation go away. The study the company funded found the fiber-packed fruits performed better in that regard than fiber pills. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Kelly Hooper talks with Robert King, who explains how CMS negotiations with manufacturers over drug prices for Medicare patients will proceed now that the agency's final guidance has been unveiled. Listen to today’s Pulse Check podcast THE LAB AP Photo Today’s the last day to comment on the National Institutes of Health’s proposed grant oversight rules. If the agency finalizes them, foreign subrecipients of NIH grants will have to provide copies of their lab notebooks and data to their NIH-funded partners every few months. Foreign researchers currently submit progress reports and financial statements and are subject to audits. The proposal would significantly broaden those requirements. U.S. researchers say the rules could slow their work and hurt relationships with international collaborators. The case against: “Anybody who does global health research is quite frustrated by this,” Gregg Gonsalves, an associate epidemiology professor at Yale School of Public Health, told POLITICO. “It's like a sledgehammer instead of a scalpel.” Gonsalves and others in public health say it would undermine carefully forged international partnerships and also create unnecessary paperwork burdens. The backstory: The proposal follows a January report from the Health and Human Services inspector general, which found that the NIH didn’t effectively monitor or enforce the terms of its grants with EcoHealth Alliance, the research group that collaborated with China’s Wuhan Institute of Virology in studying pandemic threats. The inspector general report pointed specifically to EcoHealth’s “inability to obtain scientific documentation” from the Chinese lab. The NIH agreed with the inspector general’s recommendations to enhance oversight of foreign researchers awarded subgrants and is implementing them, the agency told POLITICO in a statement. The NIH estimates that fewer than 2 percent of its primary awards will be affected. Based on existing requirements, collaborators “should already have in place processes by which there is seamless information flow between them,” the NIH says. “In well-run collaborations, information routinely flows in both directions.”   SUBSCRIBE TO POWER SWITCH: The energy landscape is profoundly transforming. Power Switch is a daily newsletter that unlocks the most important stories driving the energy sector and the political forces shaping critical decisions about your energy future, from production to storage, distribution to consumption. Don’t miss out on Power Switch, your guide to the politics of energy transformation in America and around the world. SUBSCRIBE TODAY.     TECH MAZE New research could help allay concerns that telehealth prescribers are more lax about prescribing certain drugs than doctors meeting patients in person. Bebeto Matthews | AP Prescribers who met virtually with patients were no more willing to write scripts for ADHD drugs than doctors who met with patients in person, a new analysis says. Why it matters: The study from the research arm of electronic health records firm Epic could help allay concerns that telehealth prescribers are more lax about prescribing. The backstory: The Drug Enforcement Administration is investigating at least two telehealth startups, Cerebral and Done, for allegedly taking advantage of eased pandemic rules around virtual care to overprescribe attention-deficit/hyperactivity disorder drugs. In February, the DEA proposed tightening the pandemic rules to require in-person visits but, after significant pushback from industry, backed off that plan, granting a temporary extension. Even so: The research doesn’t include telehealth-only providers like those the DEA has investigated.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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