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The Agency At Its Best

The Agency At Its BestWhen Jeffrey Koplan got word of the U.S.' first case of anthrax in 25 years, the Tufts-trained doctor knew he'd have to transform the Centers for Disease Control to respond. Atlanta.

Medford/Somerville, Mass. [11.15.01] In the early morning hours of Oct. 4, the Centers for Disease Control [CDC] was reborn. Lab test results from Florida showed the first case of anthrax in the U.S. in a quarter-century -- the first in a series of cases that would rattle the nation. At the helm of the CDC, Jeffrey Koplan woke up that morning with two huge challenges -- coping with the anthrax itself and preparing his agency for its new role in the war on bioterrorism.

"This is a big challenge," Koplan told the Atlanta Journal-Constitution. "We have got to meet it."

For close to six weeks, the Tufts-trained doctor has been coordinating hundreds of scientists and public health officials around the country who are treating and investigating the anthrax cases.

"In the anthrax crisis, the CDC has established field teams in the three outbreak sites, Florida, New York and Washington, D.C.; an emergency operational center at headquarters that pulled in dozens of people from around the CDC, including liaisons for the three field teams; a postal service team; a state support team that has dealt with 10,000 false alarms so far; and an international team that on Wednesday alone last week lent support to 60 countries seeking assistance on anthrax-related issues," reported the Boston Globe.

Stretched extremely thin, the CDC is battling a largely unfamiliar enemy.

"The CDC is neither a hospital nor primarily a laboratory: Its chief research material is data," reported the Journal-Constitution. "The gnawing frustration of the anthrax investigation has been that even with almost 500 staff members working 20-hour days on the attacks, there is simply not enough data to know what might come next."

But Koplan's colleagues are confident he will rise to the challenge.

"The CDC has vast resources, but they are finite, and he is having to mobilize them to investigate something that has never happened before," Dr. James Curran -- former head of the CDC's AIDS division -- told the Journal-Constitution. "There are a lot of people second-guessing him, but he's a man of great perspective and resilience, and he doesn't lead with his ego."

The 56-year-old doctor is well aware that he -- and his agency -- are under the microscope.

"There's a lot of Monday morning quarterbacks in public health," he told the Globe.

A veteran in his field, Koplan is no stranger to the front lines in the fight against disease.

"He first came to the CDC in 1972 as a member of the Epidemic Intelligence Service, the elite disease-detective corps on the front line of the anthrax investigation," reported the Journal-Constitution. "A year later, the EIS sent him to Bangladesh to work on the eradication of smallpox, making him part of what was the CDC's most historic campaign."

He has three degrees -- English, Medicine and Public Health -- and studied for two years at Tufts' School of Medicine, where he met his wife.

But the challenges of the last six weeks are unlike anything he's experienced.

"In every other thing we have done, whether it has been a hurricane or an infectious disease outbreak or an environmental disaster, there has been a rhythm to it," he told the Journal-Constitution. "Even if it's not entirely predictable, you can get some sense of where you are in it, enough to say 'I think we are making progress,' or 'We have learned enough to prevent this the next time.' While there is a criminal perpetrator putting this stuff out, we cannot say any of those things."

Maintaining their intensity, alone, is difficult.

"In medical training, you are in crisis mode intermittently," Koplan told the Globe. "We've had now about a month of unremitting pressure and stress. It is hard to maintain the same level of intensity and focus. When does it wear out? I don't know."

Koplan and his colleagues are pressing on, though, determined to meet this challenge as they have with many others.

"There is a feeling that this is what the place is supposed to be about, that this is the time when we have got to perform and do it well," he told the New York Times. "This is the agency at its best."

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