TOM FRIEDEN: We're confident that we'll be able to get the flu lab reopened in time to do the essential work it does like helping to prepare the influenza vaccination for Americans in tracking the spread of flu around the world and around the country. So at this point, we don't see any risk to keeping the lab closed until we have a full assessment of what happened and are sure that we can prevent future occurrence. Yes?
LISA SCHNIRRING: Thank you, Dr. Frieden. I’m just curious what kind of impact the moratorium will have on the work that you're doing, number one. And number two, you've talked a lot about putting new procedures in place. But how do you change the culture? I mean, this administration has been here since 2009 at the CDC. Obviously this is an ingrained culture. How does that change? What are you doing for that?
TOM FRIEDEN: In terms of the impact of the moratorium, we're going to assess that laboratory by laboratory. We do have partners who rely on us for sending out things like proficiency panels. And we'll just have to make sure that if any material leaves, when any material leaves, we assure that it actually needs to leave and that it leaves in a way that's absolutely safe. For example, documenting the inactivation in a fail-safe way. In terms of laboratory culture, I believe it's an issue that requires continuous improvement. And I don't think it's an issue across all CDC laboratories. We have hundreds of laboratories at CDC. And making sure that we have a culture of safety in each and every one of those is critically important. These are wake-up calls. These are events that tell us that we have a problem and we're going to fix it. On the phone?
OPERATOR: Thank you. Next question comes from Betsy McKay with Wall Street Journal. You may ask your question.
BETSY MCKAY: Thank you. Dr. Frieden, you were talking about the need to address, you know, the problem more fundamentally rather than just the symptoms. And so I wonder if you could talk about whether you think procedures for regular inspections of labs that work with select agents need to be toughened since CDC has played a role itself in these inspections. Do you need to seek more, you know, third-party oversight? Could you just talk a little bit about that?
TOM FRIEDEN: We have undertaken a series of measures over the past few years to strengthen our investigation of select agent laboratories. We do unannounced inspections. We're doing other things to look at critical control points. But I think absolutely, we're going to look at this experience and these two incidents or three incidents in particular and more broadly at a culture of lab safety to see what we can do to ensure that work that's done with either select agents or other dangerous microbes is done safely. And that's going to require careful review of what actually happened and a careful consideration for what will be effective at improving laboratory safety around the country and around the world. I think we recognize that these are dangerous agents. And to work with them means to have a special responsibility to protect both the workers and the public. And we'll be looking at what the implications are for our division of select agents and toxins as well as other partners.
BETSY MCKAY: Okay. Thanks.
TOM FRIEDEN: On the phone?
OPERATOR: Thank you. Next question comes from Eui Hoai-Tran with USA Today. You may ask your question.
EUI HOAI-TRAN: Hi, Dr. Frieden. In terms of the smallpox vials that were found at the NIH lab, you said you were planning to scour those labs. Are you also planning to scour any CDC labs or campuses that may have any unsecured samples or like that?
TOM FRIEDEN: We have done that. When smallpox was eradicated, there was a global agreement to identify any existing sample and to either destroy it or send it to one of two laboratories. Here at CDC or in Russia where there's a WHO., world health organization, authorized laboratory. So all materials either should have been here in our laboratory where they're secured or in Russia or destroyed. So the NIH and FDA are both scouring their campuses to see if there are other examples. This is something that Dr. Bell will look at in terms of our laboratory. But in terms of smallpox, we're confident that there are not other samples anywhere at CDC. I will say that there is an analogy with polio because we're now making progress toward polio eradication. Once polio is eradicated, and I am confident it will be, we'll need to do something very similar with the polio virus. And fundamentally, and this is relation to the previous question from the wall street journal as well, one of the things that we want to do is reduce the number of laboratories that work with dangerous agents to the absolute minimum necessary. Reduce the number of people who have access to those laboratories to the absolute minimum necessary. Reduce the number of dangerous pathogens we work with in those laboratories. So for example, in the anthrax episode, they could have used a harmless form of what's called bacillus, the same genus but a different species for that experiment. And also make sure that in the work that we do, we're not risking others. So it's a coning down and a stepping up of security within that procedure. Did you have a question? On the phone?
OPERATOR: On the phone lines again if you'd like to ask a question, just press star-1. Our next question comes from Helen Branswell with Canadian Press. You may ask your question.
HELEN BRANSWELL: Hi. Thank you very much, Dr. Frieden. I have three quick questions. The -- the flu strain that your lab thought it was sending isn't identified, but it was going to a bsl-3 lab. So what was that, please? It clearly wasn't seasonal flu. Secondly, at the receiving end, if USDA discovered that what they had was contaminated with h5n1, was it not also incumbent on them to report the incident on May 23rd when they found out that this was going on? And third, you know, Donald made reference to the gain of function work, and this is going to explode that issue. You just talked about coming down the amount of risky work. One of the big arguments made for -- in defense of gain of function work on flu was that this work is done very safely and that labs know how to do this very safely. And I’m wondering if you're rethinking that now.
TOM FRIEDEN: For the nonpathogenic avian influenza was h7 -- sorry, h9n2? H9n2, sorry. And we have a graphic that we can provide you, which describes the movement of that isolate and when it got contaminated and when it was then destroyed. In terms of the department of agriculture laboratory, you'd have to direct that question to them. And in terms of the gain of function studies, I think whatever you think about gain of function studies and dual use research of concern; I think it's clearly the case that these incidents indicate that we need to really ensure that whatever work is done needs to be done safely and securely. Two more questions. On the phone?
OPERATOR: Thank you. Next question on the phone lines comes from Julie Steenhuysen with Reuters. You may ask your question.
JULIE STEENHUYSEN: Hi. Yes, thank you for taking my question. Dr. Frieden, you mentioned that there will be some disciplinary action taken. Do you know at this time what those actions will be? Are there specific individuals who will be demoted or losing their jobs over this? And ultimately, who is responsible for the safety of the laboratories at CDC?
TOM FRIEDEN: Well, in terms of the individual human resources and personnel actions, it will depend on the investigation. The investigation will determine what happened and recommend appropriate action for that. And that's what I want to ensure happens. Including responsibility not only for the individuals who may have personally carried out the experiments, but for those who set up a system for them to do those experiments within. In terms of the culture of safety, while we're appointing Dr. Bell to be the single point of accountability for laboratory safety at CDC -- in fact, what we need to ensure is that safety is a laser-like focus for every single level of the organization. Every center director, every division director, every branch director, every lab director, every lab worker, and myself. Because we all share responsibility for making sure that the work we do is done safely and securely.
JULIE STEENHUYSEN: Yeah, I have just a quick follow-up. I've been covering this issue for a while. And some of the sources I’ve talked to have said and criticized CDC in saying that there is -- there has been this reliance -- almost – I don't want to say arrogance, but extreme confidence that, you know, the way we do it at the CDC is the right way to do things. This is, you know -- gives -- make you reconsider or want to take a look at that idea? I mean, basically have you been arrogant? Sorry to ask it in such a blunt way.
TOM FRIEDEN: Well, I think, as I said, I think this is a wake-up call. These events should never have happened. And they tell us that we they'd to make significant improvements to ensure that our lab workers remain safe. Did we have a question in the room?
TOM FRIEDEN: Yes. One other question for Dr. Bell. There's a mic over here, please.
DARRALL JOHNSON: Just a question for Dr. Bell. You mentioned that the delay in notification was one of your concerns. I just wanted to know what some of your concerns would be coming into this position.
MICHAEL BELL: Thank you for asking that. I think there's some major systematic issues that we want to look at. As Dr. Frieden mentioned, this is a symptom. It's not the little mistake that we're concerned about in this instance. We're concerned about what is the framework that everyone's using? And that framework includes rapid reporting. It includes an understanding of the chain of communication and who you tell when. Add to that the fact that people need to be comfortable doing this. We can bolster that and make use of this series of events to make sure that in the future; there is much less likelihood of this happening again. The work of safety is never complete. We will continue to innovate. We'll be continuing to have new technologies. There will be new diseases. And this is part of the work that we do in public health to maintain safety and grow with the science so that we can assure that what we do doesn't harm anybody that's doing the work or is nearby.
TOM FRIEDEN: On the phone?
OPERATOR: Thank you. Next question comes from Sabriya Rice with Modern Healthcare Magazine. You may ask your question.
SABRIYA RICE: Yeah, good morning. Thank you for taking my question. I wanted to ask about -- you had mentioned before that, you know, that the incident that happened in 2006 was the same lab but with a different set of staff. I wanted to know, what is the training for people when a new protocol is introduced? How are staff kind of made aware of the new protocols and what they should be doing?
TOM FRIEDEN: One of the issues, which Dr. Bell and his working group will look at is exactly that. How we train staff and how we make sure that new staff are trained, that people learn from past incidents and that procedures are in place that are clear, understandable, easy to follow and that training is then assessed and repeated as necessary. I’m going to stop there. We do have the ability to answer your questions going forward. But I do want to end with just summarizing what we found. We had three incidents, two at CDC and one at NIH where CDC was able to then secure that material. But those incidents revealed to us an unacceptable set of practices at CDC. As a result of that, we've immediately stopped shipping any laboratory samples out of our high containment laboratories, bsl-3 or bsl-4. We've established a single point of accountability, and we will look at every aspect of laboratory safety with a laser focus. And we will take appropriate disciplinary action after we complete our investigation of what actually happened in these two incidents. We wish that research of this type and organisms of this type didn't have to be studied at CDC. But given the world we live in, they continue to spread in nature and make people sick and kill them. They continue to have the potential to be used as weapons against individuals. And so we have to do this research. But we have to do it safely. Thank you very much.
