The new leaders in two key roles for healthcare epidemiology and public health are Tania Bubb, PhD, RN, CIC, FAPIC, 2024 president of the Association for Professionals in Infection Control and Epidemiology (APIC); and Mandy Cohen, MD, MPH, director of the Centers for Disease Control and Prevention (CDC).
Bubb is senior director of infection prevention and control (IPC) at the Memorial Sloan Kettering Cancer Center in New York, NY. Hospital Infection Control & Prevention (HIC) recently caught up with her for a brief interview.
HIC: How did you get into infection control originally?
Bubb: I was first introduced to IPC when, as a bedside nurse, I cared for a patient with Mycobacterium tuberculosis [MTb] and was subsequently exposed. An infection preventionist [IP] came to the unit to patiently answer the staff’s questions about the exposure and advise on follow-up steps. My interest was piqued.
Some months later, while I was in graduate school, I opted to be placed in an IPC clinical rotation at a large, urban hospital center and my interest moved from piqued to intense. Some months after that experience, I came across a job posting for an IP position at the institution where I worked. Of course, I pursued the opportunity, was fortunate to get the position, and, as fate would have it, the same IP who had patiently answered our many questions about MTb exposure with grace and expert knowledge, became my preceptor.
HIC: What do you find interesting and purposeful in this field?
Bubb: The IPC field is a continuous journey of learning and interesting challenges — an enjoyable process to me. Additionally, and importantly, it’s a profession that’s in the service of people — patients, frontline and other staff, and the public at-large — our consumers, so to speak. It’s very humbling and gratifying to have both direct and indirect positive impacts on patient outcomes through policies and practices we implement in our respective facilities.
HIC: Are there any specific challenges you want to address as APIC president?
Bubb: I will continue to support and move forward the strategic priorities of APIC. These include developing and elevating the profession, as well as advancing the scientific practice of IPC. Inherent to APIC’s strategic priorities is health equity. The intangible effects of healthcare systems that do not adequately address health disparities became tangible with the introduction of the COVID-19 pandemic. APIC created a health equity task force in 2022, which was formalized into a committee in 2023. The committee is now working on defining the role of IPs in doing our part to combat this issue within our scope. I’ve worked with the committee, and I am looking forward to future formal recommendations for IPs on ways in which they can implement processes at the program level that address health disparities.
HIC: One of the keynote speakers at the 2023 conference was Peter Hotez, MD, who has been targeted by the antivaccine movement for his research on and strong endorsement of vaccines. After falsely demonizing the COVID-19 vaccine, these groups now are affecting uptake of other vaccines, particularly the pediatric immunization schedule. What do you see as APIC’s role in what Hotez calls an “attack on science?”
Bubb: APIC’s role is to continue to support and generate sound science around IPC practices. Last year, we led a coalition of 17 organizations voicing strong support for requiring vaccination of healthcare personnel and urging promotion of science-based information to address vaccine hesitancy.1
Silos Falling at CDC
After serving as health secretary of the North Carolina Department of Health and Human Services, Cohen took over as director of CDC in July 2023.
She was interviewed on a recent podcast by the National Foundation for Infectious Diseases (NFID), fielding questions from HIC editorial board member William Schaffner, MD, a professor of preventive medicine at Vanderbilt University, and NFID director Marla Dalton, PE, CAE.2 Cohen commented as follows on the topics and questions.
Early influences: What really influenced me in terms of going into medicine is my mom, and I talk about her often. She’s a nurse practitioner. She recently retired. She was one of the very first nurse practitioners in the country. It was before they had the term nurse practitioner — they were just providing advanced training for RNs — and she had gone direct to nursing school. And she was working in the burn unit in Brooklyn and got some additional training and ultimately became a nurse practitioner and that’s what she’s been her whole career. She actually spent her career in the emergency room. As we well know, the emergency room is where you see a lot of the broken parts of our healthcare system or, frankly, lack of that healthcare system with lack of insurance, addiction and mental illness, emergencies themselves, and infectious diseases. I saw through her eyes the impact she made on patients and families.
Pandemic experience in North Carolina: Governor Cooper said our success at responding to this crisis is going to be won or lost on trust. And it made us really think differently and tactically about trust. [A priority] was being really transparent, which is tough during a crisis, because you don’t have all the information you wish you could have. We were learning in real time, but we were incredibly transparent. I think I did 175 press conferences in 18 months, and we were providing a ton of data on our website. [We were] helping folks understand how we were making hard decisions, so being transparent was foundational. We were reaching out to historically marginalized communities to build bridges to our Hispanic community, our African American community, our faith communities, our rural communities. That was really critical to keep us together as a state and moving in the same direction to try to protect health.
Focus at the CDC: How do we get to simple, clear, repetitive, timely communication, and make sure that folks are understanding what we know when we know it? We used this fall and winter in responding to respiratory viruses as an opportunity to put those lessons learned into place. We did a ton of communicating with our provider community with simple and clear messages for folks. You may have seen we’ve been putting out really fast information as we’ve seen new variants in the COVID virus for our scientific community as well as what [the public] needs to know on how will this impact their lives. I’ve been doing a lot of traveling and making sure that I am sharing what I’m doing and learning on social media.
Breaking down the silos: The barriers and things that were really hard during the pandemic are the silos in our system. Silos were not our friend, meaning that not only was public health — and within public health — siloed, but public health is itself siloed from the rest of healthcare often, so localities and states are siloed. We’re not all investing in some of our core capabilities like workforce data, laboratory, response efforts in an aligned way that really breaks down those silos. Those continue to be big barriers. We have a big initiative underway to really bring public health together as one team here at CDC. I think CDC can work better as one team with our states [and] localities as well as with healthcare.
REFERENCES
- Association for Professionals in Infection Control and Epidemiology. National organizations in infection prevention and epidemiology and organizations representing immunocompromised patients support required vaccination of healthcare workers to keep patients and residents safe. https://apic.org/wp-content/uploads/2024/01/MultiSocietyVaccineStatement-FINAL.pdf
- National Foundation for Infectious Diseases. Building trust through transparency with Mandy K. Cohen, MD, MPH. Infectious Ideas podcast. Published Jan. 3, 2024. https://www.nfid.org/podcast/building-trust-through-transparency-with-mandy-k-cohen-md-mph/
The new leaders in two key roles for healthcare epidemiology and public health are Tania Bubb, PhD, RN, CIC, FAPIC, 2024 president of the Association for Professionals in Infection Control and Epidemiology; and Mandy Cohen, MD, MPH, director of the Centers for Disease Control and Prevention.
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