TEDxUCLA 2018: Waves
Canaries in the coal mine
Tracey S.McNamara is a Professor of Pathology at Western University of Health Sciences College of Veterinary Medicine in Pomona, CA. She graduated from the New York State College of Veterinary Medicine at Cornell University. She served as senior zoo pathologist at the Bronx Zoo from 1987-2003 and held the Schiff Family Distinguished Scientist in Wild Animal Pathology endowed chair. Dr. McNamara specializes in the recognition and understanding of the diseases of captive and free-ranging wildlife and is best known for her work on West Nile virus. Her role in the discovery of the West Nile virus is described in the September 2000 GAO report “West Nile Virus – Lessons for Public Health Emergency Preparedness.”
Your life can change in a heartbeat.
One minute I was working as a veterinarian in a major metropolitan zoo working with endangered species and giving baby bottles to tiger cubs. I was getting paid for this, I was living my dream.
But the next minute I was exchanging cards with an FBI agent and his card said, “Special Agent, WMD.” And I’m looking at this card and I’m going, “What is it, what’s WMD? This is in 1999, and he said “weapons of mass destruction.” I was like, “Get outta town, you gotta be kidding me!” No, he was very serious. I was like whoa.
And then at a meeting, a guy came up to me and said, “Dr. McNamara, I know all about you. You are a legend in the defense and intelligence communities. We call you the lone wolf.” I’m like, “Oh, I like that! I’m going to put that on my business cards!” (wolf sound)
And I just assumed he worked for the USDA or the CDC and he said, “No no, I work for the DIA, the Defense Intelligence Agency, and I’ve read your file.” Honest to God. I’m like, “I have a file?! Who knew?”
Now I was speaking to these guys, they were talking to me because this was as a result of my involvement in the discovery of the West Nile virus in 1999. West Nile virus was a virus that had never before been seen in the western hemisphere. And they were talking to me because, although the public seemed generally unaware of this, West Nile is a biowarfare agent and it was ten days before we knew after it was announced whether we were dealing with a natural or an intentional event. It was pretty scary.
Now as a veterinarian, I’m trained to look at disease across all species. But this was even more true as a veterinary pathologist working in a zoo. There are only seven zoos in all of the United States that have full-time veterinary pathologists on staff, and because of that, that means I was actually working at a frontier of veterinary medicine. There was a lot we didn’t know about these species we were working on.
So I approached every case with a “what if” attitude. What if I was dealing with something entirely new? I called it, and I trained my students in, the Zen of Zoo Pathology. No assumptions, no preconceived notions, and every case had to be approached with an open mindset that encompassed all possibilities.
So in mid-August, when neurologic crows started taking nose dives into our exhibits, I paid attention. Louis Pasteur said, “Fortune favors the prepared mind,” and in this case that was very true.
Now crows had been dying since the beginning of June. In mid-August, they started dropping onto the grounds of the zoo. They’d been misdiagnosed by a wildlife biologist for two-and-a-half months.
When I began my investigation, through a process of deductive reasoning, I deduced that we were dealing with something new to veterinary medicine. When the New York City Department of Health announced that people in New York City were dying of an unusual encephalitis, I wondered if there could be a connection between the birds and the people.
So calls were placed to both the USDA and the Center for Disease Control. The USDA quickly confirmed it was indeed something new to veterinary medicine. Then I placed a call to the Center for Disease Control, but when contacted they refused to test my zoo samples, saying, “You’re just dealing with some veterinary thing and there’s absolutely no relationship between your birds and the people dying in New York City.”
I was like, “What?” In my experience, Mother Nature was not that black-and-white. New things popped up all the time. I’m like, “Are you sure? Isn’t it possible?” “No.” I was like, “Oh-kay.” So they, they had tunnel vision and basically said, “we don’t do flamingos.”
So after three — among other things. After three frustrating weeks, I finally in desperation reached out to the U.S. Army, the Fort Dietrich U.S. Army Medical Research Institute on Infectious Diseases, and that’s when progress was made.
Now in all fairness the job of the CDC is human health, not zoo birds. But this jurisdictional straitjacket and myopic point-of-view resulted in an additional three-week delay in recognition of a novel threat to public health.
Now West Nile has been followed by a series of frightening new diseases which, like West Nile, have jumped from animals to man. They, too, were not found however, until we had people that were sick or dead.
Governments have recognized that we need to take a new approach and they’ve spent hundreds of millions of dollars on what is now called the “one health approach.” It simply makes sense, when you’re dealing with diseases that can be passed from animals to people, to look at the animals. Find it before it spills over into people.
So we look at the interface of human agricultural species wildlife and the environment. It simply makes sense. Our own government has spent 150 million dollars looking for emerging viruses in Asia and Africa. Overseas.
So what do we do here? What about right here at home, right up, right here in Los Angeles? How are we protected from emerging infectious diseases? Do we practice one health in the United States? Ah, not so much.
This is the Venn diagram of the U.S. Our two biggest agencies and the size of the circle represents the financial wherewithal of the agency. The biggest one is the Center for Disease Control. Human health. The next big circle is the USDA, agricultural species of economic importance: cows, pigs, chickens.
The next circle — I really should have made it smaller — is for free-ranging wildlife. And then there is nothing for anything else that falls outside of those mandates. So this is the exact opposite of one health. It’s flip-flopped. All of these agencies are siloed. They stay in their own swim lanes, and that gets us all into hot water.
This system virtually guarantees that we will not find an emerging zoonotic threat, a virus that comes from animals to people, until we have people in emergency rooms or bodies in the morgue.
In 1999, we missed early warning of West Nile virus by two-and-a-half months because that warning came in the form of crows. Nobody cared about crows. Perhaps the question we should be asking is, if those crows had been diagnosed in early June, would there have been dead people in New York City in the middle of August? What you get, what you pay for.
And here’s the real surprise: I don’t think anyone in this audience is probably aware of the fact that all of the animals found in cities — dogs, cats, animals in zoos, animals in shelters, animals, wildlife handled by wildlife rehabilitators — none of them fall under the jurisdiction of any federal agency. They are not under any form of surveillance. Think about that the next time you share an ice cream cone with your dog.
Why does this matter? I mean really, does it matter? Well yeah! Last year in New York City, in the middle of New York City, in a crowded animal shelter, five hundred cats broke with influenza for the first time. The attending veterinarian got sick. The virus had jumped from the cats to the veterinarian. Alarm bells went off.
But guess what? Just like in 1999, the cats fell through the cracks. Instead of “we don’t do flamingos,” now there was a chorus of “we don’t do cats.” Nineteen years since West Nile virus, and nothing has changed. But for the fact that a private foundation stepped up to the plate and covered the bill for diagnostics and quarantine and personal protective gear, we would have been paralyzed by an outdated bureaucratic approach to zoonotic threats that no longer works.
The threats we face have changed and evolved, but our system has not. We’re left with a species gap. And the real problem is, by the time this was figured out, over 300 other cats in that shelter had been adopted out to families in the greater metropolitan area. That, my friends, is how a virus can spread like wildfire.
In May 2018, I met with people at the highest level of the federal government and I ask them a simple question: what if? What if this had been like the pandemic strain of flu, the Spanish Flu of 1918 that killed between 50 and 100 million people? What then? We would have wasted valuable time again, and that time would have been wasted. Any advantage we had would have been lost. We dodged a bullet. But there’s no guarantee we’ll be as lucky the next time.
So how are we protected here in the United States? Well we, we spent a lot of money on a program that looks, sniffs the air for aerosolized bacteria plague tularemia anthrax that might be released by bioterrorists. The problem is, public health departments have no faith in the technology, so they ignore it.
But we’re missing what’s right in front of our noses: all the animals that are all around us. And because of that, you know, basically at right now, we look for aerosolized bacteria and dead people. So we use taxpayers as sentinels. I don’t know if that works for you, but doesn’t make me too happy.
Is there another way to look at this? Yes. In 2001, the private sector approached the Center for Disease Control and we created a public-private partnership. We said, “Just give us the money to pay for diagnostics we performed at public health labs, and we will create a nationwide network and share the information with you. You can deputize every zoo veterinarian in the United States.”
That’s what we did. It worked. It cost a sum total of 300,000 dollars over a four-year period. Peanuts. Peanuts. They didn’t have to hire anyone. They didn’t have to create an agency. They gave us the money and the private sector did all the work. It was sustainable. It made sense. It worked. It can work again.
The, at the turn of the century, Rudolph Virchow said, “Between humans and animals there are no dividing lines, nor should there be.” It’s time to take that 40,000-foot viewpoint again and look across all species and recognize that we are all animals, and these artificial man-made bureaucratic divisions are working against us.
If we don’t find a way to think outside of the box, we may all very well find ourselves in boxes underground. We must stop ignoring the animals in urban settings or we will serve as the canaries in the coal mine.
If these obvious gaps are not addressed, I just want to know, if you or I die of a disease that would otherwise could have been detected in these animal populations, can I, can my family get a tax write-off at least?
I didn’t wake up in September ’99 thinking, “I’m gonna make history.” I simply did what I’d done every single day of my career as a veterinarian. I looked across species and I asked, “what if?” I approached my work with childlike wonder and an open mind, and discovery followed.
What if we all did that? This birdcage could be a metaphor for the mind. These bars are our self-imposed assumptions which may or may not really be true. It’s only when we strip away these rigid thoughts that we can see clearly. And when we’re freed of our expectations, we’re free to uncover the truth. And when we do that, the cage door will open and we will all fly. Thank you very much.