Interview with Congresswoman Dr. Kim Schrier, M.D.

Collaboration between scientists, physicians and legislators has been crucial in the mitigation of COVID-19. As we emerge from this pandemic and into the next public health threat of antibiotic resistance, maintaining these guiding points of teamwork and scientific leadership will be more important than ever. 

I recently had the opportunity to speak with a key player in the navigation of both crises: Congresswoman Dr. Kim Schrier. Dr. Schrier represents Washington state’s 8th Congressional District where, prior to being elected to office, she spent her career as a pediatrician. As the only female physician in Congress, she provides unique and necessary insight into acute public health matters such as COVID-19, as well as incoming issues such as antibiotic resistance. 

1. In your March interview with C-SPAN’s Washington Journal, you highlighted: “We cannot go from crisis to crisis, intervening only once a disease is at our doorstep. We need steady, regular investments in the CDC, in global health, to catch these diseases before they turn into a big deal.” As a society that is easily preoccupied with the immediate, how do we focus on preparation and prevention? Particularly with an issue such as antibiotic resistance that, unlike COVID-19, has been largely out of the public eye?

“I don’t want to lose sight of this, this is really important. And it’s something that, as a physician, we deal with really every day. It’s little sometimes, like oh we tried this antibiotic - it didn’t work. Oh, we tried that antibiotic, it didn’t work for your ear infection. Okay now we’re going to try this one - what happens if this one doesn’t work? Well, then it’s time to go put tubes in your ears [a last resort for resistant pediatric ear infections]. It happens with the littlest things, but it also happens with the big things, like tuberculosis, or our kids with cystic fibrosis and the antibiotics don’t work for their infection, and pseudomonas, like that could result in death if you can’t find an antibiotic that can treat these things. 

The guiding idea is that bacteria have been around a whole lot longer than humans have, and they’re going to be around long after we’re gone. And they always figure out a way to adapt to whatever the challenge is. If the challenge is antibiotics, and they figure out a way to adapt, then we have to stay ahead of the game because if not, these are contagious diseases that people will perish from.

The other problem is that the capitalist system rewards lots of diabetes medicines and high blood pressure medicines and depression medicines, and things that you have to take every day for a really long time, and does not reward the expensive work that is required to develop new antibiotics. So we have to make sure that we support that kind of research. It’s happening at the NIH, but we need to also have it happen in terms of clinical trials with the pharmaceutical companies, because their pay off is not going to be nearly as big as it will be with the diabetes drugs.”

2. Evidence-based changes in public policy and behavior have been crucial in slowing the spread of COVID-19, but miscommunication and misunderstanding surrounding these changes have delayed their adoption throughout the nation. As a member of both the legislative and scientific community, what do you hold as the main pillars of effective science communication?

“The first thing that comes to mind is that scientific matters, and scientific messaging, should happen from scientists. It’s really important. And I think that one of the reasons we have had such a failed response to coronavirus in this country, is that the messaging came from politicians with an agenda. 

If we had had the CDC delivering the message daily, instead of, ‘We’re going to stop this, it’ll be gone by April, all the crazy stuff,’ instead of that, if the message had been, ‘Okay, we’re in for a rough ride, everybody. This is a new virus. We don’t know a ton about it. Based on what we know now, we’re going to have you do what we do for other respiratory viruses. But please understand that as we learn more the guidance may change.’ Just saying that from the start, would have done so much in terms of public acceptance of changing recommendations on masks and those kinds of things, and preparing people for a rough time, and letting people in rural communities know that ‘It may not be there yet, but contagious diseases travel everywhere, so brace yourselves.’ And we didn’t get that, because the CDC was kind of muzzled and we put political figures, namely our president, center stage. And that’s a real problem when it’s a public health issue.” 

3. The arrival of COVID-19 exposed the rampant ageism and ableism that exists within our society. Many young, otherwise healthy individuals initially dismissed precautions, believing this virus did not pertain to them. Similarly, many individuals may fail to recognize the importance of antibiotic stewardship, while others, such as those with cystic fibrosis, deeply understand the importance. As a legislator, physician and patient familiar with the risks associated with pre-existing conditions, how do you navigate the divide in these sentiments?

“Well I think there’s a really important discussion to be had right now in terms of public health. People don’t really know what public health does, or can do. So, a lot of us have really been supportive of a national service bill, where people can become part of a public health core. People who are trained up quickly for COVID, but who really might then develop a passion for public health. Because we need it in so many ways. We don’t know when the next pandemic is coming, but we know one’s coming, and we need to have the infrastructure there. But we also need public health for a mega vaccine effort for this pandemic. We also need public health for our opioid epidemic, and helping people get well. We also need public health for helping support families with opioid addiction, or other drug addictions, to parent and to help keep families together. And to support vaccination efforts. I just think that there’s a lot of places where we could use public health. Healthy eating, healthy nutrition and exercise, because we’re dealing with an epidemic of obesity and diabetes and hypertension. I just think we should expand people’s understanding of what it is that public health does, and how important it is for community health.”