Global Health Chronicles

Martin Meltzer

David J. Sencer CDC Museum, Global Health Chronicles


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00:00:56 - Youth and education

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Partial Transcript: Can you tell me when and where you were born?

Segment Synopsis: Meltzer describes his youth in Rhodesia, now Zimbabwe, his early academic and career interests, and his move to the US

Keywords: agricultural economics; attitude tests; civil engineering; ethnicity; graudate school; high school; mathematics; pharmacy; physics; race

Subjects: Cornell University; Harare (Zimbabwe); New York; Nigeria; Rhodesia and Nyasaland; United States

00:10:24 - Joining CDC/Similar ways of thinking about human and animal health

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Partial Transcript: And then from there, of course, people always ask me, well how did you end up at CDC, and CDC deals with human public health, not animal public health.

Segment Synopsis: Meltzer describes how he joined the CDC as a postdoctoral fellow and integrating his economic background with public health. He discusses his experience with animal public health and his transition to human public health

Keywords: J. Koplan; R. Norval; USAID; USDA; W. Roper; bacterial meningitis; chickenpox; dynamics of transmission; economics; endemic stability; healthcare costs; immunity; immunizations; infectious diseases; licensure; measles; money; neutrality; pesticides; tick-borne disease; vaccines; value

Subjects: Centers for Disease Control and Prevention (U.S.); University of Florida; Zimbabwe

00:30:11 - Working as a health economist at CDC/Bringing health economics to emergency response

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Partial Transcript: I’m getting a good idea of the ideas that you’re working with as you come to CDC and integrating economics with public health. What things are you actually doing? Are you writing reports?

Segment Synopsis: Meltzer describes what it means to work as a health economist at CDC. He gives the example of creating FluAid, a simple math model that allows state health officials to calculate numbers to help them prepare for pandemic influenza

Keywords: 2009 H1N1 pandemic; FluAid; Influenza Branch; anthrax; audience; communication; data; emergency response; health economics; influenza pandemic; methodology; numbers; questions; severe acute respiratory syndrome (SARS); spreadsheets; tools

Subjects: influenza

00:42:35 - Getting involved in CDC's 2014-16 Ebola response/Building the Ebola Response model

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Partial Transcript: Tell me about how you got involved in the Ebola response

Segment Synopsis: Meltzer describes getting the call to join the Ebola epidemic response and building a model to assess how much and what kind of a response was needed

Keywords: DfID; Ebola response model; Ebola treatment units (ETUs); I. Damon; OFDA; USAID; assumptions; health economics; modeling; models; money; resources; safe burials

Subjects: Africa, West; Ebola virus disease; Great Britain. Department for International Development; United States. Agency for International Development; United States. Agency for International Development. Office of Foreign Disaster Assistance

00:51:57 - Assessing residual risk of sexually transmitted cases of Ebola

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Partial Transcript: Towards the end of the epidemic, one of the most important questions we had was residual risk.

Segment Synopsis: Meltzer describes helping to assess the degree of risk posed by sexual transmission of Ebola

Keywords: residual risk; ribonucleic acid (RNA); sexual transmission

Subjects: Ebola virus disease

00:54:56 - What it was like creating the Ebola Response model/Working with imperfect data

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Partial Transcript: I’m trying to get a sense also of the timeline here. The initial conversations start August 3rd. Is that right?

Segment Synopsis: Meltzer talks about working to put together the Ebola Response model using imperfect data and having to deal with constant demand for results. He also talks about the CDC team and people he worked with and how they made the work worthwhile

Keywords: Division of Preparedness and Emerging Infections (DPEI); M. Washington; data; pressure; public health systems; underreporting; work conditions

Subjects: Ebola virus disease; Liberia; Sierra Leone

01:11:19 - Estimating costs of Ebola equipment and supplies

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Partial Transcript: One of the ones I do remember was that it was late September. A different question came up.

Segment Synopsis: Meltzer describes having to create an estimate of the amount and cost of equipment and supplies needed for the response in order to budget how much money would be needed from Congress

Keywords: I. Damon; N. Hupert; USAID; budgeting; costs; resources

Subjects: Cornell University. Joan and Sanford I. Weill Medical College; Ebola virus disease; United States. Agency for International Development; United States. Congress; United States. Department of Health and Human Services

01:16:23 - Publications resulting from Ebola response work/Communicating important information in the models

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Partial Transcript: The one thing that’s quite different from say the more academic or research is that none of this was really written up in any papers.

Segment Synopsis: Meltzer talks about how the pace of the response allowed for only a few publications. He also talks about developing a succinct structured memo for communication with leadership and decision-makers

Keywords: Ebola response model; appendix; bottom line; communication; memo; prioritization; prioritizing; questions; readability

Subjects: Africa, West; United States. Congress

01:22:07 - The September 2014 MMWR modeling report

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Partial Transcript: Again, just pulling back to look at the timeline. Let’s see, September 26th is when the MMWR comes out with the Ebola response model and then—

Segment Synopsis: Meltzer describes his September 26th MMWR publication and the news media’s focus on the estimate of 1.4 million cases. He describes how the information in that report helped lead to an overall increase in the US Ebola response

Keywords: CDC leadership; Ebola response model; MMWR; accuracy

Subjects: Africa, West; Ebola virus disease; Morbidity and mortality weekly report. Recommendations and reports

01:27:41 - Household transmission/Work during the downward slope of the epidemic/Sound methodologies

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Partial Transcript: I know I’ve kept you here sitting for quite a long time now. So after this publication, does the question pretty quickly become that of assessing individual risk?

Segment Synopsis: Meltzer discusses just how atomized the modeling team's assessments of risk could get. He then talks about some of the modeling team's efforts in 2015, and assesses the modeling team's work overall

Keywords: household transmission; methodologies; risk

01:35:52 - The disadvantages of working in the field/Dealing with the pressure of the response

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Partial Transcript: One of the things that some of my team thought, we should’ve gone out to Liberia when we realized the data gaps and go and collect data.

Segment Synopsis: Meltzer explains his opposition to the idea that the modeling team could have been more effective if deployed to West Africa. He also further describes the stress of the response

Keywords: confusion; staff rotation; teamwork; work conditions

01:44:34 - Areas that could have been better

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Partial Transcript: Is there anything you would’ve dealt with differently?

Segment Synopsis: Meltzer describes how data collection during the Ebola response could have been improved by being simpler

Keywords: data; stress; surveys; work conditions