James Curran and Katie Curran

00:12 Good morning. I'm Jim Curran, 76 years old on July 19th, 2021 and we're here at the Rollins School of Public Health with my daughter Katie.

00:27 Hi, my name is Katie Curran. I'm 40. Today is July 19th, 2021 and we're in Atlanta Georgia, and I'm here with my dad Jim Curran.

00:42 The dad, maybe you can start and tell me about what your your current job is world for the last two decades. Or so. I've been dealing with owls and that followed a very exciting career, 25 years at the Centers for Disease, Control and prevention.

01:02 The last 15 years of that time, I worked on the beginning, in the middle part of the AIDS epidemic, and that actually began two weeks after you were born in 1981. I'm so happy that 40 years later here. We are together sharing this time and sharing the story. How did you ever end up a b? C d, c k t. So I, I mean, I think I was introduced to Public Health through you, of course, and through some of the amazing people you worked with some I did my undergrad at Emory University. It really was focus on social science like sociology, course with dr. Levinson about the social determinants of Health.

01:55 And then did an internship at the World Health Organization in Geneva. I worked at a nonprofit went back and did my masters in public health at Johns Hopkins.

02:10 Work on a HIV research study and Tanzania for a couple years. When back did my PhD in epidemiology at the University of Washington? And then I applied for Eis. I'd always heard about it is and once I was eligible, I had a PhD. I thought why not try out. It's as always, heard great things about it. So I joined CDC. As Annie is officer in the class of 2014.

02:44 The really cool thing is that I was an honorary is officer at CC and work with the IAS officers so much during my career and you and I became I think the second father daughter remembers. If he is, I was so proud when you came back and of course Juanita and I your mother were thinking after you were gone about ten years working in different parts of the world in the country and we are so happy to have you back here. In Atlanta course your first time in the is you spend quite a bit of time in global Health again.

03:21 Yeah, I did. I was in the global wash on the global wash team and waterborne disease prevention at CDC for Eis. And so I spent some time responding the cholera outbreaks in Kenya and Tanzania and then my class was sort of named the Ebola, one of the Ebola classes be started in the summer of 2014 where there was a large outbreak of Ebola in West Africa, so, I went to Sierra Leone several times and spent several months there.

04:00 We you know, as up as a professional and as someone who has such great respect for CDC and its ability to do science-based, a rapid Global Response. I always thought it was a wonderful thing to do as a father. You start to say, my daughter is about ready to go work on an ebola outbreak in Sierra Leone for several weeks away, from all sorts of places. What was that experience like you? Are you saying? You weren't? Sure you wanted me to go to say, I really admire those people put their life on the line. It's another thing to say, my daughter's over there, putting her life on the line.

04:44 What was the experience like in Sierra Leone?

04:47 You know, it was a, the great learning experience. It was challenging at times just to do this work, you know, you have long days, you know, you're in remote locations. I was in a world District Amba District in Sierra Leone, you're far away from home. And so there are things that are challenging about it, but it was very rewarding to be able to go as a CDC, stop person and work alongside the Ministry of Health and other partners, and kind of see the amazing work that they're doing. And, you know, they're dedicating their lives to this, the, you know, local Sierra Leone, Health officers, and were there to support them for a couple months at a time. So, it was a,

05:39 It was a good learning experience.

05:43 The Ebola virus was discovered about five years before you were born and there were dozens about breaks before the West Africa. Outbreak. What made West Africa so different was the enormity of it, the thousands of deaths. And then also the fact that there were some Americans who became infected and came back to the u.s. Summer traded here at Emory University.

06:07 That really got the attention of the US government and the press and and somehow or other are you were interviewed by The Washington Post? And I don't know how the Washington Post to get a hold of you and Sierra Leone, but I remember that after that President Obama was interested in having a press conference. And when time he was heaping, praise and recognition on the various people in the, in the country, I was on a plane back from California with the White House. Called me saying, did I know Katie Curran? Is there? Anyway, I could get ahold of her because the president wants to speak about her in his conference today. What happened?

06:55 Well, I was on my way home. I think I was at an airport and Europe on my way home from my first deployment to Sierra Leone and you called me. And you said, oh, yeah your Washington Post. You know, you were in The Washington Post article. And now the White House has wanted to contact you and I thought you were just teasing me because you thought that my head had gotten too big. So you're so important, but it was pretty cool. I was coming back sitting with my team and we had all been working so hard and at the time, there wasn't always a friendly response for people who had been serving on the Ebola in the Bilal break as they returned home. As you remember. There was another former he has officer who was forced into quarantine and an airport in the US when she returned. And so,

07:56 You know, President Obama was actually saying, we should, we should be supporting these the people who are responding and there, he highlighted me and some other people who were serving and and I think he likes my story because it was about how when we are working with the health department. We are going to these remote Villages and we are going out in these Dugout wooden canoes to reach the villages. And when we got there, we met with the local Chiefs and other people in the community, to talk to them about Ebola in response and health measures. And the guy was wearing a Pittsburgh Steelers hat. So I think that imagery, you know, really stuck out that will be remembered by more than just our sports teams. But the cool thing was he called out you to. What did you think about that?

08:55 Why you said, you know what, her father was one of the pioneers of the AIDS epidemic and Katie is, is charting her own course, and that's the kind of thing that brings tears to your eyes.

09:12 He is always has a. It seems like every class of you is is faced with an epidemic of some type 1980. S mint, he is officers were called upon to emergently work on AIDS and then there was a H1 N1 flu, toxic shock syndrome bowling and now the last couple years. It's all been about covid-19 crisis of the century. Have you been involved in that?

09:45 So I have as many of us at CDC have worked on the covid response last. And last year. I worked on the epidemiology team, that and help support some investigations that we're done at Correctional Facilities. To try to understand transmission and prevention efforts, testing prevention and treatment efforts. Correctional facilities in Austin, under looks and underserved population. I also have worked a little bit on the vaccine task force supporting the team that works with the advisory committee on immunization practices. So as where the STA was receiving data on the new vaccines moderna and Pfizer vaccine that had submitted, their applications for emergency use approval. We help review that data and looked at the safety and efficacy. So that was that was a pretty cool time.

10:47 The covid pandemic has been amazing. You know, it's public health is always political and it's become quite partisan during covid. That's very distressing because it, it is more difficult to get people to work together. But the people that see, see it been right in the middle of that, and remarkable thing about it. In addition, to how serious it is, is how rapidly effective vaccines were developed. The covid vaccine is save more lives already than anything since the polio epidemic and it's the most effective prevention tool. We've seen in public health in decades, but there's still so much work to be done. Is this still an active thing going to CC?

11:36 Yeah, I'm not involved with the vaccine task force now, but I know that they're really working to monitor the safety of the vaccine. And also now they're looking at applications for long term use of the vaccine so that it's no longer under emergency order. And also trying to understand vaccine, hesitancy and only work with health, departments and Community, organizations, and Faith leaders, and, and other community leaders on the ground to really try to get the right information out to the right people to address people's concerns, you know, increase vaccine acceptance. What about you and Emory? Are you guys working on this to testing vaccine? Efficacy? We've been involved in all of vaccine trials. I was actually a participant in the trial myself. Unfortunately, I got the placebo.

12:36 And we also involved in developing and testing a test for covid and therapy trials. For various Therapies in many of our physicians. And scientists have also been a public intellectuals by talking on TV Sanjay Gupta, Carlos Del Rio. And, and in many others, I think the relationship of cdc2 the world is important and isn't always understood. Well, by Americans, you you have a history of global Health that preceded CC working in Tanzania Geneva in Kenya, and then you have an experience of working for CDC oversees, both with ebola and Colorado. And and you know, what's going on with HIV. How is CDC in the ER is viewed in developing countries in other countries?

13:32 I would say it's positive. I think CDC is often seen as a trusted resource, and I think was special about work at CDC. Is that our job is to support the local governments and the Ministry of Health and they're the key partner and were there to help them do their work. And

13:55 And, you know, to do that side by side. And so, I think that we now have country offices and many countries in through the president's emergency plan for AIDS relief. We have a large presence in sub-Saharan Africa to a lot of HIV working to roll out treatment for HIV. And so I think is a. We've invested in these countries and then we you know, we're working side-by-side with the ministry I think has been a very positive.

14:30 You know, what are the one of the best things about the is from the, the fifty years? I've been observing. It. Is that it attracts really smart, motivated people to careers in public health and in careers that are science-based. So they begin with training and a scientist base and, and then the importance of service.

15:00 What what's a kept you going in public health? Why did you decide to stay in it after he is?

15:11 Well, there's a lot, you know, a lot of work still to be done. And I think I enjoyed you know, the being an epidemiologist at CDC. I think was really great. Is that we are called on to address for the most pressing Public Health matters. Like you said, it's now it's covid and then you know, our role is to work with health departments and ministries of health and other partners. And and so I think you're, you know, there's a lot, you can get a lot done that way and who your partners are.

15:50 I think the combination of Science and Community is always what's appeal to me. I thought you could do something which is of scientific uncertainty and you continue to learn and apply the principles directly to populations to try to improve their help and that gives you a feeling of learning and doing something that's rewarding at the same time. That's also useful. You been engaged in other areas in addition to Ebola and, and now you're working on HIV. Tell us about some of the compelling problems among injecting drug users.

16:28 So, yeah, I when I was in the IAS officer, I volunteered to join a team that was supporting the Indiana Health Department to respond, to an outbreak among person to inject drugs. In Scott County. That was in 2015.

16:50 And there I think, is where we just we really saw with the opioid crisis. How, you know?

17:01 That there were there was a potential to have to have HIV Transmission in these communities. This was a rural community of people who who were injecting multi-generational. That was like, the drug use was among family members and and the response included their first syringe Exchange program in the state. So they were able to address some of the barriers to Prevention Services. So getting access to clean clean needles, and also with that getting linked to HIV treatment or hiv-prevention. She's like, prepped through like a One-Stop shop. So, I think it's in serving people who inject drugs. It's really meeting people where they are.

17:57 And and, and that might be, you know, recently. I was working in West Virginia, where there's an outbreak and many of the people affected are unstable a house. Many of them are living outside living on the streets. And so, I think you really have to see where people are in their day-to-day struggles and meet their first Urgent needs, which might be food, you know, water.

18:28 A place to shower, you know, and you have to dress that before you start talking about some of their medical needs like, HIV prevention or HIV treatment. I was actually envious of you. I working in West Virginia and Scott County, but it made me think about the opportunities that you had that I didn't have and end in one of those, of course, with AIDS, the injecting drug use has always been a risk factor for HIV and but it was neglected respect her in the United States for so long. And it took the massive opioid epidemic, which this year. By the way, is back to over ninety thousand deaths per year. It took the mass of the opioid epidemic and epidemics and places like Scott County or you have would go from one or two cases of HIV to well, over a hundred hundred eighty-one inkarnate.

19:28 Phone cases, I mean explosive in a rural area and it took that explosion and then CC's investigation to make a difference. So the epidemic himself made a difference in how we view this problem in West, Virginia and other places throughout the United States. And it's an example of taking advantage of something that showed in the underbelly of our society, to make a difference. More permanently. Will you traveled quite a bit in the you still do but you did in the early days. What was that? Like

20:07 What kind of trips did you make? The first years of the AIDS epidemic? 1981, at 1982 two-thirds of the cases in the United States, were from New York city. So I was pretty much assigned to New York City while I was in Atlanta. It was at the same time. Ronald Reagan is been elected president and there was an air traffic controllers strike, which meant that every flight in and out of New York was delayed by several hours to reach flight to New York took seven or eight hours one way and seven or eight hours back. And I made I think 40 trips to New York in the first year.

20:48 I think your your mother Juanita is taking credit for raising you and your two-year-old 22-year old, brother. During the first couple years of the AIDS epidemic. The travel was extremely important, but it also was a difficult part of the assignment. And what did you do when you are in New York on this? Well, the first thing we did was make sure that people understood what was going on. And in most important thing was accurate surveillance. We gather together, all the doctors who were seeing patients with week, all days. It was not even called AIDS and show that the cases were doubling every 6 months, but this was actually occurring very, very frequently and we could understand each other. We didn't know what caused it with the risk factors. Were

21:40 So you, who were you speaking to the doctors and patients themselves and most of the cases initially were in gay men who were very eager to work with us because of the severity of the problem. And they had so many friends who had died of

21:59 And did you have the IAS officers working with you then and there was a budget fries, but we're fortunate that the is officers could come together that very summer and many were assigned to work on the task force for kaposi, sarcoma, in opportunistic infections. So we had the IRS offices in New York and California who are assigned there, and many others who were assigned to me to work there and many of the initial study and what can you tell me about some of the early investigations that he is officers contributed to and then doing active surveillance by us officers were assigned to the 18 largest cities in the United States to look for cases of what would fit the case. Definition going back 5.

22:59 Sears in the major, Municipal, hospitals, and University Hospitals, in the city's. Ironically, we found almost none that way except in New York and California. So, we will quite certain that this was a new epidemic and that it was focal. Additionally, is things involved with a case-control studies of people with what is now called, AIDS investigations of persons with hemophilia investigations of injecting drug users and their sexual partners that babies destinations of milder conditions, like lymphadenopathy syndrome relationships to new cockle, pneumonia, disseminated, tuberculosis, and others.

23:48 And what are some of the early successes and challenges that CDC face during the HIV epidemic in the US infectious disease doctors who invented, cancer doctors who were seeing cases. Had never seen anything like this in their careers. They took it very seriously and leaders in the gay. Press gay community, took it seriously in California and New York for the rest of the country into, including the gay communities outside of New York and California. I just didn't deal with it in the Press had no interest in the first year. We were desperate to get press involvement, and, and welcomed it.

24:37 Brought attention to it. How did you do that?

24:43 Well, you know, it's sometimes better to ask forgiveness than ask permission and I was fortunate to be in a situation where I could basically try to estimate how big the problem was beyond the cases, reported, and some people in the administration thought I was causing too much alarm.

25:06 And what I was called to ask about it, I would basically say what I'm saying is probably under estimate and they'd say well don't do that again, unless you let us know and of course I would do it again. Anyway, and when I asked and the sad thing was I usually was under estimating.

25:30 One of the funny stories we have in our family is about the postcards. We would get in the mail with a picture of your face and a Target on it. Tell us about that. Well, I think one of the big contributions in the AIDS epidemic is the contribution by activist and that includes act up and Larry Kramer includes many other groups group includes Community organizations like Aid Atlanta in the Gay Men's Health crisis, and we would work with the activist.

26:06 I threw out to try to get things done. They were amazing because they themselves were up and dying of AIDS. And anytime, we would get offended by their actives knew their activities. They were throwing condoms. In St. Patrick's Cathedral. They were locking themselves. Chaining themselves to my officer Tony fauci Sophos. They were doing things like that and we be reminded that. Next time we came to a meeting that some of them would be gone and we stay, well, how come they're not here and they say, well, he died last week.

26:45 So the activist were fighting for their lives. Now, one of the things that happened was that public benefits from the Social Security, ministration. I'd to the surveillance definition debase, which was a mistake and we objected to that. But Social Security didn't want to do any disability requirements. And so nobody could get

27:11 NE disability benefits unless they fit the surveillance case definition. So the activists said you should expand the case definition. So more people could get benefits. And of course, they couldn't get ahold. They couldn't demonstrate to the White House and they couldn't demonstrate to the upper levels in administration because President Reagan didn't say the word Braves and public till 1987, so they would go after whoever was there and that would include Tony fauci included me and I was The Keeper of the case definition.

27:44 So they wanted to expand it and they started to send me postcards with a very nice picture of me in a Target on it and it and they were all signed on the back by individuals saying you should have your killing people by not expanding case definition. And I think we got they had our home address and I think we got a maybe twenty thousand of these are home. I realize we got that message through mostly away quickly. Although they were souvenirs for our staff and I didn't think much of it because I don't think what you do is CDC, that the good things you do are usually credit that belongs to the group. And the thing is to get blamed for are usually blame the government.

28:33 So, I didn't take it seriously, but at the time, your older brother was just entering adolescence and he thought that I should take this more seriously. So we went to the post office went to the mailbox and he started running a few with a back of how many Delights it as well. How did you get into this into this work? How did you end up working on a JB?

29:07 Well, you were talking mostly about me. Now. I'm going to switch this back to you, but I'll tell you what. At the time. I was chief of research and STDs, and we've been working with the gay community at a trial of hepatitis B, vaccine the most serious of sexually transmitted infection for gay men in the late 70s, was Hepatitis B. So, we were working with the gay community when the first five cases of pneumocystis, pneumonia and gay men who are reported. I had a staff and there was a hiring freeze. And so, we got a group together and I was kind of elected to be the head of the group and the CDC detailed me for 90 days.

29:51 CC Weiss to have epidemics that come and go, you know, the nice thing is you that you have the best thing as you have. This urgent epidemic and the good thing is CDC provides the answer and then it goes away. But that was 90 days that turned into 15 years and 40 years actually.

30:16 You know, I'm

30:19 I want to go back to make a comment about Indiana. You know, I think that people are always dealing in in covid or Ebola or Aids in in and they don't think about the long-term benefits of what's being done. And I remember you were telling me when you were in Indiana that you met with the health commissioner and the health commissioner was named Jerome Adams and that he responded to the governor name at the time was Mike Pence.

30:53 And who are you to know that those people that were dealing with this epidemic in Scott County, Indiana, would become the next Surgeon General and the next Vice President of the United States and have their lives alter to buy it by this epidemic and the review of Public Health. So what was the experience of dealing with the political officials in Indiana?

31:24 I know, it wasn't just you.

31:29 I think that there.

31:33 Would probably work done at a higher level than the work with the officials.

31:42 To understand how urgent the situation was and then that led to this emergency order to allow for there to be a syringe Services Program. And then I think there was a lot of work that was done in the local community. I remember there was like a candle light visual that was held and I believe dr. Adams came down. I'm Scott County for that and there was a lot of people in the community who saw the human connection to people being impacted both by drug use and by Hy-Vee, and they really wanted to do something about it, you know.

32:26 You mentioned before that you liked it, really like the people you worked with during these epidemics overseas and, and locally tell me about your Collies and CDC. What do you think of him?

32:41 They're pretty spectacular. I mean there's it's a really impressive group to work with people who you know, they've dedicated their lives to Public Health. They care about social justice. Like you said, they seen the tie between science and community and public service.

33:03 And, you know, it's a great network of people who have different areas of expertise that you can reach out to and then Austin during these investigations. It's fun people to travel West and have a beer with, you know, and I think that's what kind of what gets you through it all. You know, I like to think about the stories I would hear about former. He is officers and former CDC directors, like doctor, bill Fahey, and their sense of humor and playing pranks and playing jokes on each other. Because I think you do, you need to sort of

33:39 You know, have fun even in these very dire situation.

33:45 How about you? What do you think about your colleagues? Well, you know, I think that's one of the wonderful things about public health is a sense of mission people have. We see it in our graduate students here who are drawn to each other, because of their sense of mission. And, and I see it at CTC. And the people worked at cdcr. I built a Kia course, is over here. Now, he's retired a few times from different places, but we still pulling pranks on people. He's done some unforgivable things to me over the years and I guess maybe I've done some back to him, but I think that it is a sense of Collies working together and sharing each other's experiences that allows you to get things done and allows you to appreciate how you can actually do. Well while you're doing good, relationships are key.

34:41 I also think about how important it is been at the Eis has contributed to leadership, not only at CDC but but many other places throughout the country, so many Health officers in District, Health departments, and and states. And so many epidemics in public health and in preventive medicine around the country have been for Marie is officers. I think in Georgia, here, we have two or three districts that are headed by former. He is officers and our state health commissioner herself was a former IAS officer and and people like you have gotten sucked into CDC. I've truly is you were what made you decide to stay?

35:35 Well, I think your ass is a great introduction, introduction to the works at CDC does and you know, after 2 years of training and working on numerous outbreaks investigations. It was something I wanted to do more of and I just saw, you know, I had a lot of people who had been mentored by the CDC and I admired their careers. You had a great career at CDC and you know, I thought it would be a great place to work and continue, you know responding to these pressing public health problems.

36:19 There's almost nothing good about the coronavirus epidemic except the rapid development of a safe and effective vaccine. But the one thing is, if people start to understand the importance of Public Health and I can remember when I was at CC and I would tell people, I was an epidemiologist. They would mispronounce it. I even got a national award. Once when a famous singer got up and called me at the epidermis epidermis ologist or something. And I think right now people understand what an epidemiologist is and people are starting to understand the importance of Public Health and the need to support it more.

37:02 Do you think that the Morales CDC will come out? Strengthen at the end of covid?

37:10 I hope so. I mean, I think like you said it's an exciting time to be in public health. We're also seeing there's a lot more work to do and I and hopefully a lot more funding and support for epidemiologist at the local level and also at the federal level.

37:31 What do you think? What what are your hopes for you know, CDC and our country going forward. I think they're always our examinations of how things went when they're finally over. It's premature to do much judgment now because we're still in the middle of a global pandemic and even if we can solve it in the United States better, we still have to worry about the pandemic throughout the world, but at the end I think will face a combination of who to blame for what went wrong and how can we do things better? And I'm hopeful that how we can do things better in the strengthening of Public Health and working with Society throughout the country in the world will be a lasting Legacy.

38:26 Well Dad, this is a nice time to chat about CDC and Public Health.

38:33 This is kind of like one of our phone conversation. It is great to be able to call you and ask you questions and get your thoughts on things.