What started as a clear, sunny day in Atlanta for CDC’s Captain Tracee Treadwell, D.V.M., M.P.H., ended in smoke, soot and tension in New York City.

“I was at work when the planes struck the towers and many of us congregated in an office with a TV,” she said. Soon after, Treadwell and her colleagues on the main CDC campus in Atlanta were evacuated because of evolving threat concerns expressed by the FBI.

CDC leadership met in an alternate site and began to develop the response. Treadwell was assigned to lead a team to respond to New York City.

Before that day, she had been working on bioterrorism preparedness projects at CDC. In 1999, she had served as a team leader for surveillance and response activities at the World Trade Organization Ministerial in Seattle. In 2000, she did the same at the Democratic and Republican Convention cities. “We were doing ‘drop-in’ surveillance in high profile events, looking for unusual disease clusters or symptoms being reported within the population,” she explained.

Early warning system

The value of this “drop-in” surveillance, at the time, was it could serve as an early warning system and supplement what was being done by local and state health departments.

Despite the closure of airspace over the United States, Treadwell and three others raced to a local airport to board a small corporate jet. CDC had previously established unique FAA-issued Priority Flight Designation that allowed people and materiel to be flown to New York City. They would be looking for suspect pathogens in the city.

While on the flight up to New York City, Treadwell started to organize her team’s activities, anticipating what support the health department might need. “There was a lot of tension because we knew we were truly under attack,” she said.

They called us CDC-1

Nearing the city, the pilot invited Treadwell to come up to the cockpit. “It was early dusk, night was approaching. Suddenly, in the distance was a black dot in the sky and it was moving rapidly toward us. Of course, my mind jumped straight to someone is shooting us down,” she admits. In seconds, she saw a fighter jet come up near the plane. “They were so close I could clearly see the face of the pilot. They did a wing wave and moved on. We were the only civilian plane in the sky. They called us, CDC-1.”

With that welcome to New York, the team landed. While in the movies everything works smoothly, this was real life. They found themselves hampered by spotty phone service and difficulty determining just where they needed to meet up with the city health director. A sheriff finally got them where they needed to be.

“The city health department was fairly close to ground zero. There was smoke and soot in the air. A little past midnight we hammered out what was needed for the bio-surveillance. The concern was about what agents might be dispersed. We developed case definitions and created a rudimentary system of surveillance and assessment. We were assessing hospital capacity and clinics. We expected to be overwhelmed with injuries. It was clear this was going to belabor intensive,” Treadwell remembered.

CDC should send more

They decided the first night that CDC should send more Epidemic Intelligence Service (EIS) officers to New York and more than a dozen arrived within days. Worker safety at the site became a primary concern. Treadwell assigned her team across hospitals in the city to collect information about the types of illness and injuries being seen in the ERs. “We wanted to ensure medical supplies and personnel got where they were needed and to see what sort of public health recommendations and health education would be needed onsite.”

The days for Treadwell may have blurred one into another, but not the scene outside the temporary site of operation for the health department:  it remains starkly vivid. “We were across the street from Bellevue Hospital. The refrigerated trucks for the bodies being removed from the site were next to the hospital. The constant noise from the motors, the rumble of the refrigerator cars and the sirens were reminders of the magnitude of loss. It defies description,” she admits.

I was going to turn back around

Treadwell had little time to adjust to her involvement in the 9/11 response, when she was thrust into the response to the anthrax letters.”I needed to return to CDC briefly for a specific task and I traveled back to Atlanta thinking I was going to turn back around to New York the same night. Again, it was late at night and I drove up to the CDC campus — the lights were out [CDC had experienced a temporary blackout on the campus] and it felt so strange. The weather was still warm and I walked up to someone and they welcomed me back,” she said.

However, Treadwell did not get back on that plane. She was again tapped, along with Jay Butler, M.D., to co-lead the state liaison team. This was the first team that received all of the calls from state health departments or private physicians concerned about a possible anthrax case. The team would literally start the investigation over the phone and, if needed, form the team to visit the site in person.

Treadwell has not left emergency preparedness. Today she is the associate director for infectious disease preparedness in the CDC center responsible for emerging and zoonotic diseases. “I’m proud to have been a small part of an agency that dealt with a crisis of this magnitude with dignity and dedication,” she said.

When revisiting her early drop-in surveillance work, she cautions, “we have created some sophisticated systems, but surveillance is best done by supporting the capacity at the state and local level. No one knows a city and county better than the people who live there. We need to invest in them.”

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