It’s been six years since DA Henderson died and I think it is painfully obvious to everyone — not just those in infectious disease and public health — how much he’s needed. As has become my tradition, I am going to list several questions I have for him. Thought it is a pale comparison to the terms when I could just walk through the office and find him at his desk reading and just ask him, I find it useful to refine my own thinking on the issues of the day and wonder how his unrivaled mind might approach the problem. Sometimes, it just makes me appreciate just what it was like to be in the presence of such a person.
Interestingly, just a few days ago I was excited and not surprised to see DA’s name in print in the Washington Post as an anecdote from over 20 years ago in which he warned of the threat of monkeypox was recounted.
So here are my questions for DA.
What do you think the trajectory of monkeypox will be? Is this something that will burn itself out as people become immune through vaccination and prior infection while also changing their behavior? Do you think sustained spread is possible in the US outside of men-who-have sex with men? Is this clustering among MSM akin to how meningococcus can do the same thing?
What do you think of Jynneos’s effectiveness? I know you always swore by Dryvax and it’s modern equivalent, ACAM2000, because it — with you driving its use — banished smallpox from the planet. Would you favor the use of ACAM2000 in select cases (I know I would). Also, what about Lc16m8, the Japanese 2nd generation vaccination you favored. I remember a story you told me about how after the anthrax attacks the Jynneos (or MVA) was prioritized over the existing Lc16 m8 for reasons you never quite understood (a good story for a journalist to try to uncover)
As COVID-19 becomes more manageable with all the medical countermeasures that have been developed how do you help people risk acclimatize to a never-abating threat?
What should be done about circulating vaccine derived polio viruses (cVDPVs) ? Following what you taught me I draw a distinction between wild poliovirus and these Sabin-vaccine derived strains. Should we just move to full Salk for the rest of the world to eliminate this problem? Why do people conflate wild polio — which exists in just Afghanistan, Pakistan, and Mozambique -0 with cVDPVs?
Do you think that waning immunity against ordinary respiratory viruses due to decreased social interaction because of COVID is responsible for pediatric hepatitis cases and off season RSV? What will happen with flu as some strains have become extinct ?
How do you think the CDC should be reformed? What was your final impression of it’s promise after spending so much time there? I think there was a reason you didn’t ever direct the organization that stemmed from who “they” wanted at the helm vs. who is best qualified.
These are just 6 questions I want to know DA’s answer to — there are so many more.
One last point to make. As infectious diseases have, understandably, taken center stage DA’s presence and voice would be unequalled. His would be an intransigent voice that spared no one’s feelings, one that would not be carefully calibrated to curry favor with any political party, leader, or administration, and one that provide a resolute direction for clinicians, the public health workforce, and the whole country and planet. Would that a DA-like figure emerge again — I hope his qualities are not a once in a century appearance.