CDC Director Erica Schwartz on Navigating Leadership Under RFK Jr.

In her inaugural interview since taking the helm of the Centers for Disease Control and Prevention (CDC), Erica Schwartz discussed her approach working with Health Secretary Robert F. Kennedy Jr. She stressed her comfort in disagreeing with Kennedy, but these disagreements will remain private.

Schwartz highlighted a practice from the uniformed services called ‘but sir, but ma’am,’ which allows for respectful disagreement with superiors. She expressed that such disagreements have occurred in private conversations with Kennedy during their five weeks of collaboration. Despite differing views, Schwartz acknowledged Kennedy’s authority to make final decisions given his position as Secretary of Health and Human Services.

This approach contrasts with her predecessor Susan Monarez, who publicly challenged Kennedy’s stance on vaccines, resulting in her swift dismissal.

Schwartz is recognized for her previous roles as Deputy Surgeon General under the Trump administration and a leading health official in the Coast Guard, supporting childhood vaccines. Her appointment is seen as a move towards stabilizing the CDC. Despite this, some Democrats, along with Republican Senator Bill Cassidy, question her willingness to oppose Kennedy’s positions.

Amid a significant measles outbreak in the U.S., Schwartz faces criticism for instructing the CDC to dispute four measles-associated deaths in Pennsylvania. This decision follows Kennedy’s allegations of fabricated reports and his ongoing political disagreement with Pennsylvania Governor Josh Shapiro.

“At the end of the day, he’s the Secretary of HHS. And at the end of the day, he’s going to make the decisions.”

Schwartz described the issue as a technical matter, noting the CDC lacks a standardized definition for measles-related deaths. She drew parallels to debates over COVID-19 death classifications, explaining: “If someone got hit by a bus, and they happened to have COVID, often that was called a COVID-related death.” Pennsylvania officials rely on CDC classifications for respiratory virus deaths, excluding cases where deaths result from unrelated incidents, like a car crash.

Schwartz’s comments are a part of ongoing discussions on how policy influences healthcare outcomes. Meanwhile, Philadelphia health authorities warned of potential measles exposure at the Children’s Hospital of Philadelphia. The incident occurred on September 11, and details of the exposure are currently being investigated.