Saving Lives And Protecting Americans

“I’ve worked on biodefense, health security, and public health preparedness my entire career, and I’ve had ups and downs and successes and failures. But it’s always gratifying to be part of national and global challenges focused on trying to save lives and get our economy and nation back on track.”

- DR. GERALD PARKER

Dr. Gerald Parker has served on the front lines during many biodefense and health security issues, but through his work as a federal adviser during the COVID-19 pandemic and as part of Texas’ largest and most complex vaccination campaign, he was able to play an important role in modern public health history.

Story by AUBREY BLOOM

In the medical field, the stakes are almost always high because every decision a doctor makes can impact the life of a patient. But when you’re making decisions that can affect the lives of millions of people, those are the highest possible stakes.

Being involved in those kinds of decisions is how Texas A&M College of Veterinary Medicine & Biomedical Sciences’ (CVMBS) associate dean for Global One Health Dr. Gerald Parker spent parts of the last two years, first in Washington, D.C., as a senior adviser to the Assistant Secretary for Preparedness and Response within the U.S. Department of Health and Human Services (HHS) and later as a member of the Texas Expert Vaccine Allocation Panel (EVAP).

Assisting the federal government in its response to a pandemic that mostly affects humans is a long way from the types of things most veterinary students envision themselves doing, but Parker still credits his early years at the CVMBS as giving him the foundation he needed for public health and medical preparedness.

“My veterinary education launched me,” he said. “It got me thinking about how animal health is also public health. It gave me that ability to think, early on in my career, about how public health is an extension of herd health, and it is all One Health.

“Now, more people are thinking about zoonotic diseases and how those can jump from animals to humans and back to animals,” he said. “The pandemic has heightened people's awareness that our world is interconnected in many ways, that the human and animal and environmental nexus is important.”

ENGAGING WARP SPEED

Parker is no stranger to the halls of Washington, D.C. After a 26-year military career, he spent a decade with not only the HHS, but also the Departments of Homeland Security and Defense. So when he was called to the HHS in May 2020 by colleague Dr. Bob Kadlec, Parker was ready for the challenge.

In D.C., he helped make recommendations to and supported the senior leadership team on a number of fronts. Because so little was known about the virus early in the pandemic, the federal government had the same issue everyone else did in making sure they had enough people to operate.

“Organizations at all levels have been challenged with their continuity of operations,” Parker said. “It was a trying time for everybody, and part of my day-to-day activities included our own continuity of operations to keep morale up, keeping everybody staying positive and testing negative. We had to bolster each other's morale to keep going because we had a very important mission and that was saving lives and protecting Americans.”

One of the things Parker is proudest of is his involvement with Operation Warp Speed, the federal government and the biotechnology industry’s program that fast-tracked COVID vaccines. The plan was already underway when Parker arrived, but he helped coordinate efforts and had a front row seat to the accelerated development of the vaccines.

“Operation Warp Speed was an extraordinary public health achievement and it is not getting the recognition it deserves,” he said. “It’s just extraordinary that we had two vaccines authorized for use in less than a year.

“It was an incredible effort, built on a foundation of over 20 years of investments in biodefense and public health preparedness, but it was Operation Warp Speed’s leadership who had that clarity of focus to channel the power of the federal government through resources and authorities, coupled to a willing and able vaccine industry and bioeconomy that made it possible,” Parker said.

That was one of the more impressive things he’s been associated with in his career, to be on the front lines and see leadership—from scientists, the military, multiple governmental agencies, and the private sector—operate effectively without regard to traditional organizational silos and, despite what many of the public may think, isolated from politics.

“Leadership and program management discipline drove day-to-day decisions and enabled the early recognition of problems for quick elevation to the highest levels of government for a quick resolution. This was coupled to the best scientific leadership, with experience in the vaccine industry, who created this unbelievably high-performing group,” he said. “They had singular focus and commitment and they stayed isolated from the political environment of Washington, D.C. All of that was critical to their success.”

THE EVEN GREATER CHALLENGE

Developing the vaccines, challenging as it was, was not the most difficult part of the process. Once developed and proven safe and effective, the government, public health authorities, and healthcare system had to distribute and administer vaccines.

In the fall of 2020, Parker was asked to join the Texas EVAP to advise the state on vaccine allocation priorities. Knowing that the vaccines would be a very scarce medical resource at first, the group—comprising experts on health policy, public health, healthcare administration, and the actual vaccine providers—began working on distribution plans and allocation priorities.

“I’ve served on many advisory panels in my career, and this was by far the most engaged, most deliberate, and most thoughtful,” he said. “Sometimes we had intense discussions because the stakes are so high with the recommendations we’re making. These are huge decisions that must be made when you’re trying to do what’s best with a very scarce resource that has the potential to save many lives.”

One of their early decisions was to go in a different direction from the recommendations that the Centers for Disease Control and Prevention (CDC) and the National Academies of Sciences had previously published.

Those recommendations were to vaccinate frontline healthcare workers in the 1A category first, followed by essential workers by priority occupations in the 1B priority.

But according to Parker, when the EVAP was looking at the most recent data, the vast majority of deaths and serious cases were happening in the older population and people with comorbidities without regard for occupation. So the EVAP recommended vaccine group 1B include people over 65 and those over 16 with comorbidities, regardless of occupation. It was a decision that other states and organizations, including the CDC, would later pivot to as well.

“We looked nationally, but focused on Texas, and asked what the data was telling us, what the science was telling us, and what the epidemiology was telling us,” he said. “The data told us that over 95% of the deaths occur in people over 60 years and older, regardless of comorbidities or occupations, so that's where people were dying.

“We really couldn't identify a specific occupation that was at higher risk than other occupations,” he said. “If you were over 16 with an identified comorbidity and in the workforce regardless, you were eligible under the 1B priority.”

For Parker, one of the frustrating things of working behind the scenes was the intense public and media criticism of the early vaccine rollout.

“There was a lot of criticism about the rough or slow start to the vaccine rollout; some of it was well founded,” he said. “Could it have been better? Yes. Like many things during the pandemic, the vaccine rollout could have been communicated beforehand and as the vaccination campaign began.

A rendering of the SARS-CoV-2 virus.

“It is important to understand that this is the largest and most complex undertaking of a vaccination campaign we'd ever embarked on, in public health history, really, under this tight of a timeframe,” he said. “We knew there would be hiccups along the way, particularly as you're rolling out something brand new and having to develop and use systems that aren't used on a day-to-day basis, like vaccine hubs.

“It's like my world in the past, in national security, you're always going to have a fog of war,” he added. “That's natural.”

Despite the challenges and frustrations, though, and even after a career of public service, it’s still satisfying to be a part of something so big that it has the ability to help people across all walks of life.

“I’ve worked on biodefense, health security, and public health preparedness my entire career, and I’ve had ups and downs and successes and failures,” he said. “But it’s always gratifying to be part of national and global challenges focused on trying to save lives and get our economy and nation back on track.”

KEEPING OUR GUARD UP

Despite the successes, something that Parker can’t help but think about is whether more could have been done before the pandemic hit.

“I, and many of my colleagues, forewarned of a pandemic, but the country wasn't prepared,” he said. “So I feel some responsibility. What could have I done to catalyze more attention to our preparedness needs? We all think about that.”

That’s why he’s now focused on getting through the COVID-19 pandemic while keeping up the pressure to prepare for future pandemics and biological threats from any cause—whether natural, accidental, or intentional in origin.

“COVID-19 is not our last pandemic, and while our society is very much focused on tomorrow, we don’t think longterm, unfortunately,” he said. “At the longest, a U.S. Senator is elected for a six-year term, so that’s our society and human nature; we have a short memory and attention span. Hopefully, we will avoid short-term memory this time and remind our elected officials that preparedness and One Health are important issues.

“Emerging infectious disease outbreaks with pandemic potential are increasing with alarming frequency, even before COVID, and they will continue after COVID,” Parker said. “We must put more emphasis on preventing an outbreak anywhere in the world from becoming an epidemic or pandemic. One Health preventive solutions are needed at the animal, human, and environmental nexus where outbreaks start. But, if prevention fails, we must be better prepared to respond than we were with COVID-19.” ■