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Almost a year after the last Senate-confirmed director of the US Centers for Disease Control and Prevention (CDC), was fired for backing science and vaccines, President Donald Trump has nominated Dr. Erica Schwartz to head the agency, making her his third CDC nominee in less than two years.
Appearing before the Senate Committee on Health, Education, Labor, and Pensions (HELP) for her confirmation hearing on Wednesday, Schwartz pledged to restore public trust in the CDC through transparency and evidence-based decision-making.
However, she also faced pointed questions about vaccine policy, scientific independence, and whether she would resist pressure from Health Secretary Robert F. Kennedy Jr.
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Schwartz highlighted her military background and said restoring confidence in public health institutions would be her top priority.
"If confirmed, my first priority will be restoring trust in public health institutions through radical transparency and unwavering scientific integrity," she said.
"As CDC director, my sacred responsibility is to provide the American people with public health guidance that is clear, honest, and evidence-based. I will never betray science," she added.
Schwartz previously served as deputy US surgeon general during Trump's first administration and held the rank of rear admiral in the US Coast Guard.
Dr. Erica Schwartz is a physician with an extensive background in medicine, public health, engineering, and law. She holds a medical degree (MD), a Master of Public Health (MPH) in epidemiology, a law degree, and a degree in biomedical engineering.
Before being nominated to lead the CDC, Schwartz held several senior public health and military leadership roles, including:
Throughout the hearing, Schwartz repeatedly expressed support for vaccines, including mRNA COVID-19 vaccines, and strongly endorsed vitamin K injections for newborns to prevent life-threatening bleeding.
She also acknowledged that scientific evidence does not support a link between vaccines and autism, while arguing that more research is needed to better understand the rising prevalence of autism.
"We owe it to the American people to figure out why one in 30 children now has autism," she said.
Schwartz stated that she did not believe either President Trump or Health Secretary Kennedy would ask her to take actions that would harm public health or violate the law.
She also said she was unaware of Kennedy's decision to cancel nearly $500 million in mRNA vaccine contracts and was unfamiliar with reported cuts to smoking cessation and food safety programmes.
Although many observers consider Schwartz a qualified nominee with mainstream public health credentials, some experts said her testimony did not provide enough reassurance that she would independently defend scientific evidence if political pressure arose.
Dr. Jeanne Marrazzo, chief executive of the Infectious Diseases Society of America, said she wanted stronger commitments to evidence-based science from leaders overseeing the nation's top public health institutions.
The hearing also renewed criticism of Health Secretary Robert F. Kennedy Jr.'s handling of the CDC.
Several Democratic senators, including Sen. Bernie Sanders, argued that former CDC director Dr. Susan Monarez was removed because she resisted Kennedy's vaccine policies.
"Dr. Monarez, to her credit, stood up for science, public health, and for the scientific method. Frankly, she stood up for protecting the well-being of the American people, and that was the reason that she was fired," Sanders said.
If confirmed by the Senate, Schwartz would replace Dr. Jay Bhattacharya, who’s been serving as acting CDC director since February.
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Low-dose CT (LDCT) screening of people at high risk based on age and smoking history can reduce lung cancer deaths and advanced-stage disease, according to an International Agency for Research on Cancer (IARC) working group.
Speaking to HealthandMe, Dr Abhishek Shankar of AIIMS New Delhi, the only Indian author among the 23 experts from 17 countries involved in the IARC review, said India needs to generate its own screening evidence.
The review was published in The New England Journal of Medicine as part of IARC WHO Handbook 21.
Dr Shankar, a lung cancer specialist, said India needs to generate its own screening evidence while ensuring high-risk people have access to screening and follow-up care.
“India should not wait for a perfect screening model and there is a need to generate Indian evidence while ensuring that those at highest risk have access to lung cancer screening and care pathways for screen positive cases,” he said.
Dr Shankar is leading the Indian Lung Screening Trial (ILST), which is assessing risk-based lung cancer screening across 10 centers in India.
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The evidence mainly covers people aged 50 to 80 with a substantial smoking history, typically 20–30 pack-years or more. Studies involving former smokers generally included those who had quit within the previous 10–15 years.
In India, people aged 50 to 80 who have smoked at least 20 pack-years and are current smokers or quit within the past 15 years can contact ILST about screening under the trial.
“High-risk smokers should be encouraged to participate in organized screening rather than opportunistic CT scanning, with appropriate nodule management, follow-up and smoking-cessation support,” Dr Shankar said.
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In the US National Lung Screening Trial, LDCT was linked to a 16% lower relative risk of lung cancer death at seven years compared with chest X-rays. The European NELSON trial also found lower lung cancer mortality among men screened with LDCT at 10 years.
IARC classified LDCT as Group A, indicating established evidence that it reduces lung cancer mortality and stage III or IV disease. Chest X-rays, with or without sputum examination, were classified as Group C, as a mortality benefit could not be established.
LDCT is not meant for everyone. Across studies, false-positive rates ranged from 1% to 42%. Among those with false-positive results, 5% to 32% underwent an invasive procedure, with complications reported in 10% to 22% of those procedures.
The review also estimated that 3% to 26% of lung cancers detected in randomized trials could represent over-diagnosis.
The IARC group stressed that screening requires more than CT scans, including risk assessment, nodule management, follow-up, smoking-cessation support and adequate healthcare capacity.
“India has an opportunity to build an equitable, affordable, locally relevant lung cancer screening pathway and ILST can provide the evidence needed to guide that future,” Dr Shankar said.
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Doctors may soon be able to determine a brain tumour’s type right during the surgery. Doctors remove a tissue sample during surgery to analyse the tumour. Patients undergoing surgery for brain tumour may not have to wait days or weeks to find out.
A new rapid genetic test being tested by the NHS in England promises to shorten the wait time drastically. The technology can find the precise type of brain tumour within about two hours, while the patient is still on the operating table.
Developed by researchers at the University of Nottingham and Nottingham University Hospitals NHS Trust, the test analyses the genetic code of a tumour sample rather than relying only on traditional microscopic examination.
Brain tumours are not connected to one single disease. There are more than 100 types, ranging from relatively slow-growing tumours to highly aggressive cancers. Knowing the exact type and characteristics of a tumour is important because treatment courses can differ significantly.
Traditionally, doctors take a sample during surgery and send it to a pathology laboratory. The tissue sample is then examined under a microscope. Finding out the tumour type usually takes weeks.
According to an NHS centre, the current average time for a brain tumour diagnosis can be around 26 days, while other reports have estimated up to almost eight weeks in some cases. In case of aggressive tumours, waiting period can be particularly difficult and longer.
The rapid genomic test works by analysing a small piece of the tumour which is taken during the surgery and sent to the laboratory, where its DNA is analysed using a shoebox-sized sequencing machine developed by Oxford Nanopore.
Inside the machine, DNA molecules pass through tiny pores. As they move through, the system reads their genetic information and uses the resulting genomic pattern to identify the tumour type.
Marking a significant jump in speed and time taken, the test can help doctors can receive detailed diagnosis during the operation itself instead of weeks.
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Not only this test reduces weeks, sometimes months of anxiety, it can also help surgeons make immediate decisions about how much tumour tissue to remove while protecting healthy brain tissue.
Some tumour types require different surgical approaches, and having molecular information immediately could help the surgeon take quick decisions.
A rapid diagnosis can also help patients to begin the appropriate treatment sooner and gain earlier access to clinical trials designed for specific tumour types.
The NHS is piloting the technology to determine how well rapid genomic testing works in routine clinical practice. The initial rollout covers five specialist centres, including Nottingham University Hospitals, University Hospitals Birmingham, Great Ormond Street Hospital, King's College Hospital and Newcastle Hospitals. More centres are expected to be added soon.
The rapid testing is therefore intended to complement the entire diagnostic process rather than make traditional pathology obsolete. If the NHS pilot is successful, rapid genomic testing could eventually make that information available much earlier to brain tumour patients across England.
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The early signs of type 2 diabetes could be related to your gut. They may signal a warning risk long before you take a blood sugar test.
New research suggests that changes in the trillions of bacteria living in the gut may accurately predict future diabetes risk.
An analysis of microbiome data from more than 229,000 adults in the UK and US identified hundreds of bacterial changes linked with type 2 diabetes, including changes that appeared before measurable abnormalities in blood glucose.
The findings are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan.
Researchers from the University of Trento in Italy and collaborators in the UK analysed metagenomic data, which involves examining the DNA of microorganisms living in the gut.
The study included 229,025 people, of whom 3,627 had type 2 diabetes, 14,022 had prediabetes and 211,376 had normal blood glucose levels. The average age was 50, and about 74% of participants were women.
After accounting for factors including age, sex and body mass index, researchers identified 789 bacterial species associated with type 2 diabetes.
Of these, 168 were found at higher levels in people with diabetes, while 621 were present at lower levels.
One example was Enterocloster bolteae, which was more abundant in people with type 2 diabetes. In contrast, Romboutsia timonensis was found at lower levels.
Interestingly, 587 of the 789 bacterial species were also associated with unmedicated prediabetes, suggesting that some of these microbial changes may occur before diabetes is diagnosed.
Also read: Diabetes Linked To 55% Risk Of Kidney Disease, Heart Failure Or Death Within 10 Years: Study
The researchers looked at 135,093 people who had normal blood glucose and did not have diabetes or prediabetes. They also had information about how their blood sugar responded after eating.
Normally, blood glucose rises after a meal and then falls. If it remains elevated for longer than expected, it can indicate that the body's muscles are not responding properly to insulin, an early feature of insulin resistance.
Researchers found that people whose blood sugar remained elevated for longer were more likely to have the gut bacterial pattern linked with type 2 diabetes. The microbiome changes became more pronounced as insulin resistance increased.
Therefore, it was observed that the gut microbiome carried clues about metabolic problems even when standard blood glucose levels were still normal.
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Currently, diabetes and prediabetes are diagnosed using tests like HbA1c, fasting blood glucose and oral glucose tolerance tests.
For people who have normal results, doctors generally assess future diabetes risk using factors like age, sex, body mass index and family history. A gut microbiome test is not currently part of routine diabetes screening.
The researchers believe microbiome analysis could eventually provide an additional layer of risk assessment, identifying people who could benefit from earlier lifestyle interventions.
Professor Tim Spector, one of the study's authors, Scientific Co-Founder, ZOE, said, “These latest findings represent a major step forward in understanding how our gut microbiome is linked directly with metabolic disease. Identifying these clear microbial changes before blood sugar levels worsen could lead to earlier intervention with food and lifestyle choices, as well as treatment options, to prevent T2D."
The researchers say that microbiome analysis should not replace existing tests for diabetes or prediabetes. The current findings show associations between particular bacterial patterns and diabetes risk.
The researchers also found that some of the bacteria making up the diabetes-related signature have never been isolated or cultivated in a laboratory and are new in terms of scientific investigation.
Additional research will be needed to assess whether these microbial changes can reliably predict who will develop diabetes and whether changing the microbiome can actually reduce that risk.
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