Shuford, who previously served as the chief state epidemiologist for DSHS, was born and raised in Texas. Before starting her new job, Shuford spoke with Community Impact about her career, her role in the state’s COVID-19 response and her goals as interim commissioner. This interview was edited for length and clarity.
Tell me about your career so far and what led to this point.
I grew up in Texas, and I have always wanted to come back to Texas for my career. I went to medical school in Dallas, at [the University of Texas] Southwestern Medical School, and did my internal medicine residency in Dallas. At that point, I knew that I really loved infectious diseases and wanted to sub-specialize in infectious diseases. So I went up to Mayo Clinic to do my infectious disease clinical training there.
During that medical training, I realized [that] I was really passionate about what public health accomplishes in the United States. I had a chance to come back to Texas during my infectious disease training and I spent a little time training with the state health department. [I] was able to see really up close what the health department did, and it was amazing.
After I finished my clinical training at Mayo Clinic in infectious diseases, I went to Harvard [University] to get my Master of Public Health, just to prepare myself to apply all of my medical training in a public health realm. After I got my master’s [degree], I moved with my husband back to Texas. I joined a medical practice as an infectious disease physician in Austin for about six years, and then I [had an] opportunity to get into public health at the state health department.
I joined the Department of State Health Services in 2017 as their infectious disease medical officer, and I thought I had the best job on Earth. That was until I was asked to fill the role of chief state epidemiologist [in 2020], and then I knew for sure that I had the best job on Earth.
I have loved working at the state health department. I have the opportunity to impact an entire population with some of the public health activities that we do. Medical practice is very rewarding, and patients are always so thankful. Yet, you're really impacting one patient's life. When you can take that same training and apply it to a whole population, in my opinion, it’s even more rewarding. I can really stop infectious diseases before they start circulating through communities or before they cause disease in people.
You helped lead Texas’ public health response during the height of the COVID-19 pandemic. What was that like?
It was all-consuming. And yet, it was exactly where I wanted to be. The pandemic was a time where we were working seven days a week. And it was a challenging and frankly, somewhat traumatic experience for a lot of us in public health.
[We were] trying to make things happen on a very compressed time schedule. Every time that there was any advance in the science, we were trying to push out that information as fast as we could. We were responsible for the allocation of vaccines and therapeutics, and we gained responsibilities that public health hadn't really had before.
But we were in this critical and fascinating place of being able to receive brand-new information, technology and intervention for a [previously] unknown disease and to be able to then pass it along to Texans in a way that we hoped would improve their lives and in some cases, save their lives.
I think everybody at the DSHS pitched into the COVID-19 response in one way or another. And we all felt like it was a fulfillment of [our] mission here at the state health department: to really help improve the health and well-being of Texans.
Has the COVID-19 pandemic changed how Texas responds to future public health emergencies?
I absolutely think so. There were so many lessons that everybody learned during [the COVID-19 pandemic]. I think that COVID-19 will directly impact how we handle a lot of the aspects of public health in the future.
One of the things that we did very differently during COVID-19 is the way that we presented data. Previously, when we would get data from around the state about diseases, we would take that data, make sure it was clean and complete, and finalize the data before we posted it on our website. That period of making really high-quality data would sometimes [take] a year and a half.
During [the pandemic], we knew that we needed to get information out immediately, so that the public and elected officials would be able to make really important decisions. Elected officials were trying to make decisions about the health of their communities, and individuals were trying to make decisions about their own health and the risks they wanted to take. So it was important for us to collect the data about COVID-19 and how it was spreading across our state and then immediately push that data back out.
Having made those changes and seeing the way they impacted the public and our elected leadership across the state has helped us understand how we might make changes in the future to help Texans make the decisions about diseases other than COVID-19.
As you step into this new role, what excites or worries you about the transition?
The mission of public health really excites me. The idea of trying to improve the health and well-being of every Texan is what drives me, and that is the mission of the DSHS. I have the honor of being at the helm of this great agency that does really strong work and tries their hardest to fulfill that mission.
[A lot] of what we deal with in public health is infectious diseases, and my experience helps prepare me for some of those activities. For instance, when COVID-19 appeared, I already had a pretty good understanding of the way that virus worked and [what] a novel viral respiratory disease could do to a population. It was nice having that base knowledge to inform the decisions that we were making as a department.
However, I am also excited about being able to impact all of these other areas of the health of Texans as well. Chronic diseases are a real drain on our society and around the world, and being in a position where I can help impact the burden of chronic diseases on our population is really exciting to me as well.
One thing that makes me nervous is that I think I've got big shoes to fill. Dr. Hellerstedt has been the commissioner of the DSHS for over six and a half years. He has led us with strength and integrity—he's a really good man. He was able to lead us through the COVID-19 pandemic, while many other state health commissioners weren't able to lead for that entire time, because it was so taxing on them, their families and their health. But Dr. Hellerstedt did, so it's going to be hard to fill those shoes.
What do you hope to accomplish as interim commissioner?
As interim commissioner, my goal is focused on this transition period. I have the privilege of being handed an agency that is already strong and effective. And so my goal is to make sure that our agency stays strong and effective, and advocate for [the agency] as best as I can.
