This week, as America marked the fourth anniversary of the natural disaster that devastated the city of New Orleans and the unresponsive presidency of George W. Bush, Washington’s new team barely had time to notice.
They are racing against the uncertainties of nature and science — desperately hoping the autumn return of the H1N1 virus, known as swine flu, will not become the Obama presidency’s Katrina.
They are determined to be as prepared as they can be. No one in Washington wants a repeat of the response failure that made the Federal Emergency Management Agency’s Michael Brown a household word (“Brownie, you’re doing a heck of a job,” proclaimed his maximum leader — an accolade that applied equally to both men).
But they are beset by what they know and also what they can estimate but cannot know for sure. In a stunningly straight-talking assessment that scrapped the usual governmental gobbledygook, the President’s Council of Advisors on Science and Technology estimated that half of the U.S. population could catch some form of swine flu this fall and winter. Some 1.8 million of us could be hospitalized, with 300,000 being in intensive care. An estimated 90,000 Americans could die in the coming pandemic — twice the number of fatalities in a normal flu cycle.
Never before has a government provided such specific estimates. And Health and Human Services Secretary Kathleen Sebelius has been making the media rounds, spreading the word that the H1N1 flu — which debuted in Mexico, previewed briefly here last spring before spreading to the southern hemisphere’s winter, where it has claimed 1,799 lives — could be far worse when it returns to the northern hemisphere this fall.
“This isn’t the flu that we’re used to,” Mrs. Sebelius said. “The 2009 H1N1 virus will cause a more serious threat this fall. We won’t know until we’re in the middle of the flu season how serious the threat is, but because it’s a new strain, it’s likely to infect more people than usual.”
The problem is that scientific efforts to develop the vaccine to inoculate us against this swine flu are behind where we really needed them to be. In mid-October, when the flu will be at its peak, Americans will have only one-third of the vaccine that officials had expected to be available. The Washington Post reported last week that among the complications and unknowns is whether people will need one shot or two to be inoculated against the disease. Also unknown is what the proper dosage will be.
Mindful of that, the president’s advisory council recommended that the Department of Health and Human Services step up its vaccine timetable. They urged that the five pharmaceutical companies under contract to manufacture the drug begin distributing the vaccines by mid-September in small 15 microgram quantities — even before the final testing has been completed and the final dosages have been set. That way the vaccinations can be given as soon as tests are finished, safety is assured and dosage is set. There is no time to waste. Pregnant women and children, the most susceptible to this flu strain, will be first to be inoculated.
“There’s little doubt we’re going to vaccinate people,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, the lead agency in the vaccine testing program.
“Who and when and exactly how — we have to figure out.”
There are, of course, other complicating matters that Dr. Fauci’s agency must carefully safeguard. In the anticipated swine flu epidemic of 1976, the virus proved less perilous than was anticipated — but 40 million people were given the vaccine. It was later said to have caused a rare Guillain-Barre Syndrome, which caused paralysis in some who were vaccinated.
So our fate is quite literally in the hands of those whose job is to respond to the crisis while safeguarding us all. We can only hope that Dr. Fauci really is doing a heck of a job.
Martin Schram is a columnist for Scripps Howard News Service.