Bush Suggests Using Military for Quarantine Efforts in the Event of a Flu Pandemic
President Bush on Tuesday said he would consider using the military to enforce a quarantine in the U.S. in the event of pandemic influenza, the Washington Post reports. Bush at a press conference on Tuesday also said that putting National Guard troops under federal control could be one part of a response to the "catastrophe" of an avian flu outbreak. Bush said, "The policy questions for a president in dealing with an avian flu outbreak are difficult. One example: If we had an outbreak somewhere in the United States, do we not then quarantine that part of the country? And how do you, then, enforce a quarantine? ... And who best to be able to effect a quarantine?" He added, "One option is the use of a military that's able to plan and move. So that's why I put it on the table. I think it's an important debate for Congress to have" (Brown, Washington Post, 10/5). Bush also said, "The best way to deal with a pandemic is to isolate and keep it isolated in the region in which it begins" (Orin, New York Post, 10/5).
While experts believe it is impossible to isolate an entire region during an outbreak, quarantine efforts could include a variety of strategies to reduce the chance of spreading the disease by identifying and limiting the movement of infected people. Methods that could help contain the disease include screening travelers for fever or flu symptoms, prohibiting large gatherings of people and requiring infected individuals to stay at home during the incubation period of the illness. Bush did not give any details on the specific role that troops might be given or the type of quarantine that might be invoked. The administration is expected to release its pandemic-response plan, which the government has been working on for more than a year, "soon," the Washington Post reports (Washington Post, 10/5).
HHS Secretary Mike Leavitt will tour Thailand, Vietnam, Laos and Cambodia next week to discuss a coordinated surveillance of outbreaks with officials of those countries. Leavitt said several steps must be taken to prevent a pandemic, including the creation of a global surveillance program for the disease, the establishment of a domestic surveillance system and the development of a stockpile of antiviral drugs that can be made available in the event of an outbreak. HHS spokesperson Christina Pearson said the government has purchased "millions of courses" of treatment for a flu pandemic and aims to stockpile a total of 20 million courses, each of which includes enough doses for a full treatment.
In addition, the government is underwriting research to develop new vaccines that take less time to manufacture (Harris, New York Times, 10/5). Leavitt said there is a need to "rekindle" the "entire industry" of domestic vaccine production (Vieth, Los Angeles Times, 10/5).
Meanwhile, Senate Democrats on Wednesday plan to introduce a bill that would establish a flu pandemic coordinator in the White House and create a federal buy-back program for unused flu vaccines, among other measures (New York Times, 10/5).
Using the military to effect a quarantine would require changes to the laws that restrict the role of active-duty troops in an emergency. According to the Los Angeles Times, some military officials "have expressed skepticism about assuming more responsibility" in natural disaster emergencies, while some lawmakers "have voiced concern about the diminished authority of state officials and the National Guard units they control" (Los Angeles Times, 10/5). On Tuesday, 32 Democratic senators sent a letter to Bush saying they have "grave concern that the nation is dangerously unprepared for the serious threat of avian influenza." The Democrats said in the letter that it was past time for the administration to release its flu pandemic plan. They also said the Bush administration has not provided enough funding to prepare for a pandemic.
Sen. Tom Harkin (D-Iowa) said, "'Trust us' is not something the administration can say after Katrina. I don't think Congress is in a mood to trust. We want plans. We want specific goals and procedures we're going to take to prepare for this" (New York Times, 10/5). Sen. Edward Kennedy (D-Mass.) said, "The administration has failed to stockpile needed flu medicines, delayed the publication of a comprehensive response plan, and irresponsibly cut funding for public health preparedness and hospital surge capacity" (Schulte/Grant, Houston Chronicle, 10/5).
Irwin Redlener, associate dean of Columbia University's Mailman School of Public Health and director of its National Center for Disaster Preparedness, said Bush's plan represents an "extraordinarily draconian measure" that would not have been necessary if the U.S. had made preparations for rapid vaccine production, stockpiled antivirals and bolstered the public health system's infrastructure. He added, "The translation of this is martial law in the United States" (Loven, AP/Las Vegas Sun, 10/4).
Leavitt said, "No one in the world is ready for" a flu pandemic. He added, "But we're more ready today than we were yesterday. And we'll be more prepared tomorrow than we are today. ... We need a plan. I'm resolved to make sure we have one and so is the president" (New York Times, 10/5). White House spokesperson Trent Duffy said Bush's plan would use the military in a quarantine process only "in the most extreme circumstances" when local and state resources are overwhelmed (AP/Las Vegas Sun, 10/4).
Bush said, "Some governors didn't like [the plan]. I understand that. I didn't want the president telling me how to be the commander in chief of the Texas Guard. But Congress needs to take a look at circumstances that may need to vest the capacity of the president to move beyond that debate. And one such catastrophe, or one such challenge, could be an avian flu outbreak" (Sammon, Washington Times, 10/5).
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said, "The entire world has a long way to go to achieve even the most fundamental levels of preparedness. We're going to need every possible asset within all of government -- federal, state and local -- to respond to a pandemic" (Hutcheson, Philadelphia Inquirer, 10/5).
The Wall Street Journal Online on Wednesday published an interview with Andrew Pavia, chair of the influenza pandemic task force of the Infectious Diseases Society of America, about whether the U.S. is prepared for a major outbreak.
Pavia said that although "progress has been made" in preparing for a pandemic, the U.S. "still has a long way to go." He continued, "I think you're going to see a lot of movement in the next couple of months to fix some" shortfalls in the U.S. preparedness plan (Huang, Wall Street Journal Online, 10/5).