way.
Chapter 5
Atlanta, Georgia
July 21
Nominally, the Surgeon General’s Office was a subordinate part of Health and Human Services. So there was not really an ongoing war between the secretary of HHS and the Surgeon General; it just seemed that way, which was almost as bad.
They were both political appointments, Beck recalled—HHS a former California congressman who had been instrumental in the current president’s initial campaign, the SG a women’s rights activist who had lobbied hard but fruitlessly for a cabinet-level post before settling for a position that was largely symbolic. Neither official was a physician. But both had brought to the CDC meeting aides who were, and that added an element of professional competition into the already volatile mix. The key question was the same that had bedeviled them throughout the day: Did the current situation warrant declaring an emergency? If so, there was no shortage of plans that could be put into action; but if they blew this call, the downside risk was, to appointees and career bureaucrats alike, potentially cataclysmic.
There had been heated words, some shouting, and noresolution. Porter had left in disgust, shaking his head as he stood to return to his office.
“I’m heading down to the outbreak site,” he said to Krewell in an angry aside. “You don’t need me here to deal with this crap. Not when people are dying down there.” The physician stalked out without a backward glance.
“Damn it, Larry,” Beck muttered to Krewell, who sat at his side. “He’s right. How long do we listen to politicians and bureaucrats? Somebody has to show some leadership, for God’s sake.”
Krewell looked at his watch.
“The President expects a recommendation by six,” he told Beck. “That gives them no more than—whoops. Here it comes. Watch this, ol’ buddy.”
Billy Carson had stood, and the figure he cut in his shirtsleeves was enough to draw the attention of the room.
“There really is no room for discussion,” Carson said. He half turned to address HHS. “Mr. Secretary, there is no statutory question as to your department’s responsibility in the circumstances we face. In matters of public health, you are the lead authority. Like the rest of us here today, the Surgeon General’s Office is an advisory body only. We have, I believe, heard its advice. It is time to act, sir.”
The SG’s aide, an emaciated woman who had been a family-planning specialist in Philadelphia before assuming her present post, spoke angrily.
“Mr. Carson, I resent the way you’re—” she began, and Carson’s voice overrode her firmly.
“As Dr. Krewell pointed out, we are dealing with a matter of available time. History alone demands that we accept Dr. Porter’s analysis. H1N1 is, potentially, a catastrophic threat to public health. Look at the sheer numbers involved. Over the course of twelve months in 1918, at least a half-million Americans died of influenza. One in four was incapacitated. This disease constitutes a threat to our entire population—more than two hundred fifty million Americans.”
“History demands that we not overreact, either,” the senator said, and the SG nodded. “Do we want to risk a general panic? And as long as we’re talking about ‘potential,’ how about the potential for making a bad situation worse? If we rush to produce a so-called vaccine, we’re asking for a repeat of the swine flu fiasco in ’seventy-six. More people were harmed by the injections than even got the flu: some were in comas for months, others paralyzed by the Guillan-Barré syndrome the vaccine initiated. The lawsuits went on for years.”
“If we’re going to talk about history, let’s allow an expert to have a word,” HHS interrupted. “Dr. Casey, I apologize. I have not read the complete report you prepared, but I have reviewed the executive summary. You’ve been waiting patiently, and I’d appreciate your insights, sir.”
“There’s not much to
Chapter 5
Atlanta, Georgia
July 21
Nominally, the Surgeon General’s Office was a subordinate part of Health and Human Services. So there was not really an ongoing war between the secretary of HHS and the Surgeon General; it just seemed that way, which was almost as bad.
They were both political appointments, Beck recalled—HHS a former California congressman who had been instrumental in the current president’s initial campaign, the SG a women’s rights activist who had lobbied hard but fruitlessly for a cabinet-level post before settling for a position that was largely symbolic. Neither official was a physician. But both had brought to the CDC meeting aides who were, and that added an element of professional competition into the already volatile mix. The key question was the same that had bedeviled them throughout the day: Did the current situation warrant declaring an emergency? If so, there was no shortage of plans that could be put into action; but if they blew this call, the downside risk was, to appointees and career bureaucrats alike, potentially cataclysmic.
There had been heated words, some shouting, and noresolution. Porter had left in disgust, shaking his head as he stood to return to his office.
“I’m heading down to the outbreak site,” he said to Krewell in an angry aside. “You don’t need me here to deal with this crap. Not when people are dying down there.” The physician stalked out without a backward glance.
“Damn it, Larry,” Beck muttered to Krewell, who sat at his side. “He’s right. How long do we listen to politicians and bureaucrats? Somebody has to show some leadership, for God’s sake.”
Krewell looked at his watch.
“The President expects a recommendation by six,” he told Beck. “That gives them no more than—whoops. Here it comes. Watch this, ol’ buddy.”
Billy Carson had stood, and the figure he cut in his shirtsleeves was enough to draw the attention of the room.
“There really is no room for discussion,” Carson said. He half turned to address HHS. “Mr. Secretary, there is no statutory question as to your department’s responsibility in the circumstances we face. In matters of public health, you are the lead authority. Like the rest of us here today, the Surgeon General’s Office is an advisory body only. We have, I believe, heard its advice. It is time to act, sir.”
The SG’s aide, an emaciated woman who had been a family-planning specialist in Philadelphia before assuming her present post, spoke angrily.
“Mr. Carson, I resent the way you’re—” she began, and Carson’s voice overrode her firmly.
“As Dr. Krewell pointed out, we are dealing with a matter of available time. History alone demands that we accept Dr. Porter’s analysis. H1N1 is, potentially, a catastrophic threat to public health. Look at the sheer numbers involved. Over the course of twelve months in 1918, at least a half-million Americans died of influenza. One in four was incapacitated. This disease constitutes a threat to our entire population—more than two hundred fifty million Americans.”
“History demands that we not overreact, either,” the senator said, and the SG nodded. “Do we want to risk a general panic? And as long as we’re talking about ‘potential,’ how about the potential for making a bad situation worse? If we rush to produce a so-called vaccine, we’re asking for a repeat of the swine flu fiasco in ’seventy-six. More people were harmed by the injections than even got the flu: some were in comas for months, others paralyzed by the Guillan-Barré syndrome the vaccine initiated. The lawsuits went on for years.”
“If we’re going to talk about history, let’s allow an expert to have a word,” HHS interrupted. “Dr. Casey, I apologize. I have not read the complete report you prepared, but I have reviewed the executive summary. You’ve been waiting patiently, and I’d appreciate your insights, sir.”
“There’s not much to
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