Flu’s Fine Line

What does it take to protect the American public?

The swine flu that swept the world this spring posed challenges to the public sector that find remarkable precedent in a similar outbreak of the disease 33 years ago.

Then, as now, the president and his advisers were treading a fine line between shirking their public health duties and administering an unneeded and potentially harmful regimen to the American public. The U.S. government's reaction to the outbreak of swine flu among Army trainees at Fort Dix, N.J., was far from perfect. We will see whether mistakes made then are repeated this year.

A detailed review of government's overwrought reaction to the January 1976 outbreak was commissioned by Secretary of Health, Education and Welfare Joseph A. Califano Jr. Two Harvard professors, historian Richard E. Neustadt and public health specialist Harvey V. Fineberg, interviewed all the key players and wrote a 189-page report titled "The Swine Flu Affair: Decision-Making on a Slippery Slope." This classic case study was published in 1978.

Swine flu had not been seen in humans since the 1920s. In 1976, as now, fears arose of a pandemic that might rival the worldwide killer of 1918. Prodded by ambitious science bureaucrats wanting to set new preventive medicine precedents, President Gerald Ford got behind a program to inoculate every American with a quickly produced swine flu vaccine. Forty million people were given shots between Oct. 1 and Dec. 16, 1976-twice the number ever before reached by flu vaccination programs. Then it appeared that the shots might have caused a small number of people to contract debilitating Guillain-Barré syndrome. Ford, who had led the way by bringing in television cameras to witness his own inoculation, abruptly canceled the program. Swine flu had not, in fact, spread as had been feared.

A key episode in the affair came when Center for Disease Control Director David J. Sencer drafted an action memorandum saying a pandemic was a "strong possibility, probability unknown." This memo, which was leakable at will, forced the hand of his superiors. Decisions thereafter came too quickly, without pause for adequate reflection, write the study's authors. For public health, a terrible consequence was CDC's loss of credibility, for as the authors say, this important agency could "be surely tagged as crying 'wolf' " the next time it attempted another massive exercise in preventive medicine. Sencer lost his job over the episode. And the government eventually paid more than $90 million to people who said the vaccine caused neurological problems.

Government officials of the day displayed little understanding of the power of television journalism. Of course, media hype has multiplied tenfold since 1976, when cable gabbers and the Internet were not even on the scene. For weeks this spring, it was swine flu 24 hours a day on cable; and the prospect of a sweeping pandemic has captured the rest of the media as well.

The Obama administration has benefited from the interagency effort that produced the National Strategy for Pandemic Influenza Implementation Plan, published in 2005. If officials haven't always put out a consistent message this spring, missteps have been corrected quickly. And use of new media has been impressive: a downloadable widget at HHS.gov provides links to CDC, pandemicFlu.gov, and the World Health Organization and the White House in early May rushed to launch pages on Facebook and MySpace and a Twitter feed to help meet the demand for information.

But the story is not over. Today, health experts, worried that swine flu will make an aggressive comeback this fall, are urging President Obama's incoming public health team to learn the lessons of the 1970s episode. For Obama may yet be confronted more gravely with what Califano called "the enormous difficulty that a lay official has in fulfilling his responsibility to make sound, balanced judgments about scientifically based public health issues."

Stay up-to-date with federal news alerts and analysis — Sign up for GovExec's email newsletters.
FROM OUR SPONSORS
JOIN THE DISCUSSION
Close [ x ] More from GovExec
 
 

Thank you for subscribing to newsletters from GovExec.com.
We think these reports might interest you:

  • Sponsored by Brocade

    Best of 2016 Federal Forum eBook

    Earlier this summer, Federal and tech industry leaders convened to talk security, machine learning, network modernization, DevOps, and much more at the 2016 Federal Forum. This eBook includes a useful summary highlighting the best content shared at the 2016 Federal Forum to help agencies modernize their network infrastructure.

    Download
  • Sponsored by CDW-G

    GBC Flash Poll Series: Merger & Acquisitions

    Download this GBC Flash Poll to learn more about federal perspectives on the impact of industry consolidation.

    Download
  • Sponsored by One Identity

    One Nation Under Guard: Securing User Identities Across State and Local Government

    In 2016, the government can expect even more sophisticated threats on the horizon, making it all the more imperative that agencies enforce proper identity and access management (IAM) practices. In order to better measure the current state of IAM at the state and local level, Government Business Council (GBC) conducted an in-depth research study of state and local employees.

    Download
  • Sponsored by Aquilent

    The Next Federal Evolution of Cloud

    This GBC report explains the evolution of cloud computing in federal government, and provides an outlook for the future of the cloud in government IT.

    Download
  • Sponsored by Aquilent

    A DevOps Roadmap for the Federal Government

    This GBC Report discusses how DevOps is steadily gaining traction among some of government's leading IT developers and agencies.

    Download
  • Sponsored by LTC Partners, administrators of the Federal Long Term Care Insurance Program

    Approaching the Brink of Federal Retirement

    Approximately 10,000 baby boomers are reaching retirement age per day, and a growing number of federal employees are preparing themselves for the next chapter of their lives. Learn how to tackle the challenges that today's workforce faces in laying the groundwork for a smooth and secure retirement.

    Download
  • Sponsored by Hewlett Packard Enterprise

    Cyber Defense 101: Arming the Next Generation of Government Employees

    Read this issue brief to learn about the sector's most potent challenges in the new cyber landscape and how government organizations are building a robust, threat-aware infrastructure

    Download
  • Sponsored by Aquilent

    GBC Issue Brief: Cultivating Digital Services in the Federal Landscape

    Read this GBC issue brief to learn more about the current state of digital services in the government, and how key players are pushing enhancements towards a user-centric approach.

    Download
  • Sponsored by CDW-G

    Joint Enterprise Licensing Agreements

    Read this eBook to learn how defense agencies can achieve savings and efficiencies with an Enterprise Software Agreement.

    Download
  • Sponsored by Cloudera

    Government Forum Content Library

    Get all the essential resources needed for effective technology strategies in the federal landscape.

    Download

When you download a report, your information may be shared with the underwriters of that document.