Secretary Leavitt Pan Flu Conference Call Question and Answer Session
Q. Lisa Stark, ABC News
Mr. Secretary, thank you so much. Let me ask you first of all, you say the world is overdue and underprepared. Do you put the US in that category? Or would you use the word unprepared.
A. Secretary Leavitt
The U.S. is better prepared today than we were 3 years ago by a significant measure. However, there are still gaps in our preparation and some degree of difference among different states and communities. Again, it’s one thing for the federal government to have developed a plan but the unique aspect of managing a pandemic falls into two categories. First it happens everywhere at once. Second its duration. It can last as long as a year or more. When we managed Katrina and other significant national disasters, they were localized. We were able to bring in resources from all over the country to respond.
In a pandemic, that would not be the case because those emergency responders would have to be required to be at home and would be dealing with the difficulties the pandemic presents them. Now, other places in the world, as has been well documented, there are many places in the world whose preparation is simply inadequate where the pandemic would be the source of significant loss of life as has been the case with previous pandemics.
Q. John Reichard, CQ
What advice do you have for the Obama Administration as these events unfold? Obviously you have spent many months working on this. Do you think the response is going the way it should and also I wondered about the use of the stockpile of antivirals they are calling to reducing it by about ¼ is this an argument for added steps to increase that stockpile?
A. Secretary Leavitt
The good news is that this virus appears to be responsive to Tamiflu and Relenza the two primary antivirals that we stockpiled. We purchased 50 million courses of Tamiflu and Relenza. We invited the states to make investments in antivirals as well and last count I knew, it was around 25 million purchased by states. We are also aware that stockpiles may be privately held among various companies who had done preparedness activities. I would say that’s a very important point. Right now as we begin moving toward vaccine production, if that is necessary. A vaccine will take somewhere between 8 and 20 weeks to be prepared to go into the market. Until that time, the Obama Administration will just need to follow the playbook that has been laid out and exercised. The critical link here will be the preparedness level of state and local government. I want to emphasize again that the foundation of preparedness is state and local government because they have to be the ones on the ground it will be the capacity if this should play out in a larger scale. Each community will need to utilize its various capacities for emergencies. Hopefully all of the pandemic planning they have been doing over the last 3 years will be valuable. We held pandemic summits in 50 states and all the territories where we had governors, mayors, public health officials, medical, families, schools, businesses everyone at the table to say they would come when we have to deal with this. At the time we were dealing with the H5N1 virus but we made clear that we were preparing not just for the H5N1 but it could be another virus if this swine flu produces a pandemic strength virus then all of that planning will have been important following those protocols will be the best course of action. I will say that it is crucial that the new Administration put a priority on getting HHS fully staffed. The top 20 HHS officials are vacant or being held by acting personnel. The Secretary of HHS is the key player throughout the federal government in a pandemic or natural medical disaster. Some concentrated effort needs to be made to resolve that.
Q. John Reichard, CQ
Congress is potentially going got be voting in the Senate on confirmation this week. Is this an argument to go ahead and confirm Governor Sebelius?
A. Secretary Leavitt
My point is that there are 20 slots that are currently available to be filled and in need of staffing. HHS is a critical part of the overall Homeland Defense contingent and having those spots unfilled is a significant deterrent to our best reaction.
Q. Elaine Jarvis, Deseret News
I am wondering if you know how many state governments are not prepared?
A. Secretary Leavitt
We made an effort to publish a report that had been gathered for the previous year to assess that that would be on the HHS website. Access to that report is a state by state report of planning functions. I know that report is there. It shows significant gaps but quite a bit of progress. It references really, where states are in the planning process. I will tell you the biggest worry I have among the gaps is the ability to effectively distribute antivirals should that be necessary on a wide scale basis. Some states have done a good job at being able to develop distribution methods, others have done very little.
Q. Ricardo Alonso Zaldivar, AP
What do you mean by defective distribution efforts? What does that entail? There are some states that have stockpiled antivirals and other states have not so some states seem to have enough of a supply on hand and others are lacking and how much of a difference do you think that makes?
A. Secretary Leavitt
First we have good news here. We have stockpiled antivirals that appear to be effective with this particular virus. The stockpiles are part of a system of stockpiling that HHS has developed over the last few years, they have the capacity within a 12 hour period to take a large shipments of supplies and medication to essentially any area in the country. I am told that 25% of that stockpile has now been made available for distribution. Once it is shipped, it’s essentially taken to the airport and at that point, it becomes the state and local government’s responsibility to transport that medication to places where it can be dispersed to people who are sick or who have been exposed, and in a situation where many people need to be distributed medication, there needs to be a plan in place to do it. In this case, we don’t have a widespread pandemic condition. There is some time for states to begin to plan and think through this. The distribution is most acute in a situation where you would have an anthrax attack or where distribution of the medication was crucial. And that could happen if certainly we begin to see large scale sickness spreading over an area and you need to get Tamiflu or Relenza in their hands. There needs to be points of distribution, places people can go to see a doctor and to get it rapidly without having to make an appointment.
Q. Ricardo Alonso Zaldivar, AP
Are you saying many states haven’t thought out that step?
A. Secretary Leavitt
I’m saying there are different levels of planning that have been done in various states. There are some states that haven’t planned enough and now is the time for them to being to think through this. Some thought is better than no thought.
Q. Matt Cunham, Salt Lake Tribune
Hi, Secretary. My question is obviously the US main focus is on the states and local governments helping them get prepared if it does become a pandemic. What role does the US play internationally? What attention should be given to places like Mexico?
A. Secretary Leavitt
I would suggest that there is some satisfaction that should be taken by the US in the response that Mexico has offered so far. I am told, though I have no details, that an earthquake has just occurred in Mexico. That’s a bad combination. The combination of a pandemic influenza and an earthquake is a recipe for serious consequence. I suspect we will be responding in a humanitarian way both on the earthquake and otherwise but much of what Mexico has done already is done in accordance with the playbook that we have worked on with them. We have been working with them on the border, we have shared our protocols with them. Minister Cordova is a person who we have worked with directly and I feel confident that much of what they are doing is in accordance with our plans to date.
Q. Lisa Stark, ABC
I was going to ask you about the vacancies at HHS and you touched on this a little bit, do you have any indication that the response so far has been hindered by the fact that so many of those top jobs are empty. And if not, why do you think that is the problem?
A. Secretary Leavitt
There is in place a well thought out continuity of government protocol and those spots are being occupied at this moment by some very capable people, including a former official Charlie Johnson, who is the Acting Secretary and Rich Besser, Acting Director of CDC all of these are capable people, again the think that distinguishes a pandemic from any other natural disaster is the duration and the breadth. This is not a sprint, with a pandemic it becomes a marathon response and permanent leadership is necessary.
Q. Spencer Hsu, Washington Post
The pandemic plan that the previous administration put together and the implementation plan, are those already in place or do they require additional triggering? If so, what is that trigger? And as part of that, should that be the playbook that is being followed or is it more of a framework or a plan to make a plan as we saw with Katrina. Is there a concern that because the plan is new that there may be a lack of familiarity a la Katrina.
A. Secretary Leavitt
The playbook has several different phases to it. We are in a pre-pandemic period. That is to say that a pandemic has not been declared by the WHO. The United States will be consulting with the WHO according to protocols that have been developed and should WHO in consultation with the US choose to elevate this to a pandemic condition, it would then begin to trigger another series of events inside and outside the US. But what has occurred thus far, the positioning of the stockpile, the declaration of the public health emergency, the movement of people into place, and I suspect the opening of comprehensive emergency management facilities and so forth, is in accordance with the protocols that have been developed and exercised over a long period of time.
Q. Spencer Hsu, Washington Post
How would you characterize the thoroughness of the planning that has been developed? Has it been completely fleshed out or is it a work in progress? Can you talk about plans that are not fully in place and there is this new plan going on and also the complexity of the response economics, travel, trade, international players and so on.
A. Secretary Leavitt
First of all, the current team is backed up by a very able and professional group of career HHS employees, many of whom have been through numerous emergencies and have formed the backbone of any planning effort. For that reason, I feel confident that things are unfolding as they should. The new team obviously has some learning to do. They have not been part of the exercises but they will be backed up by people who know very well the next steps. As to the nature of the plan, the plan itself is quite well developed and rather advanced in what’s been done thus far but you are never finished with a planning exercise, it’s always subject to improvement. And that’s particularly true at some of the Departments. HHS has a very robust plan for its department I suspect DHS does as well. But many other departments of government in the context of executing their governmental mission will now be looking at their pandemic plans and I frankly suspect that here are some plans that are not as robust as they would like them to be. That is true of some state plans. The state plans in many areas have been well developed, other cases they have not, and some have plans but haven’t exercised. But that’s just the nature of comprehensive emergency planning and this is the reason we spend 600 million dollars to assist in the planning process it’s the reason we had 50 state pandemic summits. It’s a constant and steady reminder that this needs to be done on a regular basis and we’re not done until every community has a plan, businesses have plans, schools have plans. If this begins to unfold as a full pandemic, every school in the country will ultimately have to face decisions as to how they respond and that will be driven by health departments and local areas and state health departments and they’ll be getting advice from CDC. This is an all encompassing social events. And that is the reason pandemics are so shaping and so unusual and in the context of other emergencies.
Q. Lisa Stark, ABC
Can you be any more specific in the preparations that the US government did with Mexico? Can you be any more specific about what those planning exercises?
A. Secretary Leavitt
Not out of a sense of secrecy, I am not sure I can be accurate in the detailing exactly what they were but it was the subject of many conversations between the Minister and myself. It was the subject of conversations and dialogue between Canada, Mexico, and the United States even at the level of the president. We had some joint protocols that were in the process of being developed. So there’s clearly communications and relationships. One thing we helped them do was to build laboratory capacity. When I left, we were in the midst of trying to build a level 4 lab in Mexico City so that they can be part of the network. I don’t think that has been completed. So my guess is that some of the lab work would have to be confirmed at the CDC or a WHO lab. I am sure they will be collaborating at that level. Right now there will be a lot of conversations with the CDC and the Mexican version of the CDC and also I know that at least according to the playbook, I know there was conference call that took place between HHS and the Mexican health ministry.
Q. Elaine Jarvis, Deseret News
Why are you speaking out now about this?
A. Secretary Leavitt
By virtue of my role as Secretary of Health for 4 years, the key figure in our pandemic planner in our pandemic preparedness. I assumed there would be some that would want to ask me questions and I feel like I have a very good perspective on the degree of our preparedness and what needs to be done to supplement it.
Q. Matt Canham, Salt Lake Tribune
What steps do you think individuals should take at this pre-pandemic stage?
A. Secretary Leavitt
I think the CDC will be providing information. You can go to the pandemicflu.gov site and there will be extensive discussions there about what people can and should do. Essentially it’s just good public health measures, its good personal health hygiene, it’s wash your hands a lot, make certain that if you are sneezing, or are around someone that is sneezing, you do what you can to avoid it, if you become ill and symptomatic in ways that are detailed on that website, which are the standard flu symptoms of fever, nausea, diarrhea etc. If you have been exposed to someone in that area, you should check with your physician. I would refer you and others to pandemicflu.gov which is a source of information that we developed to provide information to citizens. I might also add, there is a robust amount of information developed for the media to tell this story well. This is a time to where we should be informing not inflaming, it’s a time for us to inspire preparation but not panic and for that reason HHS spent a lot of time and a lot of money developing resources for reporters from downloadable answers to questions to various a/v depictions of questions that would be important to you and to the public.
