For Immediate Release
Office of the Press Secretary
May 3, 2006
Press Briefing by Scott McClellan and Homeland Security Advisor Fran Townsend
James S. Brady Briefing Room
Fact Sheet: Advancing the Nation's Preparedness for Pandemic Influenza
In Focus: Pandemic Flu
12:35 P.M. EDT
MR. McCLELLAN: All right, good afternoon, everyone. You should have our
copies of the implementation plan for the pandemic influenza, and I've got
our Homeland Security Advisor with me today, Fran Townsend, to give you an
overview of that and then take your questions on it.
And with that, I'll just turn it over to Fran.
MS. TOWNSEND: Ladies and gentlemen, thank you. As you know, we -- the
President has had us release today our implementation plan that relies on
the national strategy for a pandemic influenza. The strategy was initially
released in November of last year. And we assembled an interagency team
led, on the Homeland Security Council side, by myself and Dr. Rajeev
Venkayya, known to many of you. The team really assembled the best and
brightest of health professionals throughout the interagency community, and
we benefit from their expertise in the context of this report.
I should make clear, from the outset, that we do not know whether the bird
virus that we are seeing overseas will ever become human -- a human virus.
And we cannot predict whether a human virus will lead to a pandemic.
Moreover, there is no way to predict how severe a pandemic would be. In
the plan, we describe a wide spectrum of severity, and we are candid that
we should understand and prepare the worst-case scenario.
This brings us to the next stage of our planning efforts. I have the
privilege of releasing and describing to you the implementation plan that
is relying on the strategy, as I've mentioned. As you know, the strategy
was accompanied by a budget request the President transmitted to Congress
for $7.1 billion to support his strategy. Shortly after we released it, as
I mentioned, we assembled an interagency team of health professionals and
experts. The plan that they wrote, the plan that we have assembled, is a
road map that the U.S. government will follow to translate the principles
of the President's strategy into tangible actions by all federal
departments and agencies.
The plan outlines how the federal government will invest the $7.1 billion
that was requested from Congress, including $3.8 billion that has already
been appropriated. This is not the beginning of our investment in pandemic
preparedness. We have invested already over $6 billion in public health
and medical infrastructure since 2001. Many of those investments are
directly relevant to pandemic preparedness. The plan is a comprehensive
one divided into chapters addressing major considerations raised by a
pandemic influenza: protecting human health, protecting animal health,
international considerations, border and transportation security, public
safety and security considerations, and then planning for considerations of
institutional organizations. Each chapter describes the relevant
considerations, roles and responsibilities of federal and non-federal
entities, the specific actions the departments and agencies will take to
address the pandemic threat, and expectations of our non-federal partners
in this effort.
The plan contains over 300 specific actions for federal departments and
agencies, because we think it is important to be able to measure and
demonstrate the effectiveness of our efforts. Every one of the federal
actions included in the plan included a measure of performance and a time
line for implementation of that action.
Given the size of the document, it is worth highlighting some of the
priorities that we have identified, including advanced international
capacity for early warning and response, limiting the arrival and spread of
the pandemic to the United States, providing clear guidance to all
stakeholders, and accelerating the development of countermeasures.
We recognize that it is unusual for the government to provide this amount
of detail about its plans, but we think it is essential to demonstrate to
the rest of the world, our international partners, state and local
governments, business, families, individuals, just how seriously we take
this threat.
The implementation plan devotes a full chapter to the United States
government's response to a pandemic, and describes in detail the actions we
will undertake at each stage before, during and after a pandemic. It
describes the policy decisions that we will confront and make throughout
the response, recognizing that many of these decisions cannot be undertaken
until we know the characteristics of the actual pandemic virus, if and when
one emerges.
Finally, in Appendix A, we have offered practical advice to schools,
elementary and university; business; private sector; families and
individuals for them to consider in their preparations.
While the federal government has many responsibilities here, we cannot
forget that a pandemic occurs because of the spread of the virus from one
person to another. This means that individual actions are perhaps the most
important element of our preparedness and response activities. We depend
on everyone outside of the government to take this as seriously as we do,
and to put systems in place to reduce the transmission of infection, and to
put plans in place that will mitigate the impact of a pandemic on human
health and the functioning of our communities. We also believe that our
partners outside of government will complement our approach, the approach
that we are taking to pandemic preparedness.
In addition to describing the actions we are taking, we provide a great
deal of detail in the rationale behind our approach and our framework for
future decision making.
I'd like to take a moment to describe what the plan does not cover. It is
important that -- to point out that there are things in the implementation
-- that the implementation plan does not answer, and it is not intended to
do so. For instance, it does not answer all the questions about vaccine
and antiviral medication prioritization. We are actively discussing those
issues across the government and incorporating the scientific epidemiologic
and modeling data that is being developed in real time.
Another example is the specific interventions that we will undertake at our
borders and ports of entry to slow the entry of disease. We recognize that
we cannot make these decisions in a vacuum, and must consult with our
international partners to ensure that we adopt a consistent approach.
It was impossible to capture in a plan of this type the full spectrum of
planning that we have asked every department and agency to undertake.
Those details are captured in department and agency specific plans which
were completed in draft form on March 31st. And I would encourage you, to
the extent you have questions about specific department or agency
implementation plans, to direct your questions to them.
The President has given clear direction to departments that their plans
must show, first, how they are going to protect their employees and create
a safe work environment; second, how they will identify and ensure
continuity of operations at times of significant and sustained absenteeism;
third, how they will support the overall federal response to a pandemic and
undertake actions contained in the plan; and fourth, how they will
communicate pandemic preparedness and response guidance to their
stakeholders -- public, private, state, and local governments.
The administration takes this threat seriously. And therefore, the actions
contained within this plan -- we take the actions contained in this plan
seriously, which is the reason that we have assigned performance measures
and aggressive time frames. No one should leave with the impression that
this work is only beginning today. Many of these actions began weeks or
months ago. In some cases, we have already made -- seen remarkable
performance and results despite laying out very aggressive measures for
action.
For instance, one of the actions in the plan is to expand the Medical
Reserve Corps, a community-based program of volunteer health and medical
providers, by 20 percent. That meant from 350 to 420 chapters in 2006.
That objective was placed in the draft plan early in 2006, and the Medical
Reserve Corps has already achieved it.
You will see additional concrete examples of progress in the coming weeks,
including advancement in our vaccine efforts, which represent the
foundation of our pandemic preparedness; translation of the recent modeling
efforts to strategies for states and localities to protect their citizens
during a pandemic; additional pandemic preparedness guidance for
businesses, critical infrastructure providers, families, and individuals;
expansion of a new office at the Department of State, the Avian Influenza
Action Group, an interagency body that can rapidly gather information and
deploy cross-government personnel, material and other capabilities to
assess and respond to any international situation of concern.
These are just a few examples of the additional progress you can expect to
see. We intend to track the implementation of action contained in this
plan through the Homeland Security Council. And at the end of Chapter Two,
you will find additional examples of actions we have already undertaken.
This will be a dynamic process. We intend to update and revise the
implementation plan on a regular basis as our preparedness, the state of
technology, and our understanding of the threat evolves.
Congress has appropriated the first $3.8 billion of the $7.1 billion
requested and necessary to support these efforts. We will work with
Congress to secure the remainder of the necessary funds, including $2.3
billion in fiscal year '07 and an additional $1 billion in fiscal year '08,
to achieve the objectives in international health surveillance and
containment efforts, medical stockpiles, the domestic capacity to produce
emergency supplies of pandemic vaccine and antiviral medications, and
preparedness at all levels of government.
As you can see, we have taken an unprecedented level of activity to address
this threat. But let me say a few words about the threat. First of all, a
human pandemic has not begun, and we cannot say whether or not a pandemic
will begin. Right now, it is relatively difficult for the current bird
influenza virus to infect humans. Despite a widespread outbreak, the virus
has only infected 205 people, and killed 113 of those infected. However,
it is possible that if the virus undergoes genetic changes, it could signal
the start of a human pandemic.
Given the pattern of history, which suggests that bird flu viruses played a
role in pandemics over the past century, we cannot ignore the possibility
that this virus could evolve into one that infects and is transmitted to
humans. At present, scientists believe that there is a risk, that the
virus is more likely to be acquired and be transmitted between human in
areas where there is widespread outbreaks of virus and birds, and
significant contact between infected animals and humans. These are the
current circumstances in many parts of Asia, Africa and Europe.
If this develops into a circumstance where there is efficient human-to
human transmission, we will take immediate action to prevent or to slow the
spread of the infection, including entry and exit screening, restrictions
on movement across borders, and consider the rapid deployment of antiviral
medications in coordination with our international partners.
The key elements of an international response effort include, first, agreed
epidemiological triggers for international response and containment, the
rapid transparent reporting and sharing of samples, rapid response teams,
stockpiles of countermeasures and logistical support for an international
response.
Minimizing the opportunities for the virus to mutate, and helping other
nations to prepare should a pandemic virus emerge is a global
responsibility, and is also the first line of defense for the United
States. The U.S. has pledged $334 million to strengthen preparedness,
response and containment abroad. We are working bilaterally with nations
and also helping to improve the capacity of the World Health Organization
and other international partners to lead the international response
efforts.
To highlight the importance of this issue to international governments, in
September of 2005, at the U.N. General Assembly, the President launched the
International Partnership on Avian and Pandemic Influenza to heighten
awareness of the threat and to work to establish resources that will help
prevent, detect, and limit the spread of animal and human pandemic
influenza within and between national borders.
We will have to act fast to see if evidence that the virus is evolving into
one that presents a greater danger to humans -- in other words, we cannot
afford to be complacent. But rest assured, our investment now, regardless
of whether there is a human pandemic based on the current avian flu, will
serve to strengthen and better protect the American people not only from
pandemic flu, but from bioterror and other public health emergencies.
While the human pandemic threat is unpredictable, the spread of influenza
in birds is predictable. Nearly 20 countries have identified the virus in
their bird populations since the start of February of this year. In
addition, in 2006, the virus has been identified on two new continents --
Europe and Africa. It is possible, in fact likely, that the virus will
appear in our wild bird population this year. As we speak, scientists are
examining birds that have migrated to the U.S. from Asia and Europe to gain
early warning of its arrival.
It is critically important for me to point out that the arrival of avian
flu in our wild bird population will not necessarily represent a risk to
our domestic poultry population. The poultry industry has excellent
biosecurity practices in place that limit or nearly eliminate the
likelihood of contact between poultry, wild poultry -- between domestic
poultry and wild bird populations. The industry is also constantly on the
lookout for any new infections in their bird populations, whether an avian
influenza virus or something else. And when they find something -- and
this has happened several times in the past with different viruses -- they
take swift action to eradicate the infection.
Even if the avian flu virus were to make its way to our domestic poultry
population, we can say with confidence that the risk to human health is
exceedingly low, as long as people follow the usual practice of thoroughly
cooking poultry before eating it.
Secretaries Johanns and Leavitt have spent a lot of time explaining what it
means to have the virus here in birds, and the limited risk that poses to
human health. It is a message worth repeating. We are not in the midst of
a human pandemic, but we cannot predict when one will happen. This is why
it is important for everyone to prepare. If the H5N1 avian bird flu virus
appears in birds, it will not signify the start of a human pandemic, and
will not necessarily represent a threat to our domestic poultry population.
No matter what happens, properly cooked poultry kills the virus and
eliminates the risk to human health.
I hope that I've been able to provide you sort of with an overview and some
insight into our thinking, and the effort that went into drafting the
report. And I look forward to taking your questions.
Q There's already some criticism that you're putting out a lot of steps
that you already knew that you needed to take to prevent the spread and to
prepare. Can you respond to the criticism of that, and why more of these
300 steps that are outlined have not been completed already?
MS. TOWNSEND: Many of them are underway and great progress has already
been made. Additional steps have to be taken. And for that reason, we set
very specific guidelines and targets, objectives. I think it's a misnomer
to say that we haven't been planning before this. You're sort of in a
no-win. If we didn't put out a plan, that would have been the criticism.
The fact is, we have a responsibility to the American people, as well as to
state and local governments, to provide them with our expertise, our
insight, our advice on how best to prepare, and then to work with them in
advance of a crisis to ensure that we understand what they expect and will
need from us, and to help them to minimize and mitigate against the spread
of the disease.
Q Stockpile status -- how many doses have been manufactured, and who are
the lead manufacturers? And where does that stand right now? And how much
more is needed?
MS. TOWNSEND: I would say to you that there is no question, we do not have
enough in the stockpile for every American. And the fact is, the
President, concerned about that, met with manufactures late last year to
encourage them to return stockpile and production capacity to the United
States.
There are a number of reasons for that -- liability, legal liability in the
vaccine industry chief among them. The fact is that the plan incentivizes
both the R&D; technology that is moving from egg-based to cell-based
technology to produce vaccine, and sort of working with the vaccine
production manufacturers.
This is a serious, long-term issue. But you should also recognize that one
of the reasons you don't have the vaccine is you can't produce it until you
actually know the genetic makeup of the virus that is the basis of the
pandemic. For example, Secretary Leavitt, as you know, came out and said,
based on the current bird flu, we began vaccine production. That's mutated
again and we're beginning a second stage of vaccine production, based on
more recent developments evolving in the virus itself. We'll have to
continue to do that, and that takes time.
Q How many doses do you have on the second stage of what's thought to be
the virus -- on dosage, how many millions do we have?
MS. TOWNSEND: I don't have the number off the top of my head. I'd refer
you to HHS, Secretary Leavitt, who is responsible for that.
Q Fran, thank you. Can you tell us a little bit, walk us through the
chain of command? As we saw with Hurricane Katrina, you can have a plan,
but if it's not implemented and there's not coordination, it might not
work. As I understand it, the Health and Human Services Secretary would be
the point person. But what's the chain of command, direct access to the
President? What's the role of Secretary Chertoff, what's your role, U.S.
military, Secretary Rumsfeld? How are you going to coordinate that within
the government in a crisis?
MS. TOWNSEND: Okay, so is this one question or several? Okay. All right,
let me start from the top down, because that's the easiest way to do this.
The "who's in charge" -- I mean, essentially what you're asking me, Ed, is
who's in charge. And the answer is, in a national crisis, the President of
the United States is in charge. I am the President's staff, as are the
rest of us here, and we will support the President in that.
Let's talk about operationally what happens. You remember from the Katrina
report -- what we talked about in the Katrina report was, we ought to look
to the people with the expertise to give us the best options for solutions
to national problems. So in the case of a public health crisis, obviously,
the President is going to rely, in terms of public health advice, on the
Secretary of HHS.
That said, the Secretary of DHS, Secretary Chertoff, as the Homeland
Security Secretary, has statutory authority and responsibility to
coordinate an incident of national significance across the federal
government. There's no question, if there were a severe pandemic, there
would be activities and actions required by the federal government across
not just in Health and Human Services, but across the federal government.
And it would be Secretary Chertoff, who would be the President's incident
manager to ensure the coordination across the federal government to support
the response to a public health emergency.
Q Madam, what advice do you have for the travelers overseas? Let's say
if I'm traveling to Asia, which country you think you should warn me not to
travel? Or how this disease one can bring from overseas?
MS. TOWNSEND: I want to be careful not to panic people. I think it's
really important that we talk about -- based on facts and what we know.
Obviously, the United States government has, based on science, created a
planning assumption, a worst-case scenario. And that's our responsibility,
to assume the worst knowing that anything short of that we will, then, be
well prepared for.
We haven't seen a human-to-human transmission of the disease -- efficient
human-to-human transmission. So what we know of the facts is, this is a
bird virus now. The human infections are -- have been tied directly to
exposure to infected birds in particular countries. And so that's -- and
countries have been very transparent with the findings of infections in
birds, and people. What I would say to you is, there's not a reason to
panic now, but to be aware. And in Appendix A, as I mentioned, we talk
about particular planning considerations that people should consider
whether they're individuals, families, or organizations.
Q When the virus does arrive on the continent, what would you say to
hunters? Are there any plans to restrict or ban duck hunting?
MS. TOWNSEND: I will tell you that in terms of the wild bird population,
the Department of Interior, working with USDA and Secretary Johanns, have
an extensive planning effort, also surveillance and detection, early
warning. We expect, based on migration routes -- we look to Alaska and
then down on through the continent in that path -- and we work with state
and local officials who obviously have the greatest role in setting hunting
requirements, licensing and restrictions.
Again, we have to understand the role of the federal government. In the
federalist form of government, we give advice, we give guidance, we provide
special capabilities, but we have to work with state and local authorities
in terms of planning and preparedness and the actions that they will take
to mitigate impact.
Q So you're going to tell the states to ban -- again, the duck example
because it's a popular bird -- would you tell the states, then, to ban or
restrict duck hunting?
MS. TOWNSEND: Is that possible? Yes, it's possible we could give that
advice. But again, I'm reluctant to engage in hypotheticals -- what if
it's a duck -- because I think it has very much to do with how pathogenic
is it, how contagious is it, what are the particular qualities of the virus
that appears, if it appears.
Q This is the worst-case scenario, and you say you don't want Americans
to panic. But can you give us a general idea -- you've seen some of the
headlines today: chaos ensues -- can you give us a general idea how you
think this country would look if there's a severe outbreak, and what would
happen?
MS. TOWNSEND: I think it's important to distinguish this from a terrorist
attack or a natural disaster. I refer to those as a kinetic event. It
happens, and it's sudden, and it's pervasive. In the case of the Gulf
Coast, it was 93,000 square miles affected at one time. That is not the
scenario you will face with a pandemic. It will not be a single moment in
time event. It will unfold slowly, over days, weeks, months. It will not
be in all places at the same time.
There's good news to that. It allows us to take mitigation measures both
at the federal, state and local level, at the community and individual
level, that can have a direct impact on how many people get sick, and how
badly it affects the economy. And so that's the good news. And that's why
you want to plan for the worst, knowing very well that that -- if it's not
the worst-case scenario, we will have less of an impact on this country.
You are likely to see it arrive overseas first, which gives us
opportunities at least in an hour period to consider measures at the
border. And you wouldn't just take measures at a border. You would have a
layered approach. You would consider screening measures at points of
departure. We're working on education measures in flight, and then upon
arrival. Those measures will be for a set period of time. There's only a
set period of time that that's likely to help, because once you begin to
see efficient human transmission in the United States, those sort of
measures at the border become less important. And what you want to ensure
is that communities are prepared to start taking measures right away.
Q In terms of chaos, in terms of what happens in this country if there
is a severe outbreak here? You talk about the borders and trying to stop
it, but I think the report says, once it was overseas it would probably be
here within two months. So what happens -- assure Americans that there
won't be chaos.
MS. TOWNSEND: And that's right. I mean, I think it's -- look, we deal
with the science of this. I'm talking to scientists and doctors. We don't
see -- the worst-case scenario that we anticipate in the report, it's not
that we see it likely to happen; we think it's the worst case. Do I think
that's going to result in chaos? No. And that's the whole purpose and
whole point of doing a national planning effort.
Secretary Leavitt, for example, called in at the end of last year public
health officials from around the country and talked to them about the
importance of planning. He then has been on a 50-state tour to talk to
them, to go to their states and talk to them about continuing efforts.
We're working with them to strengthen their plans. The whole purpose of
planning and preparation is to mitigate the uncertainty, to take the fear
out of it so there's not chaos.
Q But some of it -- you have 40 percent of the workforce out in the most
severe outbreak. You've got guidelines for people to stay three feet
apart, which seems unworkable in areas of work -- I mean, how can it not be
chaos with the economy --
MS. TOWNSEND: Good planning and preparation will avoid it being chaotic.
It just will. And the answer is, we're communicating not only with
government officials at the state and local level, but it's the whole
purpose in communicating directly with the American people about steps they
can take.
Q Speaking of good planning, you all have yet to spend even half of the
amount of money that's been appropriated for this year. People have
criticized the government for getting in line very slowly to get the
antivirals from Roche. You haven't spent the money on expanding vaccine
capacity. Why has it taken so long to spend the money that you already
have in hand? And also, some in Congress said that you didn't even come up
with the most recent supplemental request, that they had to sort of push
the administration to come up with this newest $3.3 billion request. So
why has the administration, according to a lot of people, been so slow even
to spend the money that you already have?
MS. TOWNSEND: Of the $3.7 or .8 billion that is in the -- was in the
emergency supplemental, we've already obligation $1.8 billion of that. The
rest of the money will be obligated before the end of the fiscal year.
And you'll be not surprised, I suppose, to hear me say that the
administration needed no push from anyone to begin this pandemic
preparedness. As I said at the beginning of the press briefing, our
efforts, in terms of strengthening public health and preparedness,
including for pandemic, go back to 2001 and include over $6 billion. So
it's hardly that we've been slow. There is an effort. There is a -- there
has been a diminution of vaccine production capability in this country, and
it's not something that you can do overnight. It does take planning; it
does take obligating funds, and having the funds so that you can obligate
them.
I can assure you, as you go through the details of the plan, you will see
in fairly specific detail how we plan to spend the $7.1 billion.
Q Back to the drug manufacturers, you mentioned the legal liability
issue. What needs to happen in order for the drug makers to start racking
up the vaccine?
MS. TOWNSEND: Well, part of it is reestablishing, if you will,
strengthening vaccine production capability in this country, as it was
mentioned by one of our colleagues. Some of that is now overseas.
Secretary Leavitt has spent a good deal of time talking privately with the
manufacturers. I'd leave to him to what extent he wants to discuss those
discussions publicly. But the President has made very clear litigation
reform and liability reform is high on the agenda, not least of all because
of its impact -- the impact of liability litigation has had on the vaccine
industry.
Q So do they need a waiver out of legislation -- is that what you're
saying?
MS. TOWNSEND: These are ongoing talks between the Secretary of HHS, the
Department of Justice, and the vaccine manufacturers.
Q Yes, later in the report, it calls on limiting non-essential domestic
travel. Could you define what that means for us and tell us who will
decide what domestic travel is?
MS. TOWNSEND: Well, the reference to domestic travel is travel inside the
borders of the United States, and -- not that I ever seem to get to take
one, but imagine your average summer vacation. It would be limiting
non-essential travel that you don't have to take inside the United States.
These are recommendations you'll see, as I mentioned, in Appendix A. We
make all sorts of similar type recommendations to individuals to consider,
in terms of limiting their exposure to the potential virus.
Q -- to the mall, I mean, going to see friends? Would it be local? And
who would enforce it?
MS. TOWNSEND: It's not a question of enforcing it. Some of this -- it's
hard to legislate common sense. Some of this is, if we were facing a real
threat of a human pandemic inside the United States, some of our advice is
to communities, to state and local governments, but some of it is to your
average American. I have two small children, and if I thought that there
was the risk of -- the spread of a pandemic, and that they would more at
risk at the mall, I wouldn't be going to the mall if I didn't need to be
there. And I imagine that as you talk to parents and people in their
communities throughout the country, they feel the same way.
Q You touched briefly a couple of times on the potential for border
restrictions. Can you elaborate on what that would mean, since we're told
that a total shutdown of some borders would be impractical, in terms of
stopping the spread.
MS. TOWNSEND: Not only impractical -- ineffective. We don't expect that
shutting -- a tight shutdown of the borders would actually stop it from
arriving here. So worse than impractical, it's ineffective. And of
course, there are second- and third-order consequences in terms of our
economy, given that we spend -- that there's trillions of dollars in
international trade.
When you look at border restrictions, there's a period of time very early
on in a potential pandemic where they may be effective not in stopping the
arrival of the virus, but in buying us time, and slowing the spread of the
pandemic to allow communities, frankly, and individuals to get better
prepared if they haven't already.
And so we look at things like departure screening, on plane screening, and
arrivals screening. We have done -- we have continued to do planning --
Department of Health and Human Services, as well as DHS -- for medical
stations at some international airports. That plan is ongoing so that we
could ramp it up quickly if there was an indication of the virus overseas.
Yes, sir.
Q Yes, after World War II, we had a hospital system here under
Hill-Burton where we made an estimate of how many hospital beds you need
per population. Now we've long gone away from that system, and hospitals
have been working on a more for-profit motive. But given the fact of a
dangerous pandemic, wouldn't it be necessary to again look at this
situation to make sure that especially in the rural regions -- it may hit
in the rural regions, not in the big city -- there are hospital facilities
available to be able to take care of that, otherwise, you'll have to move
people from -- over long distances, thus increasing the dangerous threat of
pandemic. Have you looked at this, and have you drawn any conclusions with
regard to that in your report? Or do you intend to?
MS. TOWNSEND: I wouldn't say -- I don't think that there are conclusions
drawn in the report directly related to that. I'd have to -- I may be
wrong. I don't think so. But what I would say to you is, this goes
directly to our planning with state and local officials.
You know, I'm fond of saying, having been a local myself earlier in my
career, rarely will the solution itself to the practical problem faced in a
community come from inside the beltway, come from Washington. The answer
is, what we can do is give advice and guidance, the kinds of planning
assumptions that they ought to look at, their capacity and how to increase
the capacity and how to increase the capacity to meet local need.
And that's the sort of advice and guidance we're giving. We're working
with state and local officials through Secretary Leavitt, and we will
continue to do as part of the planning effort.
Q Can you give a concrete recommendation? I mean, you should know from
a central point of view where there are gaps and where there are potential
problems and be able to inform the local authorities of that and maybe
provide some assistance --
MS. TOWNSEND: Absolutely --
Q -- just advice, saying --
MS. TOWNSEND: No, to the extent that we identify vulnerabilities or gaps,
we are absolutely sharing those with state and local officials and working
with them in terms of closing those gaps.
Q Can I follow on that? Here in Washington and in other cities, there
are communities that are overrun with Canadian Geese. In Rockville, where
the Institute of Health is, they had to a million crows and rookeries in
the trees. Are those areas at increased risk? If we're sure that the bird
flu will come to this country, shouldn't we be culling our birds at this
time as a preventative act?
MS. TOWNSEND: You know, I wouldn't -- I don't really see that we need to
do that as a preventive act now, prior to the arrival. I don't know what
good that would do. The fact is, we look at migration routes. We've done
this sort of very much based, rationally based on the science of it, put in
surveillance and early warning, if you will, capability. And the poultry
-- both poultry -- domestic poultry and wild bird populations, we have
experience with this. This wouldn't be the first time we had this sort of
problem with a virus in poultry. Particularly the domestic poultry
industry is well aware of how to eradicate disease and infection in their
population and has a lot of experience at doing it very effectively.
In the back.
Q Getting back to the domestic travel question. Can you provide a
little detail about the set of circumstances that would have to arise where
these travel restrictions, domestic travel restrictions might be imposed
and how that might work?
MS. TOWNSEND: You know, the reason that we don't address that specifically
in the report is because it's -- a lot of this has got to do with -- we've
laid out what we think the issues are where we'll confront and the order in
which we will -- we are most likely to confront them. But it's difficult
to answer that in the hypothetical. It will depend on where it's from and
how contagious the disease is. Do we see a localized outbreak or do we see
it spread across states widely across the country? It's just -- it's near
impossible for me to answer that hypothetically.
Q And on that, if I could. What triggers the implementation of the
plan? Is it the first transmission from human-to-human? What is it that
starts the process?
MS. TOWNSEND: What you'll see, as part of the graphic I think that was
provided in the pre-briefing package, we have -- WHO divides the pandemic
roll out into six phases. We have used WHO's six-stage planning process in
terms of the outbreak of a pandemic. We have broken that into
subcategories, and we very specifically tied actions to stages in the
pandemic. And I'd encourage you to look in the sheet.
This graphic in particular lays out both the WHO stages of a pandemic and
then maps that against our subcategories and how we will behave in the
event of a pandemic outbreak.
Q I'd like to follow on his question about your advice to local
communities. HHS has made it clear, repeatedly, that they consider the
best planning to be at the local community hospitals, the state and local
public health departments. But those departments and the hospitals, almost
to the department and the hospital, have said, thanks for your advice, we
appreciate it; we do not have -- do not have the resources to buy the
ventilators, to buy the surge capacity, to buy all of the extra things that
we're being told -- and the antivirals -- that we're being told that we
need. Hospitals were here in Washington a couple of weeks ago -- Hopkins,
Stanford, top hospitals in the country -- each one of them, all together,
said the advice is great, there's no way for us to pay for it on our
margins.
So that being the case, what is the advice for those hospitals, those
public health communities to actually prepare?
MS. TOWNSEND: Well, just as you have a personal budget, I have a personal
budget, the federal government has a budget, so do state and local
communities. And it's a matter of setting priorities. We believe that
this should be a priority for resource allocation and for planning, for
policy implementation and planning. We believe those hospitals -- it's
more that they need to do than simply buying things, whether it's
antivirals and vaccine or ventilators, that's all very important, don't
misunderstand me. But there are policies and procedures they need to put
in place, in terms of essential personnel -- policies for absenteeism, how
they will staff emergency rooms -- and all that planning needs to be done
now while they look at the resource implications and plan for those, as
well.
Q May I follow on the phases? In the dark old days, there was
quarantine for people with leprosy, polio, tuberculosis. Do you envision a
quarantine aspect to any of those phases?
MS. TOWNSEND: There is certainly recommendations here that there should be
what the medical community calls social distancing -- that is, communities
to take steps, both at the individual level and the community level, to
decrease the number of public gatherings; the potential for school
closings. And we do tie those sorts of recommendations to various stages
in pandemic implementation.
MR. McCLELLAN: Let's do two more, and then Fran's going to need to leave.
MS. TOWNSEND: Let's get to people who haven't gone.
Q What fraction of the vaccine, the antiviral stockpile, whatever its
size, is the administration prepared to send overseas for containment of an
outbreak outside the United States?
MS. TOWNSEND: I don't remember the number off the top -- I don't remember
the number off the top of my head. In fact, what we've done is made
commitments based on dollar commitments, and I don't remember, standing
here, what it is. We can get that -- we can get that for you, though.
But what we've said is, the President has said, both at the U.N., and he's
continued to raise individually and bilaterally meetings with heads of
state, the importance of this. And this is not just -- the international
commitment is just that. All countries have to understand that it's in the
international community's interest to contribute to the stockpiles, but
this is not solely a U.S. burden. We will be good international partners,
and we will contribute, but every country needs to contribute.
Yes, ma'am, last one.
Q Thank you. How soon are you going to let the general public know what
you're doing and what's going on, because a lot of the people are very
afraid, they don't know -- there's going to be another New Orleans
hurricane problem, or are you going to do it via television, radio, or how?
MS. TOWNSEND: Part of the -- you'll see as part of the detailed planning
process, we talk about risk communications, and talking to the American
people. Secretary Leavitt and Secretary Johanns have already done that.
They have both met with all the major networks. We have tried to
communicate not only with the media but with the American people and state
and local communities.
We will be transparent. And that's why I said the planning and
implementation process will be a dynamic one. We will update it. We have
a website, pandemicflu.gov, where people can get additional information as
we continue to update implementation and planning efforts.
Thanks, everybody.
MR. McCLELLAN: Are there other questions?
Q Can you distinguish between this plan and the HHS plan? When we write
about this, how -- we all wrote stories last fall when HHS's plan came out,
it was the flu plan; now we're going to write another story that says, the
flu plan came out. What's the difference between the two?
MS. TOWNSEND: Well, as I said -- think of it this way: there's the
strategy, this is the implementation plan for the strategy, and then each
of the departments and agencies has their implementation plan. HHS has a
large role and responsibility in this, and so they, too, have a very
detailed plan for their department and agency.
Thank you.
MR. McCLELLAN: All right, are there any other questions? We've got a
congressional meeting starting here pretty quick.
Q A quick one on that, can I just ask you --
MR. McCLELLAN: On?
Q -- on the pandemic, just broadly speaking, the criticism from
Democrats today has been --
MR. McCLELLAN: Well, I mean, we had Fran here to talk about the
preparedness plan. But go ahead.
Q But just in general, they're saying that -- like, when Fran was asked
about chaos, she said with proper planning and coordination, there won't be
chaos. What Democrats are saying this morning and this afternoon is that
with Katrina, there was planning, but it wasn't implemented. And how can
you assure the American people that you can prevent --
MR. McCLELLAN: Well, I think the United States has been leading the way in
working with our international partners to prepare for a possible pandemic.
And that's why we are moving ahead with the implementation plan. We
outlined the strategy back in November. And we have also been moving
forward on getting the necessary funding in place to make sure we have the
resources to address this possible outbreak.
Are there other questions -- we've got a congressional meeting coming up --
on different topics?
Steve, go ahead.
Q What are you hearing about the possibility that Senate Democrats will
filibuster some of your judicial nominees, like Brett Kavanaugh?
MR. McCLELLAN: Well, my expectation is that Brett Kavanaugh's hearing --
I'm sorry, vote in committee is going to go forward this week. He is
someone who is exceptionally well qualified. He is someone who will apply
the law in a fair and impartial manner. And I think that there are some
Democrats that want to resort to some of the past old tricks. They are
simply playing politics with judicial nominations.
And there was a bipartisan agreement that was reached to move forward on
the nominees. We hope that Democrats are not going to break that good
bipartisan process that was set up to move forward, because each nominee
deserves a fair up or down vote. And Brett Kavanaugh is someone who has
been praised by people on both sides of the political spectrum who know
him, he is someone who is well qualified to serve on the D.C. Circuit Court
of Appeals, and has good, diverse experience, not only from appearing
before the courts, but also from his experience here as a senior aide to
the President of the United States.
Q Scott, Vicente Fox's plan on -- this Friday I think it is -- to sign
into a law a bill that essentially legalizes all type of narcotic drugs in
his country, and concerns about the possible availability of those to the
United States to people there. Any reaction from the White House on that?
MR. McCLELLAN: Well, I think that the State Department and our Office of
National Drug Control Policy have been talking with Mexican officials about
this. I don't want to jump ahead of where it is. The State Department has
previously talked about our views on the situation and our concerns.
Connie, go ahead.
Q Thank you. Iran now says it's close to the 5 percent mark on
enriching uranium, which is enough for electricity, but not nearly enough
for weapons. Would the U.S., would the allies accept have Iran having
electricity in nuclear energy, and not weapons --
MR. McCLELLAN: Well, we've talked about that previously. This isn't about
whether or not they should have the right to civilian nuclear power, this
is about the regime's defiance of the international community and failure
to live up to its obligations. And that's why it's important to have an
objective guarantee in place for a civilian nuclear program. It's a regime
that has defied the international community and hid its activities for some
two decades.
And that's why the Europeans were working to negotiate in good faith with
the regime so that they could realize peaceful civilian nuclear power. And
Russia even came forward with a proposal, which we expressed support for.
And it would provide guarantees.
But what the regime needs to do is return to a suspension of its uranium
enrichment and reprocessing activities, and come back and negotiate in good
faith. Now they have shown that they are continuing to defy the
international community, they're continuing to isolate themselves from the
rest of the world. That's why we are moving forward with our partners in
the Security Council and our friends and allies elsewhere to address this
in a diplomatic way and to continue to keep the pressure on the regime to
change its behavior. We are looking at moving forward on a Chapter 7
resolution at the Security Council, which would compel action by the
regime.
And that's where we are at this point. And we're involved in ongoing
discussions. There have been discussions going on in Paris, there will be
some additional discussions next week in New York. This evening the
President will be welcoming Chancellor Merkel of Germany here to the White
House, and this is a topic that they will be talking about. We all have a
shared concern about the regime developing nuclear weapons under the cover
of a civilian program.
Q On the EU summit in Vienna that the President is going to Austria, can
that be seen as a part of the effort of the administration to get the EU
into a kind of "coalition of the willing" against Iran?
MR. McCLELLAN: Well, we are already moving forward on a number of fronts
with our friends and allies at the United Nations Security Council. This
is a concern that the regime has with the international community. The
international community is concerned about their continued defiance, and
the international community is united in our goal to prevent the regime
from developing a nuclear weapons know how or nuclear weapons. And that's
why we are continuing to move forward on the diplomatic front. We're
taking it a step at a time, but we think it's time for the Security Council
to act and move forward on a resolution under Chapter 7 that would compel
action by the regime. And this is something we'll continue to discuss with
our friends in Europe and elsewhere.
Let me keep going. Sarah, go ahead.
Q Can I follow up? Can you give some details about the trip to Vienna?
Is the President going to overnight in Vienna; how long --
MR. McCLELLAN: Well, we put out a statement earlier today, I made some
remarks earlier today. That's where it is at this point, and we'll update
you as we get closer to that trip on additional activities that might take
place. But he looks forward to going to participate in the U.S.-EU summit
in Vienna.
Q Thank you. Puerto Rico is broke, out of money. Schools are closed
and most of the government is shut down. Does the President plan to ask
Congress for more money, for money to bail out Puerto Rico and again make
it solvent?
MR. McCLELLAN: I'll be glad to take your question and take a look into it.
Go ahead.
Q There are numerous reports about low-intensity operations ongoing in
Iran from three different places -- PKK going over the border into Iraq,
the MEK southern border of Iraq into Iran, and also certain operations from
Balochistan involving also the Pakistanis. Does the U.S. have a policy,
given also reports which I know you won't comment on, on possible special
forces operations in Iran? Does U.S. policy, based on the notion that an
enemy of our enemy is our friend, consider changing its policy towards the
PKK or --
MR. McCLELLAN: Our policies haven't changed on those organizations. They
remain the same. And you're bringing up organizations that we view as
terrorist organizations.
Q We would never cooperate with them, in terms of --
MR. McCLELLAN: Our policy hasn't changed.
Q Scott.
MR. McCLELLAN: Goyal.
Q Question on U.S.-India nuclear agreement, civilian nuclear agreement.
All over the United States, Indian-American leaders are here in town for
the last two days and have been going into meeting after meeting. And this
morning, they had a meeting at the White House, and Mr. Karl Rove, among
others, spoke to the group. And also yesterday on the Capitol Hill,
Senator John Kerry was speaking --
MR. McCLELLAN: Let's get to your question. I'm sorry to rush you, but we
got a congressional meeting --
Q My question is that --
MR. McCLELLAN: -- that I think you all would prefer I be in so I can
provide you information on that.
Q My question is that, what message you think President has for this
group on this agreement, and also --
MR. McCLELLAN: Same message he said previously, and we want Congress to
move forward on the agreement.
Q Thank you.
MR. McCLELLAN: All right --
Q Can you just -- on Medicare, the GAO report saying the 1-800 number is
not really working?
MR. McCLELLAN: Well, first of all, let me point out that this report that
you are referring to was a snapshot of one aspect of all efforts being used
to communicate and sign seniors up for the new Medicare prescription drug
benefit. It was a snapshot that was taken three months ago, in the January
and early February time frame. And the Centers for Medicare and Medicaid
Services has continued to take steps to make improvements to their
communications tool. But there are a lot of communications tools. There's
a website. There is outreach going on across the country, and enrollment
sessions -- the 1-800-MEDICARE line, as well.
But the Centers for Medicare and Medicaid Services also has an ongoing
monitoring program which takes a random sample of the calls coming in to
make sure that they are being answered accurately. And they have found
that 93 percent of the time, those calls from people wanting to sign up are
being answered accurately. And Secretary Leavitt also said that -- I think
this was earlier today -- that most of the calls currently being -- are
being answered in two to three minutes.
Now, this brings up a very good point. I think all of us -- both at the
government and within the media -- have a responsibility to help educate
seniors so that they know what is available for them. They have many more
options now that are available so that they can choose the health care that
best meets their individual needs and so that they can get access to
prescription drug coverage that they have not had access to previously.
A typical senior is saving 50 percent or more on their savings. Surveys by
groups like the AARP show that eight out of ten beneficiaries say they are
satisfied with the new prescription drug benefit.
So I think you have to look at all those aspects, and we need to make sure
that seniors continue to get good information about what is available so
that they can sign up. The enrollment period ends May 15th, and that's why
we're continuing to make a push to encourage seniors to take a look. There
are now a number of options available to you so that you can get better
quality of care and save a significant amount of money on your prescription
drug benefits. And I think that's important to get across to seniors
across America.
The goal has already been exceeded in terms of what we expected for this
year. But we're pleased that seniors are happy with the coverage that they
are getting, by and large. And where they're not, we'll continue to work
with them to improve.
Q Thank you.
MR. McCLELLAN: Thank you.
END 1:26 P.M. EDT
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