America needs a "pandemic czar"
Scott McPherson
in Politics and government, influenza and infectious diseases
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2 Comments
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1 Reference
And I nominate Admiral John Agwunobi.
Folks,
In July,1998, I was sitting in my office at the Republican Party of Florida when Jeb Bush's head appeared in the doorway -- followed by the rest of him, of course. I had known Jeb since 1983, when I was one of the "dirty dozen" who conspired in Miami to get him started on his path to elected office .
Jeb said, "Scooter, what's Y2K?" (Scooter is his nickname for me.) I said I would give him a full briefing. This was when he was running for governor again (this time successfully), and people were emailing him with concern about the Year 2000 issue. I gave him regular reports on where Florida was vulnerable, using my syndicated weekly newspaper column as cover to get the information I needed. In January, 1999, a week after he took office, Governor Bush commissioned me to set up a statewide Y2K awareness and preparedness effort, called Team Florida 2000. It was a national model and was held up by Clinton's Y2K czar, John Koskinen, as a shining example of a partnership between government, the private sector and the service sectors.
I became Jeb's Y2K "czar," although he is loathe to use that term (using "czarina" instead). I had the entire resources and gravitas of the governor at my disposal. I had more money than time, so I tried to "buy time" whenever and wherever possible, including making heavy use of State aircraft (bumping Bobby Bowden occasionally!).
The effort was incredibly successful. The effort was "componentized," meaning sections of it were designed to be leveraged outside of Y2K. And indeed two areas were heavily leveraged afterward; first, the Office of Information Security, which I built in early 2001; and the entire critical infrastructure monitoring effort, which we built to mitigate Y2K disruptions, but was made permanent the morning of 9/11. So Y2K was, and is, a huge success, from many standpoints.
One of my favorite agency heads who I worked with closely during my tenure with Governor Bush was then-Department of Health Secretary, Dr. John Agwunobi. John is, of course, now Admiral Agnuwobi, and he serves the people as Assistant Secretary for Health, U.S. Department of Health and Human Services. John is a blogger on the HHS Pandemic Flu Blogsite, and I wanted to publish my response to his latest blog so you can read it here, as well as (hopefully) at http://blog.pandemicflu.gov/.
John,
We have known each other for some time, and we worked together during post-9/11 efforts for the Jebster. I am so very proud of the job you are doing in Washington, and I know you are a man of deep commitment and absolute professionalism. You are one of the “good guys.”
Please remind Secretary Leavitt that Y2K was a non-event because we planned and executed the largest successful IT project in the state’s/nation’s/world’s history. He has a tendency to speak of Y2K in disparaging terms. We “worked the problem” and solved the issues that I guarantee were NOT “non-issues”, had they been left unremediated.
Let me draw another parallel, to the effort we are involved in here in Florida. Having watched the pandemic preparedness situation for the past sixteen months, and having established relationships with some of the giants of the public health/policy and influenza sectors (Osterholm, Webby, Fineberg, et al), I am absolutely convinced that we are in dire need of a “pandemic czar.” We need someone who can address both the public health and economic/security calamities that will almost certainly occur if we experience a pandemic of any significant lethality in the near future. And that person needs the resources of the White House to be effective.
HHS is doing its job, but I do not see evidence at the local level that DHS is shaking the trees violently enough to force local domestic security committees to action. I speak nationally on the subject of pandemic preparedness and have probably given upwards of fifty speeches at state and national conferences in the past year. But I have given only two presentations at the direct request of law enforcement (Infragard chapters in Tallahassee, FL and Springfield, Illinois).
A pandemic is not just a public health event. The homeland security. public safety, supply chain and long-term economic ramifications both dwarf and substantially magnify the impact of a pandemic.
We cannot reasonably expect HHS to do it all. Someone in the White House needs to coordinate the total awareness and response efforts.
I hope we get the opportunity to see each other soon. Everyone in Tally says hello!
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Reader Comments (2)
Scott: Thank you for your insights and suggestions. The effort to successfully prevent/mitigate problems from the Y2K bug could be a model for the pandemic preparedness efforts in many ways.
Government committment and oversight as well as private coordination and organization moved virutual mountains in a very short time frame.
Which brings me to a question. One of the motivating elements of Y2K was the hard deadline.
How do we motivate government, the media, and private entities/individuals to a similar level of effort when the timeline is uncertain?
Woods,
Great question. The "hard deadline" of 1/1/00 was a huge help, but it was not the only deadline. Many agencies had 10/1/99 milestones that had to be met, such as Florida HSMV drivers license system, whose remediation was completed only days before it was to fail!
Preparing for a pandemic is like looking at a clock with the hands removed. When does the alarm go off? When does the music stop and we grab chairs? That is why I use FluTrackers, FluWiki, and google Alerts to help me perform my own surveillance, and not be dependent upon bureaucracies such as WHO or CDC to tell me when to panic.
I tell people they need to grab the stuff that is hardest to grab first, then work backward. In our case, antivirals first, then NPIs (and masks at the head of that line), then save the food items for a change in the WHO threat level (I tie a lot of final preparation into a raising of the threat level). Dr. Harvey Fineberg told me that masks should not be tied to a threat level increase, however. Tamiflu will last for five years, if not longer. DOD/FDA will recertify the Federal stockpile of Tamiflu close to expiration, so we can reasonably and mentally tie our personal expiration dates into theirs, provided we keep it cozy in a sock drawer or other dry, cool place.
I say a pandemic is like Y2K except the people fail, not the machines. That frames the issue nicely for some. And another area where Y2K efforts can immediately help in pandemic planning is in supply chain management. During Y2K, we told everyone to engage their upstream and downstream suppliers to find out what their workaround plans were for potential disruptions. We then drew up contingency supply chain plans. For a pandemic, just reach in and pull those pages and put them in the pandemic notebook. Voila! If you ask suppliers what their pandemic supply chain plans are and they look at you funny, get new suppliers.
Companies that have extensive Asian presence are at the top of the list in preparedness. I asked Michael Dell personally about Dell's pandemic plans. He said their SARS experience would allow them to shift production overnight between Singapore and Ireland. He just as quickly asked me for my opinion on other ways they could prepare. So their answer is not final, but it is in progress and Dell is actively seeking thought on the topic.