President Bush on the Possibility of Military-Enforced H5N1 Regional Quarantines

I would judge the potential for a global flu pandemic to be the most pressing risk we face at this point in time. It's telling that today in President Bush's press conference, he spoke at some length on the matter. He even acknowledged that outbreaks in the American population could call for military-enforced regional quarantines ... scary stuff when you think about it.

My hat's off to him for helping to bring this to the fore while folks still have some time to prepare.

Below are his comments with regard to the danger of H5N1 breaking out into the human population. The full transcript can be read at the washingtonpost.com.

QUESTION: Mr. President, you've been thinking a lot about pandemic flu and the risks in the United States if that should occur. I was wondering, Secretary Leavitt has said that first responders in the states and local governments are not prepared for something like that. To what extent are you concerned about that after Katrina and Rita? And is that one of the reasons you're interested in the idea of using defense assets to respond to something as broad and long-lasting as a flu might be?

BUSH: Yes. Thank you for the question. I am concerned about avian flu. I'm concerned about what an avian flu outbreak could mean for the United States and the world.

I have thought through the scenarios of what an avian flu outbreak could mean. I tried to get a better handle on what the decision-making process would be by reading Mr. Barry's book on the influenza outbreak in 1918. I would recommend it.

The policy decisions for a president in dealing with an avian flu outbreak are difficult.

One example: If we had an outbreak somewhere in the United States, do we not then quarantine that part of the country? And how do you, then, enforce a quarantine?

It's one thing to shut down airplanes. It's another thing to prevent people from coming in to get exposed to the avian flu.

And who best to be able to effect a quarantine? One option is the use of a military that's able to plan and move. So that's why I put it on the table. I think it's an important debate for Congress to have.

I noticed the other day, evidently, some governors didn't like it. I understand that. I was the commander in chief of the National Guard and proudly so. And, frankly, I didn't want the president telling me how to be the commander in chief of the Texas Guard.

But Congress needs to take a look at circumstances that may need to vest the capacity of the president to move beyond that debate. And one such catastrophe or one such challenge could be an avian flu outbreak.

QUESTION: (OFF-MIKE)

BUSH: Wait a minute, this is an important subject.

Secondly, during my meetings at the United Nations, not only did I speak about it publicly, I spoke about it privately to as many leaders as I could find, about the need for there to be awareness, one, of the issue and two, reporting -- rapid reporting to WHO, so that we can deal with a potential pandemic.

The reporting needs to be not only on the birds that have fallen ill, but also on tracing the capacity of the virus to go from bird to person to person. That's when it gets dangerous: when it goes bird, person, person.

And we need to know on a real-time basis as quickly as possible the facts so that the world scientific community can analyze the facts and begin to deal with it. Obviously, the best way to deal with a pandemic is to isolate it and keep it isolated in the region in which it begins.
As you know, there's been a lot of reporting of different flocks that have fallen ill with the H5N1 virus. And we've also got some cases of the virus being transmitted to a person, and we're watching very carefully.

Thirdly, the development of a vaccine. I've spent time with Tony Fauci on the subject.

Obviously, it would be helpful if we had a breakthrough in the capacity to develop a vaccine that would enable us to feel comfortable here at home, that not only would first responders be able to be vaccinated, but as many Americans as possible, and people around the world.

But, unfortunately, we're just not that far down the manufacturing process. And there's a spray, as you know, that can maybe help arrest the spread of the disease, which is in relatively limited supply.

So one of the issues is how do we encourage the manufacturing capacity of the country, and maybe the world, to be prepared to deal with the outbreak of a pandemic?

In other words, can we surge enough production to be able to help deal with the issue?
I take this issue very seriously, and I appreciate you bringing it to our attention.

The people of the country ought to rest assured that we're doing everything we can. We're watching it. We're careful. We're in communications with the world.

I'm not predicting an outbreak. I'm just suggesting to you that we better be thinking about it. And we are. And we're more than thinking about it, we're trying to put plans in place.

And one of the plans -- back to where your original question came -- was, you know, if we need to take some significant action, how best to do so. And I think the president ought to have all options on the table to understand what the consequences are -- all assets on the table, not options -- assets on the table to be able to deal with something this significant.