By Scott Wilson and Spencer S. Hsu
Washington Post Staff Writers
Friday, May 1, 2009
The Obama administration has relied on a Bush-era public health strategy aimed at coordinating its response across an array of government agencies in the week since the first reports of a swine flu outbreak emerged, officials say, as it attempts to balance safety concerns with a desire to prevent a panic.
While Homeland Security Secretary Janet Napolitano has become the public face of the administration's effort to manage the outbreak, President Obama has been briefed three times a day on his administration's first public-health crisis. Behind the scenes, Deputy National Security Adviser John O. Brennan is coordinating the response to a borderless threat that draws on almost every Cabinet-level agency.
The administration's response has won over such usual critics as Rep. John A. Boehner (Ohio), the House minority leader, who said, "I have no complaints about how they're proceeding."
But the administration has scrambled to maintain a consistent message on how the public should respond to the outbreak, illustrating the challenge of convincing people that it understands the scope of a fast-moving problem and has a plan to contain it.
Obama has defended his decision to keep open the U.S. border with Mexico amid calls from some U.S. senators for tighter screening of travelers, while no less a figure than Vice President Biden has sent mixed messages over whether healthy people are at risk of contracting the disease if they travel.
"I wouldn't go anywhere in confined places now," Biden said yesterday on NBC's "Today" show, contradicting a message of calm caution put forth the previous night by Obama. "It's not going to Mexico, you're in a confined aircraft, when one person sneezes it goes all the way through the aircraft. That's me. I would not be, at this point, if they had another way of transportation, suggesting they ride the subway."
His spokeswoman, Elizabeth Alexander, later said Biden meant to convey the same advice that the president had the previous evening during a prime-time news conference -- that people feeling ill should stay home.
"How we explain to the country what steps we are taking in this process is very much a part of our response planning," a senior Obama administration official said. "You can't necessarily control how people react to this information. Our goal is to recognize this is a matter of concern and to channel that energy in a direction that will lead to a resolution."
A timeline provided by the White House yesterday shows that Obama received word of the outbreak from Brennan on April 24 at his regular morning national security briefing.
Later that day, the Homeland Security Council, which comprises that department, the FBI, the Justice Department, the CIA and other agencies, discussed the outbreak for the first time at its regularly scheduled meeting run by the president.
The Domestic Readiness Group, a broad interagency panel put in place by the Bush administration to respond to national emergencies, also convened that day and has been teleconferencing daily. Public health experts say the administration is benefiting from the Bush administration's 2005 National Pandemic Strategy.
"The Obama administration is following a playbook that's been developed, refined and exercised for going on almost three years now," said Mike Leavitt, former Bush health and human services secretary. "I think they're doing a reasonably good job."
"Half the battle is fighting the pathogen," said Robert B. Stephan, a former Bush homeland security official who conducted extensive planning on the impact of a pandemic virus on industry. "The other half is gaining and maintaining the confidence of the public that the government is on top of the situation."
Over the past week, the Department of Homeland Security's National Operations Center has been distributing twice-daily situation reports on the flu outbreak to a variety of agencies.
Brennan has also brought experts from the National Institutes of Health to the White House as part of an effort to define the current state of the outbreak and determine ways to contain its spread.
In one sampling of the public's eagerness for information, more than 15,000 questions were submitted during an hour-long webcast yesterday hosted by Napolitano, Health and Human Services Secretary Kathleen Sebelius and Richard E. Besser, acting director of the Centers for Disease Control and Prevention.
This week, Sens. Joseph I. Lieberman (I-Conn.), John McCain (R-Ariz.) and Susan Collins (R-Maine) urged Napolitano to tighten screening at the U.S.-Mexico border or face demands for a shutdown. In his news conference Wednesday night, Obama said closing the border now "would be akin to closing the barn door after the horses are out. We already have cases in the United States."
"How we respond -- intelligently, systematically, based on science and what public health officials have to say -- will determine in large part what happens," Obama said.
Obama is seeking a balance between advising public schools to close if students become sick and the cost of doing so. Schools often provide other health services, such as free or subsidized meals, and sending healthy children home often means that parents must miss work, which could weigh on critical services. Although Obama said Wednesday that U.S. school officials "should strongly consider temporarily closing," the decision remains up to local officials.
"Who's going to take care of all the sick people if all the nurses and health-care workers are home taking care of their kids? And the evidence that school closures are effective is pretty thin," said Eric Toner, senior associate at the University of Pittsburgh Medical Center's Center for Biosecurity. "Today, I'm seeing a lot of people who are really very scared about what they're hearing. I think the government is doing overall a good job in their communication, but it's very challenging."
Staff writers Ceci Connolly and Paul Kane contributed to this report.