"No one knows exactly how serious this threat could be. Nevertheless, we cannot afford to take a chance with the nation's health."
Last week President Bush went to the National Institutes of Health to warn the nation of a possible flu pandemic and launch an emergency campaign to protect Americans from a global attack by a new virus of mass destruction.
But the above quote doesn't come from President Bush.
The words were spoken by President Gerald Ford and they were the opening shot in what would become the Great Swine Flu Debacle of 1976.
With this quote, Ford launched a campaign on March 24, 1976, to protect the American people against a possible flu pandemic of catastrophic dimensions. He called on Congress to fund a massive program to produce an effective vaccine against the disease.
Then as now, this kind of emergency public health campaign was a preemptive strike against a potentially lethal disease. As Bush said in his speech: "Our country has been given fair warning of this danger to our homeland -- and time to prepare." And like his Republican predecessor nearly 30 years ago, Bush pointed out the uncertainty of the threat. "At this point, we do not have evidence that a pandemic is imminent."
Then as now, the new virus was compared to the Spanish flu virus that caused the great flu pandemic of 1918. Newspapers, magazines and television shows featured special reports that detailed the mayhem and sorrow of the 1918 Spanish flu pandemic. Today the media are again awash in killer flu reports and historical essays on the Spanish flu. That virus "killed over half a million Americans and more than 20 million across the globe," said Bush. "Life expectancy in our country was reduced by 13 years."
In both campaigns, there has been scientific research to support the immediacy of the threat. In 1976, one study predicted 50,000 deaths if the population were not immunized against the swine flu virus. Today researchers have found genetic similarities between the current bird flu virus and the 1918 Spanish flu virus, raising the specter of a repeat pandemic.
Then as now, public health campaigns have a political aspect. In response to Ford's speech, Congress quickly passed special legislation to spend $135 million (more than $435 million today) to manufacture a vaccine and inoculate 215 million people -- virtually the entire population -- by fall, when the epidemic was supposed to hit the United States. An enthusiastic press corps recorded the moment when Ford and his family rolled up their sleeves to be vaccinated. Who could be against a program aimed at protecting American lives?
Meanwhile, Ford could try to distance his administration from the legacy of his former boss, Richard Nixon, and restore people's faith in government.
President Bush also has strong support -- from lawmakers, medical scientists and the public -- to protect the homeland against a possible flu pandemic. He is calling on Congress to spend $7.1 billion in this campaign, with most of the money to go to vaccine research and stockpiles of vaccines and antiviral drugs. Who can be against a public health campaign aimed at protecting American lives?
But nine months after President Ford's bold announcement, the swine flu program ended in disaster. The disease turned out to be a phantom. There was no flu pandemic. Worse, the vaccine caused illness. More than 50 people who were inoculated developed the rare paralytic disease Guillain-Barre syndrome, and at least six people died.
What are the lessons of the swine flu debacle?
It was not a mistake to launch a campaign against a potentially severe disease.
The mistake was in not having an exit strategy -- not stopping the mass vaccination program when it became clear that the threat was overblown. Instead, the government tried all the harder to convince the public of the danger. A month before the program officially collapsed, health officials organized a media blitz to boost vaccination rates. By that time, only one case of swine flu had surfaced -- in a telephone lineman in Concordia, Mo., who might have contracted the disease from pigs, not from another infected person.
In any public health campaign, the risk is that once so much effort is invested, it is hard to pull back. But medical generals have to guard against hubris and be flexible and adaptable in waging war against a new virus. The risk may decrease -- or explode with a vengeance.
There is one key difference between Ford's ill-fated program and the Bush initiative. In 1976, the United States was alone in its campaign against swine flu. Health officials in other countries questioned the seriousness of the threat. The World Health Organization saw little danger of an epidemic. Asian scientists suspected Americans were panicking.
This is not the situation today. Alarm -- along with the avian virus -- has spread from Asia to Europe. Bird flu is a real disease that has already claimed at least 60 lives. It may or may not morph into a major epidemic.
At least in this campaign against a global threat, the United States is not going it alone.
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