Editore"s Note
Tilting at Windmills

Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon Sign up for Free News & Updates

October 29, 2009

THE H1N1 'POLITICAL TEST'?.... The New York Times reported today that the shortage of an H1N1 vaccine poses a "political test" for President Obama. I'm not sure if that's a fair characterization.

Indeed, given the reporting in the article, it seems as if the president has already passed the political test.

The moment a novel strain of swine flu emerged in Mexico last spring, President Obama instructed his top advisers that his administration would not be caught flat-footed in the event of a deadly pandemic. [...]

Aware that the president would be judged on how well he handled his first major domestic emergency, the Obama administration left little to chance. It built a new Web site, Flu.gov -- a sort of one-stop shopping for information about H1N1, the swine flu virus. It staged role-playing exercises for public health officials and members of the news media.

It commissioned public service announcements, featuring the fuzzy Sesame Street characters Elmo and Rosita singing in English and Spanish about "the right way to sneeze." The president added a swine flu update to his regular intelligence briefing -- he also receives an in-depth biweekly memorandum on the prevalence of the disease worldwide and in the United States -- and appeared in the Rose Garden to urge Americans to wash their hands.

Early on, Mr. Obama told his aides he wanted them to "learn from past mistakes," said John O. Brennan, Mr. Obama's domestic security adviser, who has been coordinating the flu-preparedness effort.

In June, the president even invited veterans of the 1976 effort to a private meeting in the White House, hoping to draw upon their experiences dealing with the last major flu epidemic, including the proper public role for a president in this situation.

Taken together, it seems the president immediately recognized the seriousness of a public health issue, mobilized officials, launched a public information campaign, and ordered the creation and distribution of a vaccine. The White House sought out all the right advice, from all the right people, and acted quickly. This isn't my area of expertise, but it sounds like the White House has been responding to the H1N1 problem exactly the way it should.

So, what's the problem? Apparently, HHS relied on estimates from manufacturers about the speed and supply of a vaccine, and the manufacturers were overly optimistic about what they could produce. The private companies reported in July they would have 120 million doses available by this week. They were off by about 97 million.

Counting on manufacturers' assurances, HHS Secretary Kathleen Sebelius said, may have been "naive." Perhaps. But it was obviously outside the control of the administration.

The NYT report added that vaccine shortages are "threatening to undermine public confidence in government." Quality, accurate reporting should let the public know that wouldn't make any sense.

When we think about government failures on public emergencies -- the response to Hurricane Katrina, for example -- we see certain characteristics, such as negligence, incompetence, tardiness, and ignorance. None of these concerns seems to apply to the administration's handling of the H1N1 emergency.

Steve Benen 4:10 PM Permalink | Trackbacks | Comments (44)

Bookmark and Share
 
Comments

May be wrong, but I suspect part of the problem is that other countries - the UK in particular - got ahead of the US in the queue.

Posted by: David Steven on October 29, 2009 at 4:17 PM | PERMALINK

Wait, the private sector didn't come through? We should have relied more on the government?

That dern Osama, trusting in the private sector. Socialist!

Posted by: eadie on October 29, 2009 at 4:18 PM | PERMALINK

Agreed Steve. There are folks from the local government level to the federal level working like dogs to address this outbreak. If fingers can be pointed, it's the lack of serious funding for modernizing how vaccines are produced. Drug manufacturers haven't invested in this area of research because there's no fiscal incentive to do so (see malaria/africa). It's completely maddening from a public health perspective.

Posted by: cawahine on October 29, 2009 at 4:18 PM | PERMALINK

Strange timing coincidence. A close friend, who I chatted with in person just last Friday, informed me not five minutes ago that he just got back from the hospital diagnosed with H1N1, and his hubby is starting to show signs.

Vaccinations are still scarce here, but anyone who's been paying attention knows that it's the manufacturers, not the government, that's at fault.

Posted by: Michael W on October 29, 2009 at 4:23 PM | PERMALINK

Didn't George Bush get criticized for not being on top of things in 2005 when a firm (in Britain?) ended up not being able to produce vaccines?

You could argue that that event "it was obviously outside the control of the administration".

Bush was criticized by people like me. I think Obama should be criticized for this year's problems as well.

Posted by: Quiddity on October 29, 2009 at 4:23 PM | PERMALINK

Leave it to the NYT to give us the concern trolling without the actual facts.

We don't have even ONE quality newspaper in this country any more. Time for them ALL to go out of business.

Posted by: Steve LaBonne on October 29, 2009 at 4:24 PM | PERMALINK

You lefties will never get it.

Government is by its very nature unable to solve problems. Otherwise it would have forced the manufacturer to produce.

Posted by: Myke K on October 29, 2009 at 4:28 PM | PERMALINK

Vaccinations have been given out in some areas on a first come first serve basis. That is where the administration and the states are failing.

A healthy 30 year old shouldn't get the shot over a toddler just because they can wait in line for four hours.

Additionally, supplies of the seasonal flu shot were purchased by retail chains in such large quantities that pediatricians' orders were canceled.

When we're dealing with a short supply of vaccinations, they should be rolled out to those with the greatest need first, and that's not what has happened with regards to either of the flu vaccines.

That is where the condemnable failure lies.

Posted by: doubtful on October 29, 2009 at 4:29 PM | PERMALINK

Of course it is 100% the fault of President Obama that the H1N1 strain selected for the vaccine grows more slowly in chick embryos than the strains used in the seasonal vaccine. He should have personally gone into a virus lab and developed a faster-growing variant.

Posted by: NEskeptic on October 29, 2009 at 4:32 PM | PERMALINK

Our press corps seems to have a serious addiction problem. If they're deprived of their regular dose of horserace reporting and potential scandal, they'll look anywhere and everywhere to satisfy the jones.

Posted by: Quaker in a Basement on October 29, 2009 at 4:33 PM | PERMALINK

"... threatening to undermine public confidence in government." - ! - It should further undermine public confidence in corporate claims, but the Villagers like to put the blame on the government - for trusting private corporations, but that isn't how they'll spin it.

Quiddity: No, we shouldn't blame Obama just because GWB was blamed. If GWB didn't deserve the blame then, then Obama shouldn't have to for similar action. Instead, we can just say that's one of the few things that really weren't GWB's fault.

Posted by: Neil B … on October 29, 2009 at 4:36 PM | PERMALINK

-my numbers may be off a tad, but don't 45,000 people die each year from reg'lar ol' flu? And that weekly/monthly death toll gets how much ink?

-not to mention the death toll from traffic accidents. . .

Posted by: DAY on October 29, 2009 at 4:38 PM | PERMALINK

If government is by its very nature unable to solve problems, why are Myke K and his buddies such strong advocates of sending more U.S. government troops to Afghanistan?

Posted by: cyb1851 on October 29, 2009 at 4:47 PM | PERMALINK

DAY,

Most of the people who die from typical seasonal flu have underlying health problems. Yes, those people are being hit hard by H1N1, but so are young, otherwise healthy people. The number of kids dying has outpaced the rate of standard seasonal flu.

Posted by: doubtful on October 29, 2009 at 4:54 PM | PERMALINK

A healthy 30 year old shouldn't get the shot over a toddler just because they can wait in line for four hours.

Socialist!

How dare the government redistribute our health.

Or something like that.

Posted by: lobbygow on October 29, 2009 at 4:56 PM | PERMALINK

Socialist! -lobbygow

Worn like a badge of honor. Bernie Sanders is my hero.

Posted by: doubtful on October 29, 2009 at 5:05 PM | PERMALINK

This really IS Obama's fault, because if he hadn't been a socialist intent on punishing entrepreneurs for making profits, these manufacturers wouldn't have had to go Galt in order to avoid Obama's punitive tax increases. It's not that they COULDN'T produce enough vaccine (as the market system can do anything when enough profit motive is involved), they just were worried their net income would exceed $250k if they did what needed to be done.

If you expect these people to save our butts every time, we can't punish them for doing so. Profits are God's way of saying "Well done, sir."

BTW, this is the kind of thing "Al" and "Myke K" would write if they were worth their weight in trollness.

Posted by: Doctor Biobrain on October 29, 2009 at 5:08 PM | PERMALINK

Counting on manufacturers' assurances, HHS Secretary Kathleen Sebelius said, may have been "naive."

You relied on PRIVATE INDUSTRY to provide? Isn't that what we are doing with HEALTH CARE?

Posted by: SYSPROG on October 29, 2009 at 5:09 PM | PERMALINK

Steve:

With all due respect, you're dead wrong about this. I'm a yellow-dog Dem and passionate Obama supporter but also the parent of a severely medically compromised child, and the failure of distribution is epic. At the very least the administration should have gotten ahead of this problem and communicated effectively.

If you'd paid any attention to reporting from around the country (as I and every other parent have, for weeks), healthy adults have been able to get the vaccine on a "first come, first serve" basis while I can't get ANY information on how to get a vaccine delivered to my child -- not from his various clinicians at a leading pediatric hospital, not from the visiting nurse service. This morning a pediatrician told me he suspected he wouldn't have anything until January, despite the fact that Sebelius just said it would be widely available in mid-November. NO ONE KNOWS ANYTHING.

This has to hit you in a personal way, as it does me, to see just how vast a communications failure this is shaping up to be. (I assume you don't have children or you'd be less inclined to give HHS and the CDC a pass on this one.) I voted enthusiastically for Obama to handle crises like this clearly and competently -- especially since the strain emerged last spring. I didn't expect him and supporters like you to throw arms up in the air and say, "don't blame us."

You seriously underestimate the anger building on this issue. It's huge.

Posted by: BrklynLibrul on October 29, 2009 at 5:09 PM | PERMALINK

...Except a healthy 30-year-old is more likely to die of H1N1 than most of the usual targets.

However, it isn't the overworked or underpaid 30-year-old who can stand in line for four hours.

Posted by: Crissa on October 29, 2009 at 5:11 PM | PERMALINK

BTW, this is the kind of thing "Al" and "Myke K" would write if...

Huh? Blink! Wha....? Sorry, we nodded off after your first excruciating sentence, as we always do. How's that blog readership?

Posted by: "Al" and "Myke K" on October 29, 2009 at 5:28 PM | PERMALINK

Two things:

First, this comment: "You lefties will never get it. Government is by its very nature unable to solve problems. Otherwise it would have forced the manufacturer to produce."

This is just plain hysterical. A rightie demanding the government *force* the private sector to do something. Oh my aching head. (If you really believe that, you won't like this health care reform package because it doesn't go far enough.)

Two: If these people were around throughout history, we'd still have polio, malaria, smallpox, tetanus, and tuberculosis. They probably lament the loss of such a world in which government knows its place.

Lefties get it, chum.

Posted by: stevenz on October 29, 2009 at 5:39 PM | PERMALINK

...Except a healthy 30-year-old is more likely to die of H1N1 than most of the usual targets. -Crissa

Per the CDC, the death rate for a 30 year old is 6.97%, but for the younger age groups, 0-4 and 5-24, is 22.9% and 26.7% respectively.

BrklynLibrul,

You are absolutely right about everything, especially about the misinformation from Sebelius about the timing of vaccine availability.

Posted by: doubtful on October 29, 2009 at 5:43 PM | PERMALINK

Two Republicans on H1N1:
http://www.politico.com/news/stories/0509/22205.html

Posted by: MrPinko on October 29, 2009 at 5:45 PM | PERMALINK

Per the CDC, the death rate for a 30 year old is 6.97%, but for the younger age groups, 0-4 and 5-24, is 22.9% and 26.7% respectively.

That's not the mortality rate. That's the U.S. confirmed and probable case rate per 100,000.

Posted by: shortstop on October 29, 2009 at 5:55 PM | PERMALINK

I just came to correct that, but shortstop beat me to it.

This is the mortality chart, and it uses different age groups, making a rate to mortality comparison difficult, but it does support Crissa's assertion.

I stand corrected, my apologies.

Posted by: doubtful on October 29, 2009 at 5:58 PM | PERMALINK

My son came down with the swine flu this week after we were unable to find a vaccine for weeks. We still can't, not even for the other at-risk people in our household (elderly, asthmatics).

(We did get my son -- and the rest of us -- the conventional flu vaccine, which turns out not to help, in contradiction to some early press reports that it might.)

The evolution of the vaccine industry towards epic fail is not Obama's fault. But inadequate communication is, and the lack of adequate backup plans might well be. At minimum, it seems like someone made the decision to break into the strategic stockpiles of Tamiflu later than they should have; the other day, the Washington Post covered frantic parents who couldn't find it for their kids.

Maybe having a Surgeon General approved by Congress would've helped a little with the communication, because there's immense confusion out here about H1N1. But still...

This is a complicated problem: epidemics move and change fast, and decisions that seem right in August can easily prove badly wrong in October. Obama's execution may have been better than Bush's was. Having said that, here on ground level, the government's performance seems far from adequate. And I think we citizens do have a right to expect flat-out excellence in execution on issues like this.

I also agree with BrkylnLibrul that a lot of folks of all political stripes are not feeling as forgiving as I might be.

Finally, I'd like to know what the Obama administration proposes to keep this from happening next year, or the year after. If a fix requires legislation, NOW is the time to push it through.

BTW: doubtful, I think you may be reading that CDC graph wrong (or perhaps I'm misunderstanding your reading of it). The relative dangers to different age groups is correct, but those death rates are per 100,000 age group, NOT percentages of death amongst those who contract H1N1. It's scary, but not THAT scary.

Posted by: bcamarda on October 29, 2009 at 5:59 PM | PERMALINK

...rates are per 100,000 age group, NOT percentages... -bcamarda

So noted. So not only did I cite the wrong graph, I misread it as well. Well folks, that's it for me. Two mistakes in the span of 0 seconds, and I'm calling it a day.

Apologies again all around.

It's a day.

Posted by: doubtful on October 29, 2009 at 6:03 PM | PERMALINK

bcamarda @ 5:59 is too kind. Having to field a response to this feigned concern of the Rethugs is ALWAYS a good time to body-slam the shit out of them. It would have been the perfect time to respond:
"For someone so concerned about the public health, perhaps now would be a good time to quit the politics and approve Obama's nominee for surgeon general AND quit with the obstruction of HCR and participate like grownups."

Posted by: Chopin on October 29, 2009 at 6:23 PM | PERMALINK

Am I missing something: Do people - actual citizens - actually give a sh*t about H1N1?

Posted by: jimmy on October 29, 2009 at 6:30 PM | PERMALINK

Jimmy: Those of us who have it in our household do!

Posted by: bcamarda on October 29, 2009 at 6:56 PM | PERMALINK

Yes, Jimmy, people do give a sh*t. Imagine, if you can, a parent whose child is immunosuppressed for any number of reasons (the kids on chemotherapy, say). If that child catches H1N1 from a classmate/friend/neighbor/random person because nobody's been vaccinated, than that child might very well die.

Of course, perfectly healthy kids can and are dying from H1N1, but I thought I'd give you a scenario you could more easily grasp.

This has been a huge disaster for Obama, who is now showing himself to be possibly more incompetent than Bush. After all, it's not like Bush knew that Katrina was going to hit six months in advance.

Yes, it's the private sector's fault that there's not enough vaccine, and what vaccine there is is late. So what? What if H1N1 had returned in a more virulent form? There'd be bodies piling up in city parks by now. At that point, would you still be blaming Glaxo Smith Kline?

All it's going to take is one mom with a child who died of H1N1 to go on Larry King and blame Obama for not getting the vaccine out there and it's all over for Barry. I wouldn't be surprised if the Republicans aren't out scouring the country for that woman right now.

Posted by: Jake on October 29, 2009 at 7:18 PM | PERMALINK

jimmy:

It sent my son to the hospital. What, me worry?

Posted by: noncarborundum on October 29, 2009 at 7:27 PM | PERMALINK

The government never gets anything right. That Iraq war they kept pushing was supposed to be over in six weeks, initially cost less than $50billion after which the happy Iraqis would then pay it all back with oil revenue after showering us with flowers and candy.

Posted by: qwerty on October 29, 2009 at 7:54 PM | PERMALINK

Jake:

Many thanks for your post; you nailed it beautifully.

Posted by: BrklynLibrul on October 29, 2009 at 8:47 PM | PERMALINK

"Vaccinations have been given out in some areas on a first come first serve basis. That is where the administration and the states are failing."

I can't speak for other areas, but this is not true where practice. The first supplies went out to OB's to handle pregnant women for health care professionals. They are just beginning to provide supplies of the vaccine for other high risk groups.

I imagine that once they start giving larger supplies to offices it will come down to each office as to whether vaccines are prioritized but it would be awfully hard for the government to control this.

Posted by: Ron Chusid on October 29, 2009 at 9:07 PM | PERMALINK

qwerty: not quite sure where you're coming from, but I can name dozens of things the government has gotten very right, from the national parks to funding the research that led to the Internet. Even, miraculously, my DMV has been reorganized and my last three transactions with them have rivaled Amazon.com in efficiency.

What I can't conceive of is a credible, free market solution to massive potential public health problems like H1N1. The government had better get this right, because nobody else can or will.

jake: "...and it's all over for Barry." 45,000 people per year are dying for lack of health insurance, some of them plenty visible and sympathetic, and it hasn't been the end of the Republican party. You'll have to do better than that!

Posted by: bcamarda on October 29, 2009 at 9:08 PM | PERMALINK

It is probably too early to determine if anyone deserves blame. One problem is simply that H1N1 has been growing more slowly than expected in the labs, making it take longer to produce the vaccine. Perhaps over time we'll find ways this could have been handled better, but it is nonsense to blame Obama or even the pharmaceutical companies because we knew six months in advance. There are limitations which cannot be controlled in the production of vaccines. The comparison to Katrina is utterly ridiculous.

Posted by: Ron Chusid on October 29, 2009 at 9:12 PM | PERMALINK

If Obama had *really* been Stalin-incarnate (living up to his reputation), he'd have slammed all the effing scientists into reeducation camps, up in Alaska, and kept them there, shivering, till they figured out why the damned chicken eggs, instead of producing 6 doses per egg, produced only 2. Instead, the damned slackers, in their air-conditioned labs, started the whole process over again, with a slightly different strain (which now gives us 4 doses per egg).

Why, if the Big O had been really on the ball, he'd have incarcerated the damned *chickens*, till they produced better eggs...

Of course, a lot of people got confused, because the population which needs N1H1 is *not* the same population which needs the regular, seasonal flu shots (so that now there's a shortage of both, with wrong people being inoculated with wrong shots), but that's totally irrelevant.

Posted by: exlibra on October 29, 2009 at 9:15 PM | PERMALINK
This has been a huge disaster for Obama, who is now showing himself to be possibly more incompetent than Bush.

ROFL... What can you say about drivel like this? It's self-refuting. All you can do is shake your head and hope the guy rejoins reality someday soon.

Posted by: PaulB on October 29, 2009 at 10:40 PM | PERMALINK

If you'd paid any attention to reporting from around the country (as I and every other parent have, for weeks), healthy adults have been able to get the vaccine on a "first come, first serve" basis while I can't get ANY information on how to get a vaccine delivered to my child -- not from his various clinicians at a leading pediatric hospital, not from the visiting nurse service. This morning a pediatrician told me he suspected he wouldn't have anything until January, despite the fact that Sebelius just said it would be widely available in mid-November. NO ONE KNOWS ANYTHING.

You need to blame state and local officials if they're handing out H1N1 vacs to those not in the high risk groups. Here in Chicago and the surrounding communities, we've been following CDC rcmdations with no problem. There's not yet enough vacs for everyone at high risk, but that's the fault of the chickens, not because "healthy adults" are jumping at the front of the line, like apparently they are in NYC.

Posted by: Disputo on October 30, 2009 at 6:20 AM | PERMALINK

It's not just New York City, Disputo.

And, no pun intended, Chicago is not immune to the same problems and lack of enforcement will that other cities have succumbed to.

Sure, part of the vaccine shortfall is a result of production, but to discount line jumpers is naive.

Your credibility on the issue is suspect to begin with since you basically claimed it wasn't a problem over the summer and that people need not worry about it, anyway.

Posted by: doubtful on October 30, 2009 at 10:18 AM | PERMALINK

"CDC Encourages Flu Shots, Dispels Fears" Read it at http://wp.me/pC3Xj-8c

Posted by: Alan King on October 30, 2009 at 11:17 AM | PERMALINK

Greeting. Each individual woman's body demands to be accepted on its own terms. Help me! Please help find sites for: Replica outlet. I found only this - 1795 springfield replica for sale. Grecian mix in their 1966 little development the party that lost its head, replica. Replica, and what algorithm that you can pause but you cannot become it? With love ;-), Archie from Herzegovina.

Posted by: Archie on March 8, 2010 at 3:19 PM | PERMALINK




 

 

Read Jonathan Rowe remembrance and articles
Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon Sign up for Free News & Updates

Advertise in WM



buy from Amazon and
support the Monthly