Skidmore - Presidents, Pandemics, and Politics

The Author(s) 2016

Max J. Skidmore 1

(1)

Abstract

This book examines major threats from disease to the people of the USA, and the ways in which American presidents have responded to such threats. It describes pandemics, and looks at several presidents. It looks critically at two, Woodrow Wilson and Dwight Eisenhower, and at their inaction when faced with influenza. It looks especially at Gerald Fords scorned National Influenza Immunization Program (NIIP, or the Swine Flu Vaccination plan), and concludes thatin contrast to the conventional wisdomthere is much to be learned from Fords efforts.

It discusses major achievements in combatting infectious diseases in the twentieth century, such as the eradication of smallpox, and the virtual eradication of polio and of so-called childhood diseases, such as measles, that at one time were almost universal but are threatening to return because of the irrational refusal of many parents to immunize themselves and their children.

Above all, the book demonstrates that efforts to impose severe limits on the size, scope, and expense of government are dangerous. Government, and that means presidential action, often provides the best, and sometimes the only, method of protecting the population.

Keywords

This book examines major threats from disease to the people of the USA, and the ways in which American presidents have responded to such threats. It will look critically at two presidents who had direct roles to play in pandemics, Woodrow Wilson and Dwight Eisenhower. It will look most extensively at another who faced what appeared as though it might develop into a horrendous pandemic, but did not materialize. That president was Gerald Ford, whose National Influenza Immunization Program (NIIP) sought to vaccinate all Americans against a swine flu virus that many experts thought was impending. Without a pandemic to fight, his program was derided as a fiasco. Officials from the incoming Carter administration were triumphantly scornful of the defeated President Ford, and their scorn was exceeded by that from the forces of Ronald Reagan, who had sought to seize the nomination from the sitting president of their own party, but had failed to do so, and thus seethed with disdain for Fords policies. This study will offer a rather favorable assessment of President Fords program, one that is rare for reasons that it will make clear. It will consider the health policies of Presidents Clinton and Obama favorably, and will give a mixed assessment to the policies of George W. Bush: highly critical for the most part, but surprisingly favorable in others. Above all, it will make the case that guarding against pandemics is and must be an integral part of national security. Despite the books title, now and then it will look beyond pandemics when it seems that doing so will help to evaluate presidential actions that would be relevant if the situation involved were a pandemic.

Presidents and Pandemics will argue that we must learn from past experiencemistakes and successesin preparing for the future, and that future preparation is vital to the maintenance of civilization, here and elsewhere. As critical as terrorism is in the modern world, including bioterrorism, an even greater threat comes from natural causes. It will be necessary to overcome the tendency to respond only to the most dramatic dangerthe obscenities, say, of a scowling enemy decapitating a helpless captive, attacking innocent schoolchildren, or snarling evil intent that might take place hereas opposed to preparation also for what assuredly will take place here: ever more virulent pandemics.

An examination of this kind obviously has implications not only for this country but for the rest of the world as well. The role of government will be key to national efforts; presidential understanding, commitment, and action will be prerequisite to effective government. Therefore, presidents are crucial to successful public policies.

At one time, there was little the worlds population could do in the face of pandemics. Modern medicine has given us many tools to employ. The decades since the beginning of the twentieth century have been characterized, time and again, by outbreaks of new and deadly diseases that either are or have the potential to become major threats to humanity. The greatest of these to date was the misnamed Spanish Flu of 1918 during World War 1, a swine flu pandemic that, with a death toll of some 675,000 for this country alone, killed more Americans than even the 600,000 of the Civil War, the conflict most lethal to its citizens. Worldwide, as later chapters make clear, the pandemics deaths exceeded those of any other cause in world history, upward of 50 million, sparing virtually no part of the planet in which there were human beings. Decades later, pandemics resulted first from Asian flu, and then from Hong Kong flu, each less lethal than its predecessor. Later in the century, despite being far less easy to transmit than influenza, came the march of HIV-AIDS. It was slower than the explosion of influenza, but its many tragic deaths were accompanied by sweeping cultural effects that were as serious as those of the wartime pandemic.

With the twenty-first century came SARS. According to the Centers for Disease Control (CDC), Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. The illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained. Fortunately, since 2004 there have been no reported cases of SARS anywhere.

In June of 2015, according to both official reports and the press, South Korea was facing the largest outbreak of MERS that had ever taken place outside of the Middle East. MERS, says the CDC, is Middle-East Respiratory Syndrome, a severe coronavirus infection affecting human beings. The earliest reports described MERS as having been identified in 2012 in Saudi Arabia, but later corrections indicated that there had been a case a few weeks earlier in Jordan. MERS spreads from one person to another through close contact, although the exact mechanism of transmission is not clear. It causes fever, coughing, and difficulty breathing. About 34 out of every 10 patients reported with MERS have died.

At roughly the same time there was a widespread incidence of bird flu in the USA that was causing a serious egg shortage severely affecting American restaurants. Prices escalated, and in some locations sellers began limiting egg purchases, that is, in effect they were implementing rationing of eggs. This is reasonable, but it seems poorly compatible with the attitudes of small-government Republicans, especially those of Senator Ernst, who ran for office condemning dependence upon government.

This illness was not infecting human beings, but influenza affecting human beings has emerged from other animals, and seems most often to have originated among birds. Avian flu, in fact, poses perhaps the most serious potential threat that humanity faces, along with those of climate change and environmental degradation. The New Yorker magazine, among all the publications directed toward the most literate and highly educated segment of the reading public, seems to be most likely to deal with issues of general concern, and to do so in a thoughtful and appropriate manner. In the matter of bird flu, it did so in an article under the rubric of its occasional Annals of Medicine.