Bush's risky flu pandemic planWHENEVER THE world is not to his liking, President Bush has a tendency to turn to the military to make it better. The most prominent example is the country's response to 9/11, complete with wars in Afghanistan and Iraq. After Hurricane Katrina, Bush belatedly called on the military to assist in securing New Orleans, and has since suggested that Congress should consider empowering the military to be the ''first responders" in any national disaster.
On Tuesday, the president suggested that the United States should confront the risk of a bird flu pandemic by giving him the power to use the US military to quarantine ''parts of the country" experiencing an ''outbreak." So we have moved quickly in the past month, at least metaphorically, from the global
war on terror to a
proposed war on hurricanes, to a
proposed war on the bird flu.Of all these proposals, the use of the military to attempt to contain a flu pandemic on US soil is the most dangerous. Bush says he got the idea by reading John Barry's excellent account of the 1918 Spanish flu pandemic, ''The Great Influenza." Although quarantine was used successfully in that pandemic, on the
island of American Samoa, Barry in his afterword suggests (sensibly) that we need a national plan to deal with a future influenza pandemic. He said last week that his other suggestions were the only ones he hoped public health officials and ethicists would consider, but they read like policy recommendations to me and apparently the president. Barry writes, for example, ''if there is any chance to limit the geographical spread of the disease, officials must have in place the legal power to take extreme quarantine measures." This recommendation comes shortly after his praise for countries that ''moved rapidly and ruthlessly to quarantine and isolate anyone with or exposed to" SARS.
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In 1918 the Spanish flu was spread around the US
primarily by soldiers, and it seems to have incubated primarily on military bases. It is a misreading of history that a lesson from 1918 is to militarize mass quarantine to contain the flu. And neither medicine nor public health are what they were in 1918; having public health rely on mass quarantine today is like having our military rely on trench warfare in Iraq.
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Good, clear thinking, Chairman Bush!
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