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Governor Mike LeavittGLENN: Governor Mike Leavitt is with us. He's the former HHS secretary under George W. Bush, Health and Human Services secretary Mike Leavitt. Mike, how are you, sir?
LEAVITT: Hello, Glenn.
GLENN: It is good to have you on. I just, I wanted to ask you a few questions and then if you don't mind, if somebody else wanted to ask some questions, if some of the members of the audience would like to ask some questions on, you know, what are your thoughts on the swine flu, what should we be doing, et cetera, et cetera, do you mind taking calls from the audience?
LEAVITT: Not a bit. I'd be very pleased to.
GLENN: Okay. So if you have any swine flu questions or anything that's going on, please call now. Okay. So Secretary, you were there at Department of Health and Human Services when we were going through the bird flu preparatory stage, right?
LEAVITT: Yes, I was there through that phase and through the planning we did over the next three years.
GLENN: Okay. Are we acting in a consistent manner with this swine flu scare?
LEAVITT: Glenn, these are scary propositions. It's hard to talk about them because anything you say in advance of their happening sounds like you are being alarmist. The problem is once they start to unfold, anything you've done is inadequate. And so you have to find that balance between helping people prepare but not giving them panic, informing them but not inflaming them, and that's a hard balance to find sometimes. But these are serious deals. And we've had three of them in the last 100 years. We've had ten of them in the last 300 years. There's really no reason to think the next century's going to be different than the last. We do need to be prepared and we need to take them seriously.
GLENN: What I'm asking you, Mr. Secretary, I have wrestled with this over the weekend exactly what you just said. I'm a guy who, I just believe in be prepared. You should just be prepared. You should have some food at home, you should have some water at home, you should have, you know, a small amount of cash at home in case something would happen. You should just always be prepared. And you learn this, especially if you live in New York City. However, everybody always wants to take that and turn it into, oh, fear monger and Chicken Little and everything else. So I get it. But what I believe is I believe in pandemic. I don't know if this is the pandemic. This might turn out to be nothing, and I hope it does. But I don't understand how we can declare a state of an emergency to be able to move the medicine around to get things going, how we can be so worried about it, go from 20 cases to 50 cases overnight and yet not even check people at the border.
LEAVITT: What you're saying is a logical conclusion to draw. I would tell you that I've spent a fair amount of time myself involved in this conversation, and a lot of studies have gone into it. The dilemma is that if you begin to rely on a border closure strategy or even a heavy screening, when you think of the fact that there are 400 different places where people can enter legally and then an infinite number illegally and when you consider the fact that many times the symptoms of this don't show up until two or three days after people are able to spread the disease, this is the kind of thing where border strategies don't really produce much value. And I know that seems counterintuitive and we do have the capacity to be at the borders to screen, to quarantine if necessary. The issue is, is it the best thing to do, do we create more panic than we do value, are we really going to be able to keep this from spreading, and the conclusion I think of a lot of folks who have looked at this over a long period of time is when this starts to happen, you are better it's like a forest fire. You try to contain it at its source but once it starts, then the better strategy is to try to keep people away from it and to try to keep assets from being mowed down by it.
GLENN: Okay. But I mean, somebody in that meeting, when you were sitting there and they said, you know, it's better just to not do anything at the border, somebody had to say, well, wait a minute, then what you are suggesting is don't do anything with the border? We shouldn't have people at the airport doing some sort of screening? And what was the response to that?
LEAVITT: You are right. That conversation exactly took place over and over again, and the conclusion wasn't we ought not to do nothing. But just start walking through the logistics suddenly of saying we're going to screen everyone who comes from a different country. Do we treat Americans different than we do non Americans? You got a lot of people coming in and out of the country who may have been in Mexico on vacation or on business. When they come to you, open up a hanger, do you put a gymnasium? How long do you keep them? And are we really going to do any good? And the conclusion was that we have lots of things we've got to do to help people prepare. If the best use of our resources, to do something that may look and make people feel better but isn't really going to have an impact.
GLENN: Okay.
LEAVITT: And I hear what you're saying and I understand the optics of it, but reality is it isn't a very effective strategy.
GLENN: Okay. Help me out with why it looks like it's being contained here or at least people are getting, you know, well here and not in Mexico. Is it just that we have superior access to doctors? What is it?
LEAVITT: That's a $64,000 question right now. Scientists are trying to figure that out. The best I understand, the virus is the same in Mexico as it is here. I think there are several possible explanations that epidemiologists are going to have to get to the bottom of. One may be that reporting is not perfect coming out of Mexico. It may be that there's some kind of other factor. It may be that it will have momentum as it starts passing from person to person. That would not be a good scenario. I don't know the answer to that. I don't think anyone does yet, but it's that's again part of the dilemma here is we've got to do our best to come up with solutions but not panic people but get people prepared to do the kinds of things I think the point they need to, I think you made a good point. At this point we do need to begin to recognize that we can just move forward and stay informed but we don't need to alter what we're doing day to day at this point.
GLENN: What should we be doing?
LEAVITT: We should be paying attention, and we ought to be doing the things that we should have been doing two months ago. You've stated them. It's a good thing for people to be prepared for an emergency, whether it's a pandemic or a severe storm in the winter.
GLENN: A flood.
LEAVITT: Or some kind of terrorism event. It's just basic preparedness. Have a little food in your house, make certain you've got some money, make certain you've got a supply of your medications. Those are basic preparedness that apply to a pandemic or anything else.
GLENN: There's two scenarios here that I and you don't have to give me the answer. Just tell me that you guys at least thought this through when you were secretary of HHS. One, what happens in a real pandemic? I don't think this is it but I mean, if you would even have a 1918 situation again where you have to say, "I'm sorry, you've got to stay in your house." What happens when a third of the nation is sick? How does that, how does this country or this economy or anything continue to move? For how long does that last?
LEAVITT: Well, those are exactly the questions that we spent many, many months studying and preparing, and the bottom line is everyone has to have a plan, not just the federal government. If people, if states and local communities and families and businesses fail to prepare because they think somehow the federal government's going to come to the rescue, they are going to be sadly mistaken and disappointed because it's not a matter of a lack of will or a lack of a wallet. It's a lack of it's just there's just no way.
GLENN: People.
LEAVITT: It can happen because a pandemic is different than any other kind of emergency. First of all, it happens everywhere at once. When we have hurricanes, we can bring teams from Arizona or New Jersey or the State of Washington into the Gulf Coast and help them. But in a pandemic it's happening everywhere at the same time.
GLENN: Right. The difference between an epidemic and a pandemic is epidemic is localized. Pandemic means it's global.
LEAVITT: That's right, happening everywhere at once. And the second thing is it's an endurance test. It's not just, when you have a disaster like a hurricane or even a nuclear event, there's a terrible destruction, there's a period of confusion and then we move into recovery. With a pandemic, it's six months or a year, sometimes 18 months. Sometimes it comes in waves. And so we then have to begin to operate with whatever state of normality we can while protecting ourselves, our families and our businesses. So every business ought to be thinking how would we function if 30 or 40% of our workforce couldn't come to work. If you're a principal in the school, you need to begin to ask yourself the question: At what point in time do we have school and when don't we.
Now, the federal government's role should be to provide people with information but at the heart of preparation of a pandemic is state and local governments, individual businesses, churches, schools, families thinking through how they would deal with child care issues, et cetera, in such a situation.
GLENN: You know, it's weird because it's the exact opposite direction our government is pushing us. Our government is teaching us, rely on us, rely on us, rely on us. And you are giving the exact opposite advice now. In a pandemic, don't rely on the government is what I've been saying now. I said this yesterday as well. You can't. It's just not going to happen. It's going to be Katrina. And you've got to rely on yourself and your neighbors. Well, have you guys thought through when you were secretary of Health and Human Services, did you guys think through, for instance, the Mexico scenario? If it gets much worse in Mexico, I just imagine that you're going to have especially if people don't see us getting sick, they will think, oh, it must be better medicine or whatever; I've got to get out of Mexico, and a flood of people coming over this border. Did we think that through?
LEAVITT: Actually, Glenn, again you are very perceptive. We did. We spent a lot of time. In fact, we even began to hold exercises with the Mexican government to say, how do we deal on the border if this kind of thing occurs. Now, the fact that we have a plan, the fact that we've exercised it doesn't mean it's any less of a problem. But frankly the Mexican government is responding right now in a way that I think is significantly better than it would have been three years ago, but the minister of health there, secretary of health there I'm well acquainted with because we went through pandemic exercises together, we talked about this. It even got to the heads of state. We have a relationship where once every year the presidents of Mexico, the United States and Canada all get together. This was on the agenda and discussed. These have been talked about, but it doesn't make it any less of a problem.
