As we continue the COVID-19 restrictions heading into the second month, everyone has an opinion on the handling of the crisis by local, state and federal officials. Some of these opinions have even led to lawsuits and protests, not to mention spectacular attention in the 24-hour news cycle. As Barack Obama liked to say, time will tell if these leaders “will be on the wrong side of history”.
In late winter of 1976 a flu strain, similar to the Spanish flu type in 1918, hit Fort Dix, NJ, infecting at least twelve people and exposing potentially hundreds more.
The Ford Administration, upon the advice of their medical experts, took this news very seriously. In March, the White House Press Secretary released the following memo:
BACKGROUND Last month an outbreak of swine influenza was isolated among recruits in training at Fort Dix, New Jersey. Although only 12 cases were confirmed, extensive blood testing has indicated that several hundred recruits were probably infected during this outbreak, and it was associated with the one death. This flu strain, which had been dormant for almost half a century, was the cause of an epidemic in 1918-19 that killed an estimated 548,000 Americans. The entire U.S. population under the age of 50 is susceptible. Hundreds of blood samples of individuals tested from various parts of the country show that approximately 80% of people over the age of 50 have swine-like virus antibodies in their blood from exposure to the influenza, which circulated until 1930. However, the presence of these antibodies does not insure protection against the disease if it returns. Prior to 1930, this strain was the predominant cause of human influenza in the U.S. Since 1930, the virus has been limited to transmission among swine with only occasional transmission from swine to man — with no secondary person-to-person transmission. Although there has been only one outbreak of swine influenza, person-to-person spread has been proven and additional outbreaks cannot be ruled out. Present evidence and past experience indicate a strong possibility that this country could experience widespread swine influenza in 1976-77. Swine flu represents a major antigenic shift from recent viruses and the population under 50 is almost universally susceptible. These are the ingredients for a severe epidemic, or pandemic. Pandemics of influenza occur at approximately 10-year intervals. In 1968-69, influenza struck 20 percent of our population causing more than 33,000 deaths (14 per 100,000) and cost an estimated $3.2 billion. While there is no evidence that the flu has spread beyond the Army base, the reemergence of this strain has caused great concern in the medical community. Over the last few days the President has consulted with members of the Administration, health community leaders and public officials. On the basis of these consultations, the President believes that it is important to take effective counter-measures to avoid an outbreak similar to the one in 1918.
DESCRIPTION In view of these facts, the President has announced the following actions:
He is asking the Congress to appropriate $135 million prior to their April recess so that orders can be placed with the pharmaceutical industry to ensure the production of enough vaccine to inoculate every man, woman, and child in the United States.
He is directing HEW Secretary David Mathews, to develop plans that would make this vaccine available to all Americans during the three-month period from September to November of this year.
He is asking each American to receive an inoculation this fall. Extraordinary measures are necessary because of the short time period available to assure adequate vaccine production and to mobilize the nation’s health care delivery system. An extensive immunization program must be in full-scale operation by the beginning of September and should be completed by the end of November 1976.
After some wrangling with Congress over costs and legal liabilities assumed by the pharmaceutical companies, the appropriation and subsequent plan outline was approved. Inoculations started late, October 1, 1976, slowed somewhat by difficulties in deciding children’s dosages and seriously stalled by liability issues Nevertheless, 45 million Americans were vaccinated in the short span of ten weeks. On December 16, the program was suspended to assess statistical evidence of a serious side effect that being a very small group of people (somewhere between 50-100) that were vaccinated came down with a condition known as Guillain-Barre Syndrome, a very serious rapidly moving attack on the central nervous system. Mass immunization never started up again. The pandemic failed to appear and the Ford Administration took great heat from the media saying the program was hastily put together with political motivation the primary reason (it was an election year), with secondary criticisms being the desire to inoculation the entire population and communication from true medical professionals lacking. The consensus is the message was handled poorly by the administration, which led to the above chastising by the press. For example, there was a now famous photo with Ford receiving the vaccine, which was portrayed by Ford’s political opponents and some in the media as grandstanding. The consensus from many medical professionals, in contrast, was it was the right thing to do.
The questions about this program as part of Ford’s legacy are long but forgotten, given that his presidency was so short, there was no 24-hour news cycle, and things that are so much seemingly more important have happened since then. However, leadership lessons can be discussed based on the decisions made:
- Experts on your staff giving you the right advice.
- The monetary and professional risk of spending taxpayer money compared to the cost of inaction and the potential risk of the health of the country.
- The image and message you are sending to your staff and people you lead and the image they are carrying forward on your behalf.
- Willingness to take the heat when things go not quite as planned.
There are many public documents available that discuss this piece of history in detail, from President Ford’s digital library as well as Library of Congress Holdings. I encourage those interested to take a look.
