The H1N1 flu pandemic was an early and serious homeland security challenge for the Obama Administration. The first cases were detected in Mexico, but not publicly announced, a few weeks before President Obama's April 16–17, 2009, visit to Mexico City. I accompanied Obama on that trip, but we didn't learn about the virus that was beginning to sweep through North America until we returned to Washington. We also were surprised when we found out that the director of Mexico's National Museum of Anthropology died from pneumonia and other complications from the flu less than a week after he gave us a personal tour of the museum.
By the end of April 2009, a public health emergency was declared in the United States, and an all-out government effort was under way to understand the nature and trajectory of the virus — and how we could mitigate its impact, which had the potential to be significant. I was told that the virus was related to the H1N1 flu pandemic of 1918–19, known as the Spanish flu, which infected a third of the world's population and killed an estimated 50 million people, including nearly 700,000 in the United States.
It was a baptism by fire for me on the medical front, and I quickly became an eager student of Dr. Tony Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, as well as Dr. Richard Besser and his successor, Dr. Tom Frieden, the directors of the Centers for Disease Control and Prevention. I quickly learned a lot about the science of the virus: its principal methods of transmission; morbidity and mortality rates; and which demographic groups were most susceptible to it (younger and healthy individuals were disproportionately affected, since more than one-third of people over 60 years of age had existing antibodies against the disease as a result of previous exposure to flu strains related to H1N1).
I also became familiar with the challenges and long lead times needed to develop vaccines and the complexities associated with setting up national distribution mechanisms and prioritization of recipients for antiviral medications like Tamiflu, which was determined to have efficacy. This was a whole new world for me, and it was simultaneously fascinating and challenging.
As President Obama's homeland security adviser, I tried to coordinate federal government efforts — and I was very fortunate that two former governors, Department of Homeland Security Secretary Janet Napolitano of Arizona, and newly-minted Secretary of Health and Human Services Kathleen Sebelius, of Kansas, had the lead for the Obama administration's response to the virus. Their responsibilities included engagement with state and local officials, as well as with the health care industry. The policy challenge was overwhelming: it involved orchestrating the capabilities and authorities arrayed across the departments and agencies of the federal government, and integrating them with state and local counterparts as well as private sector entities was a complex systems-engineering challenge for all involved.
The questions were many: for example, what was available; how could we procure or manufacture what was not; how would items be paid for and distributed; and who would have priority.
Throughout this time, President Obama insisted that "science, facts and data" drive administration policy and actions, and he encouraged homeland security officials to be forthcoming with the American people about the seriousness of the H1N1 flu, which subsided in the summer months but reemerged in the fall, ultimately infecting 60 million Americans and killing more than 12,000.
The strong teamwork I witnessed among the many players involved in confronting the H1N1 pandemic gave me confidence that the administration would be able to deal with other homeland and national security challenges that were yet to come.
Looking back on it now — and watching the Trump administration's response to the Covid-19 crisis — I can attest that there was never a time when any of my colleagues or I felt even the slightest pressure to misrepresent facts, dismiss advice from medical experts or heap public praise on the president for the actions taken by the administration. If any of us did, I am sure President Obama would have upbraided us for it.
It was not all smooth sailing for me during the crisis, however. In an early White House meeting on H1N1, the president turned to me and asked whether I thought the Stafford Act could be used to reimburse states for the cost of their H1N1 response efforts. Although I had heard of the Stafford Act (and would eventually come to understand that it provides a mechanism for congressionally appropriated federal funds to be allocated to states for major disaster and emergency preparedness and assistance), I had no earthly idea at the time what was contained in it. I took a few moments before responding, and then said to the president, "I don't know sir," and, remembering the advice I received as an intelligence officer to "go dumb early," I added, "and as soon as I find out what the Stafford Act is, I'll let you know."
Obama broke into a toothy smile and said, "Good idea, John."
Observing the daily coverage of the Covid-19 crisis eleven years later, it was apparent that the significant challenges of H1N1 paled in comparison — by an order of magnitude — to what we later would face as a country. Everything about Covid-19 is much more complex on the medical front and much more devastating to our national health, economy and social well-being, and it is testing the very mettle of our country.
As I watch events unfold, I am deeply grateful for all the selfless work done by individuals nationwide across so many disciplines. Once again, I am very glad that Dr. Tony Fauci, an individual of exceptional medical acumen and dedication to his fellow citizens, is playing a prominent public role in explaining the seriousness of the threat posed by Covid-19 and the important actions to help mitigate its impact.
From "Undaunted: My Fight Against America's Enemies, at Home and Abroad" by John O. Brennan. Copyright (c) 2020 by the author and reprinted by permission of Celadon Books, a division of Macmillan Publishing Group, LLC.