[Congressional Record Volume 151, Number 123 (Wednesday, September 28, 2005)]
[Senate]
[Pages S10529-S10531]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Pandemic Preparedness

  Mr. President, on another issue, an important issue--we have so much 
going on in this body with the appropriations bills, and the nomination 
coming forward, and that is going very well in terms of the discussion 
on both sides of the aisle. But there are many other issues as well.
  I want to focus for a few minutes on an issue I do not believe is 
receiving the attention it deserves given the risk that is before us.
  Yesterday, I sent a letter to Health and Human Services Secretary 
Michael

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Leavitt regarding our Nation's pandemic preparedness. The H5-N1 avian 
influenza--the name of this particular strain of virus--has spread from 
Southeast Asia to Russia. It is spreading across the world.
  If you look at a map and look at that spread, it gives you real 
pause--and it should. It threatens to land in Europe. Although you 
can't say with certainty as you look at that picture of the globe and 
you see that spread, it will next be in Europe and America, although we 
don't know what that order will be.
  It has infected more people and more poultry than any previous 
strain. If you look at the animal population--it is called the avian or 
bird influenza--it has caused the death or destruction of not just a 
few million but 160 million birds. That includes what is called the 
``culling'' that goes on. But 160 million birds have died as a result 
of this influenza.
  It has jumped from animals, the birds and other animals, actually, 
with a genetic shift to humans. People ask, How many humans have been 
infected? We do not know exactly, but we have documented 115 confirmed 
human cases of this particular H5-N1 influenza.
  How fatal is it? It is fatal. The mortality rate is very high. Fifty-
nine people out of the 115 confirmed cases died from this particular 
virus. It has a very high mortality rate.
  Just this week, Indonesian health officials reported that yet another 
person--a young woman age 30--has died from the virus. This follows 
last week's deaths of two young girls and a boy with very similar 
symptoms in Jakarta and Samarinda. Since last Monday, Indonesia has put 
itself on an ``extraordinary incident'' status.
  Experts warn that a global cataclysmic pandemic is not a question of 
if but when. Like an earthquake, or like a hurricane, it can hit any 
time. When it does, it could take the lives of tens of millions of 
people.
  People ask, Is that an overstatement? I don't believe it is. You only 
have to go back and look at the history. This August, I spent a great 
deal of time talking to experts around the country on the H5-N1 
influenza virus. In Tennessee, over in Memphis, there is St. Jude's 
Children's Research Hospital. There is a group of researchers there who 
probably know more about this particular strain than anybody in the 
world, led by Dr. Robert Webster at the St. Jude's Children's Research 
Hospital. He is one of the leading experts of the H5-N1 strain.
  He explained in very clear terms that there are 16 families of the 
avian influenza. Billions of mutations of the virus are occurring every 
day. It is constantly changing, constantly adapting. With each of these 
little mutations, the virus multiplies its odds of becoming 
transmissible from human to human. It is changing up, to be spread 
throughout the bird population to the human population. And with just 
one little, tiny change, it can be transmitted person to person to 
person. It is a little bit like pulling the lever on a Vegas slot 
machine over and over again. If you pull it enough times, the reels 
will align and hit the jackpot. In this case the jackpot is a deadly 
virus to which humans have no natural immunity.
  It is very important right now. Nobody listening to me has a natural 
immunity to this particular virus. Infected hosts are contagious before 
they are symptomatic. In other words, anyone walking around who is 
infectious can spread the disease. They may not have any symptoms. The 
virus would thus have ample opportunity to spread rapidly throughout 
the population before it could be detected or appropriately contained--
but not symptomatic. You don't know whether it can be contained or know 
to stay away from people.
  To make matters worse, we lack our best defense. People say, If it 
does happen, surely in America or in the world today we have a vaccine, 
and we have a robust antiviral stockpile. If you think you are 
disposed, or if you are a physician or health personnel and go into a 
community to treat it, do we have enough of the antiviral pill which 
you can take that will protect you? The answer is no.
  This particular antiviral pill is Tamifly. I will mention that 
shortly.
  We don't have enough today for first responders, or doctors and 
nurses who would be taking care of you. The United States of America--
the richest country in the world, and the most advanced country in the 
world--is unprepared in terms of the number of vaccines to treat, as 
well as the initial antiviral pill or therapy to treat. We do not have 
enough doses of the antiviral Tamifly. It is a drug which is effective 
today in the treatment of this particular strain. We have enough to 
treat about 2 million people--a little over that, 2.3 million people. 
We have 295 million people in this country and we can treat about 2 
million people--and then that is it.
  There is only one company located in the United States that produces 
the influenza vaccine--not the Tamifly, but the vaccine itself. In 
contrast, Britain, France, and Canada have tens of millions of doses on 
order--that is the Tamifly, the antiviral agent. We have 2 million. 
They have tens of millions in Britain, France and Canada.
  Where does the Tamifly come from? It comes from Switzerland. That is 
where the manufacturing facility is located.
  With our weakened domestic manufacturing capacity in this country for 
both something like Tamifly but especially vaccines--we do not have 
manufacturing plants to do it--it makes us dangerously dependent on 
other countries and foreign sources.
  If there is an outbreak in that country and the manufacturing plant 
is there, it is very unlikely they will send doses to the United States 
of America.
  The vaccine testing today indicates that an H5-N1 vaccine is safe and 
able to generate a robust immune response in healthy adults. That is 
good. That shows real progress. This data is preliminary, but it 
represents a very positive step that progress is being made. That is an 
important first step, however, and this is the key: It would take 6 to 
9 months to produce 180 million of what are called monovalent vaccines. 
If this virus did have that transmission ability, it would be traveling 
and ravaging our population with no vaccine available. Two doses are 
required. We could make 180 million. That is enough to treat 90 million 
people in 9 months. It would take at least a full year to produce 
enough vaccine for the entire country. By that time, because this virus 
can be transmitted or could be transmitted so easily, the risk is that 
tens of thousands could die.
  Some ask, why do I use such high figures? We do have a historical 
precedent. Look back to 1917 and 1918 and the Spanish flu. That 
pandemic killed not just tens of thousands but 40 million people 
worldwide. The Spanish flu virus killed 40 million people worldwide, 
the majority of whom were kids, children, and young adults between the 
ages of 10 and 35.
  Vaccines were available for the 1957 and 1968 flu pandemics, but they 
arrived too late and 104,000 people died in the United States alone.
  Dr. Hitoshi Ashitani at the World Health Organization warns this time 
around the avian flu virus may be impossible to contain. The geographic 
spread is historically unprecedented.
  So people ask: Well, why are you giving us, Senator Frist, all this 
bad news? What can and should be done? In my letter sent to Secretary 
Leavitt--and I had the opportunity to discuss it with him a little bit 
last night--I did ask him to finalize the agency's Pandemic Influenza 
Response and Preparedness Plan. We need a coordinated, comprehensive, 
aggressive plan which draws on public health and homeland security, 
foreign policy and defense expertise.
  The plan should serve a dual purpose: First, to detect, identify, 
contain, and respond to threats abroad; and, No. 2, to bolster domestic 
preparedness and response capacity. I also urged the Secretary to 
purchase enough additional Tamifly to treat a large portion of the U.S. 
population.
  These are critical first steps, but we have to do a lot more. We need 
to develop a bold vision of how to address this in future threats--
whether they are biological weapons or infectious disease, whether they 
are natural, whether they are accidental, or whether they are 
deliberate.
  That is why earlier this year I called for a Manhattan Project for 
the 21st Century to launch an unprecedented collaboration among the 
Federal Government and industry and academia. We must encourage and 
support advanced support and development into

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prevention and treatment. We must enable the detection, the 
identification, and containment of any emerging or newly emerging 
threat. And we must ensure our domestic ability to manufacture, 
distribute, and administer the treatments needed to protect the 
American people. This should be a central focus of our national 
attention.
  As I mentioned in opening, there is a lot going on in our response to 
natural disaster today. But we need to keep the focus, as well, on the 
potential for this pandemic. Failing to do so risks the public health 
and our national security.
  In May 2004, the Senate passed Project BioShield and shortly 
thereafter President Bush signed it into law. Project Bioshield builds 
on the Bioterrorism Preparedness Act of 2002 and strengthens our 
Nation's defenses against the threat of anthrax, botulism, smallpox, 
Ebola, or plague, as well as a radiological fallout from a potential 
terrorist attack.
  Building on the goals of Project BioShield, the leadership has 
introduced the Protecting America in the War on Terror Act of 2005 
earlier this year. I applaud my colleague for the steps we have taken 
thus far, and I applaud them for their continued leadership. But we 
have much more to do. More work remains to be done. We are in a race 
against time, and unlike the flu pandemics of the 20th century, we have 
been warned.
  I urge my colleagues to join me in this effort to protect the health, 
well-being, and security of the American people.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Vitter). The Senator from the great State 
of Florida.
  Mr. NELSON of Florida. Mr. President, I ask unanimous consent I be 
allowed to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.