[Congressional Record Volume 155, Number 68 (Tuesday, May 5, 2009)]
[House]
[Pages H5161-H5166]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                             H1N1 INFLUENZA

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Georgia (Mr. Gingrey) is recognized 
for 60 minutes.
  Mr. GINGREY of Georgia. Madam Speaker, thank you for the opportunity 
to address my colleagues for the best part of the next hour.
  What we are going to do, Madam Speaker, is talk about this current 
virus that is going around that we are now referring to as type A H1N1 
influenza. I think most people would understand better if we said swine 
flu. Now I understand why we are trying to get away from calling it 
swine flu, and obviously in States across the country where the pork 
industry is hugely important to the economy, they don't want this 
fear--unwarranted fear, really--of consuming pork products that are 
completely safe. Obviously, you have known from almost childhood that 
pork should be well cooked to a temperature of 160 degrees and it's 
perfectly safe.

                              {time}  2030

  But that is the reason why I am going to stand here tonight and 
probably not use the term ``swine flu'' very much, because I don't want 
to create an unnecessary fear of a very, very safe product that could 
be harmful to States across this country and to other countries as 
well. We are in a tough time economically on a global scale, and we 
don't want to make those matters worse by creating a false sense of 
concern.
  I will be joined, Madam Speaker, this evening by a colleague or two--
or three or four maybe--who are part of the GOP Doctors Caucus. We 
formed this caucus at the beginning of this Congress, the 111th, as we 
grew our numbers of health care providers in their previous life who 
now have morphed into Members of this great body of the House of 
Representatives. We have that really on both sides of the aisle, but 
this is a Republican hour, Madam Speaker, and I will be joined by other 
Republicans. I would welcome, if any of my Democratic friends, health 
care providers, are sitting in their offices watching us on television 
on C-SPAN, if they want to come over and join us and weigh in on this, 
I would be glad to yield them time.
  There is no partisanship involved here. The purpose is to try to 
inform our colleagues, all 435 in the House, so that they can inform 
their constituents. And each one, as you know, Madam Speaker, 
represents almost 700,000 people in their respective districts. And we 
are all getting calls. I mean, people are scared.
  I would say that some fear is warranted, but a pandemic of panic is 
not warranted. And so the more information that we, as Members of 
Congress, can give to our constituents and that our staff can give when 
they call the office, either here in Washington or in our district 
offices, then we get to keep this thing in its proper perspective. And 
that is my purpose tonight, and that is the purpose of my colleagues 
that will be joining me later in the hour to talk about this issue and 
to make sure that people have enough information that they can take 
care of themselves and their children, or maybe their elderly parents, 
or possibly someone in the family whose immune system is compromised so 
that they know what to do, they know what the risks are, they know what 
their government is doing.
  And, Madam Speaker, I want to commend and compliment the Federal 
Government and our respective State health departments, the Centers for 
Disease Control in my great State of Georgia, which, as you know, is an 
integral part of the Department of Health and Human Services and is 
really the lead agency, if you will, in regard to infectious disease, 
communicable disease, epidemiology. And Interim Director Dr. Besser and 
previously the Director of CDC, Dr. Julie Gerberding, these are the 
kinds of people, both with experience in infectious disease--in fact, 
Dr. Gerberding, internal medicine specialist, subspecialty being 
infectious disease. It is comforting to know that these kinds of 
professionals are standing guard, they are watching our back.
  We had a hearing last week when, both Republicans and Democrats, the 
new Secretary, the day after she was confirmed, Kathleen Sebelius, 
former Governor of Kansas and now Secretary of Health and Human 
Services, former Governor of Arizona, Janet Napolitano, now Secretary 
of Department of Homeland Security, and Admiral Schuchat from the CDC, 
all spoke to us and told Members of Congress exactly what the plan was 
and what was being done and what is currently being done in regard to 
this impending pandemic. We are pleased, a week later, to find out that 
things are much better today on, what is it, the 5th of May, than they 
were a week ago or 2 weeks ago. And it looks like we are not, Madam 
Speaker, going to have a pandemic of this potentially very virulent 
virus that has occurred in our past history.
  We will talk a little bit maybe about what happened in 1918, when 50 
million people across the world died from influenza. Of course that was 
a different time. It probably started in the United States in very 
confined quarters as men were training to be rushed into the battle of 
the great war, World War I, and in very close contact. But of course 
back then there were no vaccinations against any kind of flu, seasonal 
flu, avian flu, this current type, H1N1 influenza virus, no vaccine, 
and more importantly, Madam Speaker, no antibiotics. It was not until 
1941, I think, or thereabouts, that penicillin was discovered.
  So you really had no effective way of treating complications, and of 
course the complications that would lead to death. And let's say even 
the 35,000 deaths that occur today following just regular seasonal flu, 
complications from seasonal flu, they are respiratory; it's pneumonia, 
it's sepsis. And back in 1918 I don't think there were any respirators 
that I'm aware of. I don't think that's true. My colleague from 
Georgia, Dr. Paul Broun, a family practitioner, has joined me. And when 
I yield time to him, we can talk about that in a colloquy about what 
was available.
  But I think we could compare the current situation, this 2009 concern 
over this influenza, to 1976, when a very similar virus struck--again, 
originated in a military facility; I think it was Fort Dix. There was, 
I think, at least one death, and five soldiers came down with this type 
A influenza, H1N1, very similar--I said I wasn't going to say swine 
flu, but very similar to what we are looking at today.
  Back then, a vaccine was developed very specifically, and we started 
a big vaccine program. I think 50 million people in 1976 during the 
Ford administration were vaccinated against this virus. In retrospect, 
it may have not been necessary. And finally that program of vaccinating 
everybody was canceled because of complications. We had more 
complications really from the vaccine than we did from the flu. And I 
say that not to suggest today that we shouldn't prepare ourselves--and 
again, I compliment the respective Secretaries in the CDC and the 
States that are ready. And they are ready, and people should be very 
comforted by that. But we need to question how much money we spend. Is 
it appropriate to, let's say, spend $2 billion in the upcoming 
emergency supplemental that is primarily for the ongoing cost of trying 
to win in Iraq and Afghanistan, a very important spending that is 
probably going to end up being $90-plus billion in this emergency 
supplemental? But whether or not we need to spend $2 billion 
specifically in this emergency supplemental on developing a vaccine and 
vaccinating 50 million people like we did back in 1976, there is some 
question in my mind, as a physician who practiced for 30 years, 
although not infectious disease, but I do have some concerns that we 
don't overreact and that we make sure that we have a measured response.
  The President has an obligation to do that. And I can understand that 
he doesn't want to take this too lightly.

[[Page H5162]]

I'm sure he remembers Katrina just as we all do. I will use the 
expression, he doesn't want to get ``Katrina'ed'' over this issue by 
not responding appropriately. And I do understand, and I think we all 
understand what I'm talking about when I say that. But we will spend 
the best part of an hour talking about this issue.
  I have got just a very few posters that I want to share with my 
colleagues, Madam Speaker, before yielding to Dr. Broun, the great 
physician Member from Athens, Georgia.
  This first slide is referencing that outbreak that occurred back in 
1976. And again, it was very similar. The serotype, the specificity of 
the virus then was very similar to this 2009 outbreak. Five soldiers at 
Fort Dix, New Jersey, I believe--contracted H1N1 influenza and one 
soldier died. Tests on many more--of course I'm sure everybody at the 
base was tested for this virus, and it confirmed that 500 actually were 
infected, but most of them really showed no noticeable symptoms. I 
mean, they may have had a sore throat, they may have had what we call 
rhinorrhea--technical name for runny nose, sneezing and body aches and 
things like that--but they really showed no severe symptoms. And over 
the following months, no other Americans died from that virus. The loss 
of one life, of course, is one life too many, especially for the family 
of that individual, but clearly things kind of resolved themselves in 
pretty quick fashion. And as I say, no other Americans died from the 
virus.
  But the inoculation that we did develop--and I think I may have this 
included on the slide, Madam Speaker--but we spent $135 million 
developing a vaccine. That was back in 1976, 1977, what, almost 40 
years ago. And we have just appropriated or are on the verge of 
appropriating $2 billion to our response to this flu. And it may be 
that a lot of that expense will be developing a vaccine. And it is 
possible, if we do that, develop a vaccine in mass quantities, that we 
will never use it. Because remember in this experience, where the 
complications from the vaccine--and I want to talk about that just 
briefly--might end up being worse than the disease itself.
  So as I say, in 1976, this $135 million--and that was a lot of money 
back then--developing this vaccine and inoculating 50 million people, 
the vaccinations began on October 1, 1976, and by December 16--so we're 
talking, what, 2\1/2\ months later--the Federal Government decided we 
needed to suspend this program because there were increasing reports, 
Madam Speaker, of side effects. And I am not talking about just a 
little swelling or rash or itch at the injection, the vaccination site. 
I'm talking about some serious things. In fact, I want to talk about 
one thing in particular.
  But there were some deaths attributed to the vaccine; 50 million 
people received the vaccine. And one of the side effects was a very 
serious condition, Madam Speaker, called Guillain-Barre syndrome. I 
don't know who Guillain was and I don't know who Barre was, but maybe 
Dr. Broun will tell us about that. But it was named after some very--
not American physicians. But this Guillain-Barre syndrome is a 
paralysis that occurs, and it literally causes paralysis from the neck 
down. And these people couldn't survive back in 1918, certainly, but 
even today without the aid of a respirator.
  The good news is this condition usually goes away and they recover 
full function, but it can take as long as a year. And some of these 
patients spend most of that year in a hospital, away from their 
families, away from their jobs, and many months on a respirator so they 
can even breathe.
  So this was a very, very serious complication, Madam Speaker, from 
these vaccinations that were developed back in 1976 to treat this very 
similar virus that we are facing today.

                              {time}  2045

  So what happened is pretty quickly the vaccination program was 
suspended. And then you have to say, well, was that $135 million well 
spent? I think maybe in retrospect, but you have to be careful about 
saying, well, you know, don't do this or don't do that, that it looks 
like this is not going to be a very serious flu, that it's not going to 
be even, Madam Speaker, as serious as seasonal flu, and there's just 
going to be a few people sick in a few States and maybe other countries 
as well, but it's not going to be a pandemic. And maybe if we have the 
money available to produce a vaccine in mass quantities, the decision 
very well could be not to do that, and then we will be able to return 
some of that money, maybe most of that money, to the taxpayer. Maybe 
we'll be able to spend it on something that's equally as important or 
maybe even more important. But that's a subject for debate, and I 
realize that you have to be very careful about saying that we don't 
need to do anything because clearly we do, and I think we are doing a 
lot.
  At this point I want to yield to my colleague from Georgia, who 
represents Athens and my home of Augusta, Georgia, and he does it very 
well, and that's my colleague and fellow physician, Dr. Paul Broun.
  Mr. BROUN of Georgia. Thank you, Dr. Gingrey, for yielding.
  As you were discussing the past flu epidemics and the 1976 swine flu 
that happened back then, I was practicing medicine in rural southwest 
Georgia. At the time, of course, the recommendations were for everybody 
in this country to get a swine flu vaccine. As a practitioner, I was 
concerned about that, and I was asked by many of my own patients should 
they get this flu vaccine. And, frankly, I was not recommending it 
because, as I looked at the data that were available at that time, I 
just really questioned the wisdom of exposing people to the vaccine. So 
I was not recommending it to my own patients. I did not get the vaccine 
myself. And actually, in my practice, which was a very busy general 
practice in rural southwest Georgia, I did not have one single patient 
come down with swine flu, not the first one. But I had several patients 
get Guillain-Barre syndrome from the vaccine. One was a good friend of 
mine who was a newspaper publisher in the community, and he struggled 
and his family struggled with his paralysis. But people died.
  A lot of folks don't consider that these vaccines aren't innocuous. 
There are side effects and can be tragic side effects and can lead to 
death. More people died from the vaccine than died from the swine flu 
back then.
  Just Monday I was chairing a facility at the vet school at the 
University of Georgia, in Athens, Georgia, and went into a 
biocontainment lab, a level 3 biocontainment lab. There's a researcher 
there who's doing probably the cutting-edge technology research on this 
infection that we have out in the public today. He came from the CDC 
before he came to the University of Georgia, and he deals with these 
viruses. They have some pretty potent viruses in their laboratory 
there. And he told me that a week ago he was telling the CDC and the 
people in the Federal Government, anybody who would listen, NIH, et 
cetera, that this virus did not have the characteristics of being what 
we call in medicine a very virulent virus. In other words, it was not 
one that was going to create a lot of infections and severe infections 
in this country.
  I asked him, why do we see in Mexico people dying at a greater rate 
than we do here? And he said, well, we really don't have the data of 
how many people are infected down there. But from what he could 
ascertain, and he was part of the group who was studying the virus in 
Mexico, and he said that down there the people who are getting the 
virus, this current infection, and who were having severe difficulties 
and were dying principally were people that had other what we in 
medicine call comorbid conditions. In other words, they had respiratory 
problems. They had other illnesses that created a problem where they 
would develop secondary infections and die.
  Mr. GINGREY of Georgia. If I could reclaim my time for just a second 
and yield right back to him, he brought up a very important point, 
Madam Speaker.
  There have been two deaths in the United States thus far attributed 
to the current version of this same virus, H1N1 influenza type A. One 
was a 2-year-old toddler, a Mexican national, who came to Texas for a 
visit and was actually sick before, and I think this was a little boy, 
before they came into Texas, and subsequently the child died in Houston 
in the hospital. And what you get from the news releases, from

[[Page H5163]]

the press releases, is that it says that the child had multiple health 
problems before developing the flu. And now we just heard, and I'm not 
sure if Dr. Broun is aware of this, but another death has occurred. 
This was an adult woman, I believe, also in Texas that lived in a 
border town very close to the Mexican-Texas border. And also it says 
this woman that died had multiple health problems.
  Now, Dr. Broun and I are physicians. When you start talking about 
multiple health problems, are you speaking of metastatic cancer, as an 
example? Maybe somebody who had breast cancer that had spread to other 
parts of her body? Possibly. Are you talking about somebody that has 
coronary artery disease and has had three or four heart attacks and a 
bypass procedure done who is in congestive heart failure? Are you 
talking about somebody who has severe type 2 diabetes who is on 
insulin, who is on dialysis because of renal failure?
  I mean, I think the media has a responsibility here that they are not 
fulfilling because they don't give you the whole story, and I think 
it's very important that we get that so we understand what the true 
risk is and how severe the flu is.
  And I yield back to my colleague, but I wanted to make sure people 
understand these two deaths, these were sick people: one, a very young 
child; another, a past middle-age adult woman who had health problems. 
``Comorbidity'' is the term that my colleague used.
  Mr. BROUN of Georgia. I appreciate the gentleman's bringing that up.

  You're exactly right. Any death is tragic and we in medicine try to 
prevent all deaths. When I graduated from the medical college in 
Georgia just like you did, I think you were a year ahead of me there in 
Augusta or maybe two, but I took the Hippocratic oath. They don't do 
that in medical school because the Hippocratic oath says, ``I shall do 
no harm,'' and it says ``I shall not perform an abortion,'' and Roe v. 
Wade has changed that; so medical schools are not taking the 
Hippocratic oath anymore because there are doctors that are doing harm. 
They're killing babies through abortion. I am very pro-life, and I know 
that life begins at fertilization, and I want to protect all life. And 
it's tragic whenever a life is taken, whether it's an unborn child or 
whether it's a 23-month-old child that that died like this one from 
this H1N1 type A flu or whether it's an elderly person. But what 
happens, and particularly has happened in this case, is I think the 
gentleman is exactly right that the media has overblown this.
  There is a lot of misunderstanding when the World Health 
Organization, the WHO, says there is a pandemic. What does that mean? 
Most people in America think, well, people are going to be dying in 
wholesale lots all over this country as they did in the early part of 
the last century. Well, the World Health Organization, when they talk 
about a pandemic, they just mean there's flu in multiple areas, and it 
doesn't mean that people are going to be dying. In fact, the flu in 
America has been very mild. Most people, as it was in 1976, who have 
contracted the flu go about their business. And that is a danger in 
that people, if they start running a fever, they need to stay home, 
whether it's with this flu episode or any flu episode. They need to 
take care of themselves. If they run a fever more than a day or two, as 
a primary care physician, I would tell them they need to see their 
physician. Now, they don't need to take antibiotics.
  Mr. GINGREY of Georgia. Let me reclaim my time to make a request, 
Madam Speaker, of Dr. Broun, because I think that our colleagues and 
their constituents really need as much information as they can possibly 
get.
  The media creates a near hysteria situation, and then when, of 
course, the fires are going out and there's no longer a crisis, then 
they are on to the next story. I can tell you that I was scheduled on 
several national opportunities to talk about this issue when it was the 
news du jour. Then all of a sudden when things get better, they just 
say we don't need you anymore because we're on to another story and 
there's a runaway teenager somewhere or some other more exciting story.
  But I think, Madam Speaker, it would be great if Dr. Broun and 
anybody that joins us later in the hour could tell us exactly what you 
would do as a physician, as a health care provider, when someone comes 
to your office and they either have some symptoms, they think they 
might have the flu, or maybe they just come because they have heard 
that they ought to be taking Tamiflu or Relenza. They're not sick yet, 
but they think, well, maybe if I get on some medication ahead of time 
that I can somehow prevent this and I owe it to my children to get a 
prescription from Dr. Broun.
  Would you talk about that for us?
  I think, Madam Speaker, if we can have Dr. Broun do that, it would be 
very helpful for people to understand what they should do.
  Mr. BROUN of Georgia. Certainly I would be happy to discuss how I 
approach patients. In fact, I've had patients come in and say, Dr. 
Broun, I don't want to get the flu. I want some Tamiflu or I want 
Relenza. And, frankly, taking it prophylactically may help, but the 
thing that we are doing is we are spending a lot of money to take that, 
and once they take the preventative, if just a few weeks later they get 
exposed, then they could still get the flu. It doesn't have a lasting 
effect.
  So what we do know is that taking these antivirals like Tamiflu and 
Relenza, if you take those very early on in the course when people 
first start getting a fever, when they first start aching all over, 
when they first start getting the runny nose and the cough and the sore 
throat, if they'll go to their doctor then and be evaluated to see if 
they indeed do have the flu and then get on the medicines, that's the 
best way, most cost-effective way of treating this.
  Now, a lot of patients will come in the office and say, I've got the 
flu, I want antibiotics, or they'll call on the phone and say, Dr. 
Broun, I'm running a fever, I need an antibiotic. Well, most fevers 
aren't susceptible to antibiotics because most fevers are due to viral 
illnesses. Even allergies can cause fevers. Fever in itself doesn't 
indicate that a patient needs an antibiotic.
  Mr. GINGREY of Georgia. What you're saying, Dr. Broun, is that 
antibiotics are not really effective in treating a viral illness.
  And I want to ask another question of the doctor, Madam Speaker.
  Does everybody that goes to see their family doctor, primary care 
physician, infectious disease specialist maybe, does every one of them, 
if they have symptoms, runny nose, aching a little bit, maybe a low-
grade fever, headache, whatever, do they all need to be cultured for 
this particular H1N1 type A influenza virus? Do they all need to have a 
culture done? Respond to that, if you would, Dr. Broun.
  Mr. BROUN of Georgia. No, I would say that they don't need a culture 
unless they're at high risk. In other words, if they had been in 
Mexico, particularly Mexico City, which is apparently where the nidus 
of this infection began--we don't really know for sure, but if people 
have been in Mexico City, if it's within the incubation period, which 
is about a week, and start running a fever, then maybe it is a good 
idea for them to have the culture done or the flu test done to see if 
this is indeed the swine flu.

                              {time}  2100

  But the thing is, the treatment that they are going to get, even if 
they have the H1N1 flu is not any different than if they have any other 
of the viruses. The big question is, do they need antibiotics or not? 
Do they need the antiviral, the Tamiflu-Relenza types of medications, 
or are they better off with penicillin or some of these other high-
powered drugs that are on the market today?
  And a CBC, a complete blood count, will help the doctor to understand 
whether they have a viral infection or bacterial infection. If their 
white blood count is high, if they have what we say is a left shift, in 
other words if they have types of white blood cells that indicate a 
bacterial infection, then they do need antibiotics. They do need a 
bacterial culture just to see if any of the antibiotics that the doctor 
prescribes are going to eradicate that particular bacteria.
  But as I mentioned earlier, most fevers, most colds, most pneumonias, 
most bronchitis, most ear infections are not caused by bacterial 
infections. So utilizing antibiotics in those cases is a huge waste of 
money, it exposes

[[Page H5164]]

the patients to developing allergies to those antibiotics. Plus, it 
also sets up a situation where people can develop a superinfection.
  So they need to be evaluated, but let the doctor direct how that care 
is going on. Hopefully, that answers your question.
  Mr. GINGREY of Georgia. It does. I want to continue this colloquy, 
Madam Speaker, with Dr. Broun, because, if, as Dr. Broun said, every 
person that comes in that office that thinks that they may have the 
flu, not seasonal flu, but this flu that everybody is panicking over, 
that, you know, the doctor, Dr. Broun, you correct me if I am wrong, 
but the doctor is going to do a physical examination on that patient. 
They are going to look at the throat, the tonsils where strep throat 
can occur.
  They are going to listen to the lungs; they are going to use that 
stethoscope. They are going to make sure that patient doesn't have 
pneumonia. And they are going to make an evaluation. As Dr. Broun was 
saying, it's the very young or the very elderly or somebody that's 
immune compromised, the approach may be a little bit different.
  But this Tamiflu, which is a pill or capsule, and this Relenza, which 
is a nasal aspirate, they are as effective 2 or 3 days later, I think 
certainly if they are administered within 48 hours. So, Dr. Broun, you 
might say to those folks that they are real nervous about, well, look, 
we are going to treat this symptomatically, and probably not with a 
antibiotic, as Dr. Broun said.
  And if in 24 to 48 hours your child is getting worse, then, 
absolutely, you come right back here to my office, I believe available 
24 hours a day. That's the way we practiced when Dr. Broun and I were 
practicing, and we will then go ahead and do a culture and start your 
child or your mom or your dad or your mother or your sister or your 
wife or husband, we will put them on the antiviral, the Tamiflu or the 
Relenza. And then we will kind of wait and see what the culture shows.
  So there is time. What Dr. Broun is talking about is treating people, 
using your brain and using your skills and not wasting precious 
medication if you don't need to.
  Mr. BROUN of Georgia. You are exactly right, Dr. Gingrey. Putting 
people on antibiotics or just taking Tamiflu because you are scared is 
not a good utilization of your money. And certainly the health system 
is overburdened by the misuse or overuse of antibiotics and all kinds 
of drugs.
  But you brought up a good point too that I wanted to focus on just a 
second.
  And the thing is, if a child starts or a person, adult, starts 
running a fever, if they don't have any other health problems, if they 
don't have chronic lung disease, if they don't have severe asthma or 
chronic bronchitis, if they don't have diabetes where they are more 
liable to develop infection, secondary infections, if somebody is 
basically healthy, then waiting for 24 hours is not going to hurt those 
healthy people, in all likelihood. It's worthwhile monitoring that 
patient, just seeing what they do, treating the fever with some Tylenol 
or Advil, one of those types of medicine.
  Mr. GINGREY of Georgia. If I could make one point, we are not talking 
about meningitis here. It's not meningitis. It can be a severe illness, 
as Dr. Broun says, but it's not going to kill you within 24 hours. And 
I think you are approaching it the way Dr. Broun is describing.
  I didn't mean to interrupt him, Madam Speaker, but I thought it was 
important that people understand because people do know about 
situations where somebody was perfectly well one day and dead the next 
from meningococcal meningitis, a bacterial infection, not a viral 
infection. Viral meningitis usually just causes a severe headache and 
is time limited. I thought it was important to make that point.
  Mr. BROUN of Georgia. The gentleman is exactly right. The severity of 
the illness makes a big difference. Dr. Gingrey, you had been talking 
about the doctor taking the time to do a history and physical, which is 
extremely important. I want to point out here, just to go off on a 
tangent for just a moment, as we see what the majority here in this 
House is trying to propose, this push towards socialized medicine, 
doctors aren't going to have time to take a proper history and physical 
because they are going to be pushed to ration care.
  And so that socialized medicine that's being pushed by the leadership 
in the House and the Senate is not the way to go, and it's going to 
hurt people more than help people. And it's going to be disastrous 
economically.
  But getting back to the flu, if somebody is concerned, they need to 
look at the possibility of this person having the flu. My daughter 
called me up just the other day when this was so hot in the news, and 
she was concerned she might have the flu. Well, she is a stay-at-home 
mom. She hasn't been out to be exposed to anybody where she would get 
the flu.

  So people need to have a little common sense about this as they think 
about this. Just because it's in the news doesn't mean that they are 
going to get it. Just because WHO is saying that there is a pandemic, 
that just means that people in multiple areas have the flu, and it 
doesn't mean that people are going to be dying in wholesale lots.
  Mr. GINGREY of Georgia. Absolutely, you are right, and you pointed 
out this earlier, Dr. Broun did, that a pandemic just means that it has 
spread to the point that multiple countries are involved, and they are 
talking about the volume of cases, not necessarily the severity.
  And they, by the way, so our colleagues can understand this and 
advise their constituents when they call, the World Health Organization 
has not declared a pandemic.
  Mr. BROUN of Georgia. That's correct.
  Mr. GINGREY of Georgia. They have declared a category 5, which is one 
step from saying there is a pandemic. I don't believe they are going to 
get to category 6 and make that declaration, as things have improved. I 
mean, that is not wishful thinking on my part. I understand that it 
could go the other way, but I don't think it will.
  Mr. BROUN of Georgia. Well, you are exactly right. And we have had 
over 400 cases that have been reported here. In fact, there have been 
several cases in our own State of Georgia that have been diagnosed 
serologically, which means through the testing that they do, indeed, 
have the type-A H1N1 flu, but in most cases it's very mild.
  And the people that are dying, this 23-month-old infant, as well as 
the lady in Texas, both by reports, we don't know for sure, by reports, 
those people had other conditions that led them to have the possibility 
of secondary infections.
  The way I remind my colleague--I don't have to remind my colleague, 
because he knows very well that the way people die from flu is through 
pneumonia, through respiratory difficulties and, and they will develop 
severe respiratory stress syndrome or some other types of respiratory 
problems or will develop pneumonia and die from the pneumonia. 
Frequently, it's a bacterial pneumonia with these co-morbid, as we say 
in medicine, conditions that give them the greater possibility of 
developing those types of things. But going to your doctor, or even 
consulting your doctor or even the doctors and nurse by phone is, I 
think, an appropriate reaction in not being afraid as the American 
public are.
  As I mentioned, my friend at the University of Georgia has been 
telling the people within government, the government entities, the CDC 
and all, that this particular flu is not of epidemic proportions. It's 
not one that is going to be very virulent and, thus, is not going to 
create a lot of severe problems besides these two deaths, which are 
tragic. We have had very little problems in America with the flu.
  And my friend also said with it being more widespread in Mexico, he 
doesn't really have the data but he thinks that probably in Mexico, 
where we have seen people die, a whole lot more than here, that it's 
probably the same proportion of deaths that we see with every flu 
epidemic. So people shouldn't be afraid.
  He also tells me that there is a possibility that next fall we are 
going to see this same H1N1 flu virus come back to America and come 
back as a potential infection, viral infection, on a bigger scale; but 
people should just do the commonsense things to help them from having 
the flu, which means they should wash their hands. If somebody is 
running a fever, they should talk to

[[Page H5165]]

the doctor and not send the child to school who is running a fever.
  They need to make sure that they keep their fingers out of their nose 
and keep their hands out of their mouth and things like this. It may be 
just common sense.
  I have had some of the liberals who don't particularly like me in my 
district complain about my making those recommendations, but people 
don't think about those things. And it's important to do those 
commonsense things to prevent yourself from getting the flu. So we need 
to just do those commonsense epidemiological measures of trying to 
prevent ourselves from getting the flu and not be afraid.
  Mr. GINGREY of Georgia. I chuckled just a little bit at what Dr. 
Broun was saying, but it is absolutely right. He is absolutely right. 
And, colleagues, I don't know, on Sunday morning you refer CNN or Fox 
News--I guess my Democratic colleagues, it's CNN; and my Republican 
colleagues, it's mostly Fox News. But they have a medical consultant, 
Sanjay Gupta on CNN, and Isadore Rosenfeld, a gentleman that I listen 
to.
  Fortunately, they don't limit him to a 2-minute sound bite. On Sunday 
morning Dr. Rosenfeld has a 30-minute interview.
  And he, Madam Speaker, he was so good and so practical and talked 
plain talk, just like Dr. Broun about, you know, the risk and the 
relevant, what do you do. And I imagine that he will be talking about 
that this Sunday, Dr. Gupta probably as well on CNN.
  But, generally, the information is outstanding, and I say that from 
the perspective of being a practicing physician, and Dr. Broun as well, 
and they talk about cover your nose and mouth with a tissue when you 
cough or sneeze, wash your hands often with soap and water, especially 
after you cough or sneeze.
  Avoid touching your eyes or your nose or your mouth, because germs 
definitely, as Dr. Broun said, spread that way.
  So it's so much common sense. And I commend Dr. Rosenfeld, Dr. Gupta 
and others, and of course earlier, Dr. Broun, before you got here, 
Madam Speaker, knows that I talked about the response that we have 
gotten from the Secretary of Health and Human Services, Governor 
Sebelius, the Secretary of the Department of Homeland Security, 
Governor Napolitano, the acting director of the CDC, Dr. Bessler, and 
on and on and on.
  President Obama's response in regard to the budget, we talked about 
the fact that he said, well, let's put $1.5 billion in case we have to 
develop a vaccine specific, in case this thing does become a pandemic, 
and we have got lots of folks that are getting very sick, and we need 
to go in that direction.

                              {time}  2115

  So I think the response has been good, but we need to make sure that 
we don't overreact and we don't let the inappropriate media cause panic 
to set in. These good doctors that speak on these shows I think are 
doing a good job to prevent that from happening.
  Mr. BROUN of Georgia. Dr. Gingrey is exactly right. And I want to 
know what this $1.5 billion or $2 billion that the President has 
proposed to spend on this flu outbreak is going to be spent on? Is it 
going to be a useful expenditure? Is it going to be needed?
  We saw in 1976 under President Ford when they spent all that money 
that actually caused more harm than good. More people died and had 
disease from the vaccine. Now, we have better technology; in fact, the 
gentleman at the University of Georgia has just some outstanding 
technology today where they can help develop vaccines very quickly. But 
still, it takes a while to produce enough vaccines to be able to help 
if they are needed. And what we see in this particular flu outbreak is 
that I don't think they are needed. I don't think we need to be 
appropriating $1.5 billion or $2 billion for the H1N1 flu. We need to 
give those funds to our military personnel to keep them from dying in 
Afghanistan or Iraq.
  Mr. GINGREY of Georgia. Reclaiming my time, because that is a great 
segue for me; because, Madam Speaker, I represent a district, Marietta, 
Georgia, is part of it, Cobb County. Lockheed Martin has a plant there 
where we employ almost 8,000 great Georgians, probably a few folks from 
Alabama and surrounding States that work on those flight lines for the 
C-130 and also, more specifically, the F-22 Raptor.
  The Department of Defense has made the decision to cancel that 
program at 187 F-22s, when originally we thought we needed 700, the 
military. The Air Force in particular has said, Madam Speaker, 
repeatedly that even 240 planes would put us in a moderate-risk 
situation, and all of a sudden this administration has made the 
decision to cancel that flight line and I think put us at a high-risk 
situation.
  I feel very strongly that in this emergency supplemental there are 
four, and that is it, four of these F-22 Raptors that give us that 
fifth generation of air superiority, best in the world, and we are 
going to appropriate as a part of an emergency supplemental mainly for 
continuing to fight and win in Iraq and Afghanistan, particularly 
Afghanistan now; yet, we are going to spend $2 billion possibly 
preparing a vaccine that will never be used?
  Let me tell you what happens, Madam Speaker, with that vaccine if we 
produce it at 50 million or however many doses like they did back in 
1976 when it only cost $135 million. We might be spending $2 billion on 
a vaccine that gets poured down the drain and is never used, and we 
could have purchased 15 or 20 F-22 Raptors.
  Again, that is getting off on a tangent a little bit, but I feel like 
I really need to mention that because we have to prioritize our 
spending. We have to do these things in an appropriate manner. We can't 
let all of our spending and our reaction be media driven in responding 
to a panic so that we don't get Katrina'd. And I would yield back to my 
colleague.
  Mr. BROUN of Georgia. I would like the gentleman to clarify something 
for me. You made a statement, and I am not sure if I understood it.
  It is my impression that actually it is the administration who 
decided to cancel the Raptor, the F-22. It wasn't the Air Force. Is 
that correct? What was the situation?
  Mr. GINGREY of Georgia. Madam Speaker, reclaiming my time, the 
gentleman is absolutely correct. He is absolutely correct.
  Thirty different studies have suggested that we need a minimum to be 
able to have enough planes. We have a situation in Hawaii at Hickam Air 
Force Base where they only have one squadron, that is 20 F-22s, and the 
same thing is true at Tyndall in Florida. They have one squadron of 20 
planes. And it is very possible that with the limit of 187, which the 
Air Force clearly has said on repeated occasions that that is not 
enough, that it puts the Air Force in a high-risk situation, that they 
may just have to BRAC those bases and take those planes and put them 
somewhere else, Elmendorf as an example or in Guam or Okinawa.
  But, Madam Speaker, the gentleman from Georgia is absolutely correct 
that this was a decision that was made by the administration, and it 
was based on cost. It was not based on the needs, as repeatedly stated 
by the highest ranking members of the Air Force and by 30 different 
studies, that we need more planes.
  We got off on a tangent, Madam Speaker, but it is important because 
what we are talking about as we discuss the appropriateness of spending 
$2 billion to produce a vaccine that may never be used, that is a very 
important decision that our country has to make, and I think the 
American people need to understand that. So I thank the gentleman for 
asking that question, Madam Speaker, and I gladly yield back to Dr. 
Broun.
  Mr. BROUN of Georgia. While we are talking about defense, let me 
point out something else, too, that was a cost decision evidently by 
this administration. The North Korean Government fired off a rocket. It 
wasn't quite successful, but they are working on intercontinental 
ballistic capability, and they are developing nuclear weapon technology 
in North Korea. We know that without a question. The day after the 
North Koreans fired off their rocket, our President announced that he 
was going to cut the antimissile defense spending. And we need that 
spending. We need an antimissile defense system in this country more 
than we ever have.
  President Reagan suggested that we develop an umbrella over this 
country, an umbrella that would make nuclear

[[Page H5166]]

weapons totally obsolete. But this administration wants to cut that 
antimissile spending which we desperately need and is, in fact, one of 
the most important constitutional functions of the Federal Government.
  We need the F-22 Raptor. We need the antimissile defense system. I 
don't think we need to spend $1.5 billion on a flu vaccine when already 
the research shows that it is not going to be very virulent.
  Before I yield back, I would like to make a very strong point here. 
We are stealing our grandchildren's future by borrowing and spending. 
We are borrowing too much, we are spending too much, we are taxing too 
much, and it has to stop. And we need to spend on things that are 
critical, that are constitutional, that have to do with our national 
defense, that have to do with our national security. And we need to 
drive things by science and not by hysteria. This hysteria over the flu 
is driving the media and is driving the administration, driving the 
leadership here. We have got to stop that.
  Mr. GINGREY of Georgia. Let me reclaim my time and try to wrap up, 
Madam Speaker, as we get close to the allotted time.
  What Dr. Broun is talking about, my colleagues, I want you to think 
about what he said, if you think we have gotten a little afar from our 
starting point on talking about this H1N1 influenza. The health of the 
Nation is more than just protecting people from a pandemic, from 
disease, from infection. That is certainly a huge part of the 
responsibility of our government, to try to protect its citizens, and I 
think that we do a great job and we have a great health care system. 
But the health of the Nation also, as Dr. Broun is suggesting so 
accurately, has to do with national defense and to make sure that our 
leadership understands the importance of us being respected. It is nice 
to be liked, and we all want to be liked. When our Commander in Chief 
goes to Latin America or goes to speak at the European Union or the 
Group of 20 or to Turkey or wherever, or visits our troops in Iraq, I 
think we need to understand the health of the Nation is more about 
freedom from disease. It is about strength. It is about character. It 
is about making the important decisions of where you spend the hard-
earned tax dollars that 300 million people in this country have to 
write a check every April 15, that we have that responsibility, and we 
can't afford to squander one dime of it.

  I am going to yield back to my colleague maybe for the final 30 
seconds, but, Madam Speaker, I just want to say that during this hour, 
this Republican GOP Doctor's Caucus of which Dr. Broun and I are a 
part, I want to point out this last slide. We are talking about 
strengthening the doctor-patient relationship, but we are talking about 
a lot of things tonight in regard to the health of the Nation.
  With that, I want to yield back to my colleague for some closing 
comments, and then we will wrap up.
  Mr. BROUN of Georgia. Very quickly, I want to bring out that the 
economic health of the government is very important for fiscal health, 
too. I think a lot of people who may be dying in Mexico is because of 
their poor economic health, and we are going down a road now with this 
tax-and-cap policy that is being fostered by the Democratic majority to 
tax energy, which is going to create a tremendous downturn in our 
economy. It is going to put people out of work. And we have got to stop 
that, too, because it is going to affect the physical health of those 
people who aren't able to buy their insurance, who aren't able to go to 
the drug store and buy their Tamiflu or their antibiotics. So economic 
health is going to be critical for physical health, and we have got to 
stop this cap-and-tax policy that Nancy Pelosi and company are trying 
to force down the throats of the American people.
  Mr. GINGREY of Georgia. Let me reclaim my time for the remaining 
minute or less. But Dr. Broun I think, Madam Speaker, hit on a good 
point. We talked tonight mostly about the physical health of the 
country, the Nation, and the importance of providing that and 
protecting people from disease, if we can. But what Dr. Broun 
mentioned, the fiscal health of the country, is almost as important if 
not as important. And so when we start recommending policy that a small 
group of zealots want us to go down a road of cap-and-trade or cap-and-
tax, we can hurt this Nation just as badly by being fiscally 
irresponsible as physically irresponsible.
  Madam Speaker, I yield back the balance of my time.

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