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State of the Union
Press Conference on Swine Flu; Interview With White House Photographer Peter Souza
Aired April 26, 2009 - 12:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JOHN KING, HOST: With as many people as 81 in Mexico feared dead from an outbreak of a new form of swine flu, the World Health Organization calls it a public health emergency of international concern.
And just this morning, New York City Mayor Michael Bloomberg announced it is confirmed that eight local high school students have contracted the disease after a spring break trip to Mexico. As many as 100 students at the same school have complained of flu-like symptoms, but only eight students, only eight, have been confirmed to have this virus.
In the White House, officials are preparing for a briefing in the next 30 minutes on what the United States will do to respond. We'll bring it to you live.
And a special look at President Obama's first 100 days in the White House, including unique behind-the-scenes accounts and images. White House photographer Pete Souza will join us with some never- before-seen images of the new administration.
And the release of top secret memos on CIA interrogation is fueling one of the most sensitive debates of the Obama presidency. Three key senators on whether this undermines national security and what should happen next.
That's all ahead in this hour of STATE OF THE UNION.
Live pictures of the White House there on a Sunday in Washington. Again, we should remind you in about 30 minutes, a briefing there on the swine flu outbreak in Mexico and what is happening here in the United States to deal with it. We will take you to that live in about 30 minutes at the bottom of the hour.
Few journalists, in fact, few Americans have had the opportunity to witness history in the making like our guest Pete Souza. He covered Senator Barack Obama's race for the presidency and now he has the good fortune of being the official White House photographer, unparalleled access to the intimate private moments of the first family and the big decisions facing this new president.
Pete Souza, thanks for joining us. And I want to put up some of our images as we go forward, because you have brought to share with us today some never-before-seen photos. But I want to start with one image as we were looking. This particular image, and I'll hold it up here and then we'll show it on our screen, we can show it around the room, President Obama leaning back in the chair, reflecting, he almost looks like he's taking a time-out there to rest in his office.
What is this -- tell us about this picture and is there any time -- as you tell us about this picture, is there any time when he says, you know, Pete, not now, don't take that?
SOUZA: This is taken during an economic meeting and I think he was just listening to the advice being given and was reflecting upon it.
KING: Just reflecting upon it. This is a pensive president, how would you describe that?
SOUZA: You know, I think he has a range of emotions like we all do.
KING: And here's an Oval Office shot of the president in shirt sleeves, hands on hips, looks like he's getting to business there. Rahm Emanuel across the table. These are two very interesting guys. You get to see them every day. I know you're not here to reveal any state secrets, but how does the president -- what is the interaction of these two?
SOUZA: Well, I think they interact together a lot during the day and, matter of fact, at the end of the day he has one last meeting with his chief of staff.
KING: And when you have access to these moments, what are the ground rules on Pete Souza?
SOUZA: The ground rules are, I try to photograph everything that -- you know, every meeting that the president does. I mean, I'm smart enough to know that if he's having a one-on-one with meeting with a head of state, I let them have some privacy.
So, it's sort of like I'm still trying to get used to, you know, how to move and when to stay and how to be...
KING: How to be almost invisible.
KING: Now here's another shot here of Rahm on the phone. And the president is obviously waiting for the result of a phone call having a little meditation in there. In a moment like that, I want to -- you're in this room, the chief of staff is making an important phone call, the president is in the chair relaxing, how does Pete Souza decide what am I going to put in the lens here?
SOUZA: Well, this was right when they were trying to finish up the stimulus package. And I think he was -- I think Rahm was talking to, I can't remember if it was the speaker of the House or -- so it was just, you know, a moment at the end of the day, I make a few pictures, and then I let them have their conversation. KING: And here is a fascinating shot here, this is, I believe, Air Force One. And you're literally peeking through the door. You get a shot through the door. I assume you're leaving them alone. You said you leave people alone at some point and then you decide to get this image. Tell me about that. A lot of people want to know about this relationship.
SOUZA: This is -- well, I mean, they meet on a regular basis and I think there is mutual respect for each other. That was on Air Force One on the way to France.
KING: This is the president walking out, I assume, for one of his primetime news conferences.
SOUZA: Yes, that was his...
KING: I've been in the White House and they introduce him from that holding room and out he comes to go down the hall.
SOUZA: Right. That is at the -- his first primetime news conference.
KING: And what is it like right before that door opened and he walks out that door, how is he getting himself ready? That's a big moment. He's going to give an opening statement. He is going to field the questions. The world is watching.
SOUZA: You know, he likes to walk around the Blue Room and look at the paintings. There is a painting of Thomas Jefferson that for, you know, both news conferences I think he has gone and looked at just before he has walked out.
KING: As you know, the American people and people around the world, those are pictures of the president at work, the president is very athletic, he's a very energetic guy, and he has a new partner.
I want to show this picture because I find this to be a fascinating picture. The president running down the hall with his new jogging partner there, Bo. What is it like now to add this to the diversity of your work at the White House?
SOUZA: This was way back about a month ago when they had a secret visit with the dog to introduce the dog to the girls and the president just started running down the hallway in the East Wing with the dog.
And as I was shooting this photograph, I remember -- there was a famous picture of Bobby Kennedy running along the beach with his dog, and that's sort of what came to mind as I was shooting that photo.
KING: And there were some photos, I don't have them in front of me, because you have just shared them with us, they have never been seen before, so I'm going to ask our people to put them up on the screen one at a time and ask you to walk through them with us.
One I know is the president -- I'll let them go first, here it is here on this monitor over here, the president looking out a window, you see the Washington Monument there in silhouette, hands in his pocket, obviously reflecting on something, and you're giving him some space but also capturing the moment. What does this tell us?
SOUZA: This is in the Green Room of the White House just before an event in the East Room. And he actually got there a little bit early and, you know, I think he was waiting to go out and just started looking out the window towards, not only the Washington Monument, but beyond the Jefferson Memorial.
KING: There is a picture we showed, you shared it with us and we showed Valerie Jarrett earlier in the day, of the president and the first lady dancing in the East Room. Very expensive there. Big happy smile on the president's face.
There's an energy in the White House, you see Secretary Vilsack, this is the Governors Ball at the White House there. Tell us about following the couple and the energy?
SOUZA: Well, this was the first kind of big formal event at the White House and Earth, Wind and Fire was the band and I think the president was singing along to the music. And I think, you know, their intention is to bring some fun to the White House, too.
KING: And you are the official photographer now for President Obama. You are in the same role at the end of the Reagan administration. A very different president from a philosophical and ideological standpoint. But like Obama in some ways, a tall guy, a little bit lanky, liked to do athletic things.
I want to show our viewers the two pictures here side by side of President Reagan at the Resolute Desk. Here's President Obama at the Resolute Desk. They used the same desk. This was John Kennedy's desk.
One of the style differences here, Pete, is that Ronald Reagan would never sit at the desk without the jacket on. President Obama here in a more casual moment.
But what are they -- just give me your -- you've watched history with both of these men. How are they alike, how are they different?
SOUZA: I mean, I think you hit the nail on the head. I mean, I think President Reagan was very formal. I think they're both comfortable with themselves which makes them, you know, a great photograph -- great photographic subjects.
The presence of the camera in behind-the-scene situations didn't seem to bother either president, which, you know, is good for me.
KING: And they are both men who rely both from a policy standpoint or an inspirational standpoint, a support standpoint, and a fun standpoint on their wives.
I want to show two more pictures. One is Ronald Reagan, you wouldn't know it, Ronald Reagan in the role of Santa Claus with Nancy Reagan on his lap. I love that photo. Look at the energy in her face.
And then on the other side, I want to switch that picture on the other side, if we can, to a picture of President Obama, then-Senator Obama getting ready to announce his candidacy for president.
And he is with Michelle in a holding room. And they have the daughters who are right there. And she's patting him on the back. We're trying to get that photo. We'll see if we get to it. But I can hold it up here.
This is a much more serious photo here, but in terms of the women behind the presidents, tell us about your -- through your lens on that.
SOUZA: I mean, I think it's hard to compare those two photographs. I mean, I look at the photograph of just before he was to walk out when he announced he was running for president, that I can't imagine what was going through his mind because the minute he stepped through that door, his life is forever changed, as well as for his wife and the girls.
And I think you look back on that photograph now and you see that emotion in his face.
KING: And we asked you -- we wanted to end this conversation by asking you, what's your favorite? And you picked this photo. I want to put it up on the screen for people to see. It is what we would call the "presidential head-butt," I guess.
And you see this looks like a freight elevator, if I have it right, and you see staff off to the left in the picture there and the president is smiling playfully, the first lady is smiling playfully, she has -- I guess it's chilly on that elevator, she has borrowed his jacket.
Tell us, A, about the moment, and, B, why it is your favorite.
SOUZA: I have lots of favorite photographs. Your staff asked me to pick one, which is like, you know, impossible to do. But I chose this one because it's a genuine moment. I mean, it was chilly in the elevator.
He took his coat off, put it around his wife's shoulders and then, you know, there is this private moment going on between the two of them. And, yet, the staff doesn't quite know whether to look or not look.
And you see the one Secret Service agent on the right kind of sneaking a peek. And it's just a complete storytelling picture, which is -- I think it also is a very genuine moment.
KING: And as you have this unique perspective on history. If you read things you have written in the past between jobs in the White House, you talked about being with Ronald Reagan the day of the Challenger explosion, and at one point alone with him and having some conversation with him. How about this president, are there times when all of a sudden you look around and you realize, oh, Mr. President, it's just me and you, and what are the conversations?
SOUZA: You know, I let him initiate any conversation. I am not there to, you know, take up his time in conversation. If he starts to talk to me, I'll obviously respond.
KING: And so let's end the conversation with telling me what it's like. You walk into a room. There is a meeting.
KING: And a lot of activity around the president of the United States and you pull up your camera and you're looking through the lens, in your mind, what is it that Pete Souza has to get?
SOUZA: I look at my job as a visual historian. I'm trying to document the presidency for history. Certain photographs get released now and we're showing a bunch this week that we want to get out right away, but the most important thing is to create a good visual archive for history. So, 50, 100 years from now people can go back and look at all these pictures.
KING: How much does it matter to you that the guy at the end of the lens is an African American and, you know, they didn't have cameras for some presidents if we went all the way back in time, but there has never been an African American man in the lens of the official White House photographer.
SOUZA: Certainly you feel a sense of history, no question about that. When I look at him, I look at him as the president. I don't look at him as the African American president, I look at him as the president.
KING: Pete Souza, the official White House photographer. We're grateful for your time and insight today in sharing these gifts, remarkable pictures. The president in picking the staff, the president couldn't have done any better in picking the photographer.
SOUZA: Thank you for having me.
KING: No, Pete, thank you very much.
And a reminder. We're waiting for that White House briefing on the swine flu outbreak. We expect it will happen in about 20 minutes or so at the bottom of the hour. We'll take you there live, but straight ahead, did the release of those top secret interrogation memos undermine national security? We'll put that question to three key senators and ask them where we go from here.
(BEGIN VIDEO CLIP)
KING: Do you believe the president of the United States has made Americans less safe?
CHENEY: I do. And now he is making some choices that, in my mind, will in fact raise the risk of the people to another attack.
(END VIDEO CLIP)
KING: Vice President Dick Cheney there on this program just about a month ago. President Obama's election mandate was to fix a struggling U.S. economy but as he starts his 97th day in office today national security challenges are front and center. A debate whether releasing Bush administration terror policies was a blunder and over whether some of the Bush officials should be prosecuted and fresh violence in both Iraq and Pakistan will test the new administration's military and diplomatic strategies.
Joining us to talk about this and assess the president's first 100 days, Democratic Senator Dianne Feinstein of California, the chairwoman of the Select Committee on Intelligence, Senator Joe Lieberman of Connecticut, the independent, former Democrat and from South Carolina, Republican Senator Lindsey Graham.
Chairwoman, I want to start with you. On the vice president's point, you heard the vice president say there he thinks the new administration is making the American people less safe. He also says that there are other memos not released into the public that prove his point that these controversial interrogation tactics used in limited circumstances actually produced intelligence that saved U.S. lives, including preventing an attack in your home State of California, the City of Los Angeles. Is he right?
FEINSTEIN: Well, I've received those memos. I asked him for them and he sent them to me. They are classified memos so I won't go into them. That's the reason why I believe the Intelligence Committee is the oversight agency for 16 intelligence agencies, including the CIA. It is our responsibility to do oversight. We have access to the classified information. And we have set upon a course, a bipartisan course with a program scope, approved by the committee, to review the conditions of detention and the techniques of interrogation of each of the high value detainees. We estimate that will take six to eight months. My hope is that the public debate quells, that we have an opportunity to do our work. The committee will consider it and then we will release, most likely, findings and recommendations.
KING: Findings and recommendations. I want to get to the other senators but to the vice president's point he believes the documents would show that the tactics worked, saved lives.
FEINSTEIN: It's very hard to tell on the face, because you have to go into who learned what at the time. Now I can go into one, at least one specific case, and it's very uncertain. So we need to find these things out and we need to do it in a way that's calm and deliberative and professional, because I think all of this, on the front burner, before the public, does harm our intelligence gathering, it does harm America's position in the world. And President Obama has worked so hard now to open a new page, to go to so many countries, to say that America is now on a different course. Let us do our work and let us do it the way it should be done.
KING: Senator Graham, you and Senator Lieberman opposed relieving these documents even though you were critics of the interrogation tactics, you thought it would undermine the mission of the united states and the CIA and now that some are out does the former vice president have a point? If some are out, should all be out?
GRAHAM: Well, here is my concern, is that, one, I think it was a mistake to release the techniques that we're talking about and inform our enemy as to what may come their way. I like what Senator Feinstein said, to go through it. And there's no doubt in my mind you may have gotten some useful information out of these techniques but the other side of the story is very real. The more than America embraces these techniques like waterboarding that comes from the Inquisition, the harder to get allies to go with us into the Mid East to fight the insurgents. You inflame the opposition. Our energy uses these images against us.
To say these techniques have brought about no good or no information is wrong, but also to say that it's been a net positive is wrong. There's a way to get good information in an aggressive manner to protect this nation without having to go into the Inquisition era. I believe you can do both.
KING: And what about going forward, Senator Lieberman? The president, in relieving these memos, you didn't like that he did, but the president's message let's look forward, not look back but then the president said I'll leave this up to my attorney general who should be prosecuted. Let's listen to Mr. Holder.
(BEGIN VIDEO CLIP)
HOLDER: I will not permit the criminalization of policy differences. However, it is my responsibility, as the attorney general, to enforce the law. It is my duty to enforce the law. If I see evidence of wrongdoing, I will pursue it to the full extent of the law.
(END VIDEO CLIP)
KING: Are you comfortable with that? Do you think this should be pursued and if you rule out the interrogators saying they were told, they were following orders and acting on legal advice what they were doing was right, who are we talking about here? Are we talking about the CIA director, are we talking about the attorney general in the previous administration, Secretary Rumsfeld, somebody in the White House?
LIEBERMAN: Yeah, no, it's not clear who we are talking about. And I think it is a mistake. I go back to what the president said at the beginning. It's time to look forward. These are top secret documents. These were lawyers -- you could disagree with them, but, in my opinion, they were trying to do what they thought would protect our country.
And here is the most important point. This whole debate is moot. President Obama has prohibited these tactics from being used in interrogation, so what do we gain -- well, what do we gain, first, by releasing the memos, but, secondly, what do we gain from indicting lawyers for their opinions, if that is a possibility here, or holding a so-called Truth Commission that the reality is, it will poison the water here in Washington. It will achieve nothing.
It will make it harder for the president to do some of the big things he wants to do for the country -- not just get the economy going, but get some Republican support for health care reform, energy independence and education reform.
So let the Intelligence Committee do its work. That should be the end of it.
(BEGIN VIDEO CLIP)
KING: On a scale of 1 to 10, sir, how confident are you, 10 being fully confident, that you will meet that deadline, that all U.S. troops will be gone at the end of 2011?
GENERAL RAY ODIERNO (USA), COMMANDER, MULTI-NATIONAL FORCE-IRAQ: As you ask me today, I believe it's a 10 that we will be gone by 2011.
(END VIDEO CLIP)
KING: That was General Odierno on this program, Easter Sunday morning. Since then, as you're all aware, there has been an uptick, as the military would call it, in violence across Iraq, Mosul, Baqubah, including in Baghdad.
And on the front page of the New York Times today, "Iraq Resists Pleas by U.S. to Placate Hussein's Party."
Essentially, Nouri al-Maliki, the prime minister, has not, at least if you believe U.S. officials, reached out to former Baath Party members and said, it's time to move on; it's time to reconcile. Senator Lieberman, to you first, are you worried at all about the combination of those things, more violence and the slower pace of political reconciliation will knock the U.S. timetable off track?
LIEBERMAN: Sure, I am. I'm concerned about it. And incidentally, it's part of why I'm so grateful that President Obama did not yield to the calls for a precipitous rapid withdrawal of our troops from Iraq.
He's got us on a timeline. It's based on conditions on the ground. And what's happening now shows that all that we've sacrificed so much and worked so hard to gain is not quite set. So we need to be careful here.
But I think Prime Minister Maliki has really done a pretty good job at reconciling a lot of the divisions in Iraqi politics. The Sunnis are much more involved than they used to be. I know that there's some problems with former leaders what was basically Saddam Hussein's party.
We ought to encourage Prime Minister Maliki to try to bring them in as well so they all could be united at what seems to be remnants of Al Qaida in Iraq that are carrying out these brutal bombings against Shia, this an attempt by al Qaeda to try to stimulate sectarian conflict again in Iraq and neither Prime Minister Maliki or the American forces or the Iraqi forces can let that happen.
KING: And if that challenge were not great enough for the military to deal with and the president to deal with, Senator Graham, you also have this expansion of the Taliban influence inside Pakistan. And ...
KING: ... Admiral Mullen was just there, the is due back for a White House meeting on Monday, administration officials say they have some big decisions to make based on what Admiral Mullen tells them. There are now more U.S. troops heading into Afghanistan and the question to you is if Pakistan is in such trouble and you have the Taliban on the move inside Pakistan, is it time for the president to slow down the deployment of U.S. troops in Afghanistan? Will they be at risk on the other side of the border or will we need perhaps more troops because of the uncertainty in Pakistan?
GRAHAM: I would counsel the president to do what General Petraeus and others in the region tell him about troops. There is a provision in the supplemental that is coming up in about a month that provides economic aid to Pakistan and $400 million to help them create a counterinsurgency program.
I've been talking with administration officials, Republican Party leaders, to see if we can break some of that money out and pass it as a stand-alone provision soon to show the Pakistani people and government that we're with you, to give them some money to accelerate their counterinsurgency program and give them some money to provide economic aid to their people, the people do not want the Taliban to run Pakistan, but the economy in Pakistan is on its knees and we've got to get the Pakistani Army focused on the insurgency, as well as the government.
The threat the Pakistan is not an invasion by India. It's insurgents, the Taliban and others destabilizing the country and I think we need to be all in in helping Pakistan
As to Iraq in 2011, I hope we will have a strong contingent of Americans there training their Air Force, their Navy. It is in our long-term best interest to have an enduring relationship with the people of Iraq, militarily and otherwise.
KING: Admiral Mullen says Pakistan could be at a tipping point. You see the intelligence. Is the Taliban, Senator Feinstein, a threat to the government, the central government of Pakistan?
FEINSTEIN: Oh, in my opinion, yes. I also think that these bombings, the size of the bombings in Iraq are a real danger signal. And I think that Mr. Maliki has to step up to the plate on this. And it's going to be very interesting in the next few weeks to see how he handles this. If these bombings continue and there is an escalation of violence, I think it jeopardizes everything the united states is trying to do.
With respect to the Taliban and particularly in both Afghanistan, as well as Pakistan, I think the takeover of the Swat Valley, the movement up north is a very serious thing. The fact that, despite the fact that we provide money for the Pakistani military, they have done nothing to stop this Taliban advance, I think, causes me great concern that Pakistan may be in very deep trouble. And I would think that -- and most of us, I think, do agree that Pakistan is sort of Ground Zero for terror today and that this thing has to get sorted out and sorted out quickly or you could lose the government of Pakistan and Pakistan is a in nuclear power and that concerns me deeply.
KING: A grave issue there. I want to close on a lighter note.
And that is, as we approach the 100 day note we are in a political environment where people are making assessments.
I want to take you, Senator Lieberman back to something you said when you were campaigning for John McCain at the Republican National Convention. Let's listen.
(BEGIN VIDEO CLIP)
LIEBERMAN: Senator Barack Obama is a gifted and eloquent young man who I think can do great things for our country in the years ahead, but, my friends, eloquence is no substitute for a record. Not in these tough times for America.
(END VIDEO CLIP)
KING: We've been discussing a number of tough issues and there are many more, senator, has he proven you wrong, Barack Obama, in his first 100 days. LIEBERMAN: First, John, let me thank you for running that tape.
KING: Tape's a dangerous thing.
LIEBERMAN: I have no regrets about supporting John McCain and really what I said then, I meant. Barack Obama is extremely gifted. Coming in at a very difficult time. I was thinking particularly about Iraq and Afghanistan, the war on terror. And McCain, of course, great experience, bipartisan record.
Once the election was over, I said I would do everything to support Barack Obama as president. He is our president. I have, but I'll say this. I've been impressed by what he has done. He is a young man but he is extremely gifted. He has acted with strength, I think, and purpose in Iraq and Afghanistan, rebuilt some of our relations around the world and acted very boldly here at home on the economy where we needed him to particularly with the stimulus package.
But it's early -- but I would say he is off to a very good start. Maybe the most important thing he's done overall is that he has restored the confidence of the American people in the American presidency and he has raised their hopes about the future of our country. That is critically important. KING: We're out of time. I want to give Senators Graham and Feinstein one sentence each. Senator Graham, to you the question is what does the Republican Party need to do in the second 100 days?
GRAHAM: To stand up for fiscal responsibility, work with the president and to make sure that we end Iraq right, win in Afghanistan and stabilize Pakistan, be a partner where we can and loyal opposition where we need to.
KING: There is a question as to whether you want to be the next governor of California.
FEINSTEIN: Well, let me answer the prior question.
No. You said "in a sentence," so give me an opportunity.
KING: All right.
FEINSTEIN: I think the Republican Party should stop being the party of no. This is a president well elected by a large number of people. He has had a very strong first 100 days. He has traveled to countries abroad, he has turned the page, he has opened a new day, he has taken strong executive actions, he's put together programs. He's delved into the economy. And I would hope that the second 100 days would find more Republican cooperation.
KING: OK, when do we get the answer to that other question?
FEINSTEIN: Oh, you'll see.
KING: "You'll see." OK, great.
We're out of time. Senators Feinstein, Lieberman and Graham, thanks so much.
We want you to stay with us. We're waiting for a live White House briefing on the swine flu outbreak: 81 dead in Mexico; no fatalities in the United States, as yet, but 19 cases confirmed now in the United States. We'll go to the White House to take you to that briefing. Among the speakers, the Homeland Security Secretary Janet Napolitano.
We'll also have some analysis on the challenges facing the administration. Stay right with us. That briefing, just ahead.
KING: Live picture of the White House Briefing Room there. We're about a minute away from an administration briefing on the swine flu crisis. Eighty-one dead in Mexico, no one dead in the United States yet, but 19 cases confirmed. I'm joined by our security analyst Fran Townsend.
Fran, as we wait for Janet Napolitano and others to come out and speak here, what is the biggest challenge for the administration at this point?
FRAN TOWNSEND, CNN SECURITY ANALYST: Well, they have got to communicate to us, John, what they know and what they're doing about it.
First of all, one of the things that is incumbent upon Napolitano is to declare an incident of national significance. You've highlighted the number of confirmed cases. They are around the country, not in any specific area, and so they need to have now a coordinated federal response to deal with the state and local emergency responders.
KING: And our medical correspondent Elizabeth Cohen is standing by in Atlanta.
Elizabeth, in advance I apologize if I cut you off. I'll watch the picture of the briefing. From your sense of how they have come to know, it was 11 cases yesterday. we're up to 19 confirmed cases now, what do we know about the incidences, the cases being confirmed here in the States?
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: John, what I would expect, and this is because the CDC has told us to expect that, expect to see these numbers rise. CDC officials were very clear about this. They said, as we look for this more, these numbers are going to go up.
Remember the symptoms of this flu are very much like the symptoms of any flu. Relatively mild symptoms like fever and body ache and headaches, well, when someone has that and then you test them, now there's somewhat of a chance that you're going to find out that that's positive.
KING: All right. Let's go into the White House now. Robert Gibbs, the press secretary, introducing the other speakers at the White House briefing. Let's listen. ROBERT GIBBS, WHITE HOUSE PRESS SECRETARY: ... Sunday afternoons.
We wanted to bring together many of the people that have the primary governmental responsibility in dealing with the situation and to discuss the government's capacity and capability, to discuss the steps that our government is taking to address this.
Three people you'll hear from today, and then we'll take some questions. First, John Brennan, assistant to the president for homeland security and counterterrorism. Dr. Richard Besser, the acting director of the Centers for Disease Control and Prevention. And Janet Napolitano, the secretary of the Homeland Security.
So with that, I'll turn it over to Mr. Brennan.
JOHN BRENNAN, ASSISTANT TO THE PRESIDENT FOR HOMELAND SECURITY & COUNTERRORISM: Thank you, Robert. And, thank you, everyone, for coming here today.
Obviously, President Obama is very concerned about the recent cases of swine flu that have been identified in the United States, as well as the outbreak in Mexico. The president's thoughts are with those who have been affected by this illness. He is monitoring the situation very closely and has ordered a very active, aggressive, and coordinated response by his administration.
The president wants Americans to be fully informed of the situation, which is why we have convened this press briefing today. The vast majority of these cases have occurred in Mexico.
Building on the close bilateral cooperation that President Obama advanced during his recent visit to Mexico, he has asked me to publicly convey his full support to President Calderon, the Mexican government, and the Mexican people in their efforts to contain the outbreak.
Both the U.S. and Mexican governments are taking steps to reduce the potential for further transmission. Our goal is simple, to communicate information quickly and clearly to our citizens, to rapidly address any new cases that emerge, and to have the capacity to effectively limit the spread.
At this point, a top priority is to ensure that communication is robust and that medical surveillance efforts are fully activated. This will enable both the rapid identification and broad notification of any new cases that may occur in the U.S., as well as in Mexico.
We believe that our increased surveillance efforts have resulted in the identification of new cases over the last 24 hours. Early identification is vitally important to the overall effort.
In the event that additional cases or sites of infection occur within the United States, we want to recognize them quickly and then respond rapidly with appropriate guidance for the public health community and the general public in the affected area. We also want to ensure medical surveillance and testing and the provision of medications and medical supplies are distributed where necessary.
I would like to share with you some of the steps the administration has taken to ensure that information about this evolving event is flowing swiftly among federal, state and local partners; between U.S., Mexican, Canadian, and other governments; and with the World Health Organization.
First, the president is receiving regular updates and briefings on the situation. I updated the president earlier today. The president has reviewed our national capabilities to mitigate the effects of a broader outbreak in the United States and the steps we're taking to support state and local governments and their public health experts.
I'm consulting closely with Secretary Napolitano, who is the principal federal official for domestic incident management with responsibility for spearheading our efforts. The Homeland Security Council has convened an interagency body of senior federal experts to facilitate coordination among the federal departments and agencies that have a role in recognizing, responding to, and communicating with domestic and international partners regarding health incidents that have the potential for significant impact to our nation's well-being.
This group has been conferencing daily to share updates and to identify actions we can take now to respond to developments in an accelerated and effective manner.
The information and decisions of the group are reported daily to senior leaders in the federal government and throughout the White House. Additional reports are provided as new information of significance becomes available.
While the president and his administration are actively coordinating the overall government response, individual departments and agencies with specific responsibilities, as well as unique expertise and experience in dealing with public health risks, are leading key elements of the effort.
For example, the Department of Health and Human Services is responsible for the overall effort to coordinate disease surveillance, medical preparedness, and guidance to public health professionals in the event that further cases are detected.
The department's Centers for Disease Control and Prevention has responsibility for identifying and tracking the spread of the disease and for communicating health-related information to the government, media, and public.
To this end, the CDC has held regular public briefings since Friday.
BRENNAN: In a moment, Dr. Richard Besser, the acting director of the Centers of Disease Control and Prevention will provide an update on the situation in the United States and Mexico, as well as where health professionals and the public can go for reliable information and guidance on swine influenza.
As I mentioned, Secretary Napolitano and the Department of Homeland Security have the overall lead for coordinating the federal response to an influenza epidemic in the United States. The Department is closely coordinating with Health and Human Services and CDC to monitor the situation. After Dr. Besser speaks you'll hear from Secretary Napolitano who will update you on the Department's efforts to coordinate response preparations and actions to date.
The secretary also will describe actions that are under way to ensure communication of timely and accurate information at land borders and at ports of entry, as well as to travelers who seek additional information. Clearly, we all have individual responsibility for dealing with this situation. We should all be practicing good hygienic practices, such as hand washing on a regular basis and if you feel sick, stay home. And also following the other practices that are common sense when we deal with an outbreak of flu every year.
I would ask that you hold your questions until after Dr. Besser and Secretary Napolitano have finished their remarks. Thank you.
DR. RICHARD BESSER, ACTING DIRECTOR, CDC: Thank you, Mr. Brennan. First of all, our hearts go out to people Mexico and the people in the United States who have been impacted by this outbreak. People around the country and around the globe are concerned with the situation we're seeing and we're concerned, as well.
As we look for cases of swine flu, we are seeing more cases of swine flu and we expect to see more cases of swine flu. We're responding and we're responding aggressively to try and learn more about this outbreak and to implement measures to control this outbreak. Let me provide for you an update in terms of where we are today and what kinds of public health actions are being taken here as well as abroad.
Today we can confirm that there are 20 cases of swine flu in the United States. We have five infected states. There are eight cases confirmed in New York City, there is one case confirmed in Ohio, two in Kansas, two in Texas and seven in California. And, again, as we continue to look for cases, I expect that we're going to find them. We ramped up our surveillance around the country to try and understand better what is the scope, what is the magnitude of this outbreak.
The good news, all the individuals in this country who have been identified as cases have recovered, only one individual had to be hospitalized. But I expect, as we continue to look for cases, we are going to see a broader spectrum of disease. What we know about this virus is it looks to be the same virus as is causing the situation in Mexico. And given the reports out of Mexico, I would expect that over time we're going to see more severe disease in this country.
There's some things that it's important people understand. Flu viruses are extremely unpredictable and variable. Outbreak of infectious diseases are extremely unpredictable and variable. And so, over time what we say about this and what we learn will change.
Expect changes in terms of the number of cases. We're going to try and give you consistent information and have it on our Web site once a day so that we don't get into the situation where you're hearing different numbers of cases throughout the day. We're going to report that daily.
And we expect that we're going to be changing our recommendations over time based on what we learn and that's an important thing. You'll start to see different activities taking place in different parts of the country, depending on the local, the local outbreak picture and that's good. You want people to respond based on what the situation is in their community based on what situations are in particular countries.
Because of the speed at which things are progressing, you will find at times inconsistent information and we're going to work really hard to make sure that that doesn't stay up for long, but as we're updating recommendations and they're going out through various sources, you may find some inconsistency and we will work to minimize that.
This is moving fast, but I want you to understand that we view this more as a marathon. We do think that this will continue to spread. But we are taking aggressive actions to minimize the impact on people's health.
It's important that people understand that there's a role for everyone to play when there's an outbreak going on. There are things that individuals do, there are things that families do, communities do to try and reduce the impact.
At the individual level, it's important people understand how they can prevent respiratory infections, very frequent hand washing is something that we talk about time and time again and that is an effective way to reduce transmission of diseases. If you're sick, it's very important that people stay at home. If your children are sick, have a fever and flu-like illness, they shouldn't go to school. If you're ill, you shouldn't get on an airplane or another public transport to travel.
Those things are part of personal responsibility in trying to reduce the impact. It's important that people think about what they would do if this outbreak ramps up in their community. We understand that in New York City there is a cluster of disease in the school and New York City has announced that they're not having those children come back to school on Monday. So that they can understand better about transmission in that school. There's a similar situation in Texas. Those are very smart public health decisions. If there are other communities where we saw cases in the school, we would be recommending that they take those actions, as well, so it's time for people to be thinking, forward thinking about, well, if it were my child's school, what would I do? How would I be prepared for that kind of event? We view the public as partners in the efforts to try to control what's going on.
There are a number of sources of information. I want people to know that the CDC Web site, www.cdc.gov has our latest information on swine flu. There's a link from there to very current information. And there's a link there to a Spanish language site, as well.
So, let me talk about some of the public health actions that are going on. We are working very closely with state and local public health on the investigations going on around the country. We're providing both technical support on the epidemiology as well as support in the laboratory, as far as confirming cases.
We're also doing a lot of work with the World's Health Organization, the Pan American Health Organization and the governments of Mexico and Canada on this outbreak. There is a tri-national team that is working in Mexico to try and understand better the spread. Why are they seeing more severe disease in Mexico than we are here? That's a critical question.
We're working to assist Mexico in establishing more laboratory capacity in country. That, again, is very important because when you can define someone as a truly confirmed case, what you understand about how they acquire disease takes on much more, much more meaning.
We issued two days ago an outbreak notice on our Web site regarding travel to Mexico. It indicated if you were traveling to Mexico that you looked at that to see what precautions could you take as an individual to reduce the likelihood that you became ill? We are going to continue to evaluate the situation in Mexico and if need be we will increase the warnings based on what the situation warrants.
Later today, we're going to be putting out some additional community guidance so that public health officials will know what our general recommendations are should say see cases in schools or additional cases in their community. And I think that the last thing I want to mention is that whenever we see a novel strain of influenza, we begin our work in the event that a vaccine needs to be manufactured. So, we've created that seed stock and we've identified that virus and discussions are under way so that should we decide to work on manufacturing a vaccine, we can work towards that goal very quickly. Our support to the states and locals will continue, we provide epidemiologic support, laboratory support, and we provide them support in terms of their medications and other material that they need to work on this outbreak. So, thank you very much and I'll turn it over to the secretary.
JANET NAPOLITANO, HOMELAND SECURITY SECRETARY: Thank you. Thanks, Dr. Besser.
A number of things going on and the purpose of today, this briefing, is to give you the most current information about what is happening. And as has been mentioned before, this is a changing picture and, so, we intend to conduct these types of briefings daily for a while so that you know and can help us communicate to the public what is happening and so that with knowledge people know what kind of issue we're dealing with.
The first thing I want to announce today is that the Department of Health and Human Services will declare today a public health emergency in the United States.
NAPOLITANO: That sounds more severe than really it is. This is standard operating procedure.
It allows us to free up federal, state, and local agencies and their resources for prevention and mitigation, and allows us to use medication and diagnostic tests that we might not otherwise be able to use, particularly on very young children. And it releases funds for the acquisition of additional anti-virals.
So, you'll see those declarations coming out today. And when I say standard operating procedure, that's exactly what I mean, we issued similar declarations for the recent floods in Minnesota and North Dakota, and for the Inauguration.
Second, I want to give you some information about where we are with respect to anti-viral drugs. These are the kind of things you would take, should you get sick with this strain of flu. We have 50 million treatment courses of anti-viral drugs, Tamiflu and Relenza in the Strategic National Stockpile.
We are releasing 25 percent of those courses, making them available to all of the states, but particularly prioritizing the states where we already have confirmed incidents of the flu. In addition, the Department of Defense has procured and strategically pre-positioned 7 million treatment courses of Tamiflu.
The United States Department of Agriculture is heavily involved in monitoring and testing to ensure that there is no issue with our food supply. And everything looks fine. I want to underscore that you cannot get the swine flu from eating pork. So that is very important. And we are screening and testing livestock to monitor any developments there.
Next, in the Department of Homeland Security, we have a number of components with direct responsibility here, the CBP is inventorying for every duty station and every employee our resources, personal protective equipment and so forth to make sure that we have adequate supplies on hand at the borders themselves.
Secondly, we have implemented passive surveillance protocols to screen individuals who may arrive at our borders. All persons entering the United States from a location of human infection of swine flu will be processed to all appropriate CBP protocols.
Right now those are passive. That means that they're looking for people who and asking about, are you sick, have you been sick, and the like. And, if so, then they can be referred over for further examination.
Travelers who do present with symptoms, if and when encountered, will be isolated per established rules. They will be provided both with personal protective equipment and we will continue to emphasize universal health measures like hand-washing and gloves.
And if and when the situation develops, all CBP sites can implement and we can deploy additional personnel to the borders.
In addition, at the TSA, many of the similar measures are being implemented there with respect to the protection of our TSA workers and also their experience with travelers.
To date, the State Department has not issued official travel advisories for, particularly, Mexico, but, again, as I said earlier, these situations are very fluid and, so, you need to keep up-to-date on that.
In addition to the CDC Web site, the Department of State has a Web site that will keep travelers posted on what the situation is, not only with our neighboring countries, but with countries around the world.
As I said earlier, our intent is to update you daily on this situation so that you can know what is happening within the federal government. State and local governments, obviously, now are in the loop.
State and local public health authorities, obviously, are working very hard and will be working hard because, as the doctors said, this will be a marathon, not a sprint. And even if this outbreak is a small one, we can anticipate that we may have a subsequent or follow- on outbreak several months later, which we will be prepared for.
And again, the government can't solve this alone. We need everybody in the United States to take some responsibility here. If you are sick, stay home, wash your hands, take all of those reasonable measures. That will help us mitigate, contain how many people actually get sick in our country. Thank you.
GIBBS: With that, let's take a few questions.
QUESTION: Thanks, Robert. Are there any U.S. clusters that suggest this is easily spread? Have we seen any pockets of suspected cases in the U.S. that suggest this could be on the scale of Mexico? And you say this is a marathon, how long is this marathon going to be?
BESSER: Thanks for those questions. You know, in terms of duration, my comment earlier about every outbreak is unique is really important to remember. And so it's very hard to say.
There is one thing in our favor, we're nearing the end of the flu season. We're nearing the end of the season in which flu viruses tend to transmit very easily. And so, we would expect to see a decline in cases just like we're seeing a decline in cases of the seasonal flu, at some point. The issue of clusters is an important one. And New York City earlier talked about their school cluster. And that's important. Some of our early epidemiologic investigations are showing that contacts of people who have been diagnosed have a significant rate of respiratory infection. Not confirmed to be this.
We only have one documented by viral isolate case in this country of person-to-person spread. And that was an individual who had gone to Mexico and came back and then there was a spouse who was diagnosed, as well. And both are doing well.
GIBBS: Yes, sir?
QUESTION: Robert, how concerned are you about the potential for this outbreak to set back the hoped for economic recovery both here in the United States and globally?
And, secondly, what, if anything, are we meant to read into the fact that President Obama decided to go golfing today? Is this part of your effort to reassure Americans that there is no need to panic?
GIBBS: I'm not sure I would draw a direct conclusion between the news today and the president's golf. I think, as Mr. Brennan said, the president has been updated regularly on this, and will continue to do so as we will continue to regularly update you.
In terms of anything that is affected economically both here and worldwide, I think it's probably far too early to determine whether that will be a case or whether that will have some factor.
We just want to ensure that people understand the steps that are being taken both here and throughout government to address the situation, as well as, as each of these speakers have said, understand the individual responsibilities that people have.
If you have questions, go to the CDC Web site at cdc.gov. And as the doctor mentioned, there's also a Spanish version of that site.
QUESTION: First one to you, Robert. Why was it necessary to have the president checked for swine flu?
GIBBS: The president hasn't been checked for swine flu.
QUESTION: Ms. Jarrett indicated today on a Sunday morning program that he had been.
GIBBS: I will double check. I don't know of any reason why he would have.
QUESTION: And, Dr. Besser...
GIBBS: And just -- let me just -- let me expand that a little bit. I think these guys obviously have more medical degrees than I do. But the incubation period for this is a 24- to 48-hour incubation period. The doctors advised us that the president's health was never in any danger. We've been gone from Mexico for now more than nine days.
QUESTION: Dr. Besser, you mentioned seed stock for vaccines. What is the threshold that you have to meet before you consider developing that vaccine and deploying that vaccine?
BESSER: There are a number of things that we look at going into the decision as to whether to make a vaccine. One is the severity of the strain, its sustainability in the community. Do we anticipate that it's a virus that will be here next flu season? So you want to prepare for that.
Then there are issues in terms of production. Currently manufacturers are working on seasonal flu vaccine for next season which has three types of influenza virus or influenza antigen in it.
We have to have discussions to determine could they add a fourth or would it require substituting or changing production in another way? All of those discussions are under way so that if there is a decision to move in that direction, we'd be ready.
QUESTION: I noticed that you're not recommending that people, even if they're ill, become vaccinated. Has the president been vaccinated by Tamiflu or Relenza? And at what level does this have to get before we go from a public health emergency to a federal pandemic plan? BESSER: I wanted to clarify a couple of things you said. Oseltamivir and Zanamivir are not vaccines. Those are anti-viral drugs that can be used to treat somebody who is ill.
BESSER: One of the points I didn't make before is that, if someone is ill with flu-like symptoms, in particular if they've traveled to an area that's been involved, they need to contact their doctor and determine what type of testing and treatment is -- is indicated.
At this point, there's not a vaccine for this swine flu strain. It's a new strain of influenza. And so what we're talking about is whether it's warranted, at this point, to move toward manufacturing a vaccine.
QUESTION: Two questions. First, I want to know if the public health emergency declaration allows the federal government to invoke any kind of quarantine powers? And, if so, how would that be used?
And, second, you know, we've been hearing for years that we could have another 1918-like pandemic. So, based on what you know right now, how likely is it that this could be a very, very severe outbreak?
NAPOLITANO: Yes, the public health declaration does not, in and of itself, convey quarantine authority. And most quarantine authority is held at the local and state level.
So we're -- and we're nowhere near that -- that sort of decision. The decisions that I've made, to date, are the common-sense ones, the few places where we've had a U.S. outbreak, to close a school here, close a school there.
But most quarantine authority is held at the state and local level. And this declaration does not, in and of itself, provide that.
BESSER: The other part of your question had to do with 1918 and what we're -- we're seeing here. And one of the very important issues that we're looking at is how severe is this outbreak that's taking place?
What we're seeing, in this country so far, is not anywhere near the severity of what we're hearing about in Mexico. And we need to understand that.
It's also important to recognize that there have been enormous efforts going on around the country and around the world for pandemic preparedness, and that our detection of this strain in the United States really came out as part of that.
There was work going on in San Diego, in terms of developing a point of care test kit, something that could be used in doctors' offices that detected the strain that they couldn't identify. And that was identified in our laboratories as the swine flu strain.
And so, really, some of the preparedness activities, the laboratory capability that we have now is not what it was five years ago, let alone in 1918. We understand a lot about how flu should be managed and -- and treated.
QUESTION: If I could just follow on that question, (OFF-MIKE) and Tamiflu -- how effective are they in treating this particular strain, if at all?
BESSER: At this point, it's premature to talk about how effective they are. Those are some of the studies that we would want to undertake and assist Mexico in undertaking. We do know, from seasonal flu, that early treatment with anti-virals can shorten the course of illness.
And -- but in terms of this situation, we know that the strain is susceptible. It's not resistant to those drugs. It is resistant to two other drugs, amantadine and rimantadine. But it's not resistant to oseltamivir and zanamivir, which are the drugs that we've been stockpiling.
NAPOLITANO: I just wanted to clear up -- on the declaration of emergency, I wish we could call it "declaration of emergency preparedness" because that's really what it is, in this context.
It's similar to what we do, for example, when we know a -- when a hurricane may be approaching a site, we will go ahead and issue an emergency declaration that allows us to -- allow -- freeze up money, resources to get prepositioned, to get ready. The hurricane may not actually hit a particular landfall, but it allows you to undertake a number of preparatory steps.
And, really, that's what we're doing right now, the government. We're leaning forward. We're preparing, in an environment where we really don't know, ultimately, what the size or seriousness of this outbreak is going to be.
QUESTION: Dr. Besser, you said we were likely to see more cases, and the CDC's Dr. Anne Schuchat said yesterday we do not think we can contain the spread of this virus. What exactly does that mean?
BESSER: You know, in strategies for outbreak control, there -- there's a concept of containment, where, if you can detect it very quickly in one community, that you could swoop in and try and quench it and knock it out so it doesn't go further.
We don't think that that's a possibility. But we do think that it's very possible to mitigate or reduce the impact of this infection around the country.
In terms of detection, what we're seeing in this country is mild disease, things that would never have been detected if we weren't ramping up our surveillance.
And so my comment there is that, by our efforts of asking doctors to culture -- we are asking doctors, when they see someone who has flu-like illness who's traveled to an affected region, to do a culture, take a swab in their nose and send it to the lab so we can see, is it influenza; is it this type?
And I expect that, as we do that, we're going to find cases all -- in many different parts.
When I mentioned the states we're seeing cases in right now, they're not all contiguous. The travel patterns of people now are such that we would expect that we're going to see cases in more states.
QUESTION: If I could follow up on that, is it true that it took a week until after Mexico had invoked it own protective measures before the U.S. was notified of this?
And is it a significant concern that HHS is in charge of this, at a time when it doesn't have a secretary?
GIBBS: Well -- you do the first part.
BESSER: I'll do the first part.
In terms of detection and reporting, you know, the -- the confirmation of swine flu from Mexico was shared with us immediately. There was great collaboration between Canada and Mexico on doing that testing.
I'm in daily communication with their public health leadership and the collaborations have been absolutely superb. We share information about what we're seeing here, and they're sharing information about what they're seeing in Canada and in Mexico.
QUESTION: They sent this test to Canada rather than the U.S., apparently, because of paperwork?
BESSER: Well, we have -- there are quite a number of isolates that we've tested here for Mexico, as well.
GIBBS: In terms of the secretary, I think these guys have given you a pretty good indication of the response mechanisms that are in place and that have been activated relating to this, so, I think it's all-hands-on-deck and we're doing fine.
I would say we're hopeful that we have a new secretary very shortly.
QUESTION: Secretary Napolitano, I believe Japan and South Korea have both now announced that they're going to be doing testing on passengers coming in from the U.S.
Why is the U.S. not doing that with passengers coming in from Mexico? And then, also, do you have any indications -- I know it's still very early yet, but any indications that perhaps this might have been caused by bioterrorism, this new strain of flu?
NAPOLITANO: I'll let -- I'll let John answer the second part. With respect to that, we're doing, as I said, passive surveillance now. Right now, we don't think the facts warrant a more active testing or screening of passengers coming in from Mexico, although, obviously, we are letting air carriers and our employees at the gates on those flights make sure that they are asking people if they're sick, and if they're sick, that they shouldn't board the plane -- you know, that sort of thing, passively.
But, again, this is a changing dynamic that we may increase or decrease that, as the facts change, over the next 24, 48, 72 hours.
BESSER: Yes, the question about the strain that we're seeing here -- we analyzed that strain and are continuing to do further analysis of that strain. And we expect to see the emergence of new flu strains. That's something that we are continually watching for, to ensure that we're ready, should a strain emerge that there's not immunity and protection in the community for it.
This strain is not unlike other new strains that have emerged. It's an assortment. It's got genetic components from a number of sources, including human, swine and avian sources. And that's something that you see with new strains.
So, there's nothing that we have seen in our work that would suggest anything but a naturally occurring event.
QUESTION: But from a security perspective, nothing to rule it out, either, as a possibility of bioterror?
BRENNAN: We are looking at all different aspects here, but as the doctor said, there is no evidence whatsoever that we've seen. But clearly, in order to make sure that we're doing everything possible, we're looking at all potential explanations here, but no explains on the bioterrorism.
QUESTION: How did the -- Madam Secretary, how did the stocks of effective antivirals today compare to previous outbreaks -- SARS, for example?
And would these stocks be available for the public or just for DOD?
NAPOLITANO: Right now, the DOD stocks, I believe, are for the DOD personnel, but I'll have to confirm that for you later. I believe that to be the case.
We have 50 million courses that are in the national stockpile. As I said, we're freeing up a quarter of those for use by the states, in addition to whatever state stockpiles they have, should they need it. Priority will go the states that have confirmed outbreaks of disease.
NAPOLITANO: And I don't have the history on how that compares to what we had on hand for SARS.
BESSER: Yes, the Strategic National Stockpile has considerable assets for treating flu. In addition to the anti-virals, there's the supplies should we see hospitalizations that would warrant support. SARS is a different picture in that there was not a medication that people could take to treat it. And so this is a very different situation. And as part of our planning for a large outbreak, this pre-deployment availability is a leaning forward step.
We know that many states aren't seeing any cases, but it was our belief that having things there ahead of time was the way to go rather than waiting until it got to a point where people were asking.
QUESTION: Secretary Napolitano, you mentioned the quarantine power and that's really a state and local issue. What additional authority does the president have? What other powers does he have to contain this, to mitigate it? What else can you do?
NAPOLITANO: I don't want to give you a legal brief on that right now, but that's, it's -- yes, exactly.
NAPOLITANO: Well, what -- because we want to make sure that it's very precisely explained to you and to the public. So perhaps we could brief that to you later on this week. But...
QUESTION: But there are additional things. You guys are confident that measures that you can take is beyond the declaration of emergency, things that you can do at the federal level?
QUESTION: And (INAUDIBLE), can we follow up on the eco question on the eco trade? I just want to be clear, you're not at all studying this, measuring what sort of effect this could have economically, you're just not at that level yet?
GIBBS: I'll check with NEC, I don't know of any -- I don't know of anything related to that at this point, but we can certainly check.
Yes, ma'am. QUESTION: What happened to the U.S. travel to Mexico and why haven't you changed the U.S. alert level in the face of this, unless the declaration of a public health emergency is doing that?
BESSER: You know, I can comment. We have it at CDC posted, an outbreak notification regarding Mexico. And we're continuing to watch the situation there and evaluate. And should it be warranted, we would make the change in that regard.
In terms of the stages and phases of pre-pandemic situations, the real important take-away is that we have an outbreak of a new infectious disease that we're approaching aggressively, and it matters much less what you call it.
Those things are designed to trigger actions, but we trigger our actions based on what we're seeing here in-country as well as what we would see around the globe. And given that this new strain is something we're experiencing here on the ground, we're being very aggressive and addressing that based on what we're seeing in each community.
QUESTION: What has been discovered so far about why people in Mexico have died, but not elsewhere?
BESSER: You know, that's an unanswered question. We have folks on the ground and we haven't been able to find an answer for that. There are a number of different hypotheses and I'm hoping that we'll be able to shed some light on that as these teams get more established and continue their studies.
QUESTION: For Dr. Besser, is there evidence of ongoing transmission in Mexico or are the cases being picked up there ones that happened in the last couple of weeks and are over or are there new chains or transmission being generated?
BESSER: You know, again, I don't want to comment on the situation on the ground in Mexico. I have not heard that it is stopping. Their overall flu surveillance is only showing a small increase from what they would see annually, which, again, makes it difficult to use some of the surveillance tools to measure the impact of a new strain when you're in the midst of another flu season.
QUESTION: Thank you.
QUESTION: Follow-up on what the president -- for you, Robert, just with the president, did you say that he had not been treated with any kind of...
GIBBS: When I checked yesterday, he had not been. I am going to -- I will re-check with the doctor. Again, based on the incubation period, he -- neither he nor anybody that he traveled with nor anybody in the press corps that I'm aware of would have exhibited any symptoms that would have caused any heightened awareness. And, you know, I mean, it would...
QUESTION: (OFF-MIKE) did doctor check him out...
GIBBS: No, no. Again, in the absence of symptoms -- I think this probably goes without saying, too, in the absence of symptoms, you shouldn't go get tested. That is going to crowd any sort of either public health or private health infrastructure. If you are sick or you do have symptoms, then you should take precautions.
But there is no reason to believe that his or anybody that traveled with him, that health was ever in any sort of jeopardy.
QUESTION: Follow-up on the HHS question. Not only HHS but CDC, surgeon general, there are no...
GIBBS: I thought he was doing a pretty good job. (LAUGHTER)
QUESTION: But it raises the political question about, you know, how movement there has been stalled because of HHS. I mean, you had the president express concern about the fact that you don't have a team in place there or at the FDA to fill...
GIBBS: Well, because -- I want to be very -- I want to be very clear here. There is a team in place. The team is -- part of it is standing behind me and part of it is working as we speak to identify exactly what the doctor and others have talked about.
I think this notion somehow that if there's not currently a secretary that there's not the function that needs to take place in order to prepare for either this or any other situation is just simply not the case.
(UNKNOWN): Thank you.
GIBBS: Thanks, guys.
(UNKNOWN): Thank you.
KING: You have been watching a live briefing that White House. The administration laying out the steps it is taking to try to prevent further spread of a swine flu virus here in the United States. More than 80 dead in Mexico. No fatalities reported as yet in the United States, but 20 cases the administration now confirms in five states.
We have Fran Townsend, our homeland security adviser with us, Elizabeth Cohen, our medical correspondent.
A quick programming footnote at the top. "FAREED ZAKARIA: GPS" will be seen in its entirety. If you tuned in expecting to see Fareed, we will play that program for you in its entirety.
First, though, we want to take a few minutes to discuss these important developments.
Fran Townsend, let me start with you, a few months ago, that would have been your job to step into the briefing. You were the homeland security adviser to President Bush. In terms of the plan they laid out, about how they're monitoring this and what they plan to do, how are they doing?
TOWNSEND: Not bad. I mean, this is a good start. A little interesting that John Brennan, who occupies my former position, led off the brief. We need to know who's in charge. More importantly, the president needs to know who is in charge. That is Janet Napolitano.
They talked about her being the lead member of the cabinet, but there is not -- it was a little inconsistent, but it will be important as she asserts herself. One thing they mentioned was that there has been this announcement of a public health emergency. Well, the companion piece to that on the security side is the declaration of an incident of national significance. They've now confirmed 28 confirmed swine flu cases in five states. They're taking actions with state and local officials, regardless of even if this doesn't get any bigger, this is an incident of national significance.
She needs to assert her role so she can coordinate across the federal government that not only includes the Department of Homeland Security, but as she mentioned, the military, DOD, Health and Human Services, who doesn't have a cabinet secretary. And so she has got a larger role.
The other thing I would note, John, is the State Department, we haven't heard much about the travel advisories. Most Americans, when they go to travel overseas, look to the State Department travel advisories, those haven't been posted yet with over -- you know, many deaths.
KING: And let's show our viewers, as you make that, what could be an important point. The CDC, the Centers for Disease Control, does have an advisory on its Web site, but if you're leaving the country, as you know, if you look do online, you would probably look at the State Department.
This is the State Department Web site there. You see Secretary Clinton, a message about her efforts to bring stability to Iraq, but as yet nothing on the home page of the State Department site, which is, again, where many Americans might go if they were leaving the country, especially going to Mexico.
Fran, stand by for a second.
Elizabeth Cohen, they said 20 cases now in five states. Eight of them in New York, one in Ohio, two in Kansas, two in Texas, and seven in California. In terms of the spread of this, though, they did voice concern that they expect, as this plays out, to get many more. What else did we learn from a health standpoint? COHEN: Oh, John, one thing really jumped out at me in that press conference, and that is when Dr. Richard Besser, the head of the CDC, said, expect to see more severe illnesses than we've already seen. That is so significant.
The reason why is that the 20 cases that we've seen now are mild. People are recovering on their own, only one person has gone to the hospital. As far as we know, no one has even needed an anti-viral medication.
So these numbers, 20 or 30 or 40 or 50 or whatever, if it's not -- if it's mild illness, that is not nearly as big of a deal as even a few cases of severe illness like they have in Mexico.
That is the scenario that no one wants to see. No one wants to see even a single case in this country like they have had in Mexico where they have 20 dead and 81 deaths that are also, they say, likely linked to swine flu.
That was the severity that sort of caught my attention, John. KING: And, Fran, as they play this out, you know, we were having a conversation, listening to the briefing in part, they would be talking about the playbook. In terms of what they're doing 100 days into office in the Obama administration, the career people in place have plans to respond to things like this, correct?
TOWNSEND: Absolutely. And in fact not only do they have plans, we exercised them during the prior administration at a cabinet level and then throughout the departments.
TOWNSEND: So, fortunately, you have career public servants who working with in each of the departments and agencies who are familiar with the plan and who are advising sort of the new political leadership of the administration and we ought to feel good about that.
One of the other things they talked about was the strategic national stockpile, that's where the antivirals are and the medications. What they didn't really talk about, Janet Napolitano said she was sharing 25 percent of that with state and locals and she also talked about border folks, TSA folks all having access to those materials. What we don't know 25 percent of what number. How much of the strategic national stockpile is being drawn down and prioritized across law enforcement and border officials.
And we need to understand that so we know really what we have access to.
KING: Elizabeth, we're going to work in a break in a second, but beforehand, the question was raised do we need a vaccine for this and Dr. Besser I believe said they're gathering the strengths in case, but they haven't made the decision as yet. Is that right, my understanding correct?
COHEN: That was my understanding, as well. Someone asked, do you have a vaccine, he said, no. This is so new there is no way they could have come up with a vaccine even at this point, but, certainly, they're going to look forward. Is this a threat we expect to see again? If we expect to see this strain again, there might be a reason then to come up with a vaccine to this swine flu.
KING: I'm going to ask Elizabeth Cohen to stand by. Fran Townsend as well. We'll be back for more of our discussion at the White House and what you should do at home and what the government is doing for you.
And this programming reminder. FAREED ZAKARIA, GPS will be seen in its entirety later this hour. But more information on the swine flu crisis, please stay with us. We'll be right back.
(BEGIN VIDEO CLIP)
NAPOLITANO: The Department of Health and Human Services will declare today a public health emergency in the United States. That sounds more severe than really it is. This is standard operating procedure. It allows us to free up federal, state and local agencies and their resources for prevention and mitigation and allows us to use medication and diagnostic tests that we might not otherwise be able to use.
(END VIDEO CLIP)
KING: Secretary of Homeland Security Janet Napolitano there just moments ago at a White House briefing.
I'm John King in Washington. FAREED ZAKARIA GPS will be with you in its entirety in just a few minutes. First, though, we're continuing to analyze this important announcement at the White House about how the Obama administration is dealing with a swine flu outbreak here in the United States. Twenty cases so far. None fatal. There have been a number of fatalities in Mexico.
I'm joined here in the studio by Fran Townsend, our national security consultant here at CNN and Elizabeth Cohen, our medical correspondent in Atlanta. Fran, in terms of a public health emergency as she announces there, it allows them to move resources around and get ready. I was struck to a degree, but that's what they are doing, by what they are not doing. In a sense they say if you're coming across the border right now, if you're an American citizen and you're in Mexico and you're walking across, driving across or flying across into the United States, they're asking you some questions. Essentially, how do you feel? And if your answer is fine, you come on in. Is that the right approach?
COHEN: I think, John, as we see an increase in confirmed cases in the U.S. there will be increasing pressure on the Department to actually become more aggressive to deploy - I would imagine right now what they're not saying but what I hope they're doing is deploying rapid diagnostic testing. It's not the end all, be all to the perfect answer but it can tell you whether or not something falls into the swine flu category and requires further testing.
There's going to be tremendous pressure on them to get to that point and get there quickly over the next 24 to 48 hours if we see increasing numbers of reported cases.
KING: Let me ask you from a security standpoint, it's a bit of a footnote, but it's an interesting footnote. The president of the United States was just in Mexico along with other senior administration officials and the White House is saying he was not tested in any way because he has not exhibited any symptoms, essentially the same test, how are you feeling, you don't have a fever or flu-like symptoms, is that the right approach?
TOWNSEND: There is no question that he would have been -- He and his entire team would have been briefed on the influenza in Mexico before they went. One of the things they're not talking about was he treated prophylactically before he went with an antiviral. I would leave it to the doctor, but there is some medical evidence to suggest that prophylaxis treatment with antivirals can be helpful in protection and Robert Gibbs didn't tell us whether or not he was treated prophylactically. KING: And Elizabeth Cohen, from a public health standpoint, I want to play for our viewers first Dr. Richard Besser, the acting director of the CDC, the Centers of Disease Control and Prevention because he sounded on the one hand a hopeful note in the context of the number of cases in Mexico and there have been fatalities, 20 cases in the United States, certainly not a good thing, but a relatively small number and, yet, Dr. Besser says he expects it to get worse. Let's listen.
(BEGIN VIDEO CLIP)
BESSER: This is moving fast, but I want you to understand that we view this more as a marathon. We do think this will continue to spread.
(END VIDEO CLIP)
KING: So, Elizabeth Cohen, for somebody watching at home, you come out of this briefing just as an average American sitting at home, what are you supposed to be doing?
COHEN: Well, what you are supposed to be doing is really what you've always done. If you feel like you have the flu, you should contact your doctor and should not go to work or go to school. Now, if you have just come back from Mexico or if you have had close contact with someone who has just came back from Mexico, you need to tell your doctor that.
The CDC has put out the word to doctors, hey, if any of your patients come in with flu-like symptoms, you need to get a travel history from them. And I thought one of the things that Dr. Besser said that is very important that we didn't hear in that sound bite just now is that he expects to see more severe illness. What we've seen in this country so far has not been of crisis proportion. People get sick for a couple days, people recover on their own, only one person's even needed to go to the hospital. If there is more severe illness in this country as he suggests, that's a whole different ball of wax.
KING: And he also suggested, again, sounding hopeful note that we're near the end of the traditional flu season. How important is that if you're a state health official looking around trying to get a sense of what is the universe of the problem here. A federal health official with the same question. How much is when this is happening impact what happens next?
COHEN: Well, John, this is the time of year when state health officials breathe a sigh of relief. It's April, we're done. We got through the flu season. Well now they have to sort of gird up for a possible outbreak in their state of swine flu because really any state could be vulnerable to getting swine flu right now.
It's a good thing that we're not right in the middle of seasonal flu season, winter flu season. Because then you'd have to deal with both on top of each other. So I guess you can look at it that it's good we're at least done with the winter flu and now we seem to be starting a new kind of flu. KING: And Fran Townsend, as every individual takes a necessary precautions, and that's everything from washing your hands to keeping clean to just trying to stay in good health.
KING: In terms of this is -- the World Health Organization is warning of a potential pandemic. Twenty cases in the United States right now -- that's not a pandemic, but the government says it could get worse.
What are the resources available, if it gets worse, in terms of, from your days as President Bush's homeland security adviser, if you're looking at a menu of resources the United States can move on a moment's notice, what are they?
TOWNSEND: Well, there's no question that there is the ability to move additional assets into our international stockpile. That is, where you see outbreaks around the world, what you want to do is you want to keep them away from our borders.
And so the first question will be, working with State and the Department of Homeland Security and Health and Human Services, do we want to add to our investment in the international stockpile?
That, of course, is going to be informed by how big and how adequate is our domestic stockpile; what is the requirement and then the level of outbreak here?
And by the way, John, we have to remember, this isn't just a government requirement to have anti-virals for law enforcement and military personnel, but our critical infrastructure.
We need water and food to continue to move around. We need tolls to work on roads. I mean, all sorts of things have to be put into the consideration, not to mention senior government officials who we want to make sure continue to get to work.
KING: Elizabeth Cohen, I wanted to give you a chance just for a final thought, here, before we move on.
COHEN: Actually, some interesting news that I just heard about, John, is that there are now four confirmed cases in Nova Scotia. They are all mild cases. They are all recovering.
And so I think that's what people need to remember. I mean, public health officials have been telling us, basically, don't freak out. So far what we've seen in this country has all been mild, and, in most cases, even more mild than the regular winter flu that many of us get.
KING: Our thanks to Elizabeth Cohen in Atlanta; Fran Townsend in the studio with me, here in Washington, D.C. I can assure you, CNN reporters here in Washington and Atlanta and around the world will continue to monitor this story and we will continue to bring the latest throughout the day. Please stay right here at CNN. We will continue to track this swine flu; more information as it comes in to us. For now, though, I'm John King in Washington. Thanks for your patience and staying with us today.