So, in the course of an accidental career, I was briefly attached to the staff of the Secretary of the Department of Health and Human Services. It was an odd thing for a career intelligence guy, and quite interesting. Secretary Thompson was interested in what the well-manicured briefer from the three-letter-agency had to tell him in the weekly meeting, but he wanted more. He wanted a dedicated means to get the truth as it happened, since his assortment of health agencies in multiple departments and states needed coherent guidance. That meant information, and that was what the Secretary asked me to do.

So, trying to set up a good-looking version of a military crisis center was a good show, though I doubted its survival competing against real organizational requirements already in process. Besides, there was something else happening in 2002. It was a plague that had the potential to get loose and really screw us up.
Given the experience we have shared this past year, I need not go into the detail of the number and peculiarity of the expert opinions there were to chose from. The internal means by which the Department handles these things, away from the media gaze, is businesslike since there are so many equities in the Health Community. The senior folks from the Offices and Centers all show up for conferences and assessments at the headquarters. Being an otherwise no-equities visitor to the Department, I was told to help out where I could. I did not know much, but did have a detectable pulse.
Maybe you don’t remember SARS (Severe Acute Respiratory Syndrome). It was, in its way, completely like COVID: Fever, dry cough, headache, muscle aches, and difficulty breathing. Sometimes acute death. The SARS virus story should now be familiar, since we have seen one way to respond. It originated in China: it was spread through aerosol transmission, pretty impressive in contact transmission, and had the Department’s complete attention. There was more, of course, since some of the health response offices admitted that no treatment existed except for supportive care. Which was going to be a problem, and how I met some nice people in the VA hospital business who seemed suspicious of my good will.

So, attending the meetings, I had a chance to see the Nation’s best doctors as the undeclared emergency hopped across the globe. We had a grim joke about the Hotel Metropole in Hong Kong, since a Chinese Physician checked in to infamous “Room 911” unaware he had been infected. It is what we call now asymptomatic transmission. He died a couple weeks later, in hospital, but he had associated with guests who later traveled to Singapore and Hanoi. And from our viewpoint, a very near city: Toronto, Canada. There was some concern about places like Disneyworld.

The implications and threat level were first, of course, and all sorts of options were discussed on how to respond. Despite the number of luminaries doing the discussing, one of the most impressive was the Director of the National Institute for Infectious Diseases, Dr. Anthony Fauci. He seemed to like being called “Tony.” Maybe it was his background as a captain on his high-school basketball team. He had poise and confidence, and the ability to keep things simple when they actually were remarkably contorted.

He was a primary thought lead in the response, and his peers seemed to acknowledge it. We were sitting around after one of the big meetings broke up, awaiting the next one to start. The earlier discussion had been about social behavioral issues involving things like the Spanish Flu in 1918-19. Being still on active duty, I will concede that my un-informed (not “uniformed”) opinion was that direct action was usually the most effective approach to big problems. It seemed like a restriction on places and people would work. I asked Dr. Fauci about that. He smiled, then did one of his masterful jobs of leading lesser people through the factors that made the “Q-Word” a potentially worse alternative than the usual ones. He said: “Sometimes the answer has larger consequences than the problem did.” I immediately swung over to his expert opinion.

There have been no outbreaks of SARS in several years, although similarly malevolent things that shared symptoms (Middle East Respiratory, et al). But something was going on, and the SARS experience and many of the people, including Dr. Fauci, were still on duty. There were stories that research into the viral composition had been outsourced from the U.S. due to concerns of its lethality. The entity funded to do research is a now famous: The Wuhan Institute of Virology.
The name was familiar to Washington insiders, since the National Institutes of Health had contractual relations with the lab.

Meanwhile, in 2017, US Embassy staff attention was drawn to reports of the Institute’s research on bat viruses, prompting them to alert DC that the lab’s own scientists had reported “a serious shortage of appropriately trained technicians and investigators needed to safely operate this high-containment laboratory.” There is more we do not know, at least publicly. But the response, when SARS Jr. was recognized as a major threat, was “The Q-Word.”

So, I only know how things worked on one viral outbreak, but I learned a couple things about Dr. Fauci’s business. The first was to marvel at aspects of epidemiology that closely resembled trying to track Soviet submarines beneath the waves. The second was the role of policy and the broader implications of policy-driven action in public health. What he was telling me then was that his opinion that the situation did not merit imposition of the Q-Word and the impact on social order and the economy.

I respected Dr. Fauci then and respect him now. I know he is aware of the implications of doing the things we have done in our SARS-related COVID adventure. In the last one, a policy decision was made, the SARS virus was last reported in 2004 and the response worked. COVID’s real name is SARS-CoV-19. I have every confidence Dr. Fauci’s recommendations all through this year were made with complete awareness of the consequences. He has been reviled for his changing positions on things like masks, since he has progressively told us not to worry, then to mask up, and most recently to double mask. Whatever he has said, it made sense in the policy climate of each announcement.

Now we are dealing with life in the Q-Lane. I suspect we will be seeing this response again, since a lot of people seem to like it. As Rahm Emmanuel famously observed when he was President Obama’s Chief of Staff, “You never want a serious crisis to go to waste. I mean, it’s an opportunity to do things that you think you could not do before.”

Copyright 2021 Vic Socotra
www.vicsocotra.com