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The Swine Flu Affair: Decision-Making on a Slippery Disease
This calls for a reconstruction of events, which we have undertaken by combining press accounts, hearings, official files, and interviews with participants, as many as we could reach during the time we had available. Our efforts still leave some participants unreached, some happenings unrepresented. We are sorry for that but time pressed. In establishing "what happened" we have sought not less than three and preferably five opinions when there were as many or more persons present. In the case of actions taken by one person we have sought both his account and the impressions of contemporary bystanders, along with written records if available. Throughout we have sought views from informed observers.
This remains a reconstruction. It cannot be "the" truth as actually experienced, for there were many truths then, all imperfectly recalled; we now select among them with the benefit of hindsight. We are surely not infallible; we seek to be responsible; the judgment is our own.
Many of our informants spoke for background only. All were offered confidentiality if they so chose. Therefore, attributed quotations from our interviews have all been checked with sources for accuracy and propriety. As cannot help but happen, checks produced some changes of memory, or concerns about good taste, or insistence on non-attribution. For quotation purposes we honor the source’s preference. Readers need not fear. This does not change the substance of the story; it just makes for a little less enjoyment in the reading.
What follows is our response to the Secretary’s request, written for him and for whomever else he chooses. There are ten chapters of narrative ending in March 1977. We do not deal with everything. We deal with those things we believe can best help Califano think ahead. Chapter 11 sketches open issues in the swine flu program’s wake: a national commission, liability legislation, and a new immunization initiative. These we watched while researching the earlier story. We are current through March 1978. We then stopped watching; for the last three months we have been editing. Those issues remain open but our text closed as of March, a year after the program’s termination.
We conclude these chapters with our own reflections, placed in Chapter 12. They bring us to administrative issues and to realms of current policy for Russian flu and after. They bring us also to the underlying issues posed by current knowledge about influenza, and by ignorance as well. We deal here with a slippery disease. What makes it so we address in a technical afterword.
There follow five appendices. "A" is a "cast of characters" named in our narrative, and a chart of certain agency relationships. "B" is a glossary of abbreviations and "C" is a detailed chronology from January 1976 to mid-March 1977. "D" contains certain documents described in narrative chapters, and "E" offers questions useful for the next pandemic threat.