A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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August 7, 2005 - Major Sunday news day with front page article in NY Times predominantly quoting me) regarding the successful preliminary data from the NIAIDfunded H5N1 vaccine trial that showed safety and an immune response that would be predictive of protection. This is obviously very good news in our comprehensive plan for pandemic influenza preparedness. This article in the Times kicked off a very positive media frenzy with front page articles in virtually every newspaper (it was on the Times web page the night before and so other papers picked it up) including Washington Post, Baltimore Sun, Wall Street Journal (Web), AP, Reuters, etc, etc. I appeared on ABC Nightly News on Sunday night, NPR's All Things Considered" on Sunday, CNN American Morning on Monday AM. Very positive "ink" weekend".
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August 17, 2005 - Briefed Secretary of State Condoleezza Rice at the State Dept. on the threat of Pandemic influenza. Also present were Sec/ Mike Leavitt, Rich McKeown, Bill Steiger, Julie Gerberding, Bruce Gellin, Bill Raub, Dan Singer, and a few Assist. Secs in DoS. We gave Dr. Rice a primer on Pandemic flu and also discussed the international implications, particularly related to the recent findings that migratory birds have brought H5N1 to chicken flocks in Siberia, Russia, Mongolia, and Kazakhstan and flyways will likely bring it to India and Europe. She was very gracious and was glad to see me again since I had briefed her a few times on HIV/AIDS and biodefense when she was at NSC
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August 19-28, 2005 - Very productive meeting of editorial board of Harrison's Principles of internal Medicine (HPIM) - 17 and McGraw-Hill publishers at Spring Creek Ranch in Jackson Hole, WY to plan the 17th Edition that will be published in 2008. We returned there after our 1991 planning meeting for a prior edition. I am the editor-inchief for the 17th and I picked Jackson Hole. Great choice. Beautiful weather and above all, Bob and Colleen Grady have a beautiful home there and our girls stayed with them while Chris and I stayed at the Spring Creek Ranch. Did fishing (caught several cutthroat trout), hiking and just relaxing, although I worked every day (1 1⁄2 day off) on the book. Very frightening experience when Bob, Colleen, Chris and the girls took a (supposedly 6 hour) 12 mile hike on the Teton Crest trail. A bit reckless on Colleen's part in that we started late (1:45 PM) and would have cut it close to get to destination by nightfall. Trail we difficult, but incredibly beautiful. Unfortunately, we got lost (wrong turn) and lost >2 hours. We hiked the last hour+ in the dark. Alison was totally frightened. We saw up close several bull moose, mountain lion tracks and wolf tracks. Danger was being stranded in the woods overnight with temperatures going down to <40 F every night. We finally made it to the fire road and out by 9:25 PM.
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August 29, 2005 - Hurricane Katrina totally wrecked New Orleans, parts of Mississippi, Alabama and Florida. Levies caved in New Orleans and Lake Pontchartrain poured into New Orleans together with the river. May be biggest natural disaster in USA history. Thousands dead and stranded. Hundreds of thousands of refugees living under terrible conditions unable to be rescued. Cliff Lane and I are planning a consulting arrangement with IDSA and RCEs for infectious diseases. More to come. Bird flu activities continue with migratory birds now infected in Russia, Siberia, Kazakhstan. Europe worried.
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2005-09-01 00:00
Anthony S. Fauci
September 1, 2005 Senator Arlen Specter Senator Patrick Leahy Committee on the Judiciary United States Senate Dear Senators: I am writing to request that you question Supreme Court nominee John G. Roberts about his role in a particularly shameful chapter in the history of the AIDS epidemic in the United States: the hysteria that led many communities to bar children with AIDS from attending school. In 1985, unfounded fears over AIDS transmission were sweeping across the country. The Centers for Disease Control and Prevention (CDC) responded on August 30, 1985, by issuing a landmark scientific statement. The agency reviewed all available evidence and concluded that there was no evidence of spread through casual contact. CDC recommended that most children with AIDS "should be allowed to attend school and after-school] day-care and to be placed in a foster home in an unrestricted setting." Two weeks later, President Reagan had an opportunity to reassure the nation. Draft briefing materials for a major press conference advised the President to say that "as far as our best scientists have been able to determine, AIDS virus is not transmitted through casual or routine contact." Yet in his role as Associate Counsel to President Reagan, Mr. Roberts recommended striking this statement from the President's briefing. Claiming that AIDS transmission through casual contact was a "disputed scientific issue," Mr. Roberts wrote that "we should assume that AIDS can be transmitted through casual or routine contact." Five days later, when asked whether it was safe for children with AIDS to go to school, President Reagan did not cite the nation's leading public health officials. He instead stated, "I can understand both sides of it." The President's failure to speak clearly about scientific understanding of AIDS transmission is now widely understood to have stoked the hysteria about AIDS and the social stigma suffered by children with AIDS. I urge you to question Judge Roberts about his actions in this case. How he answers will shed needed light not only on the past, but also on Judge Roberts's future approach to using scientific evidence in the formulation of law and policy. LANTOS, CALIFORNIA ONE HUNDRED NINTH CONGRESS PLOWENES, NEWYORK EDOLPHUS TOWNS, NEW YORK rary McrUGH, NEWYORK Cc 3 f (5 I it dv St t S PAUL E. KANJORSKi, PENNSYLVANIA ONC MCR ROADS ongress ol tye Canite ate CAROLYN B; MALONEY, NEW YORK GIL. GUTKNECHT, MINNESOTA C.A, DUTCH RUPPERSBERGER, HUSETTS Senator Arlen Specter Senator Patrick Leahy
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September 1, 2005 Background In the summer and fall of 1985, the nation was swept up in a tide of hysteria about th presence of children with AIDS in public schools. Parents and school authorities worried th AIDS might be transmitted through casual contact among children and widespread panic ha begun to set in. That summer, an Indiana school had barred 13-year-old Ryan White, a hemophiliac with AIDS, from returning to school.' Protesters organized mass boycotts of N York schools that had decided to allow children with AIDS to attend." It was a time of grea and confusion. At the same time, however, scientific evidence had emerged to demonstrate that the of transmission from casual contact was certainly remote and very likely nonexistent. Basec this evidence, public health experts drew up comprehensive guidelines on the issue of AIDS children in schools. The goal of the effort was to counter the prevailing hysteria with the fa actual risk. On August 30, 1985, the Centers for Disease Control and Prevention (CDC) issued t first public health recommendations for children with AIDS.' The recommendations began reviewing available evidence to date. According to CDC, not a single case of AIDS in the United States was known to have been transmitted in "school, day care, or foster-care settin; through other casual person-to-person contact." The agency also pointed out that not a sing! one of the family members of over 12,000 AIDS patients had been reported to have AIDS. / agency concluded that "casual person-to-person contact as would occur among schoolchildr appears to pose no risk." CDC recommended that most children with AIDS "should be allo to attend school and after-school day-care and to be placed in a foster home in an unrestricte setting." In drafting and publicizing the guidelines, leading public health experts attempted to parents' fears by raising public awareness of overwhelming scientific evidence that AIDS cx not be transmitted through casual contact. Director of the National Institute for Allergy and Infectious Disease Dr. Anthony Fauci stated, ""There's no evidence the virus is spread by ca: contact, by saliva, by coughing, by any of the normal contact children might have in the ' 4IDS Victim Kept From School in Indiana, New York Times (Aug. 1, 1985). ? The New Untouchables; Anxiety over AIDS is Verging on Hysteria in Some Parts 0 Country, Time (Sept. 23, 1985). 3 Centers for Disease Control and Prevention. Current Trends Education and Foster Senator Arlen Specter Senator Patrick Leahy
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September 1, 2005 classroom setting." CDC director Dr. James Mason described the risk of getting AIDS fror another child in schools as akin to the risk of "being struck by lightning when you walk out: front door in the morning" and "much less than the chance of the boiler that heats the build blowing up."* He stated that AIDS was causing an "epidemic of fear" that was "entirely unnecessary." Inside the White House In the midst of a battle to counter ignorance and panic with science and reason, Presi Reagan held a press conference on September 17, 1985. It was a critical moment. Even tho more than four years had passed since the first cases had been reported, it would be the first that the President had discussed AIDS in public. In preparing for this appearance, the White House staff debated what the President should say about the transmission of AIDS. Draft briefing materials provided to the White House counsel's office advised that tl President clearly explain the views of leading scientific experts. He was to say, "as far as ov best scientists have been able to determine, AIDS virus is not transmitted through casual or routine contact."" Yet in a memo dated September 13, 1985, John G. Roberts, who was then Associate Counsel to the President, advised a completely different approach. In an internal memo, Mr Roberts recommended deleting any reference to the best scientific evidence. He gave severz reasons. First, Mr. Roberts argued that the President should not provide information to the pul on a technical point. He wrote that the President "thas no way of knowing the underlying val of the scientific 'conclusion,' which has been attacked by numerous commentators.'"* No citations were provided. Second, he expressed concern that relating the views of the country's top scientists c embarrass the president if the state of scientific evidence changed. * 4s schools opened across the nation this month, the spectre of young AIDS' victims attending classes with healthy children has created an epidemic of fear..., United Press International (Sept. 15, 1985). > U.S. Counters Public Fears of AIDS, New York Times (Sept. 15, 1985). ° Id. 7 John G. Roberts, Deborah K. Owen, Memorandum for Fred F. Fielding, Domestic ee, ements eet.Bn et ae gee et ee Senator Arlen Specter Senator Patrick Leahy
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September 1, 2005 Third, he endorsed the scientific idea that "we should assume AIDS can be transmitte through casual or routine contact, as is true with many viruses." He stated that the assumptic that AIDS can be transmitted through casual contact could be overcome only when "it is demonstrated that it cannot be." At the same press conference, the President provided technical information to the put on the impact of tax reform and trade policy. But Mr. Roberts apparently did not object to tl use of these data on the ground that the President was not an expert. Mr. Roberts provided no scientific support for his assumption that AIDS can be transmitted through casual contact. Moreover, his standard for dislodging that assumption w require scientists to conclude otherwise with absolute certainty, a standard that is not applied elsewhere in medicine or public health. Sadly, President Reagan followed Mr. Roberts's advice. At the news conference on
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September 1, 2005 asked to explain why he blocked President Reagan from referring to the views of our nation leading scientific experts, why he substituted his own uninformed scientific judgment for th and whether he regrets contributing to a climate of unsubstantiated fear. Judge Roberts also should be asked to explain his actions in the context of how he v the appropriate role of scientific evidence in the formation of law and policy. One importar question is whether he would now defer to the medical judgment of public health officials, ; failed to do in 1985. This issue came before the Supreme Court in Schoo! Board of Nassau County v. Arline, 480 US. 273 (1987), which involved a school teacher with tuberculosis w had been fired from her job. In that case, the Court held: In the context of the employment of a person handicapped with a contagious disease agree with the amicus American Medical Association that this inquiry should includ "findings of facts, based on reasonable medical judgments given the state of medical knowledge about the nature of the risk (how the disease is transmitted) ... and the probabilities the disease will be transmitted ...." In making these findings, courts normally should defer to the reasonable medical judgment of public health officials. Similarly, the case of Bragdon v, Abbott, 524 U.S. 624 (1998), involved a patient wi HIV whose dentist had refused to treat her. In that case, the court stated: In assessing the reasonableness of [the dentist's] actions, the views of public health authorities, such as the U.S. Public Health Service, CDC, and the National Institutes Health, are of special weight and authority.'* Another important question relates to the role of scientific certainty in regulatory anc judicial decision-making. In 1985, Mr. Roberts appeared unwilling to take any position on| transmission in the absence of complete scientific certainty. He applied a standard that requ scientists to prove a negative, a requirement that can be impossible to satisfy. But the Supreme Court must make decisions in the absence of total scientific certain For example, in the recent case of Roper v. Simmons, (125 S.Ct. 1183), the Court held the d penalty to be unconstitutional when applied to those who commit crimes under the age of 18 reaching this conclusion, the Court relied on an array of studies and expert opinions that "tend[ed] to confirm" the limited maturity and sense of responsibility of juveniles under 18. 2 4rline, 480 U.S. 273, 288 (1987). Emphasis added. '° Abbott, 524 U.S. 624, 650 (1998). The Court continued: "The views of these organizations are not conclusive, however. A health care professional who disagrees with tl prevailing medical consensus may refute it by citing a credible scientific basis for deviating the accepted norm." /d. The Court then found that there should be a remand to allow this k 2. PR Sig ae x < bee. Senator Arlen Specter Senator Patrick Leahy