U.S. Department of Health and Human Services.  HHS.gov  Secretary Mike Leavitt's Blog

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March 2008

Honduras Cantaloupe

FDA recently placed an Import Alert on cantaloupe coming into the United    States from Agropecuaria Montelibano, a  major Honduran grower and packer. This action was taken after the Centers for  Disease Control and Prevention (CDC) determined fruit from the company was  associated with outbreaks of Salmonella Litchfield in 16 states. 

Watching these things unfold is fascinating. Each situation is like a mystery being solved by investigators at FDA and CDC. The investigators are often referred to as disease detectives because their techniques are a blend of scientific skill and detective shoe leather. 

The investigators piece together extensive interviews with affected people until they can find a common thread tying them together. When there are cases across 16 states that can be difficult. Once they find what is  causing it, they have to track the product back through an intricate system of  distributors, import brokers and suppliers. When the product comes from outside the United States, it is even more complicated.

An Import Alert has cascading consequences. Not only does it  affect consumers, but it immediately changes the livelihood of thousands of farm workers, processors and shippers and in many cases the viability of  companies and the way an entire nation’s products are perceived. As a result we  have to take these things very seriously. 

The cantaloupe problem is complicated further by the fact that Honduras  is in the middle of their season. There is fruit in process and still on the  vine. 

I spoke twice with Honduran President Manuel Zelaya Rosales who asked that I meet with his Agriculture, Health and Commerce Ministers the  next day in Washington.  Of course, I agreed. The envoys flew all night; their plane touched down at 5:30 a.m. for an 8:30 a.m. meeting with me and FDA Commissioner Andy Von  Eschenbach.   

The three Ministers were most cooperative and understanding  of the situation. They pledged their full cooperation, asking only that we move  with all speed to find the solutions. Knowing what is at stake both in terms of human health, economics and our friendship with Honduras, I committed we would  have a team on the ground by the next day.   

The next morning a team of people from FDA and CDC left for Honduras.  As I write this over the weekend they are in the fields where we suspect the contaminated fruit originated.  We agreed at the meetings  with the Ministers that our team would work side by side with their  regulators to get at the bottom of this as quickly as possible. We have put FDA labs on notice that we want to make this a priority. Hopefully, we can get to the bottom of this quickly and help the producing company remedy any problem.

Social Security Trustee Meetings

I wrote yesterday in anticipation of going to the Spring Trustee meeting of the Social Security System. I promised a little more commentary today, after the meeting.

We met in the Secretary of Treasury’s conference room. The meeting did not include the public trustees, because the appointments expired and none have been confirmed yet.

Once again, we listened to reports from the actuaries and administrators of the Social Security Trust Funds. I will link to the materials that were released.

The bottom line is that the system is not sustainable and has the potential to become an increasingly large (prosperity altering) problem for our country. The Medicare Trust Fund is broke in the first few weeks of 2019. That is almost a year sooner than last year’s forecast.

I will confess to frustration over the fact that the repeated warnings and Trustee reports seem to have no impact on Congress. I agree with so many others who have said this is the biggest long term threat to our national prosperity. I am disappointed entitlement solvency has not become a matter of discussion in the Presidential campaign.

I decided while sitting at the table that I want my strongest and clearest expressions of concern to be recorded for history. I formally asked the Chairman to leave the record of the meeting open so I can prepare a piece containing my thoughts and recommendations. It will take a couple of months to complete, but I’ll put it on my blog upon sending it to the Secretary of Treasury as part of the record of the meeting.

Aging

While serving in the President’s Cabinet, I reside in Washington D.C. area. However, I still consider Utah my home, and we gathered there over the weekend for a wedding celebration.

Before returning to D.C., my wife and I attended church at the congregation where we have attended since our late twenties. We have attended there for more than twenty five years.

As you might imagine, in the four years we have been gone, there are lots of new people. The place was bustling with new families. However, it was a chance to greet a number of people I haven’t seen for a while, including a charming collection of people who are now in their eighties and nineties whose lives are affected, nearly every day, by the programs of HHS.

One of them is Lowell, whom I met nearly 30 years ago just after he retired as a high school music teacher. He is now 94 years old and still hauls his vibraphone (electric xylophone) around in the back of his pick-up truck so he can play for audiences at senior centers and nursing homes. He told me he always asks his audience, “anybody here older than me?” There are fewer and fewer who can answer yes. Lowell still plays the piano in church and routinely jazzes the hymns with a little spontaneous riff that makes even the most somber worshipper grin.

Another favorite of mine is Lee, a retired business man who went to the office until just a few years ago. He just turned 95. He and his wife lived in our neighborhood for more than 65 years. Once he told me he paid $6,500 for his charming little cul-de-sac home. That was another era. His wife is gone now and I sense things are hard. I said, “Lee, it’s good to see you.” He smiled and said, “Well, I can’t see who you are; my eyes are about gone.” Later, he told me he has a machine that allows him to magnify the newspaper and mail so he can see it on his television. He called it “a life saver.”

There is a wonderful couple who live right across the street from us. He was a respected high school counselor and community leader until he retired. I don’t recall her career, but in post retirement they did missionary work in Mongolia and then volunteer work for many years. They are now walking the lonely and hard path of Alzheimer’s disease. She is the heroic caregiver along with a daughter. He still smiles at me, but I know our friendship is stored in a part of his brain that is no longer accessible. He relies on others to guide his steps. What great people; what a devastating disease.

It was good to see Renee and LoVinia sitting together; they often do. Both lost their husbands many years ago. Lovenia is a stylish woman and a long time teacher, similar in age to Renee. I won’t speculate on their exact age but I will confide that Renee complained to me that the Senior Games she enters each year no longer has a tennis bracket for her, and she has to play with the younger 85 year-old’s group.

Renee said, “but I still win.”

I appreciate that we live in a nation committed to see that people who struggle with the ravages and riggers of age have the health care they need. They have spent their lives contributing and now deserve to be treated in respectful and dignified ways.

As I talked with my friends, it occurred to me that when I first got to know each of them, they were in their sixties or seventies. Twenty five years passed so quickly.

During those years, things have changed for my wife and me too. Twenty five years ago our children were toddlers. Now they are adults with children of their own. In a similar amount of time, I’ll be dealing with the difficulties of age that challenge my friends and my children’s generation will be running Medicare.

What will Medicare be like then? Can my generation count on it to be there for us?

Today I will be attending a meeting of the Medicare Trust Fund. Reading the briefing papers causes me to worry. When the meeting is over, I’ll write more of my thoughts.

Pandemic Exercise with Bloggers

We routinely hold readiness exercises at HHS on various emergency scenarios. Typically, people from various parts of the emergency management community sit around a square table, and a moderator paints a picture of a disaster unfolding. It is like a reader’s theater. As events are described, each actor assumes their part, describing what they are thinking and doing to respond.

Slowly, the moderator heightens the stakes and intensifies the nature of the problems, throwing out more complicated circumstances, and challenging the reasoning various players use. It is an excellent way to learn and refine emergency protocols.

Monday, we had another exercise on pandemic influenza. Included in the exercise was a group of journalists, including bloggers. Not amateur bloggers like me. Real pros, people who have built reputations with their readers for innovation and speed.

We invite journalists to participate in our exercises because managing their needs for information is a part of crisis management. We need to learn more about how bloggers would react and interact.

Television reporter Forrest Sawyer was the moderator. He has done several of our exercises and he’s very good. He laid out a set of facts that represent routine health news from around the world and laced it with a few interesting tidbits that could attract the interest of people following the flu world.

Turning to public health officials at the table, Mr. Sawyer asked if they found any of the news that day interesting or concerning. He did the same with the journalists, asking what they would do to get more information and how big a story they thought it was. As the facts became more concerning, several observations came to me.

I found it reassuring how important accuracy was to those that attended our session. They were willing to report rumors but made a point of distinguishing them as such. Many of them said they had separate sections of the page for rumors.

The blogs represented at our session tended to be rather specialized and the bloggers knew a lot about the subject matter. It made them better at challenging the facts they were given. I suspect in a major emergency we would be dealing with a broader range of understanding than in our exercise. These people knew their stuff.

I was surprised how much interaction there is between online communities. They seem to share information, monitoring one another’s sites.

More than one of the blogs talked about the way they use traditional news sources but provide added value. One example is translating foreign news articles into English.

I enjoyed watching the interaction between traditional media and blogs. It’s clear television, major radio and newspapers are monitoring blogs all the time. It is also evident most of them are starting to use blogs to supplement their own reporting. The unlimited supply of space and time is appealing to traditional journalists.

The exercise went most of the day. I was only able to stay until noon, but it was a morning full of learning.

The bottom line for me: Government needs to understand the blog world better, and factor it into the way we interact with people. A growing part of the world relies on bloggers for unvarnished information; something they are not sure they always get from us in government.