Planning in a chaotic, dynamic and uncertain environment with incomplete information.

From Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It by Gina Kolata.  Page 163.   

Planning in a chaotic, dynamic and uncertain environment with incomplete information.  Sometimes the best course of action is to let nature take its course.  And sometimes it is not.  And no one knows in advance which will be which.  

At an American Legion convention in a Philadelphia hotel a group of people fell ill and twenty-six died of a mysterious disease. It seemed to be a respiratory disease. It looked, in fact, like the flu, and some doctors said publicly that the men might have died from swine flu. For four days, while television stations showed funerals of the Legionnaires and the new disease made headlines, it seemed that the predicted flu epidemic had begun.

On August 5, the Centers for Disease Control completed its laboratory studies of the disease. Whatever was sickening these men, the data showed, it was not swine flu. (Later, the culprit turned out be a hitherto unknown bacterium that had gotten into the hotel’s air-conditioning system and was pumped throughout the building.) But even though Legionnaires’ disease, as the illness became known, was not swine flu, the message was not lost on Congress: if it had been swine flu instead, the criticisms of Congress would have been withering and the ensuing panic impossible to counter with arguments about liability insurance. If it turned out that the American people were denied a vaccine because Congress refused to give legal protection to the vaccine makers, it could be a political nightmare. So Congress acted quickly, passing a “tort claims bill” that required that any claims arising from the swine flu vaccine be filed against the federal government. The bill, which came before the Senate on August 10, was rushed through without hearings or a committee report. The next day, it went to the House of Representatives, where it passed even though many members had not seen the legislation.

Senator Harrison A. Williams, Jr., of New Jersey, said that the law broke new ground. “This is pioneering, in a sense,” he said. But, he added, “it is in response to an emergency.”

In the House of Representatives, Paul G. Rogers of Florida urged Congress to step in to help the vaccine makers. The federal government, he explained, has “asked the drug companies to produce this vaccine. We have told them how to do it. We have told them the dosage we want, what strength. We gave them the specifications because we are the only buyers, the Government of the United States. This is not the usual process of going out and selling.” But “if someone is hurt, we think people ought to have a remedy.”

On August 12, President Ford signed a bill into law committing the federal government to insuring the swine flu vaccine makers against claims that their product injured people.

A Gallup poll taken on August 31 found that 95 percent of Americans had heard of the swine flu vaccination program and that 53 percent planned to take part. Although officials at the Centers for Disease Control were disappointed—they were aiming for 95 percent participation—the poll nonetheless showed that the message had gotten through. An ominous flu could be on its way, a repeat of 1918’s epidemic, and the government was going to sponsor an unprecedented immunization program to protect Americans.

The first Americans were immunized on October 1. Ten days later, the first deaths occurred.