The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight, our summary of the news; then, we get the word on opening day of early voting in Florida from Ray Suarez; our own debate over the terrorism debate in the presidential campaign; the latest on the flu vaccine shortage; and an update of the U.S. Army reservists' refusal to go on a convoy in Iraq.

NEWS SUMMARY

JIM LEHRER: The race for the White House went into the final two weeks today. President Bush and Sen. Kerry focused on Iraq, terror, and Social Security as they campaigned in critical states. Kwame Holman has our report.

KWAME HOLMAN: Sen. Kerry spent the day in Florida. This afternoon in Fort Myers, he criticized the administration's Iraq policy, citing a report in today's Washington Post that said a top U.S. General in Iraq had complained he didn't have enough supplies on the ground to fight the insurgents.

SEN. JOHN KERRY: Lieutenant Gen. Ricardo Sanchez argued last winter that without increased supplies, "I cannot continue to support sustained combat operations." The day after Gen. Sanchez wrote his letter, George Bush went out and told the American people our troops were properly equipped. Despite the president's arrogant boasting that he has done everything right in Iraq and that he's made no mistakes, the truth is beginning to catch up with him.

KWAME HOLMAN: Earlier in West Palm Beach, Sen. Kerry used another newspaper report to attack the president onSocial Security. Yesterday's New York Times Magazine quoted an anonymous source as saying Mr. Bush had told a group of wealthy supporters that he would "come out strong" for the "privatizing of Social Security" in a second term. Sen. Kerry called that the president's "January surprise."

SEN. JOHN KERRY: Americans have a right to count on the money they've got coming to them, and I will never privatize Social Security, I will never lower the benefits, and I will never raise the retirement age.

KWAME HOLMAN: In an interview aboard Air Force One this morning, President Bush accused his rival of "shameless scare tactics," saying "he's trying to scare our seniors." The president's first campaign appearance of the day was in Marlton, New Jersey, where he focused on the war on terror, but also took on Sen. Kerry's stance on the war in Iraq.

PRESIDENT GEORGE W. BUSH: He refuses to acknowledge progress or praise the growing democratic spirit in Iraq. He has not made democracy a priority of his foreign policy. But what is his strategy, his vision, his answer? Is he content to watch and wait as anger and resentment grow for more decades in the Middle East, feeding more terrorism, until radicals without conscience gain the weapons to kill without limit? Giving up the fight might seem easier in the short run, but we learned on Sept. 11 that if violence and fanaticism are not opposed at their source, they will find us where we live.

KWAME HOLMAN: Tomorrow Sen. Kerry heads to the battleground states of Pennsylvania and Ohio, while President Bush visits Florida.

JIM LEHRER: Voters in Florida began casting ballots today, 15 days before Election Day. It's one of the changes introduced after the long recount there four years ago. A number of other states also offer early voting. We'll have more on this story right after this News Summary. In Iraq, more than 20 people died in a series of attacks over the weekend. All were Iraqis. Car bombings in Baghdad and Mosul killed 11, and wounded nearly 50. And an ambush south of Baghdad killed nine Iraqi policemen. Two American soldiers were killed on Saturday when their helicopters crashed. That puts the overall U.S. death toll at 1,100. According to the Associated Press, a total of 1,097 U.S. troops have died since the war began. Three American civilians also have been killed. U.S. air and ground forces hit key targets in Fallujah over the weekend. Talks to return the city to government control broke down last week. But Iraqi Prime Minister Allawi said today there's still time for a peaceful solution. The government has demanded the city turn over terror suspect Abu Musab al-Zarqawi. Local leaders insist he's not in Fallujah. The U.S. Military said today it has not decided whether to discipline 18 army reservists. They refused a supply mission last week. They said their convoy lacked proper armor and had no armed escort. Relatives say the soldiers were threatened with being discharged. We'll have more on this story later in the program. An Anglican Church Commission urged the U.S. Episcopal Church to apologize today for naming a gay bishop. Episcopalians are a branch of the worldwide Anglican Communion. Last November, Episcopal leaders consecrated an openly gay cleric, Gene Robinson, as bishop of New Hampshire. Today the Anglican Commission sharply criticized that act in a new report. It said those who took part should withdraw from their duties until they apologize. In London, commission leaders and their critics addressed the apology issue.

ARCHBISHOP ROBIN EAMES: We invite offending provinces anddie since first of all to issue an expression of regret to the actions they have taken which have breeched the bonds of affection and communion.

REVEREND COLIN COWARD: From my point of view, I don't think there is anything to apologize for. The church has always ordained gay priest and bishops. It's simply now being more honest and open about it, and that's a very good thing.

JIM LEHRER: The commission also called for creating an "Anglican Covenant" to unify beliefs across the globe, and it urged conservative bishops around the world not to help disaffected Episcopalians leave the church. The U.S. Supreme Court today ordered a lower court to reconsider a congressional redistricting plan in Texas. Republicans pushed the new map through the state legislature last year. It could give the party up to six more seats in the U.S. House. Today's ruling will not affect next month's election. The U.S. Secretary of Health and Human Services urged seniors today to stop standing in long lines for flu shots. In Tampa, Florida, Tommy Thompson said, "We want people to relax. The flu season is not here." Thompson said there will be enough vaccine for most people who need it. We'll have more on this story later in the program. On Wall Street today, the Dow Jones Industrial Average gained nearly 23 points, to close at 9956. The NASDAQ rose 25 points, to close at 1936. That's it for the News Summary tonight. Now it's on to the early birds of Florida; the terrorism issue; the flu vaccine crisis; and refusing to obey an order in Iraq.

FOCUS - VOTING EARLY

JIM LEHRER: Early voting: Florida, the center of the electoral storm four years ago, is one of 26 states that now allow voters to vote early without having to give any special reasons. Sen. Kerry campaigned in Florida today. President Bush will be there tomorrow. We get an update from Ray Suarez. He's in Jacksonville tonight.

And good evening, sir.

RAY SUAREZ: Hi, Jim. Jim

JIM LEHRER: Ray, an overview. How did things go in general today?

RAY SUAREZ: When they opened the door at 8:00 A.M. At the supervisor of election office in Duval County, which includes Jacksonville, Florida, there was already a long line waiting at the doors and heading down the sidewalk waiting to get in there and vote when the polling places opened. They had two kinds of voting open this morning. You could vote with the new touch screen machines that are being used in Florida or use a paper ballot that has filled in ovals that get scanned if you took standardized tests in school during the '60s and '70s, this will be familiar to you; fill in the little boxes for the candidates you choose, this will be familiar for you. It seemed to be going smoothly and both the Republicans and the Democrats have original needs heavily around early voting here.

JIM LEHRER: The voting is the same kind, mechanically it's the same that will be in effect on Election Day? You go to your local polling place or are there central places? Are there fewer places in each county to go?

RAY SUAREZ: Many, many fewer places. Each county of Florida's 67 counties has a few designated early voting sites. Here in the county that includes Jacksonville, Duval County, it's one of the largest counties in the state of Florida and controversially only opened one early voting site today.

JIM LEHRER: Now, unlike absentee voting, you can just show up, if you're a registered voter, you can show up, right? You don't have to have an affidavit or have to have any excuse or reason for voting early, is that right?

RAY SUAREZ: Exactly. This was introduced, according to supervisors of election, for the convenience of the voter, and it smoothes out the demand for places in the polling places. In effect, Election Day is 15 days in the state of Florida. It's election season rather than just one day.

JIM LEHRER: What's the point of this, Ray? Why did they do this?

RAY SUAREZ: Well, one thing is that there are hundreds of thousands of more registered voters in the state of Florida and in counties like Miami Dade, there are fewer polling places, so this will shorten the lines, lighten the crush that's expected to show up at the polling places in Florida on Election Day. It gladdens the hearts of both Republicans and Democrats who have organized very heavily around this, so they haven't opposed what the election authorities have introduced. They're using it as what they call "banking the vote." They put their first emphasis on absentee voting to get out their most loyal voters and get those votes in the pipeline. Then they put their second line of emphasis on early voting, using the machinery that we're all familiar with, carpools and phone banks for over the period of two weeks, then finally they'll put their Election-Day strategy into effect on Nov. 2.

JIM LEHRER: Essentially, this gives them a two-week election-day strategy, does it not? They can track, Sammy Sue has not voted, Billy Bob has, up over next two weeks, correct?

RAY SUAREZ: Absolutely. They can get partial counts and know not who has voted necessarily but know how many people have voted and get a rough idea of how much of their vote they're pulling out in advance of Election Day. Then you can use targeted phone banking, check in with people, see if they've early voted, check in with people you know who have applied for absentee ballots and checked they've mailed them in and keep that emphasis on all the way up until Election Day so you can more particularly target your Election Day get out the vote strategy because you've already known how much of your vote you have gotten out.

JIM LEHRER: Is there any informed speculation thus far, Ray, as to what percentage of the electorate will take advantage of this early voting?

RAY SUAREZ: Well, they're really not sure. This is the first time that early voting has been available for a national election. They've used them before in Florida for statewide races. So everybody's watching very closely to see how many people come out. The election supervisor in Hillsboro County, which includes Tampa as its largest city, is predicting a 70 percent turnout for his county, which is far in excess of what has turned out nationally in recent presidential elections. So given the attention on 2000, the controversy surrounding the 36-day count, supervisors of election in the counties across the state are expecting very, very heavy turn out, thus much heavier demand for early voting.

JIM LEHRER: That's part of the 70 percent, in other words, they think the early voting will help contribute to this high turnout, correct?

RAY SUAREZ: Absolutely.

JIM LEHRER: And the problems of four years ago, this was also designed to alleviate those or the eliminate those, correct?

RAY SUAREZ: Well, they are still wrestling with some of the problems that they had, but I interviewed the secretary of state, the chief elections officer of the state of Florida earlier today, Glenda Hood, and she says pretty much everything is in place that they could put in place to protect the vote, ensure that people can vote. They've put in new procedures so that one of the big problems that occurred in 2,000, people showing up and not finding their names on the roll and then casting provisional ballots only to have them not counted, only to have them thrown out, that won't happen this time. They've got a system in place where those votes will be adjudicated and then if they're found to be from valid voters counted.

JIM LEHRER: Okay. Well, you're going to be doing some more reporting from there between now and Election Day. We'll look forward to that. Ray, thank you very much.

RAY SUAREZ: Good to talk to you.

FOCUS - FIGHTING TERROR

JIM LEHRER: Now, also about the presidential campaign, the fighting terrorism issue, and to Gwen Ifill.

GWEN IFILL: Few issues provide as stark a contrast between President Bush and Sen. Kerry than how government should cope with terrorism. For President Bush, it is a war on terror, an open-ended and necessary call for constant awareness and preemptive action, where needed, to protect Americans in a dangerous world. Both men addressed the issue while campaigning today. President Bush was in New Jersey.

PRESIDENT GEORGE W. BUSH: My opponent has a fundamental misunderstanding of the war on terror.

GROUP: Yeah!

PRESIDENT GEORGE W. BUSH: He has said this war is primarily an intelligence and law enforcement operation. (Audience boos) He has declared we should not respond to threats until they are "imminent." He says that preemptive action is unwise, not only against regimes but even against terrorist organizations. Sen. Kerry's approach would permit a response only after America is hit. This kind of Sept. 10 attitude is no way to protect our country. (Applause)

GWEN IFILL: Sen. Kerry argues that the president has taken his eye off the ball in the war on terror, pursuing a misguided war in Iraq instead of tracking down Osama bin Laden. He spoke in Florida.

SEN. JOHN KERRY: As president, I will never take my eye off the real enemy: Osama bin Laden, al-Qaida and other terrorists that threaten America and our allies. America, I will fight a smarter, more effective, tougher war on terror. We will hunt down and capture and kill the terrorists, no matter where they are. But we will conduct the critical diplomacy this administration has failed to do. We will bring allies to our side, because that's how you make America strongest. And let me make this crystal clear: Just because President Bush couldn't do it, doesn't mean it can't be done. It can be done. (Applause)

GWEN IFILL: The dispute between the two major candidates has spilled into all areas of the campaign. On the airwaves, both campaigns have released new ads this week, pointing up the other's perceived shortcomings.

AD SPOKESPERSON: In Iraq, American troops are attacked 87 times a day. At home, the Bush administration has acquired just 530 doses of licensed anthrax vaccine for America's civilian population. In Afghanistan, the Bush administration relied on Afghan warlords to go after Osama bin Laden. He got away. Bush said, "I don't spend that much time on him, I truly am not that concerned about him." It's time for a new direction.

AD SPOKESMAN (Bush Campaign Ad): After Sept. 11, our world changed. Either we fight terrorists abroad or face them here. John Kerry and liberals in Congress have a different view. They opposed Reagan as he won the Cold War, voted against the first Gulf War, voted to slash intelligence after the first Trade Center attack, repeatedly opposed weapons vital to winning the war on terror. John Kerry and his liberal allies: Are they a risk we can afford to take today?

GWEN IFILL: In last week's New York Times, Sen. Kerry was quoted as saying terrorists should not be the "focus of our lives," but a "nuisance." "It's something that you continue to fight," he said, "but it's not threatening the fabric of your life." President Bush said Sen. Kerry's words proved he would be weak on terrorism.

PRESIDENT GEORGE W. BUSH: See, I couldn't disagree more. Our goal is not to reduce terror to some acceptable level of "nuisance."

GWEN IFILL: The debate over terror was a recurring theme in each of the three presidential debates. And with states like New Jersey-- where nearly 700 residents died in the 9/11 attacks-- suddenly in play, it is a debate that could tip the electoral balance as well.

GWEN IFILL: So whose approach can best stem the tide of terrorism? For that we're joined by Morton Halperin, who's held various Pentagon and State Department posts, his last being director of policy planning at the State Department under President Clinton; and Kiron Skinner, assistant professor of history and political science at Carnegie Mellon University in Pittsburgh. She also sits on the Defense Policy Board, which advises the secretary of defense.

Kiron Skinner, could you describe for us in general President Bush's vision for his war on terror?

KIRON SKINNER: His vision actually I think, first of all to, answer that we have to start with what is his big objective in the international system. And he's said it in the 2000 campaign, actually in his inaugural address quite clearly, and that is to spread freedom and democracy around the world. I think he's extremely contiene in that way. He believes fundamentally that if you increase the zone of free states in the world that there will be less war, that there will be more peace and stability. Now, to get to that, the tools and the strategy that he has put forth, after 9/11 in particular, is that first he sees the global war on terror as a fundamental challenge, the way that communism was during the 20th century, the way that fascism was during World War II. He sees a global threat. And I think he's different from Kerry on that. To this end, he has spent a lot of time, this administration, under Bush, focusing on both the non-military and military side of getting to peace and freedom. We have focused on Iraq and the problems on the ground in the after-war aftermath actually, and we've talked about the insurgency and so forth, but what we've not spent much time talking about is the non-military dimension of getting to this global war that he sees, which is a multi-front, not just Afghanistan but Iraq and other places; that includes fighting the forces of despair, HIV, AIDS, unemployment, lack of education and opportunity through the millennium challenge account and so forth.

GWEN IFILL: Okay. I just want to -

KIRON SKINNER: So I think he sees a great challenge.

GWEN IFILL: Okay. I want to bring Mr. Halperin in for the alternative vision. Is there an alternative?

MORTON HALPERIN: Well, I think that President Bush has really tried to have it both ways in explaining his position and Sen. Kerry's position. He says, as you heard the ads, that everything changed after Sept. 11, and that's because he doesn't want to be criticized for his failure to act effectively against terrorism during his first nine months in office. Then he turns around and all of his criticisms of Sen. Kerry are for things that happened before Sept. 11. Now, a lot of them are exaggerated. A lot of them are wrong. But the main point is that either the president should be willing to have a debate about what he did before Sept. 11 and then we could argue about what Sen. Kerry's positions were then, or to say, as he wants to, that the world changed on Sept. 11, and then the question is, what is the difference between what Bush did after Sept. 11 and what Kerry would do. And they both see this as a worldwide threat. They both believe that it involves military elements and non-military elements. They both believe, contrary to what the president has said, that you don't sit and wait for attack, you go after it. The fundamental difference is that the president did not understand that it was not Iraq that attacked us, it was bin Laden, and that the point was to defeat him in Afghanistan and not to quickly move on our military four Iraq where there was no immediate threat to the United States. Now that we've gone into Iraq, I think everyone, including Sen. Kerry, agrees that we have a to win that war because it was started, but the question was: was this the right place to go?

GWEN IFILL: Well, that's the question I want to direct to Ms. Skinner. The president spoke today in his speech about opposing violence and fanaticism at its source, and that if we don't win the victory in the war on terror, he said requires victory in Iraq. Why is that? What is the reasoning behind that?

KIRON SKINNER: I think that that's an excellent question. I'll answer that. Then I want to come back to something that Mort said. Victory in Iraq, and this has been such a difficult issue in a campaign season to really talk about in any kind of rational way, but the campaign against Iraq was really specific, and this administration's understanding of a multi-front conflict; it's always said that it's not just Afghanistan and it's not just those that attacked us on 9/11, that this is a broader conflict that has many fronts and that Iraq was important because Saddam Hussein was unique among dictators. He'd used WMD, and let us not forget this, on his own people, on his neighbors. He had... he was, in fact, in a state of war with the world. He had violated more than a dozen of U.N. resolutions, in effect violating the ceasefire agreement, ending the Gulf War. He was in violation of international law. The U.S. reentered, in fact, what was a conflict that he himself had started. So I think that you have got to look clearly at the Iraq case, and what has been said about it, we have just ignored Iraq's role. There's kind of an amnesia going on. Now, onto this point about what the Bush administration had done before Sept. 11, I asked you to look back at the 9/11 Commission report that was recently published. Nowhere does it state that the Bush administration is responsible for 9/11, that it made such missteps that it made 9/11 happen. This is an entity that spent a lot of time studying very closely in a powerful narrative how 9/11 happened. So I don't think the issue...

GWEN IFILL: Let me just interrupt because I want to ask Mr. Halperin if that is what he was actually saying.

MORTON HALPERIN: No. What I was saying is that -- the question of whether we did all the things we might have done before 9/11, and I think one can argue that even if we did everything we should have done, that it still might have happened, but my point is that the president is criticizing Sen. Kerry for what Sen. Kerry did before 9/11 while he wants us not to criticize his own behavior before 9/11, and he can't have it both ways.

GWEN IFILL: If you'll just let him finish, come back to you. I promise. Finish.

MORTON HALPERIN: I want to get to the question of Iraq, because everything that was just said about Iraq is true. It was in violation of its U.N. commitments and it needed to be confronted, but it was not part of the terrorist attacks on the United States. It was a separate problem, just as Iran is a separate probability and North Korea is a separate problem. And, as Secretary Powell pointed out, before the administration decided to go to war in Iraq, Iraq was contained. And the reports that we now have after the war show that, in fact, it was contained. Yes, it was hoping to end the sanctions, and if it ended the sanctions, it might have gone to try to develop weapons of mass destruction, but if an effective diplomacy would have not ended the sanction, would have done what Secretary Powell was trying to do, which was to strengthen the sanction, to make them more effective so that we continue to contain Iraq and could focus our main energy on dealing with the terrorist threat.

GWEN IFILL: Okay. Ms. Skinner.

KIRON SKINNER: Okay. I have a couple responses to that. If you read the testimony, which I think gives another powerful narrative, he says it's not just an issue of containing Saddam Hussein through sanction, that the sanctions were badly eroding and in fact in the abuse of the oil-for-food program, the revenue, that millions of dollars were going into the very military commission that was where WMD had been developed before the sanctions had been imposed and that there was this... it wasn't just an issue of sanctions keeping the pressure on. They were eroding badly. And where the money was going, from oil for food was very troubling toward a weapons program. And he also suggested, if you read his testimony, that if sanctions were, in fact, lifted, Saddam Hussein might be able to extremely...

GWEN IFILL: I'm going to stop you. Wait, wait, wait. I'm going to stop you both because we have gone way off topic. We can talk about Iraq and we can fight the Iraq War; what but I really want to focus here on is what these two candidates have opposing in the war on terror and whether terrorism is going to continue to be a factor in our lives. To that point, Ms. Skinner, and I'll continue with you, what is it that -- when Sen. Kerry talks about the nuisance and when the president talks about this is a war that cannot be won necessarily, how does, what does that tell Americans about the future of this so-called war on terror?

KIRON SKINNER: Thank you so much for bringing us back to that fundamental point. I think the president's vision of how to get to peace and freedom in the world is that we're now in a global conflict, and I think that's where he may be different with Kerry in some fundamental ways, that was as powerful as what we saw in the 20th century with Communism and Fascism. It is multi-front, which means we're going to be in many places. It is not a nuisance; it is something where we can't just stamp it out one day. It's across borders, many countries, it's multifaceted. The objectives of the terrorists and the tools they use will be varied. And I think he sees a very stark challenge to democracy and freedom and the way of life that we've come to see as one holding universal values --

GWEN IFILL: Mr. Halperin, is it a winnable world?

MORTON HALPERIN: It's a total distortion of Sen. Kerry's position. He said the goal was to get to the point where terrorism is only a nuisance, because you carry the war to the terrorists, you defeat them where they're training; you defeat them where they're trying to operate; and you eventually reach the point where they cannot effectively challenge you, and you also have to build democratic institutions and deal with the problems of poverty. There is no fundamental difference between what Sen. Kerry is proposing and what the president is proposing except for Sen. Kerry's view, which I think is clearly correct, that Iraq was a diversion which took us away from the fight. But they both believe that it's a worldwide fight. They both believe it's going to be very hard to win. They both believe you need military and non-military means to fight it. And they both agree that you're never going to have a final victory. The president said this is a war you can't win. Sen. Kerry said the goal is to get to the point where it's a nuisance. And I think it is a total distortion on the president's part to try to suggest that there is a fundamental difference between the two of them about how to fight the war other than whether we should have gone into Iraq in the first place.

GWEN IFILL: Ms. Skinner, is this necessarily an open-ended conflict, this war on terror?

KIRON SKINNER: I think that President Bush sees it as an open-ended conflict that will not eventually or anytime soon get to the point of a nuisance. I think there is a fundamental difference in how they see this war, and I think there is a fundamental difference in how they also put forth a plan. I think Mr. Kerry has spent more time criticizing instead of laying out a grand strategy for the U.S. And I think that Bush has and I think what he has not done, President Bush enough in this campaign, is talk about in detail the grand strategy he has, in fact, put forth, the millennium challenge account. I refer you back to that; also the G-8 Summit in Sea Island, Georgia in June. I thought it was an historic moment when the industrialized nations were engaging the leaders of African nations on the issues of poverty, AIDS, opportunity, lack of education and so forth, that this is part of changing the international system... and make it inhospitable for terrorists.

GWEN IFILL: We have just enough time for Mr. Halperin to have a final word.

MORTON HALPERIN: And I'm sure you're aware that Sen. Kerry, in fact, was pushing the administration before and after Sept. 11 to do a lot more on the AIDS problem in Africa than the president has, in fact, been willing to do. There is a worldwide challenge. I think everybody agrees with that. The fundamental question for the American people is who will make them safer; and I think Sen. Kerry has laid out a plan for both protecting us more effectively at home to protecting chemical plants and the nuclear plants to deal with the loose, fissional material which is in the Soviet Union, and to take the fight to the terrorists where they are and where they were and not to divert our energies to the Iraq invasion.

GWEN IFILL: All right, Morton Halperin and Kiron Skinner, thank you both very much.

MORTON HALPERIN: Thank you.

JIM LEHRER: Still to come on the NewsHour tonight, a flu vaccine update, and disobeying orders in Iraq,

UPDATE - SHOT SHORTAGE

JIM LEHRER: Margaret Warner has our flu story.

MARGARET WARNER: The flu season begins in earnest next month. On an average year, it puts some 200,000 Americans in the hospital, and kills 36,000 of them. When the government announced two weeks ago that only half of the expected 100 million flu vaccine doses would be available, the Centers for Disease control said the vaccines should be reserved for people 65 and older, children six to 23 months old, pregnant women, people with chronic metabolic or kidney disease, blood disorders, or weakened immune systems; and health care workers who deal directly with patients. Since then, people have been lining up for shots at clinics, hospitals, and grocery stores throughout the country. Many leave disappointed. Today Health and Human Services Secretary Tommy Thompson said there should be enough doses to cover the high-risk patients.

TOMMY THOMPSON: We don't want them to stand in line and wait for the vaccine because we still have approximately 20 million plus doses of vaccine that we are getting shipped out about three million doses each particular week. We're looking all over the regions to find out where there's a shortage, and we will redeploy the resources to make sure that the seniors get the vaccine first.

JIM LEHRER: But officials of the American College of Emergency Physicians warned today that the U.S. may be facing a catastrophic "perfect storm" in public health when a surge in flu cases hits an overburdened emergency health care system. So how is the public health system dealing with the vaccine shortage? And what problems lie ahead? For that, we turn to Dr. Joseph Dalovisio. He's director of infectious diseases at the Ochsner Clinic Foundation Hospital in New Orleans, where he and some 600 other doctors also see private patients. Dr. Arthur Kellermann, chairman of the Department of Emergency Medicine at Emory University and a board member of the American College of Emergency Physicians; and Dr. Allen Craig, the state epidemiologist for the Tennessee Department of Health. Welcome to you all.

Dr. Dalovisio, let me start with you. You heard Secretary Thompson say they're going to be plenty of doses for those who really need them. What's the situation at your hospital and practice in New Orleans?

DR. JOSEPH DALOVISIO: Well, I'm an infectious disease specialist at a large community hospital and clinic. Every year we start planning for the flu season, usually in the springtime, we order our vaccines in based on our prior year's experience. This year we ordered 64,000 doses of the vaccine from the two manufacturers who are making it this year. We try to always split our order up amongst the various manufacturers who have it because we have a problem getting our supply every year. This year we're down to two, and we were expecting our doses when we found out recently that only half the allotment was going to come, we started being concerned about exactly how we would deploy this. The Center for Disease Control had planned to broadly vaccinate the population this year, but once they found out the shortage was going to happen, they revised their recommendations to include the groups that you just mentioned. Our problem is...

MARGARET WARNER: So how are you making these decisions? If you only have half the number of doses you expected, what are you doing?

DR. JOSEPH DALOVISIO: It is a problem to actually translate that plan in your own hospital and clinic. We started out by getting the message out to our health care workers who don't have hands-on contact and to our healthy patients, asking them to forgo the vaccine this year. For our sicker patients and for our hands-on health care workers, we asked them to get vaccinated as soon as possible. Realizing the bottom line here is that we, at least in this community, weren't going to have enough vaccine to vaccinate everybody. This is really distressing for an infectious disease physician or any physician because vaccines are one of the most effective tools we have in our toolbox for preventing disease and the toolbox is about empty.

MARGARET WARNER: Dr. Kellermann, what's the situation at emery?

DR. ARTHUR KELLERMANN: At Emory we have adequate supplies of vaccine. We ordered early and we picked the right within.

MARGARET WARNER: You picked the right supplier?

DR. ARTHUR KELLERMANN: Yes. Aventis sent their supplies to Emory, and many of us have been vaccinated. In many health systems around the country, they're not in the same shape. Many members attending our meeting here in San Francisco are in health systems where they have not been able to get access to vaccine. In fact, we bring 1,000 doses a year to give to our members as a convenience. We had lines one and two hours long yester for that vaccine. We're going to run out of vaccine before we run out of emergency physicians who need it.

MARGARET WARNER: Talking to your colleagues out there at this convention, are you saying that it's not just the patients in their respective home cities and locals but even emergency workers aren't getting...

DR. ARTHUR KELLERMANN: Absolutely. Absolutely. That's really important to understand because if an emergency nurse or an emergency physician is laid low by the flu at the height of flu season, their ability to care for patients is lost. There aren't enough of us on a good night do what we need to do. If we lose a significant number of our colleagues at the height of the season, that would be a problem. Also, infected health care workers can inadvertently pass on the flu early in infection to patients. We don't want that to happen.

MARGARET WARNER: All right. Dr. Craig, you're looking at the entire system in Tennessee from not just hospitals but clinics, private practice, grocery store chains. What's the situation overall in Tennessee?

DR. ALLEN CRAIG: We've certainly been recommending, as the CDC has, that only high-risk individuals be vaccinated and that healthy individuals forgo the vaccination. We've been working hard to get the word out. Vaccine clinics began today around the state. There is a vaccine in most of our health departments today. We anticipate we will run out over the next few weeks. The good news is with the redistribution the CDC is planning, we anticipate vaccine will be coming in slowly over next two months.

MARGARET WARNER: Is demand higher, we've heard anecdotally, that demand is higher because of all the publicity about the vaccine shortage?

DR. ALLEN CRAIG: Typically in an average year, about 90 million people fit into the high-risk category talked about. We have about 55 million doses of vaccine available. So... with about half the people usually getting vaccinated, there would be enough if the demand were normal. I think you're exactly right, the demand will be increased because of the increased concern and publicity.

MARGARET WARNER: Now, explain to us how the distribution system usually works. Is there anyone, any government agency in charge of who gets vaccine?

DR. ALLEN CRAIG: The vast majority of the flu vaccine distributed in the United States is through the private sector, hospitals and clinics and pharmacies order vaccine directly from the manufacturer or from distributors and it goes directly to them. State health departments also order directly from manufacturers. We do have a system through the Centers of Disease Control that provides vaccine for children called the Vaccines for Children's program. What's unique about this year is about 33 million doses have already gone out through this distribution system. Now the CDC is working closely with Aventis to redistribute what sounds like about 22 million doses that are left in the warehouses. That will actually go out to groups that are... only the groups taking care of high-risk individual, so doctors, nurses, practices, health departments as well as nursing homes.

MARGARET WARNER: Back in New Orleans, Dr. Dalovisio, has your hospital been given indications or word yet that you are going to be able to tap into this 20 million coming doses to cover your high-risk people?

DR. JOSEPH DALOVISIO: We haven't. We've been told that we've gotten all the vaccine we're going to get. So we're trying to deal with that as it is. I'd like to say that infectious disease doctors are trying to deal with this shortage locally, but this is really a national crisis. The Infectious Diseases Society of America has been urging medical communities, pharmacy and government to all work together to ensure that we have vaccines and antibiotics to take care of our patients. These are the two most important tools we have to take care of people, vaccines and antibiotics.

MARGARET WARNER: All right. Dr. Kellermann, back to you. You were part of a group of ER Physicians that warned of the perfect storm that's coming. Describe it to us.

DR. ARTHUR KELLERMANN: We already have a problem in this country with our emergency departments filled with patients, intensive care units filled with patients and ambulances being diverted from hospital to hospital due to lack of emergency care capacity. That's before the flu season strikes. The American College of Emergency Physicians have been calling for action on this problem for four years. US News and World Report ran a cover story called "Crisis in the ER" Three years ago. The date of that issue was Sept. 10, 20001. Nothing has been done since to deal with this problem.

MARGARET WARNER: So what's the impact? What are the ramifications here? We know there will be more flu cases. Is that a given?

DR. ARTHUR KELLERMANN: Americans have to be very concerned that if we have tens of millions of high-risk Americans that can't get this vaccine and they're not going to and they get sick this winter and come into emergency departments in hospitals that are already full, we could have an extraordinarily difficult situation on our hands. We have to clear the decks now, take the careful planning and contingency steps into account to be able to ensure that America's health care resources are there to meet the needs of these patients. That's not happening. That's why my organization today issued a call to the federal government and to our partners in health care for a crisis summit to plan to deploy our resources to meet the needs of every American in this flu season.

MARGARET WARNER: Dr. Julie Gerberding, the head of the CDC, said it's not known how serious a flu season this will be. Do you have any evidence of how serious it will be? Is it possible to know at this point?

DR. ARTHUR KELLERMANN: You know, we can hope and pray for the best, but wishful thinking is no substitute for prudent planning. We only have a limited amount of time to prepare for not only the worst-case scenario, simply a worse-than-average flu season. And I think it would be very unwise for us to simply hope that things are going to work out okay. That's never served public health's interest before. It won't serve it now. We need to be prepared for a severe flu season so we can do the best for patients. That's what we're committed to doing.

MARGARET WARNER: Briefly, Dr. Dalovisio, because I want to come back to Dr. Kellermann on the recommendations, do you agree hospitals aren't prepared for this surge?

DR. JOSEPH DALOVISIO: I agree. I think it's not there, the capacity, in terms of hospital capacity nor in terms of vaccine capacity and possibly even antibiotic capacity used to treat the complications of influenza. We really are weak on all counts.

MARGARET WARNER: Dr. Kellermann, back to you. This call to action you all issued today, part of it sounded like you were suggesting that regional or state public health officials really be in charge, what, of allocating beds, of managing beds, are we talking about rationing hospital stays?

DR. ARTHUR KELLERMANN: Well, we need to make sure that critical health care workers are vaccinated as quickly as possible. We also need to ensure that we're looking at health care capacity on a reasonable level so every hospital is playing by the same rules. We also need to be prepared to defer or delay elected admissions so that our very precious critical care beds and hospital beds are available to the patients who need them most. We have to get boarded patients who are in the ER, who are admitted hours or days earlier out of the emergency department, packing the hallways of America's ER's with admitted patients at the height of a flu epidemic could be a disastrous situation. We simply cannot allow that to happen.

MARGARET WARNER: And just to explain to our viewers, by boarded patients, you mean patients who belong in the hospital proper but they're being kept in the emergency room because there is no room in the hospital.

DR. ARTHUR KELLERMANN: Absolutely. We're talking about seriously ill and injured patients who we have stabilized, had planned on admitting to the hospital but cannot move upstairs because the ICU is full or the in-patient units are full. Today many hospitals keep those folks in the ER for hours or even days at a time. That practice has never been good. It is absolutely unacceptable when we're facing the prospects of a major epidemic.

MARGARET WARNER: Okay. So, Dr. Craig, back to you; you're a state public health official. Do you think this has to be managed now, that the government has to get into it and start managing it in anticipation of a surge in flu cases?

DR. ALLEN CRAIG: I think this is really a wake-up call for us I guess in two regards. The first is that we need to do more planning to plan for such surge capacity, and we've certainly spent a lot of time with our bio-terrorism planners working with hospitals and public health to try to do that planning. The second thing is we need to be talking about the manufacturing of the vaccine for the future to make sure that there is enough vaccine and they are more than simply three manufacturers that make vaccine in this country. There's a lot to be done, and we need to be involved in this planning effort with hospitals.

MARGARET WARNER: But is it fair to say for this year there are no other doses available, say, from overseas or from other manufacturers; that this 55 million doses, is it?

DR. ALLEN CRAIG: I think it's very unlikely we'll have other manufacturers from overseas get their product licensed in time to be used this season. I guess there is another thing we haven't talked about, which is the vaccine flu mist, which is a nasal live vaccine that can be safely given to adults, low- risk adults under age 49. But it includes health care workers and parents of very young children under aged six months. That's another resource that we certainly are encouraging hospitals in Tennessee to tap into.

MARGARET WARNER: All right, Dr. Kellermann, Dr. Craig and Dr. Dalovisio, thank you all three.

FOCUS - DISOBEYING ORDERS

JIM LEHRER: And finally tonight, refusing a military order. Terence Smith has that story.

TERENCE SMITH: Last week, a U.S. military unit in Iraq reportedly refused an order to join what the soldiers called a "suicide mission" to deliver fuel from their base near Nasiriyah to another base near Taji further north. The soldiers were reservists in a Quartermaster Company. The army says it is reviewing the case.

For more we go to the reporter who broke the story, Jeremy Hudson of the Clarion-Ledger in Jackson, Mississippi.

Jeremy Hudson, welcome. Tell us what you learned about this incident and where it stands now, as you understand it.

JEREMY HUDSON: Where it stands now it's initially five of the reservists have been reassigned to different units from... away from the 343rd because of the refusal. We initially learned of this through the wife of one of the reservists, Sgt. Larry McCook. His wife, Patricia McCook, basically went to us sort of as a plea for help, just as a way to get the word out that this had happened to her husband, and she wanted basically everyone to know, and we were there to address it.

TERENCE SMITH: Okay, back up a little and tell us what happened, what the convoy was supposed to be, and what happened.

JEREMY HUDSON: Sure. The convoy was supposed to leave Wednesday about 9:30 A.M. They were supposed to deliver fuel. And they had had some concerns previously about delivering the fuel because of, as they termed it, ill-equipped vehicles mainly lacking the proper armor, and even maintenance problems with the vehicles. They had expressed this, from what I have been told, to their commanders, and basically it fell on deaf ears.

TERENCE SMITH: And so, when it came time to do it, what did they do?

JEREMY HUDSON: Well, they got together and talked to their commanders, from what I'm told was for sometime, and basically got nowhere. So they decided together to not go. And once that occurred, they were told to... and there is some question about whether they were actually detained, or what exactly happened there. Relatives have said that their soldiers were in fact detained; the military has denied that they were detained. In either case, statements were taken from the reservists, and from there they were able to determine the reassignments and five of the reservists were reassigned because of, as one relative told us, they were labeled as the instigators of the refusal.

TERENCE SMITH: Okay, that's five out of a group of eighteen. And did they actually refuse a direct order to conduct this convoy?

JEREMY HUDSON: From what I've been told, yes, they did. They were told to report at, I believe, 7:00 A.M. Wednesday to prepare for a 9:30 convoy; from what I've been told, none showed up. And the investigation really began from there.

TERENCE SMITH: And after they either were or were not detained, they contacted their families. Were they directly seeking help, legal or otherwise, for their situation?

JEREMY HUDSON: I think so. From what I've been told, what happened was a soldier or reservist from another unit heard of what happened, went to the area where these reservists from were being held, gathered telephone numbers and names, contact names of the soldiers, and was able to go by and individually let the family members know what was going on. And in turn, some of that information was relayed to us, and it has sort of gone from there.

TERENCE SMITH: Tell us who these reservists are, and whether they had been complaining in the past about their service in Iraq, or not.

JEREMY HUDSON: I've heard some relatives say that they had complained about some things in the past, but I really have no firsthand knowledge of that, I'm not certain. But two of the folks from Jackson, from our area, one works in the Jackson public school system as a carpenter during his civilian life, and the other-- and that's Sgt. Butler. The other gentleman is Sgt. McCook. He works as a jailer at our county jail here. And I'm not certain about how long either has been employed, but Sgt Butler has been a member of the reserves for, I believe the number is 24 years.

TERENCE SMITH: And the army says that there are two investigations, in fact, going on into this right now. What are you hearing through the families as to how those investigations are going, and what they may or may not know about what is going to happen to them?

JEREMY HUDSON: At this point the scary thing is for the families is they don't know what's going to happen to them. We've heard everything from general discharge to criminal charges. The army... and I think it's way too early to speculate on any of those things right now, but... and that's what the military is actually saying, is that it's way too early to speculate. But the families are obviously very concerned about what's going to happen to their soldier. And there's really... only time will tell as the investigation bears out the facts.

TERENCE SMITH: And I understand that the local congressman, Benny Thompson, has asked for a congressional inquiry into this. Was he also contacted by the families?

JEREMY HUDSON: Yes, he was. Patricia McCook, Sgt. McCook's wife, sought out help from Congressman Thompson, and he in fact... I believe the day of their contact, he contacted or filed a congressional inquiry into this. And he is expecting a report today from... it's going to be the first written report from the investigation.

TERENCE SMITH: Meanwhile, from what you hear from the army, are they doing anything to further protect, armor or otherwise improve the vehicles and equipment that they're using there in Iraq?

JEREMY HUDSON: That's exactly what I've heard from some of the family members. They've told me at least even if their soldier gets some sort of discipline from this, they're hoping that other lives are going to be saved because they've heard accounts of some of the vehicles being equipped or fitted with the armor that they feel they should have been fitted with initially.

TERENCE SMITH: And I gather that these units, they have been under fire in previous convoys so they know what the dangers are.

JEREMY HUDSON: Yes, sir. Some of the... one gentleman from Alabama told us that prior to this refusal, or this apparent refusal, the convoy with the same folks had come under fire during a previous five-day convoy that immediately led up to this. And I'm certain that played some role in the decision.

TERENCE SMITH: Okay, Jeremy Hudson, thank you very much for bringing us up to date. We'll obviously have to stay tuned.

JEREMY HUDSON: Thanks for having me.

RECAP

JIM LEHRER: Again, the other major developments of this day: Sen. Kerry accused President Bush of "arrogant boasting" on Iraq, and said the truth is catching up with him. Mr. Bush charged the senator is trying to scare seniors into thinking they'd lose Social Security in a second Bush term. And the federal government urged seniors not to stand in long lines to get flu shots, because the flu season has not yet even begun. We'll see you online, and again here tomorrow evening. I'm Jim Lehrer. Thank you, and good night.