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THE SITUATION ROOM

World Health Organization: Swine Flu Pandemic Imminent

Aired April 29, 2009 - 17:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


(BEGIN VIDEO CLIP)

DR. MARGARET CHAN, DIRECTOR-GENERAL, WORLD HEALTH ORGANIZATION: I have decided to raise the current level of influenza pandemic alert from Phase 4 to Phase 5. All countries should immediately now activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia. It really is all of humanity that is under threat.

(END VIDEO CLIP)

BLITZER: A call to action from the World Health Organization, warning of an imminent pandemic of swine flu and urging all nations to implement their pandemic flu plans immediately. This comes only hours after confirmation of the first death here in the United States from the virus -- a 22-month-old boy visiting from Mexico who died in a Houston hospital.

And the Education Department now reports 100 schools are closed nationwide because of confirmed or suspected cases of swine flu. More than 50,000 students across the country have now been told, stay home. President Obama is now calling on all schools in similar circumstances to do exactly the same thing.

We want to get right to our chief medical correspondent, Dr. Sanjay Gupta -- he's on the phone -- as well as Dr. Anne Schuchat, who's the interim deputy director of the Centers for Disease Control & Prevention.

Sanjay, stand by for a moment.

I'd like you to join me in the questioning of Dr. Schuchat.

But let me get your reaction to what we just heard from the World Health Organization, Dr. Schuchat, that they're going to a Level 5, which means, according to the World Health Organization, that a pandemic is imminent.

DR. ANNE SCHUCHAT, CDC INTERIM DEPUTY DIRECTOR FOR SCIENCE & PUBLIC HEALTH: Yes. This is important news and very important for countries around the world to pay attention.

Here in the United States, we've been paying attention for a while now. And we've been taking things very seriously. So the impact of this information for Americans is less important, really, than for those around the world who haven't yet intensified their surveillance and really stood up their planning efforts. Here in America, we have been taking steps. And, as you know, it was a difficult day here with the announcement of the first death from the new influenza virus.

We think it's important for people to know that many steps that are going on to take efforts to protect communities, to reduce the spread of this virus from person to person and to really limit the impact on public health that we have from this new virus.

BLITZER: We heard from Janet Napolitano, the secretary of Homeland Security, earlier, that she's been working -- and I assume you've been working over these past several days, under the assumption that it wouldn't only just go to a Level 5, it would go to a Level 6, and that there would be a full scale pandemic around the world, is that right?

SCHUCHAT: Yes, that's right. We've really been taking steps to prepare ourselves for the -- actually, the worst case scenario. You know, here what we have done is deployed our anti-viral stockpiles. Twenty-five percent of the stockpiles we've reserved for the states are on their way and we will expect by May 3rd, they'll all be -- have been delivered.

We really issued quite a bit of guidance for communities, for families, for doctors, for laboratories. But we also want people know that there is an individual role and a family role in this. Each of us can take steps to reduce the spread of respiratory viruses, including this new novel influenza virus, by taking steps to stay away from other people when they're sick with respiratory symptoms. That's part of the idea in keeping children home from school when they're sick, not going to work yourself if you're sick, really trying to avoid spreading this virus and washing your hands, washing your hands, washing your hands.

BLITZER: Is it time, though, Dr. Schuchat...

SCHUCHAT: It's also...

BLITZER: ...for people to stop shaking hands, to stop hugging each other?

What am I hearing?

SCHUCHAT: You know, it's really important for people to know that hand washing frequently or using an alcohol hand gel if you can't wash your hands is an important step in reducing the respiratory viruses. Not touching your nose, mouth or eyes after you touch a surface that might have a flu virus on it -- that's also an important step.

So I think we do think that there's quite a bit individuals can do. And one of the most important things people can do is stay informed about what's going on in your own community. Things might be different in one state or another or one town or another, and your local authorities will know what's going on.

You can also get lots of information at www.CDC.gov...

BLITZER: All right...

SCHUCHAT: We're really committed to share information as we know it, so you can help yourself.

BLITZER: All right. I want Dr. Gupta to come into this conversation and ask you a question, as well.

But very quickly, is the CDC now recommending against shaking hands -- just casual shaking hands?

SCHUCHAT: No. The CDC today is telling people just wash their hands. The most important thing is wash your hands frequently and make sure that when you are sick or your children are sick that you don't go to work or you keep your child home from school and that you stay aware of what's going on around you. And if there aren't outbreaks in your own, community, think about what you would do if there were outbreaks, if you have a plan if your child's school was closed in the future.

Do you know how you would cope with such a thing?

If you're in a workplace, do you -- do you have a plan for such eventualities?

Is there telecommuting that possibly could help with people when they have to stay home to care for their children.

BLITZER: All right...

SCHUCHAT: Those are things people can do right now.

BLITZER: All right -- Sanjay, I know you're anxious to ask Dr. Schuchat a question, as well.

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Yes.

BLITZER: Go ahead.

GUPTA: Yes, Dr. Schuchat, now that we are at Level 5 I think it's time for some specific answers to the questions regarding vaccines.

Are we going to have a vaccine?

When will come and how much of a difference do you think it will make?

SCHUCHAT: Vaccines are a very important part of response to influenza, including novel influenza that may become pandemic. CDC has isolated this virus, the new virus, and is working to make a seed strain that can be put into industry's hands to scale up for production of a vaccine.

There are many steps involved with producing a vaccine and we are committed to go forward, together with the NIH and FDA, FARDA (ph), the manufacturing community to see about developing a full scale vaccine production.

But influenza vaccine production is pretty unpredictable. People -- viewers know that even with seasonal flu, we don't always get vaccine as soon as we want it and we don't always get as much as we want. And we really need to be patient and make sure that we're taking the careful steps to produce vaccine the way it's supposed to be. We're going to need to be patient with this.

If things go well and we develop a full scale production, it would be several months until the vaccine were available. But unlike years ago, when the world faced pandemics, we do have other tools right now. We have anti-viral drugs that are available and that do work against this virus. So we think people who develop this novel influenza virus and are ill will probably do better with treatment.

So vaccine is an important tool for the future. It's going to take a few months before we have such a tool available to us. But we have other steps available in the meantime. And while everyone gets focused on vaccines and drugs and these technological fixes, mom's advice about washing your hands is really important.

BLITZER: All right. Sanjay, I know you have another question, but did she answer your first question?

GUPTA: Well, I'm still curious, have we started vaccine production?

Is there a trigger to make that happen?

And how much of a difference will that make?

SCHUCHAT: We have started the process toward vaccine production. Initially, a strain is grown. We try to find which of the strains is the most effective -- is easiest to grow. And then there are steps to process that strain through eggs or through -- or through cell-based approaches.

And then manufacturers will develop pilot lots that can be studied through NIH-sponsored trials, that will look at the best dosing, whether we need something called an adjuvant that can help with the immune response.

We do studies to understand how to make the vaccine and then something can be selected that's sort of the best way to go, based on a lot of scientific input from expert committees. And that is when the full scale production would go forward.

So, yes, Sanjay, we are definitely taking those early steps aggressively, working closely with manufacturing and the rest of the government.

BLITZER: All right, Sanjay, I know you have another question and our time is limited, so, Sanjay, go ahead. GUPTA: With regard to the anti-virals that you mentioned and weren't around in -- for previous pandemics, Dr. Schuchat, is there going to be enough?

I mean how does that work?

Dr. Chan was asked that question and she said -- you know, she was appealing to the social responsibility of pharmaceutical companies to ramp up production.

Should it get to the point where we really need to give a lot of people anti-virals, is there going to be enough?

SCHUCHAT: Here in the United States, we've invested in our strategic national stockpile and we do have on hand quite a bit of anti-viral drugs.

The global situation is a bit more complicated. And under the leadership of Director-General Chan, we are much better prepared than we were several years ago. But we do agree with her that appealing to the pharmaceutical community and understanding the global impact of today's announcement is very important.

BLITZER: Dr. Schuchat, I know your time is limited and you have to go.

We want to thank you very much.

We'll stay in close touch with you.

Dr. Ann Schuchat is the interim deputy director of the Centers for Disease Control for Science & Public Health.

Good luck to you and all the men and women who work with you.

We're counting on you.

SCHUCHAT: Thank you.

BLITZER: Sanjay Gupta is still with us. He's in Mexico City -- Sanjay, you've been telling our viewers -- and I'm concerned about this, as well. And I've been getting a lot of e-mail about what's called a second wave. Since we're now ending the traditional flu season -- the flu season will begin -- will ramp up later in the year, in the fall, explain what that means if there's a decline in this swine flu, let's say, over the next few months, we shouldn't necessarily think we're totally out of the woods?

GUPTA: That's exactly right, Wolf. And that's based on sort of looking at the behavior of these viruses and also looking at history.

For example, if you look back at the 1918 flu pandemic, which we were talking about earlier, there was a rash of infections in the spring of that year. And then, over the summertime, that -- those numbers seemed to decrease. The worst part of the pandemic actually occurred later on in the year in the season that's typically associated with the flu.

And, you know, I think that this is a -- this is a message. I think it's some good news and bad news.

The good news is, I think, based on natural history, over the next couple of months, we should see a decrease in this particular viral activity. We can't be sure of that, Wolf. That's just based on past history.

But I think the message -- and it's not necessarily bad news -- but the message is we have to be hyper vigilant about this come fall and winter. And being hyper vigilant goes to all the things that were just mentioned by the World Health Organization.

It's at a country level, it's at an institutional level and at an individual level, we just have to be really, really careful about protecting ourselves and making sure that we're not unwitting participants in spreading this virus person to person.

BLITZER: Normally, Sanjay, the flu is most serious with older people. But in this particular case, we've seen a lot of healthy young people in their 20s come down -- and in Mexico, even die.

Is there any explanation we already can get for this?

GUPTA: Yes. This is one of the first red flags for the public health organizations, when they saw exactly what you're describing happening.

And there is an explanation for it. It's somewhat of a counterintuitive explanation. Think of it like this. Typically, you think of someone who has a weakened immune system -- as you mentioned, the elderly, the very young. They have weakened immune systems, so they're not going to do as well from a significant infection. They're not going to be able to fight it off.

What we find with this particular virus, at least here in Mexico, this has been the behavior of it. What happened, it's not so much the virus itself that's causing the problem, but it's someone's -- a healthy person's robust immune system and how it reacts to that virus.

It reacts so profoundly, all the inflammatory cells rushing in to try and fight this infection, that it's those inflammatory cells themselves, Wolf, that can sometimes flood lungs, causing the pneumonia that Dr. Chan was speaking about, and, in the worst case causing death.

So it's not so much the virus as it is the body's reaction to it, in a healthy person. And that's what we're seeing here in Mexico.

BLITZER: All right, Sanjay, I want you to stand by.

We're going to continue our coverage of the breaking news. The World Health Organization announcing only an hour ago that it was raising the threat level of a pandemic from a four to a five, meaning a pandemic is now imminent. We'll continue our coverage of this story momentarily.

I want to bring in Jack Cafferty right now for The Cafferty File -- you know, it's a long time since we've heard the World Health Organization warn the world of a pandemic -- all of humanity, Dr. Chan said.

CAFFERTY: Yes, although the point is well taken that they haven't had this grading system that they're using now but, what, for the last four or five years.

The other point that's worth, you know, I think, making is that here in this country, there has been one death from swine flu -- a youngster from Mexico.

Since January 1st, 13,000 people have died from ordinary flu in this country. So everything in perspective.

THE SITUATION ROOM is all about politics, excerpt when there's a pandemic. So let me do that.

BLITZER: All right.

CAFFERTY: Senator Arlen Specter's defection to the Democratic Party just the latest bad news for the Republican Party.

Politico suggests the GOP's meltdown is the worst of any party's in decades and has left the Republican Party on the brink of irrelevance, with few obvious paths back to power.

Specter's abandonment comes in the same month as a traditionally Republican leaning district in Upstate New York tipped for Democrats. That means in the nine Northeastern states now, there are only 15 Republican House members out of 83 seats and only three Republican senators out of 18.

On a national level, the GOP is near record levels for unpopularity. Only about one person in four now identifies himself as a Republican. And a new CNN/Opinion Research Corporation poll shows only 39 percent of those surveyed have a favorable view of the Republican Party. That's not enough to win any election. Even a lot of Republicans don't like the Republican Party much anymore.

Some Republicans say conservatives have left the GOP with an extraordinary exclusionary message. Senator Olympia Snowe says: "Being a moderate Republican sometimes feels like being a cast member on "Survivor." You're presented with multiple challenges and you often get the distinct feeling that you're no longer welcome in the tribe."

Meanwhile, Specter's switch to the Democrats is less than genuine. As recently as March 17th, just a scant month or so ago, Arlen Specter of Pennsylvania insisted in an interview he would never switch political parties. But once the polls indicated he would lose his bid for re-election, well, he jumped on the Democrats' bandwagon like a bird on a worm. This is called political opportunism and hypocrisy.

Anyway, here's the question -- is the Republican Party on the brink of irrelevancy?

Go to CNN.com/caffertyfile and you can post a comment on my blog.

Arlen Specter has a long history of saying one thing and then doing something else.

BLITZER: But then again...

CAFFERTY: This is another example.

BLITZER: He's -- 30 years he's been in the Senate. So he gets himself re-elected.

CAFFERTY: Well, swell.

(LAUGHTER)

BLITZER: Thanks, Jack.

Jack will be back shortly.

President Obama marking his first 100 days in office with a town hall meeting in St. Louis. He promised bipartisanship, but is he delivering?

Also, ground zero of the swine flu outbreak -- a small village in Mexico and a young boy now confirmed as the first victim. We're going there.

And hundreds of suspected cases right here in New York City -- prompting the city and the state to prepare for a worst case scenario.

Stay with us.

You're in THE SITUATION ROOM.

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BLITZER: We're following the breaking news for you. The World Health Organization, just within the past hour, announcing that it was going from a four to a five -- the threat level of a pandemic. The Level 5 -- that's the second worst level. Six would be the highest. Level 5 means a pandemic is now seen by the World Health Organization as imminent. We're all over this story for you.

Mexican health officials think they've found the epicenter of the swine flu outbreak and the first human victim.

CNN's Ted Rowlands is in La Gloria, Mexico, now believed to be ground zero -- Ted.

TED ROWLANDS, CNN CORRESPONDENT: Wolf, the world's attention is on La Gloria, Mexico. It is a tiny town about five hours east of Mexico City and it could be the spot where the swine flu virus originated.

(BEGIN VIDEOTAPE)

ROWLANDS (voice-over): It's home to 5-year-old Edgar Hernandez, who had the first confirmed case and it's where Mexican health officials acknowledge dozens of people were sick in early April -- weeks before the virus surfaced anywhere else.

VIVIAN RODRIGUEZ (through translator): All of us had fever. All of us had the same symptoms -- temperatures, pain in our bones, chills, runny nose and cough continuously.

ROWLANDS: Vivian Rodriguez says she, her husband and all four of her children were sick. She says they were given medicine that seemed to work initially, but she says now the children are sick again and she's worried.

RODRIGUEZ (through translator): We're worried because we've never seen a case like this here before. What we want to know is where this has come from, because the truth is, here we get prescriptions and medicines, but it's not enough. We don't know what we have.

ROWLANDS: Health care workers are in La Gloria this week going door to door, checking on people's welfare. So far, they tell us they haven't found any new cases of swine flu. The question still unanswered is how the virus started. Most people here blame a nearby pig farm.

FELIPE BELLO-TENCELE (through translator): The farms are endangering us. We're blaming the pollution for the virus -- the pig farm. When the wind blows south, the pollution moves our way.

ROWLANDS: The industrial pig farm is owned by American-based Smithfield Foods. The Mexican Department of Agriculture and the company have done tests at the farm and they say they've all come back negative.

(END VIDEO TAPE)

ROWLANDS: And, Wolf, medical personnel say they'll continue to go door-to-door to make sure people here are getting the treatment that they need.

Meanwhile, the actual cause and origination point of this virus is still a mystery -- Wolf.

BLITZER: Ted Rowlands at the epicenter -- believed to be the epicenter, in Mexico.

Meanwhile, Mexico City's Chamber of Commerce estimates that closures and cancellations are costing that city about $57 million a day. Travel advisories around the world are furthering the impact on tourism to Mexico. Let's go to our Abbi Tatton -- Abbi, how is that tourism industry being affected?

ABBI TATTON, CNN INTERNET REPORTER: Wolf, this is flights, vacations, cruises -- all being postponed, delayed or even canceled as people try and watch and see how this develops.

Carnival Cruise Lines this week said that they're going to be stopping ports of call in Mexico until May 4th. That means if you are on a ship that was heading to Cabo San Lucas, now you might find yourself stopping in San Francisco on the other coast. Instead of Cozumel, you might now be heading to Key West.

In Britain, where there's a similar travel advisory to that in the United States, essentially about non-essential travel, the three of the biggest tour operators there have said no flights -- none of their flights will be operating to Mexico until May 8th.

And then two countries have gone much further than that. Cuba and Argentina have especially put in a place a travel ban to Mexico, no flights in our out of Mexico from those countries.

That's not the case here in the United States. You've got about 4,000 flights a week to and from Mexico to the United States. Those are not being canceled. But the U.S. carriers are making sure that passengers can change and alter their trip easily with no fee.

American Airlines said today that they have seen some increase of people doing that. They say it is less than a severe weather event, like a hurricane. But if you look at some of the pictures -- this one a flight to Mexico City -- you'll see that some are all but deserted -- Wolf.

BLITZER: Yes. Tourism is such a critical, critical lifeline for everyone in Mexico. And look at that -- one person, it looks like, sitting in that seat on that flight to Mexico City.

All right, Abbi, stand by.

These swine flu fears -- they have people flooding urgent care centers in California. We're going there live for you.

Also, Cuban leader Raul Castro says the ball is now in Washington's court -- details of his new criticism of the U.S.

Stick around.

Lots of news happening today, right here in THE SITUATION ROOM.

(COMMERCIAL BREAK)

BLITZER: We've got much more coming up on this swine flu that's getting very close to -- to some sort of global pandemic that the World Health Organization is warning about. They've gone from a Level 4 to a Level 5. Level 6 is the worst. Much more on this story coming up. But let's check in with Fredrick Whitfield right now.

She's monitoring some other important stories incoming into THE SITUATION ROOM right now -- Fred, what's going on?

WHITFIELD: Hello to you, Wolf.

Well, April is proving to be a deadly month in Iraq. Six car bombings in a four hour period rocked Baghdad today. Authorities say three of the blasts happened in quick succession at crowded marketplaces. In all, the bombings killed 48 people and wounded dozens more. Last week, bombings killed more than 150 people over a two day span.

Cuban leader Raul Castro says it's up to the U.S. to improve relations and says America hasn't done enough. Castro made the comments today in Havana. President Obama recently relaxed some travel restrictions to Cuba, but kept the decades-old trade embargo in effect. Castro says there is no justification for the embargo and says because the U.S. has imposed sanctions, the onus is on America to make gestures.

And an amazing sight -- scientists say they caught a glimpse of the oldest known object in space -- take a look right there -- a star that exploded 13 billion years ago. Last Thursday, scientists say a satellite picked up a 10 second blast of energy known as a gamma ray blast. They say the blast came from an enormous dying star 30 to 100 times larger than the sun -- Wolf.

BLITZER: All right, Fred, thanks very much.

And to our viewers, you're in THE SITUATION ROOM.

Happening now, the breaking news we're watching. The number of swine flu cases in the United States balloons. Health experts are working to get a vaccine ready. But see why mistakes made more than 30 years ago are now getting a critical closer look.

And fighting the virus on the front lines -- urgent care centers are packed with people who fear they've come down with swine flu. The five symptoms doctors say should set off alarms.

I'm Wolf Blitzer.

You're in THE SITUATION ROOM.

We want to continue our coverage of the breaking news right now.

Our senior medical correspondent, Elizabeth Cohen, is standing by.

She's tracking how the U.S. government is dealing with this crisis -- Elizabeth, the World Health Organization says a pandemic is now believed to be imminent.

Tell us the latest of what the U.S. government is doing about all this.

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: What the U.S. government doing -- is doing right now, Wolf, is that they say they are moving faster than ever to develop a vaccine.

(BEGIN VIDEOTAPE)

COHEN (voice-over): The cases are mounting, the scope is widening -- the World Health Organization makes a dramatic move.

CHAN: I have decided to raise the current level of influenza pandemic alert from Phase 4 to Phase 5. It really is all of humanity that is under threat.

COHEN: In the United States Wednesday, the Centers for Disease Control's acting director, Dr. Richard Besser, again underscored the seriousness of the 2009 swine flu virus outbreak.

DR. RICHARD BESSER, ACTING DIRECTOR, CDC: Very sad news coming out of Texas that a child has died from the H1N1 virus. As a parent and a pediatrician, my heart goes out to the family.

COHEN: One of the more aggressive tactics to stem the spread of H1N1 -- a vaccine.

KATHLEEN SEBELIUS, HHS SECRETARY: Currently, the FDA and Centers for Disease Control & Prevention are developing virus reference strength -- the information regarding a virus that's necessary to develop a vaccine. And today, there are a series of steps that HHS is taking in that vaccine development.

COHEN: The newly confirmed secretary of Health & Human Services, Kathleen Sebelius, promised that developing a vaccine, which usually takes months, will be speedier than before. Still, so many unknowns -- how far will the virus spread, how soon will we have an effective and safe vaccine and how many people will be touched by H1N1? What is sure, say officials, is more hospitalizations and most likely more deaths.

UNIDENTIFIED FEMALE: What we're seeing is a situation where I would say state and local partners and the federal government is as prepared as they have ever been to deal with a situation. They are out ahead of it.

(END OF VIDEOTAPE)

COHEN: Wolf, infectious disease experts tell me that no matter how fast the government moves, it still is going to take months to come up with a vaccine. Wolf?

BLITZER: Elizabeth Cohen watching this story for us. Let's go from Atlanta, to 29 Palms, California right now, CNN's Dan Simon is standing by. Dan, the U.S. Marine Corps says swine flu has come into 29 Palms?

DAN SIMON, CNN CORRESPONDENT: That's right Wolf, we can tell you that one marine here has tested positive for swine flu. He seems to be on the mend. But as a precaution, both he and his roommate have been quarantined. We can tell you that 35 other members of this unit are separated from the rest of the marines here at the base, simply as a precaution, they're not allowed to go into the mess hall and certain areas, they have also started taking Tamiflu as a precaution. If after the five days in terms of being quarantined, separated from the rest of the marines here, if they seem to be ok, then they will resume active duty. But at this point, just one marine here has tested positive for swine flu, the rest of the marines in that unit have been separated as a precaution. Wolf, back to you.

BLITZER: Dan Simon's at 29 Palms, thanks very much. Let's bring in Ed Rollins, our republican strategist, the CNN contributor and Donna Brazile, our democratic strategist also a CNN contributor. Donna, the president of the United States said today if there's an incident of swine flu in a school, you know what, the school should shut down because they want to err on the side of caution right now. What, about 50,000 students already across the country, this number is going to go up. Are being told at least for the next few days don't go to school. Is this what the president should be talking about right now?

DONNA BRAZILE, DEMOCRATIC STRATEGIST: Absolutely Wolf, I think the president should share everything that not only he knows, but I think the administration is doing a great job in keeping us informed almost every other hour, so this is the right approach, it's a balanced approach and perhaps we'll learn a little bit more in the days to come in terms of how far and how fast this disease has spread.

BLITZER: As much as this story, you know you don't want to get people overly alarmed, it's not every day as you know that the World Health Organization says a pandemic is imminent.

ED ROLLINS, REPUBLICAN STRATEGIST: Those are very scary terms and as a father of a 14-year-old child, it worries me. I think this is not about partisanship, this is about Americans and the world. Clearly whatever the president does we'll support, and I think he obviously and the new secretary of health and human services who had to have the roughest day anybody has ever had first day on the job. But I think the bottom line is they're trying to get on top of it, they're trying to get things moving quickly and I support him totally.

BLITZER: She was confirmed yesterday by the senate, they got her on a plane from Kansas where she was the governor, they got her to Washington, they swore her in as the secretary of health and human services and today she's dealing with a real crisis.

BRAZILE: One of the reasons why I think the president chose so many governors in his cabinet is because they know how to handle a crisis, not only Janet Napolitano, who I think is doing a fabulous job.

BLITZER: She's a former governor of Arizona.

BRAZILE: But clearly Kathleen Sebelius understands the nature of this crisis, she's been briefed by people in the White House and she's ready to help navigate this strategy.

BLITZER: You wrote a column on cnn.com today Ed and I want to read a line because it sort of jumped out at me, the commentary is entitled "Is Obama a Clinton or a Carter?" Referring to Jimmy Carter and Bill Clinton. "As Obama has said I won and the republicans lost, it's his prerogative to try to carry this ball up the hill for the next 1,361 days to the next inauguration day, as marathoners quickly discover, the race is long and victory comes to those with staying power. All I can say after 100 days is, good start Mr. President, I wish you well." Go ahead and explain.

ROLLINS: I have worked in three White Houses, I have watched the best of them start and crash and burn and I think to a certain extent we don't want that. This president has so much on his plate as I also (INAUDIBLE) in the column. That you just don't know where he's going to be, I mean so far it's a good start, but we're just moving forward and basically trying to put him on Mt. Rushmore at this point in time is a disservice to him. He's got all the tools he needs, he's got democrats in control of both the senate and the house now, it's his agenda, he ought to be able to implement it and at the end of the day, he gets measured by the American public. I'm just one of them.

BLITZER: Yeah, like all of us. But this is a marathon, this is four years, maybe eight years for President Obama and he's trying to do so much in what he and his advisors clearly see as a window of opportunity, his popularity is still very, very strong right now, but is he behaving as if this is a marathon or a sprint?

BRAZILE: A marathon, this is a guy who is prepared for the long haul, and that's one of the reasons why he has been working very swiftly to get so many policy initiatives in place, in housing, in the financial crisis, the banking. This president understands this is about the long haul and not just the short-term.

BLITZER: Explain what your result is, is he a Jimmy Carter or is he a Bill Clinton?

ROLLINS: The headline basically, what I said, is the first 100- day period, everyone thought Jimmy Carter was going to be a historic president, he had a great start. He went walking down Pennsylvania Avenue --

BLITZER: Coming after Gerald Ford and Watergate and all of that --

ROLLINS: It became a disaster for a variety of reasons. Bill Clinton stumbled out of the box and no one thought he was going to be very effective and I think the republicans getting elected in 1994 basically helped him get reelected in 1996. He had a game to play against. There's a whole lot ahead of this president and the key thing here is he's starting a lot of things, is there going to be resources to finish all of the things.

BLITZER: I think he would not like want to be either Jimmy Carter or Bill Clinton, he'd like to be FDR if he has a role model to base his presidency. ROLLINS: I think he has an opportunity to be his own president. He's an historic president already and every presidency is a little bit different. But my point is, trying to measure someone at 100 days is kind of foolish.

BLITZER: Donna, listen to this i-Report that we got, Joseph Taggi, this is his i-Report, his commentary, I want you to listen to this.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: In terms of leadership, President Obama has shown that he is capable of learning quick and can become an effective leader, right now he is a very good orator and a very good diplomat which are two good qualities that President Bush did not have. So I would give him a grade of an A on that for effort and a B for overall success.

(END OF VIDEO CLIP)

BLITZER: You're going to be hearing a lot about grades in our national report card later tonight. Give me a quick grade, this is one of the early questions that we're going to ask, a quick grade for Vice President Joe Biden. How is he doing?

BRAZILE: I give Joe Biden an A as well. I think he is off to a great start. President Obama has put a lot of faith in his ability to help him maneuver this financial crisis. He's in charge of this middle class task force. He's in charge of working with the cabinet now and making sure this money quickly gets to the states. I give him an A.

ROLLINS: I give him a B minus because he's not a good staff person, right now he wants to take credit for everything and as the president usually get credit for everything. He's taking credit for Specter, he's taking credit for I'm the last man in the room (INAUDIBLE), he needs to get a little humbler.

BLITZER: We have a lot more to talk about in the course of these next few hours guys. Stand by, we have a big night coming up. A reminder, the night will start right after THE SITUATION ROOM at 7:00 p.m. eastern, our national report card on President Obama's first 100 days in office. Today is day 100. We'll assess how the president is handling the economy, the wars in Iraq and Afghanistan and other issues important to you. It begins, CNN's National Report Card, 7:00 p.m. eastern only here on CNN and you'll have a special chance to weigh in.

Hundreds of suspected cases of swine flu among New York City school students. Now the city and the state are preparing for the worst.

And a top presidential adviser David Axelrod, he's here in THE SITUATION ROOM as we grade President Obama on his first 100 days in office.

(COMMERCIAL BREAK)

BLITZER: World Health Organization announcing about an hour or so ago that they've gone from a level four to a level five, meaning a swine flu pandemic is now considered imminent. The highest and worst level is a level six. New York City where we are right now clearly preparing for a worst case scenario. CNN's Mary Snow is here, you've been watching this really closely, what's the latest?

MARY SNOW, CNN CORRESPONDENT: The numbers are rising Wolf, the latest update, there are 49 confirmed swine flu cases in New York City. Four city schools are closed, but two private schools shut down on their own, out of caution, two others were directed to do so by the health department.

(BEGIN VIDEOTAPE)

SNOW (voice-over): This elementary school for special needs children remains closed as the health department continues their swine flu investigation. But the city's health commissioner says the main cluster of swine flu remains linked to St. Francis Prep High School in Queens where students who traveled to Mexico began getting sick last week.

DR. THOMAS FRIEDEN, NEW YORK CITY HEALTH COMM.: There are many hundreds of people who had symptoms of swine flu in a very brief period of time, just two or three days, three or four days, during the peak of the outbreak at St. Francis.

SNOW: Those numbers aren't reflected in the official count because the city is not testing everyone at the school. Officials have indicated at this point they are most concerned with severe flu. They say people most at risk are the elderly, babies and people with existing medical problems. City and statewide officials say those who've gotten sick are feeling better.

GOV. DAVID PATERSON, (D) NEW YORK: We are preparing ourselves for the worst-case scenario, but at the same time, we have not identified anyone who is healthy who has become critically ill as a result of this virus.

SNOW: As concern rises, the city's health commissioner says so do the rumors in a city that has 1.2 million kids in its schools. The education department says attendance remains normal and says it's closely monitoring the situation. One Manhattan private school that was tested by the health department refused to close. And a church leader blamed the health department and media for overreacting.

REV. JOHN DUFFELL, ASCENSION SCHOOL: Parents have been calling in because you have created a sense of panic and that's unfortunate.

(END OF VIDEOTAPE)

SNOW: The priest at this private school says the health department told him today there was no evidence of swine flu. The health department has been stressing, it's not trying to alarm people but it's trying to provide as much information as possible so people can stay alert.

BLITZER: And are people suddenly showing up at hospitals.

SNOW: Yeah, and that's one thing the health commissioner said, he said that people are showing up at emergency rooms who are not sick, they're just worried. They're urging people do not to do that. He said that they should stay home, call doctors if they feel they have symptoms but just don't show up at emergency rooms because of worry.

BLITZER: Because they're overwhelmed. Mary, thanks very much. I want to go to Thelma Gutierrez right now she's out in Los Angeles where there are a lot of worried patients as well. What are you seeing Thelma out there?

THELMA GUTIERREZ, CNN CORRESPONDENT: Wolf, we have been checking with urgent care centers and hospitals in our area and they are seeing a slight surge. Now Children's Hospital in Los Angeles told us in the last three days they have been 21 percent busier. Santa Monica UCLA Medical Center says they're seeing about 20 percent more patients. But of all the patients they have seen, they have only diagnosed one flu case and it was not swine flu.

(BEGIN VIDEOTAPE)

GUPTA: Runny nose, headache, fever.

GUTIERREZ (voice-over): The symptoms of swine flu that health officials are telling us to watch for.

UNIDENTIFIED MALE: Have you had chills for this?

GUTIERREZ: At this urgent care center in San Diego Dr. Ricardo Romero sees an average of 40 patients each day, these days he's busier than ever with some people worried they may have swine flu.

DR. RICARDO ROMERO, URGENT CARE PHYSICIAN: I think its human nature that you have a little panic button in you that when you hear something that's threatening to life and limb, you tend to press that button.

GUTIERREZ: Especially with any sign of symptoms. Marlene Gregor says she had them all a couple of months ago.

MARLENE GREGOR, URGENT CARE PATIENT: I think it might be that swine flu that I had because I was very lethargic, it was in my upper chest, you could hear me wheezing, coughing.

GUTIERREZ: Vidal Curtidor took his son to this urgent care center in Los Angeles because he was complaining of a sore throat.

VIDAL CURTIDOR, CONCERNED FATHER: Took him as a precaution you know, alarm.

GUTIERREZ: Dr. Romero says it's important to be cautious and vigilant but not to panic. ROMERO: One patient just returned from Mexico and his only symptom was fatigue.

GUTIERREZ: There's not much you can do then?

ROMERO: Not much we can do.

GUTIERREZ: Nick Toda came in with body aches a sore throat fatigue and a fever under 100.

UNIDENTIFIED MALE: (INAUDIBLE) sometimes when you tend to hear a lot about these things and you kind of diagnose yourself with them.

GUTIERREZ: Toda left that up to Dr. Romero who concluded without high fever and coughing, he didn't have swine flu or any other kind of flu.

(END OF VIDEOTAPE)

GUTIERREZ: Dr. Romero did tell us that if he believed that Nick had the flu, he would have taken a culture from his nose and if he couldn't type it, it would have been sent to the health department in his area. Now if the health department can't type the virus, then it would be sent off to the CDC. Wolf?

BLITZER: Thelma Gutierrez in Los Angeles for us. Thanks very much. We'll continue our coverage of the breaking news. The World Health Organization announcing that a pandemic is now considered imminent. Stand by for more details.

He campaigned on bringing a new era of bipartisanship to Washington, here's the question. Is President Obama keeping his promise? And rating the president's first 100 days in office, we're counting down to our national report card and your grades of President Obama. Stay with us, you're in THE SITUATION ROOM.

(COMMERCIAL BREAK)

BLITZER: In a town hall meeting in Missouri today, marking his 100th day in office, President Obama said he's not pleased, but he is pleased, I should say, but not satisfied about what's been accomplished so far. But what about the president's campaign promise to begin a new era of cooperation here in Washington? Let's bring in our senior political correspondent, Candy Crowley. She's taking a closer look. Good question. What's going on?

CANDY CROWLEY, CNN SENIOR POLITICAL CORRESPONDENT: Well, you know, he campaigned on change. But not just policy, not just direction. But this was about a change in tone. And 100 days in, what we know is he's going to need a little more time.

(BEGIN VIDEOTAPE)

CROWLEY (voice-over): The promise of bipartisanship.

OBAMA: I don't want to pit red America against blue America. I want to lead the United States of America.

SEN. JOHN MCCAIN, (R) ARIZONA: I pledge to him tonight to do all in my power to help him lead us.

CROWLEY: Bipartisanship looked good at first. CNN's senior congressional correspondent, Dana Bash.

DANA BASH, CNN SENIOR CONGRESSIONAL CORRESPONDENT: There was a kumbaya feeling big time at the beginning back in January.

CROWLEY: The president wooed republicans on the hill, invited them to cocktail parties at the White House, and they said nice things.

UNIDENTIFIED MALE: I think that the president is setting the right tone in Washington, D.C. he's reaching out.

CROWLEY: By late February, kiss it good-bye.

BASH: It dissolved so fast.

UNIDENTIFIED MALE: What happened to the promise --

CROWLEY: Harmony turned into dissidents with the president's $787 billion stimulus bill with near unanimous republican opposition, the president went to a democratic retreat, a pep rally of sorts and mocked republicans.

OBAMA: We got the argument, well, this is not a stimulus bill, this is a spending bill. What do you think a stimulus is? That's the whole point.

CROWLEY: His former opponent went to the senate floor.

MCCAIN: The whole point, Mr. President, is to enact tax cuts and spending measures that truly stimulate the economy.

NANCY PELOSI: The conference report is --

UNIDENTIFIED MALE: The motion is agreed to.

CROWLEY: Three of 219 republican lawmakers voted with the president. And bipartisanship turned into partisan debate about who was not being bipartisan. There are fundamental policy differences that make this promise hard to keep, but not impossible. Generally republicans have been supportive of the president's policy in Iraq and Afghanistan. And they can't afford to counter a popular president at every turn. Polls show most Americans blame the GOP, not the president, but he can't write them off. Democrats will not always vote together. Bipartisanship is often born of necessity. CNN's senior White House correspondent, Ed Henry.

ED HENRY, CNN SENIOR WHITE HOUSE CORRESPONDENT: In the days ahead, on health care, on energy reform, he's going to need some republican votes to get some of these big things done.

CROWLEY: But so far --

UNIDENTIFIED MALE: It will be like a declaration of war.

PELOSI: We've reached out to republicans.

UNIDENTIFIED MALE: This is a joke. And we ought to treat it as such.

OBAMA: It is inexcusable and irresponsible.

UNIDENTIFIED MALE: They don't send us here to flog one another.

OBAMA: Just say no is the right advice to give your teenagers about drugs. It is not an acceptable response.

CROWLEY: Nobody makes the grade.

(END OF VIDEOTAPE)

CROWLEY: It is interesting now, Wolf, is that as the president moves ahead on some really tough policy issues, he is going to lose some of those democrats. So, even as the going gets tougher, there are going to be more opportunities to try to create that bipartisanship.

BLITZER: Tough as these first 100 days were, the second 100 will be even tougher. All right, thanks very much.

We're only an hour away from tonight's CNN "national report card," grading President Obama on these his first 100 days in office. And in just a few minutes our own John King will be here. He will be over at the magic wall and they'll show us how you can rate the president. Plus, one of the president's top advisers, David Axelrod, he's also standing by live to join us right here in THE SITUATION ROOM.

(COMMERCIAL BREAK)

BLITZER: Major change over at the Bank of America. Let's check in with Fredricka Whitfield. What do we know, Fred?

FREDRICKA WHITFIELD, CNN ANCHOR: He saw it coming, I'm talking about Ken Lewis, the chairman and CEO of Bank of America. Now this CEO no longer chairman. He was ousted today. There was -- there were many boos taking place today during the annual shareholders' meeting and many of them voted him out as the chairman, but voting in as the replacement, Walter Massey who was once the president of Morehouse College here in Atlanta between August 1995 and June of 2007. Now he will be the chairman of Bank of America. Many of the shareholders were very angry during that annual shareholders' meeting today. Blaming Lewis for the most part for the plunging stock prices that followed the purchase of Merrill Lynch. Wolf?

BLITZER: All right, Fred, thank you very much. Let's go back to Jack for "The Cafferty File." Jack? JACK CAFFERTY: The question this hour -- is the Republican Party on the brink of irrelevance. The question prompted in part by the switching to the Democratic Party of Senator Arlen Specter of Pennsylvania. C.J. in Atlanta, "They passed the brink a long time ago. The Republican Party might as well build an isolated compound in the middle of Texas, wall themselves in and then try to repress each other with who can be the most conservative prude. That's their vision for America. Put them to pasture and let them have at it."

Maggie says, given the fact that most sensible conservatives have abandoned the Republican Party and the party itself is striving for purity in its ideology, only a miracle will save it from extinction. The GOP has now established its standard answer to solving any and all problems is just say no." Except, of course, when it comes to torture. They support that. Missy in Phoenix, "Jack didn't we say the same thing about the democrats eight years ago. Yes, the GOP isn't too popular right now. But that's ok, it's not their turn in the limelight. Let the democrats have their time in the sun. Hopefully the GOP will use this time to refine their message and find new energy."

Sarge in Indianapolis, "The budget was passed today, 233-193 without a single republican vote. Very soon the democrats will have a filibuster-proof majority in the senate. So, who cares how the GOP votes anymore and if that isn't irrelevant, what is?" Dave in Utah, "The two-party system is in place and it will remain that way. The GOP will stay relevant but it will change. I think the party will get back to its fiscal roots and small government." John in Oxford, Mississippi, "Jack, the Republican Party plenty relevant as long as you're a 60-year-old southern white male who hates government taxes and gay marriage." And Harold in Anchorage, Alaska, "Will the last person leaving the Republican Party please turn out the lights." If you didn't see your e-mail here, you can go to my blog at cnn.com/caffertyfile, look for yours there among hundreds of others. Republicans have their problems. Wolf?

BLITZER: Jack Cafferty, thanks very much.

And to our viewers, you're in THE SITUATION ROOM. Happening now, breaking news. The swine flu outbreak nears widespread human infection. The World Health Organization raising the alert level and warning a pandemic is now considered imminent. So, how's the White House responding and preparing?

The White House senior adviser, David Axelrod, he's here in THE SITUATION ROOM this hour.