In the White House Situation Room, the hardest calls were never the obvious emergencies. What kept me up were the nights when a fragment of information came in and the debate wasn’t about what to do. It was about whether anything concerning was happening at all.
In 2023, my team and I were assessing the nation’s pandemic influenza plans when the Situation Room notified me that H5N1 influenza had infected a father and killed his daughter in a remote Cambodian village. Was the virus spreading between people – the start of a pandemic that could kill millions? The national security adviser asked whether to brief President Biden immediately. If these cases were the first signs, we would need to commit billions of dollars to vaccines and treatments within days.
