An excellent article on the CIDRAP site by Maryn McKenna (late of the Atlanta Journal Constitution where she had the CDC beat) won’t be news to readers here, but it is news that it is news. The subject is efforts by non public health types in preparing for pandemic influenza. McKenna notes that recent reports by two different but highly regarded groups has noted that governmental planners are not making full use of grass roots groups outside of professional boundaries. In fact they aren’t making use of them at all. Communication with the public is one way.
The first report, “Community Engagement: Leadership Tool for Catastrophic Health Events,” was published Apr 4 by the Center for Biosecurity at the University of Pittsburgh Medical Center (UPMC). The report, which sums up the findings of a 27-member panel convened by the center during 2006, asserts that official planning incorrectly assumes the public will panic and create a “secondary disaster.”
“The civic infrastructure” comprised of the public’s collective wisdom and capability to solve problems; voluntary associations (both virtual and face-to-face) that arise from shared interests or a public good; and social service organizations that look out for the well-being of various groups?is essential to managing a mass health emergency,” the report says.
“US homeland security and health emergency policies, however, do not adequately reflect the civic infrastructure’s proven contributions in catastrophes. Nor have most top officials yet realized the potential value for local and national communities–and for themselves–of preparing knowledgeable, trained networks of constituents who can mobilize in a crisis.” (Maryn McKenna, CIDRAP)
The second report comes from the Institute of Medicine (IOM), the medical component of the National Academies of Science:
The report quotes Jason Corburn, assistant professor in the urban planning program at Columbia University, New York City: “Engaging community members and their knowledge about how they move through the world, and what they know about their disease management and exposure risks in their community, can contribute to better science and policy.”
“The rational planning unit is the neighborhood,” [risk communication expert Peter Sandman of Princeton, N.J.] said in an interview. The ideal planning unit “wants to be geographically compact, it wants to be something with more storage capacity than individual homes, and it wants to be something that, when government has its hands full, can be autonomous.”
This is the moving idea behind The Flu Wiki (our sister site) and McKenna appropriately quotes my Wiki partner DemFromCT:
The central cyber-site for pandemic planning is the FluWiki, a sprawling collection of thousands of collectively assembled posts that has garnered 1.5 million visits in its 22 months. In FluWiki’s earliest days, participants anonymously shared advice about preparing their own households, said Dr. Greg Dworkin, a pediatric pulmonologist in Danbury, Conn., who is one of the site’s volunteer editors under the name “DemfromCt.”
But in recent months, he said in a phone interview, participants have begun reaching out to each other through pages dedicated to US states and foreign countries and have begun sharing strategies for area preparation and for communicating with public health agencies and local governments. At the same time, a few planning agencies have begun using the site as a resource; the New York State Department of Health, he said, posted its draft guidance for using scarce ventilators during a pandemic to the FluWiki before the document’s public release.
Michael Coston (A Flu Diary), Crawford Kilian (H5N1) and Debi Brandon (A Bird Flu Journey) are also given thmbnail sketches and quoted. It’s nice to see flublogia given its due. Through McKenna’s story CIDRAP now becomes the third important source to point to the vast well of knowledge, wisdom and expertise being overlooked by “official” planners. She points to a few exceptions (Berkeley, California and Seattle-King County health department), notable for being so different. As for the rest, it is a case of blindness and misconceptions about “the public.” This is a prejudice that is difficult to overcome. Too bad for everyone concerned.
I have only given a few excerpts from this substantial piece. Give it a read (here).