There was a story about prepping for a pandemic in the Washington Post a couple of weeks ago I made note of but didn't get to commenting on. Now's my chance.
When Alexandrians opened their June FYI newsletter, out slipped a slick brochure with a photo of a stern-faced crowd staring out from the cover. "Be Ready, Alexandria!" the boldface type warned, "For a Pandemic Flu Outbreak."[snip]
"We must take this risk very seriously," Mayor William D. Euille said in an interview. "If a pandemic were to occur, we are going to have a lot of people infected. People are going to die. Some people are going to have to be quarantined. Events are going to have to be canceled. Schools are going to have to be closed. It's a serious state of affairs.
"Rather than wait until something happens and be reactive, my position is to be proactive," he said.
So seriously have Euille and city leaders taken the threat of a flu pandemic that they have gathered representatives from government, business, hospitals, churches, nonprofit groups and other organizations for meetings. They have been meeting since November 2005 to figure out how to respond to an outbreak. Eight work groups are considering such matters as how government would continue to function, where emergency health stations could be set up, how to keep the supply of groceries flowing and, most soberly, finding warehouse space for bodies should fatalities overwhelm local mortuaries.
[snip]
The main message to residents is this: If the worst happens, you have to be able to fend for yourself. Wash your hands. Stay home if you have flu symptoms, unless the situation becomes dire. Don't expect grocery stores to have as much food as usual or restaurants to be serving. Have medicines and a supply of water and canned and dry food on hand.
"People are going to need to do some of this themselves," said John Clizbe, emergency planner for the city's Health Department. "There isn't anything that the government or the private sector can do to assure people that everything is going to be like it normally is, because it won't be.
"The important message in that brochure is, people need to start thinking how they are going to be accountable for some of their own health care," he said. "There are things people are going to have to do differently if a pandemic comes." (WaPo)
This is a long article with much I wish to comment on, but let's start with the pull quote, above. First it must be said, planning and thinking ahead is the right thing to do. Taking the risk seriously, even if the risk is small, is also the right thing to do because it is a high consequence event. I don't see anyone in Alexandria panicking or unduly frightened. I see a city government doing what it is supposed to be doing.
I am more hesitant about the projected notion there are only two possibilities: the health care system and government take care of you or you are on your own. There is a lot of room between these two extremes. A third alternative is that we work to take care of each other. A description of the eight working groups the mayor has set up -- groups such as one that looks at government continuity of operations in the face of widespread absenteeism or the one looking at how isolation and quarantine would work, show none explicitly oriented to the organization and efficient use of volunteers, the organization of non-governmental groups or similar techniques to promote community resilience and cohesion. I am sure this is part of the discussion in one or more of the working groups. I'd like to see it as a front and center objective.
Some of the groups are also of dubious value, or worse, for example the isolation and quarantine working group.
Another working group is studying how isolation and quarantines would work. How would a mandatory quarantine work? (It wouldn't, Clizbe said. At least not once the numbers became overwhelming or the deputies guarding the houses got sick.)
So some people get it. The mayor apparently doesn't. The distinction between quarantine and isolation -- quarantine the explicit segregation of people who are well but possibly exposed, isolation the segregation of the sick -- is not just terminology but of practical significance. Quarantine won't work. Isolation will be relatively easy. We are past time when these two terms should be confused.
There is a lot government can do in advance of a pandemic event, even if its active role during a pandemic will be reduced because of general absenteeism. So what Alexandria is doing is good.
But there is room for improvement and clearer thinking. Most importantly, there is a need to get citizens involved. Some of them are no doubt already way ahead of their leaders.
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HHS recently closed a five week long blog devoted to Pandemic Flu Leadership. It was almost counter-productive, in that it sent out canned talking points that were often in contradiction.
But the commenters were pretty savvy, and many of them participate in the FluWiki website. Grassroots groups have also published pandemic preparation guides for individual, family and local community use. That's where I think the planning efficacies and utility lies.
No one can articulate how vulnerable segments of the population will be able to be offered any support. Many on food stamps, for example, have no means to stockpile food, hygiene items and medications. Many who work have no financial means to stay at home, even when ill.
The country has abandoned social safety nets for the most part, and with so much in the national supply chain being delivered on a just-in-time basis, I think the national is going to be extremely vulnerable to a national or multistate pandemic.
The healthcare infrastructure is already at or over capacity, as well. I think that many providers - including nurses and physicians - will not report to work in favor of staying home and protecting their families.
All around, there are just too many vulnerabilities and weaknesses in pandemic preparation to give any assurance that the effects can be significantly mitigated via current preparation tactics.
Revere,
This has to be great news, that a community has responsible leadership and have taken the initiative to begin preparedness activities. There may be some deficiencies such as you've highlighted, but hey, it is a big task afterall, and a very steep learning curve. Sadly, there are not many communities that have been proactive and are this far down the road to mitigate the severe impact of a Cat. 5 pandemic.
As was called for by the posters to the HHS Pandemic Leadership blog, there has not been enough clear communication by the (Federal/State) authorities to the municipal and local government levels to begin preparations, nor validation that there are already community members (like Fluwikians) who are knowledgable and passionate resources who can assist them.
It seems to me there is a "failure of imagination" as to what a Category 5 pandemic would be like, so it's hard for leaders to get off their duff and lead because they don't "get it" yet.
Seems like the community leaders in Alexandria "get it", so I say to them, "Well done!"