Homeland Security Watch

News and analysis of critical issues in homeland security

May 1, 2009

Swine flu: operational plan and playbook

Filed under: General Homeland Security — by Philip J. Palin on May 1, 2009

The Secretary of Homeland Security has testifed that in responding to the outbreak of H1N1 the administration is following the National Pandemic Strategy and Implementation PlanIn today’s Washington Post it is reported, “The Obama administration has relied on a Bush-era public health strategy aimed at coordinating its response across an array of government agencies in the week since the first reports of a swine flu outbreak emerged, officials say.”

The Strategy and Plan highlights “three pillars”: 1) preparedness and communication, 2) surveillance and detection, and 3) response and containment.

In terms of our state of preparedness, in February 2009 the Government Accountability Office released a report entitled  Influenza Pandemic: Sustaining Focus on the Nation’s Planning and Preparedness Efforts.  Among several other findings, GAO highlighted the following:

  • Leadership roles and responsibilities need to be clarified and tested, and coordination mechanisms could be better utilized.
  • Efforts are underway to improve the surveillance and detection of pandemic-related threats, but targeting assistance to countries at the greatest risk has been based on incomplete information. Steps have been taken to improve international disease surveillance and detection efforts. However, information gaps limit the capacity for comprehensive comparisons of risk levels by country.
  • Pandemic planning and exercising has occurred, but planning gaps remain. The United States and other countries, as well as states and localities, have developed influenza pandemic plans. Yet, additional planning needs still exist.
  • Further actions are needed to address the capacity to respond to and recover from an influenza pandemic. An outbreak will require additional capacity in many areas, including the procurement of additional patient treatment space and the acquisition and distribution of medical and other critical supplies, such as antivirals and vaccines for an influenza pandemic.
  • Federal agencies have provided considerable guidance and pandemic related information, but could augment their efforts. Federal agencies, such as HHS and DHS, have shared information in a number of ways, such as through Web sites and guidance, but state and local governments and private sector representatives would welcome additional information on vaccine distribution and other topics.
  • Performance monitoring and accountability for pandemic preparedness needs strengthening. Although certain performance measures have been established in the National Pandemic Implementation Plan to prepare for an influenza pandemic, these measures are not always linked to results.

In terms of surveillance and detection, perhaps a post and comments made yesterday provides a good summary.

In terms of communication,  response, and containment… well, it is ongoing and available for our observation and analysis.

 The three strategic pillars could be applied to most (all?) homeland security risks.  The GAO findings – with some modest editing – might also be applied to most (all?) homeland security risks: natural, accidental, and intentional.  If not, I look foward to your disagreement and clarification.

But to the extent the last several weeks have exposed our risk readiness for pandemic flu, what might we reasonably conclude regarding our broader level of risk readiness?  So far, where are we doing the best?  Where did we fail to meet expectations of the plan?  What are the gaps in the plan?  As you look at the plan, our current condition, and what may be ahead, where are you most concerned?

Without disrespect to the illness and death that has already occurred, we can nonetheless see this emerging situation — slow-moving as most crises go — as an opportunity to examine our overall readiness.  What can we learn?

(EDITORIAL NOTE: An anonymous reader submits a news-breaking — if off-topic — story by the ever-vigilant Daniel Fowler at CQ (access below): “Sen. David Vitter has placed a hold on the nomination of Craig Fugate, President Obama’s choice to serve as administrator of the Federal Emergency Management Agency.”)

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9 Comments »

Comment by OU812

May 1, 2009 @ 6:30 am

Senator Vitter, who didn’t deem it important to attend the nomination hearing, turns attention to removing his arms from around prostitute to placing a hold on Fugate’s confirmation

CQ TODAY PRINT EDITION
April 30, 2009 – 7:34 p.m.
Louisiana’s Vitter Places Hold on FEMA Nominee
By Daniel Fowler, CQ Staff
Sen. David Vitter has placed a hold on the nomination of Craig Fugate, President Obama’s choice to serve as administrator of the Federal Emergency Management Agency.
“The senator submitted some questions to the nominee, and the nominee did not answer those questions sufficiently for the senator,” Vitter spokesman Joel DiGrado said.
Vitter, a Louisiana Republican, is providing Fugate with follow-up questions related to FEMA activities in his home state, which bore the brunt of the botched agency response to Hurricane Katrina in 2005.
“Hopefully, the senator will be able to release his hold . . . if he gets the answers to the questions he’s trying to have answered,” DiGrado said.
Before Vitter’s hold, there had been no drama surrounding the nomination of Fugate, Florida’s top emergency management official. Fugate’s confirmation hearing before the Senate Homeland Security and Governmental Affairs Committee went off without a hitch last week, and he was approved by voice vote April 27.
“Mr. Fugate is supremely qualified,” said DHS spokeswoman Sara Kuban.
“FEMA has been working through many complicated issues with Sen. Vitter and has provided written answers to his questions,” she said.
Vitter’s home-state colleague, Democratic Sen. Mary L. Landrieu, said she was “glad this hold came to light, because only public holds are effective. When we all understand the problems with a particular nominee, we can all work to address those issues.”
Leslie Phillips, a spokeswoman for committee Chairman Joseph I. Lieberman, I-Conn., said Vitter will soon meet with Fugate.
“Hopefully that meeting will resolve Sen. Vitter’s objections to the nominee,” Phillips said.

Comment by Nicholas Weaver

May 1, 2009 @ 8:06 am

One thing we have learned: The press can do a lot more harm than good.

Yes, influenza is nasty. But the experience so far shows that this strain doesn’t appear as nasty as first reported.

A little scale from the press, something like “In the past week, there has been one reported death in the United States associated with H1N1. Yet in the past week, there have probably been a couple of hundred associated with other influenza strains, and another roughly 700 killed in motor vehicle accidents.”

At the start of every article on Swine Flu might be good. Scale matters.

Comment by Arnold

May 1, 2009 @ 10:30 am

I certainly don’t disagree that scale matters, and I’ll leave out discussion of the cosmic balance sheet for the press, but I do find it interesting that there is a push for reason in reporting about the flu that was totally lacking in terms of terrorism.

Now I don’t fully support John Mueller’s “overblown” argument, but he does make some interesting points. More people die from heart disease than terrorism, but it or car accidents or X does not get the same coverage or drive similar levels of action.

I understand why but to take just one example, when the press and others don’t push back on news of a supposed plot to topple the Sears Tower by a group that probably couldn’t afford to even get to Chicago (they did ask the FBI informant for boots…), it is interesting that a naturally occurring threat is producing a stronger pushback.

Comment by Wayne

May 1, 2009 @ 1:11 pm

Concerning the operational plan for Pandemic Influenza, several agencies have published them over the past few years. CDC has removed thiers from the CDC website, however the has a July 2007 revision posted at the following URL: http://www.upmc-biosecurity.org/website/resources/govt_docs/avian_pandemic_flu/hhs/cdc_influenza_pandemic_operation_plan.html

Other relevant Federal Agency plans are also available at http://www.upmc-biosecurity.org/website/resources/govt_docs/avian_pandemic_flu/index.html

Comment by Peter J. Brown

May 1, 2009 @ 3:01 pm

Yesterday, I mentioned a Canadian press story that gave high marks to the North American Plan for Avian and Pandemic Influenza which was implemented by Canada, Mexico and the U.S. in 2007 — See
http://cnews.canoe.ca/CNEWS/World/2009/04/30/9307416-cp.html

Among other things, the article quoted Mary Mazanec, deputy assistant secretary for preparedness and response at the U.S. Department of Health and Human Services.

“One of the things that really this plan helped us to organize and co-ordinate is communication efforts,” she said.

Well, today, I feel compelled to add a footnote here.

Here in Maine, we were all informed during our Wednesday night TV newscasts that 3 cases of swine flu had been detected in Maine and that number has subsequently increased to 5 over the past 24 hours. Now, we are receiving mixed messages because confirmation is apparently slow in coming. For example, the CDC web site has not included Maine on its list of almost 20 states now reporting flu cases. You would think that this matter would be clarified quickly and that Maine officials and the CDC would get together to sort this out, especially when national TV newscasta are displaying Maine on their updated U.S. maps tracking the spread of the swine flu.

Right now, only 3 northern border states including New York, Ohio and Michigan are on the CDC list. Maine is not only a border state, but it borders on two Canadian provinces including Quebec which is now listed on the Canadian list of 5 impacted provinces as of April 30, and New Brunswick which is not. Maine also serves as the gateway to Atlantic Canada.

The relevant Public Health Agency of Canada web site can be found at —

http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/surveillance-eng.php

Maine TV and radio broadcasts are easily and routinely received over the border in Canada, among other things. It is this routine cross-border flow of TV and radio news that concerns me here. What are Canadians to think, if one minute they are hearing and seeing that swin flu is in Maine, and the next minute the CDC data does not reflect this fact?

Finally, in another border-related development, Anthony Kimery at HSToday has done an excellent job in his reporting today. His article covers considerable ground, including the dispute involving the National Treasury Employees Union (NTEU) acting on behalf “of the entire 22,000 Customs and Border Protection (CBP) workforce and thousands of Transportation Security Administration (TSA) airport passenger screeners” over the issue of access to gloves and face masks. DHS is apparently refusing to demonstrate a necesssary degree of flexibility in difficult circumstances. For front line border personnel, DHS has apparently wanted things to remain business as usual despite the heightened risk. Check it out..

See — “Flu’s Strains on Health Care, Effective Info-sharing” —
http://www.hstoday.us/content/view/8334/128/

Comment by William R. Cumming

May 1, 2009 @ 9:37 pm

I argue from limited knowledge too early much too early to decide on virulence of H1N1. Virus evolve and sometimes quite rapidly once beyond “tipping point” but time will tell.

Also “communications” is component of all pillers not just the first–preparedness! I translate “preparedness” quite simply to meaning the full spectrum of capability including mobilization systems and Emergency Public Information. Above and beyond that Preparedness almost means 24/7 x365 verification of capability. A very tough business.

Comment by Peter J. Brown

May 2, 2009 @ 7:47 am

Update to comment above. DHS has reversed itself now and given border screeners permission to use PPE’s, ie, masks etc. See Washington Times article —
“Reversal lets screeners wear protective masks” — at

http://www.washingtontimes.com/news/2009/may/02/screeners-get-ok-for-masks-in-a-reversal/

Excerpts —

“That all changed Thursday night, however, after Homeland Security issued new guidelines to be followed by all 22 of its agencies.

“The health of our employees is of utmost importance to us, which is why we issued department-wide interim guidance to our work force [Thursday],” said Amy Kudwa, Homeland Security spokeswoman.

“According to the new guidelines, certain employees must wear personal protective equipment, including those who work in direct contact with or within 6 feet of travelers who are suspected of carrying the virus, and they “must wear respiratory protection.”

“For example, Customs and Border Patrol, Immigration and Customs Enforcement, and TSA employees who are “in close proximity to a person who is being held in isolation due to flu-like symptoms must wear a mask,” the new directive said…”

Comment by Christopher Tingus

May 3, 2009 @ 1:00 am

While I have been making every effort to convey my idea that global soft-drink, juice, and water producer and distributor Coca-Cola’s Board of Trustees and executive management be the first coporate entity to show us for example – Coca Cola’s loyal global consumers – a sense of real concern for the public by offering a N-95 hospital quality facemask in every 12-pack packaging to enable many us folks globally the opportunity to have a functioning quality facemask for themselves and loved ones in case needed…and while my emails may not have reached up the ladder of just deleted, as a global new business development type, just as government here and there has reestablished some trust and recpatured some confidence among us citizens that government may have some compassion for us, it would be terrific to see coporate America and other global entities to utilize their distribution networks and show a sense of reciprocal loyalty to customers in need….

In these days of uncertainty and the lack of trust we the people have for politicians here and there, whether the swine flu virus becomes a serious concern affecting many, we greatly appreciate the new President and Washington’s communications making us aware of the possibilities and what remedy may be at hand.

The other day at Walmart, someone sneezed in front of many of us at the register and a customer behind me spoke up and said, “Oops, the swine flu” causing many in line to immediately smile and then begin sharing the latest flu information. If it were not for the flu and the updates from the government and media, no one would have been talking with one anothet – it was very interesting to see teh concern and how people shared….

While we all of course hope the flu does not affect many, those of us who entrust government officials to do their very best to inform us and to respond accordingly, greatly appreciate the proactive stance of this new administration which I am not a supporter, yet, we appreciate being kept up to date.

While hoping that Coca-Cola will adopt my idea of placing one (1) N-95 facemask on every 12-pack, I reiterate our sincere appreciation to Washington’s informational response and hope that corporate entities like Coca-Cola and others find it feasible and cost effective to pledge the same to loyal customers by sharing information in a social commitment globally taking one-minute infomercials and distributing N-95 hospital quality facemasks to as many as possible….

In parallel with kudos extended to Washington and local officials as well as to governments everywhere,
we as citizens thank the devoted research scientists, those at DHS HQ and all others who have kept us informed.

Let’s hope very few become ill.

Christopher Tingus
Harwich, MA 02645 USA
chris.tingus@gmail.com

Comment by Philip J. Palin

May 3, 2009 @ 2:35 pm

I like the old-fashioned social networking referenced by Mr. Tingus, especially if reasonably accurate information was being shared. A survey conducted last week by the Harvard School of Public Health found an interesting mix of accurate and inaccurate understanding (see link below). The survey and Mr. Tingus’ report from the street both suggest the difficulty in finding the Goldilocks solution of neither too much nor too little public information, but a tone and amount that is “just right.”

http://www.hsph.harvard.edu/news/press-releases/2009-releases/survey-americans-concerned-swine-flu.html

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