Homeland Security Watch

News and analysis of critical issues in homeland security

August 12, 2009

Pandemic planning and communicating: Not too hard nor too soft, but just right

Filed under: Biosecurity,Preparedness and Response — by Philip J. Palin on August 12, 2009

goldilocks-and-the-three-bears

In a recent discussion with the USA Today editorial board, Secretary Napolitano said:

You can speculate about a 1918-type situation, (but) the data suggest that we will have an outbreak more similar to what happened in the ’50s, or perhaps what happened in 1968. I prefer that we educate people about what we are more likely to experience: a heavy outbreak in the fall that has a focus on young people, including college-age and pregnant women. Then, we will focus on what we need to do to work our way through that, such as keeping schools open as much as possible.

That’s entirely reasonable, given what we know about the virus today — especially given how H1N1 is presenting in the Southern Hempishere during the winter flu season there.  With rather rare exceptions, the new virus has been no more virulent than the seasonal flu of recent years.

But is the Secretary’s tone potentially too reasonable? 

Focusing on those germ-factories — otherwise known as schools — makes a lot of sense.  Great gobs of written guidance has been made available to school administrators.   This is even more important than usual given the youth-oriented targeting of this virus. Most confirmed cases have involved  individuals 19 years of age and younger. (See the European Centre for Disease Prevention and Control H1N1 Risk Assessment)

But none of the teachers or school administrators I know had seen or heard of the pandemic plans until I sent them along. 

In a joint op-ed published yesterday, Secretaries Duncan, Napolitano, and Sibelius (the three bears?) encourage,

Parents should talk to their employers and make child care arrangements in case their kids get sick. And if a school closes, learning shouldn’t stop. Schools need to create opportunities to learn online and work with parents to find ways for students to bring textbooks and other resources home.  If you’re an employer, you should plan to get by with a reduced staff. You don’t want an employee who’s ill to spread flu in the workplace. If you’re a medical provider, you should plan to handle more calls and patient visits.”

All good advice.  Is anyone listening?

At the NAFTA summit John Brennan, Deputy National Security and Assistant to the President for Homeland Security and Counterterrorism, was considerably more severe in his tone:

“I think everybody recognizes that H1N1 is going to be a challenge for all of us, and there are people who are going to be getting sick in the fall and die… The strategy and the effort on the part of the governments is to make sure we do everything possible and we collaborate to minimize the impact, and make sure that the severity of the illness is kept at a minimum.”  (More by Sam Youngman at The Hill)

What’s included in “everything possible”?  Some are expressing concern.

In late July CNN reported on some DOD contingency planning for something more than a plus-up of the seasonal flu.  Earlier this week Fox  News reported that the prospect of military involvement in an H1N1 response is prompting angst from both left and right. 

Well, someone is listening. But they are talking about the constitution, not the contagion. 

This suggests a fully functioning civil immune system.  Glad to see it and we are probably in for a veritable explosion of libertarian white blood cells. According to Josh Gerstein at Politico, “The Obama administration is quietly dusting off an effort to impose new federal quarantine regulations, which were vigorously resisted by civil liberties organizations and the airline industry when the rules were first proposed by the Bush administration nearly four years ago.” (See the current Executive Order 13295)

Depending on our personal angles, any of us can quibble with what is being said or proposed or planned.   My quibble is for a bit more of John Brennan’s growl and a bit less of Janet Napolitano’s reassurance.  But my “just right,” is probably too hard or too soft for you.

The biggest challenge today is less a matter of what is being said than what is being heard.  I don’t perceive many are listening.

Do what you can today to be better prepared whatever unfolds over the next few weeks.  Otherwise, an unexpected mutation in the virus could have us all sounding like the end of the story: “Goldilocks woke up and saw the three bears.  She screamed, “Help!”  And she jumped up and… ran away into the forest.”

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5 Comments »

Comment by William R. Cumming

August 12, 2009 @ 7:36 am

Well Phil an excellent post even if not a “reasonable” one!

Highly recommend the site FLU.GOV as containing the most accurate information.

Comment by Peter J. Brown

August 12, 2009 @ 8:20 am

The problem is not schools per se but rather the specific high risk groups which populate those schools. Having spent the last 3 months examining contingency and continuity planning issues in schools while waiting to see what sort of guidance would emerge from the federal and state educational sectors, I see lots of opportunities here to do the right thing. Will we pull it off? Keep your fingers crossed.

Comment by Peter J. Brown

August 12, 2009 @ 10:01 am

FYI, a very relevant interview appears in today’s New York Times —

http://www.nytimes.com/2009/08/11/health/11docs.html?_r=1&ref=health

Comment by Mark Chubb

August 12, 2009 @ 10:04 am

H1N1 raises some interesting questions for us about prevention and preparedness. I fear too many people see prevention/mitigation efforts primarily in terms of avoiding transmission among humans when, in fact, the opportunity to apply prevention techniques was more or less lost as soon as the virus jumped the species barrier from pigs to humans.

Preparedness too, it seems, has come to imply a readiness to manage those infected to prevent them from spreading the virus among others rather than seeing to their care and the continuity of operations disrupted by their illness. This not only highlights the futility of such conceptions, but also illustrates some of the confused thinking around the important differences between prevention and preparedness.

One of the things that makes this episode scary is the fact that such a small percentage of people now living have acquired immunity to all or part of the virus now circulating. As such, until a suitable vaccine becomes available in sufficient quantities to immunize very large proportions of the vulnerable population, allowing the virus to spread is our best defense against future outbreaks.

It wasn’t so many years ago that a mother would willingly and knowingly expose her children to others in the neighborhood with chicken pox or other virulent diseases against which no vaccine was available. Sure they would become sick, but she would be there to manage their illness and nurse them back to health (in most albeit not all cases). She did this with full knowledge that the illness presented certain risks, but the risks of acquiring the disease in later life without such acquired immunity was potentially much greater.

Today, we might consider such behavior abusive even to the point of applying criminal sanctions. I have to ask, is this wise?

Pingback by Sick Thinking « R4 Resilience

August 13, 2009 @ 9:52 am

[…] current events by chubbm As usual, Phil Palin at Homeland Security Watch has some interesting thoughts on pandemic influenza planning and response, particularly at the federal level.  Getting the […]

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