Homeland Security Watch

News and analysis of critical issues in homeland security

November 10, 2015

Critical and creative as complementary

Filed under: Biosecurity,Border Security,Preparedness and Response,Public Health & Medical Care — by Philip J. Palin on November 10, 2015

Last week the Secretary of Homeland Secretary presented awards recognizing, “the work, sacrifice, and professional excellence of employees from components all across the Department of Homeland Security.  [Individuals who] performed above and beyond the call of duty, responding in extraordinary ways to the challenges of protecting the homeland.”

The DHS website provides quick profiles of several team-based and a few individual awards.

Most of the awards focus on success addressing a specific problem and most of the problems are component-specific (i.e. involving only one agency).  But of eight award categories, one addresses “unity of effort“.

Three of the awards given in this category relate to a National Special Security Event (e.g. papal visit), one on a public-private effort at the Federal Law Enforcement Training Center, one on Southern border operations, and one on Ebola response.

The Ebola team honored especially caught my attention:

Aaron Firoved, Ph.D., Office of Health Affairs
Captain David Lau, ICE
Mallory Lowe, FEMA
Jamie Johnson, FEMA
Elizabeth Harman, FEMA
Jeremy Guthrie, FEMA
Mike Turner, OIA
Pedro Bordatto, TSA

Last year most of the Ebola related news focused on actions by the Centers for Disease Control or Department of Defense.  But behind the scenes even more was happening.  CBP developed new policies for enhanced airport screening.  Several DHS components were involved in responding or preparing to respond.

The team honored last week was involved in policy/strategy development. But as important they were charged with a proactive, coordinated reach-out across DHS and with state, local, tribal and private sector colleagues to communicate the situation, problems, and opportunities.  I am told this group became a trusted go-to source within the Department for timely and accurate information, especially when the immediate answer was the dreaded, “I don’t know.”

This is a communications role seldom sought out within the public sector and like-wise across the culture.  There is often an expectation for expert and authoritative information, even–especially–in the midst of an emerging crisis.  The messenger can be damned regardless of what s/he does or doesn’t. (If you need to be reminded of the epidemic potential for paranoid criticism just google “fema ebola”.)

A friend who came to depend on the team told me, “It really was less about what they communicated and more how they communicated. Often they had bad news or no news, but they were receptive, responsive, and proactive in trying to trace what they did not know and getting back with whatever they had.  This encouraged ongoing exchange and increased institutional confidence. It may have even increased competence.”

(But even this good example and the award does not allow my friend to feel sufficiently empowered to be named as a source. She admits trust-building takes two and she is not–yet–ready to do her part.)

Critical thinking is usually a very productive skill.  A great deal of critical thinking was applied to last year’s Ebola crisis.  What I perceive this task-team was able to do is complement the critical thinking with creative thinking.  They generated new capacity by using the questions they received to “learn-from-artful-searching”, “give particular attention to strengths” that could be found within DHS or across the whole-of-government, while inviting DHS personnel to “create new ways to pursue… a positive future.”  (The quotes are from Appreciative Inquiry by Frank Barrett and Ronald Fry.)

The Secretary expressed his appreciation for their appreciative approach.

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14 Comments »

Comment by William R. Cumming

November 10, 2015 @ 1:57 am

FEMA successes often have involved internal communications flows and failures their absence. The low regard of specialized liason roles by some often create barriers to taking advantage of the leverage that can be provided by internal communications.

Perhaps information sharing was a key failure on 0/11/01! I provided a five hour briefing to 9/11 Commission staff on this issue and preparedness of the civil sector.

Comment by Donald Quixote

November 10, 2015 @ 10:35 am

For the amount of lessons learned truly and honestly implemented and our national preparedness enhancement after the recent Ebola experience in the United States, luck may be the true award winner. I just hope and pray that luck maintains its level of success for the benefit of all of us.

I concur that critical thinking is a very productive skill, but so is critical action (which is its long ignored partner). For those many that claim it is better to be lucky than good, lucky is not an acceptable public policy even though it is often the standard.

Comment by Philip J. Palin

November 10, 2015 @ 3:55 pm

Donald Quixote: I perceive that many of those involved with the Ebola response agree that luck was entirely too influential on outcomes. There have been efforts at serious lesson-learning, but I don’t see much actionable yet emerging. In terms of this specific recognition, it is my impression that this team (for reasons I have not been able to get explained) responded effectively “under fire” with non-bureaucratic, open, collaborative, and constructive style and substantive. Even luck sometimes needs this kind of help.

Comment by William R. Cumming

November 10, 2015 @ 6:50 pm

While all rooting for an Ebola vaccine still far off!

Comment by Arnold Bogis

November 10, 2015 @ 9:18 pm

I would actually like a little bit more on this sense that it was more luck than preparedness that was so influential on the outcome.

Despite the horrible conditions in West Africa, Ebola is hard to get and difficult to spread. Despite the worst case scenarios shared, what exactly was just barely dodged?

Let’s not forget the United States’ best friends – the oceans. How many travel to the U.S. from those regions?

Our healthcare system might not be the most equitable, but it is incredibly talented and adaptable. What was the threat from Ebola (compared to everyday threats that take the lives of healthcare workers every day and month?) to our healthcare system?

Comment by Philip J. Palin

November 11, 2015 @ 4:07 am

Arnold, When I hear folks talking about being “lucky” last year, they often begin with the core characteristics of Ebola. They are usually wondering/worrying about what might have happened if this had been a more readily transmittable disease. Ebola is known, yet early detection and intervention measures were ineffectively applied at the point-of-origin. If this had been a novel virus…?

In terms of US domestic response, under the surface there were several indicators that if something more easily transmitted had presented we had (probably have) extremely limited surge capacity. In my world, the medical goods supply chain — PPE in particular — was extremely short. Clinical protocols were sketchy. Risk communication was very uneven. We were lucky, some perceive, that Ebola is “hard to get and difficult to spread.”

Perhaps the most dramatic indicator of the healthcare system’s capacity at least in my book, was how very effective public health interventions (especially epidemiological tracing) were in Nigeria. Without that preexisting capability effectively executed, even Ebola might have been much more difficult to contain. So, I am not trying to suggest that luck was the only saving factor… here or there.

I don’t know if any of this is what Donald Quixote had in mind when he raised this issue. But he is not alone in highlighting the need to differentiate between outcomes related to systemic prevention and preparedness and outputs that emerged unrelated to these inputs.

Comment by William R. Cumming

November 11, 2015 @ 7:30 am

Note Bene! Most of Sub-Saharan Africa has NO air traffic control. VFR only!

I mention this only to point out that cause and effect analysis a product of Western Civ?

Comment by Tom Russo

November 11, 2015 @ 5:31 pm

WCR

Don’t get too excited about an Ebola vaccine…a distribution system to get it into arms remains distant!

The 2009 H1N1, a low-impact pandemic, challenged U.S. distribution in a moment of crisis and I have yet to see those challenges be addressed. Funds continue to be directed to vaccine production but the emphasis on distribution has a unique set of barriers that require collaboration and legislation to address in moments of emergency that require mass vaccination. These have yet to be addressed.

For background see:
Pandemic Vaccine Distribution Policy for the Twenty-First Century: https://www.hsaj.org/articles/207

Comment by Concerned Citizen

November 11, 2015 @ 10:56 pm

(Thank you for your service)

“Honor to the soldier and sailor everywhere who bravely bears his country’s cause. Honor also to the citizen who cares for his brother in the field and serves, as best he can, the same cause” — Abraham Lincoln

Submitted by:

(Chris)topher Tingus
skype: christopher.tingus

Comment by William R. Cumming

November 12, 2015 @ 6:51 am

Thanks Tom! Yes no real assigned responsibility or accountability for vaccine policy issues including development, implementation, and operations.

Comment by Donald Quixote

November 12, 2015 @ 11:41 am

We were extremely lucky that so few traveled unknowingly to the United States with active Ebola virus or the many other serious endemic or emerging pathogenic threats. The nation does not have an efficient and/or effective strategy or existing infrastructure to interdict an emerging threat at the border or many other primary locations. We react to the threat, not prepare for it. We were lucky that the one unexpected carrier only infected two others in an advanced health care setting and none at his residence. If there were scores of infected people in various locations, the story would not have been so rosy for us. At this point, a hospital will quietly settle a pending lawsuit and many of us that dodged a bullet will feel successful and proud of the response. That is what I mean by luck. I fear for a real public health threat in the future, not a warning shot such as Ebola.

The national pandemic strategy and its implementation plan are getting rather dated and likely would not withstand a proper comprehensive evaluation by GAO. GAO, CRS and DHS OIG have been addressing portions of it and other strategies/plans from different angles with less than stellar findings. A National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts (October 2015) will generate limited interest and interesting articles, but will likely be placed on a shelf (or in an electronic folder) until our luck runs out. When it does, the blue ribbon study will be a very valuable document for congressional hearings and another healthy supplemental bill.

As the ever house cynic for this subject, discussions, planning and preparedness resulting in action does not produce robust supplemental bills to expand limited appropriated budgets. Unfortunately, Congress is much more likely to reward failure with follow-on funding than success (9/11, Katrina, Sandy, et al).

The oceans were not as helpful as expected in 1918 with the “Spanish Flu”. The oceans were our friends until those pesky Wright Brothers diverted from their primary mission of bicycle design…….

Comment by Tom Russo

November 12, 2015 @ 5:10 pm

And vaccine distribution in an emergency has become more complicated given that the public health nurse corps and diminished in the past decade while vaccine administration has migrated from primary care offices and public health clinics to private sector in-store clinics whether pharmacy, big box stores or other retail sector clinics.

But where does CDC distribute emergency vaccine…those state and local public health offices who no longer have the capacity to support vaccine distribution.

Comment by Donald Quixote

November 13, 2015 @ 11:18 am

You make a great point about points of dispensing/distribution for medical countermeasures and other resources. I am unsure that we are fully prepared to execute this mission during a critical time with limited or no warning – especially on a grand scale. For those that say that we are prepared, what is the evidence beyond a well written plan or successful tabletop exercise? What happens when the stars do not line up and the public or pathogen did not read the plan?

Comment by Tom Russo

November 15, 2015 @ 3:45 pm

Agreed Quixote and the Ebola dust-up in the U.S. revealed a few cracks in the “system” of public health/medical response and that was quite limited.

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