I've discussed preparedness issues previously (like here, here, here, here, and here, for instance), and noted that we're still sorely unprepared for an outbreak of pandemic influenza. It's also been a frequent topic at Effect Measure, and of course at the flu wiki. What's largely been discussed, however, is preparedness at the personal level, and at the federal level. Discussed less frequently has been preparedness at the local/community level (though again, I should note this definitely has been a concern and emphasis of the flu wiki folks, and is specifically included on this page of their site). An article on MSNBC further highlights local preparedness--or the lack thereof.
In the event of a disaster or deadly pandemic, "local public health departments have to be ready to shoulder the load and do it without any external help, at least for the first couple of days," said Etkind. "The federal government has been quite clear. They've said, 'We don't have any personnel to come to your rescue,' and the states are saying the same thing."
Here's one of the problems:
Last fall, President Bush proposed approximately $7 billion in emergency funding to help states prepare for a possible outbreak of bird flu. But only about $600 million was earmarked for local public health departments. Congress has approved roughly $3 billion of Bush's proposed funds, setting aside around $350 million for local preparedness.
As I've mentioned before, local public health departments are, more often than not, understaffed and underfunded. Even those who work there may not have the qualifications to head up a pandemic response team. Even running a fairly simple mass vaccination campaign (if there is such a thing as a "simple" one) could easily swamp the resources of many local health departments--and that's assuming that the workers would 1) remain well themselves, and 2) diligently report for work in the event of a pandemic. Neither is certain.
"Supporting local public health is the best bang for the buck," said Etkind. "We can have all the vaccines we need, but who is going to administer them? Who is going to work in the labs? Remember the anthrax scare?"
"Finally there's federal recognition that they can't do this alone, because it's not like the CDC is a huge force of saviors that will swoop in.... It's not going to happen. They're finally getting that.
"On the other hand," Smith said, "the federal plan calls for the development of a local 'infrastructure' for medical convening and planning. I'm it around here in terms of infrastructure."
And that's how many counties are as well--they have a few doctors or nurses who are "it" as far as local public health goes. This is where the rubber meets the road...and if a pandemic were to happen tomorrow, there'd be a lot of engine trouble, to say the least.
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This is really scary. Especially after reading the post on Effect Measure about giving the sickest morphine and leaveing them to die. I also read that a lot of health care workers thought they could stay home should a pandemic occur becaue they did not work in the ER. I really hope it never hits because we are not ready at all and to many people are still in denial over it.
If the last pandemic was, what, 1918, then we're talking about a job that has to be done, but not very often. Sounds like a job for volunteers. I'd suggest something like a club. In the off years, club members meet periodically, like monthly, to shoot the breeze and get caught up with the latest news. Periodically, maybe yearly or so, members would be certified as knowing the currently accepted proceedures.
My point is that being currently able to cope is not a full time job. So, get a bunch of people to have some reason to check each other's progress. A social event. In the event of an outbreak, these people would be recognized by the local government (town?) to help out, even lead the activities. Club members would make public presentations, and local officials would be required to attend.
Perhaps a new club need not be started. Perhaps the local Elks or something could take it on as a sub group.
That's how to fight an unfunded mandate.
The last pandemic was actually 1968--the 1918 one is just the worst influenza pandemic in modern history.
The club idea is a good one (and indeed, I gave a talk on the topic of avian flu earlier this week, and discussed a bit of what you touch on with one of the women in the audience), but it's not nearly enough. Even if you get people trained a bit in preparedness, and a local plan spearheaded by those group members, that can't really deal with the bigger issues that are beyond their control--hospital beds, business/school closures, graves/coffins, vaccination procedures, licensed nurses and doctors to handle the overflow, litigation, etc. It would be a great start, but still not nearly enough.
While all levels of society have a role in the preparedness hierarchy, it is important to understand that those most at risk of death appear to be under 35. These are also those most likely to have young, dependent children at home.
ANY person who is under 35 and/or has dependent children should be given a gracious pass on performing any public duties. Those over 35 should step up to the plate and fill their posts.
We must start putting out the word to enlist potential volunteers from the ranks of "used-to-bes" and retired folk. And we must give up on any notion that people who have children at home to worry about are somehow turning away from their "duty" by staying home. They are stepping up to their most important duty by doing so, that of protecting their off-spring and guarding the next generation to benefit the society in the future.
Are you still yelping about the bogus avian bird flu (or is it Nigerian ostrich flu or feline cat flu?)
My oh my.
Hey, at least ABC is on the case! Let's all set our tivo for May 6, 2006, so we can cozy up on the sofa and eat lots of popcorn together.
I love it -- science thru cheesy made-for-tv movies:)
Hank Barnes
Addendum:
If you're gonna be fraidy cats, at least you oughta make some $$ from the hysteria. I suggest buying stock in No-Germs
A revolutionary concept: washing one's hands kills bird flu virus!
Hank Barnes
Hank, it doesn't matter whether it's H5N1 or a different strain...the point is that we're underprepared at every level.
Oh, man...from Hank's link:
Apparently their "scientists" don't even realize MRSA is a bacterium, not a virus. I wouldn't go sinking any money into their stock if I were you!
Au contraire. I'm prepared at every level. I just bought several boxes of No-Germs. Also, I bought some popcorn and beer to watch the movie. Maybe, I can entreat the missus to fry me up a few BLT's.
This is almost better than John Travolta in The Boy in the Plastic Bubble from 1976 -- your birth year! -- which sent otherwise sober and collected scientists flailing about in other bogus scientific endeavors.
Hank Barnes
"This is almost better than John Travolta in The Boy in the Plastic Bubble from 1976 -- your birth year! -- which sent otherwise sober and collected scientists flailing about in other bogus scientific endeavors."
What are you babbling about, Hank?
GE