No plan for all seasons (flu)

Almost everyone now seems to think the Iraq debacle was, well, a debacle. Many of us thought invading Iraq was a terrible idea to begin with. Others are silent on that issue (or approved) but think it was carried out poorly. No planning. Failure to plan, however, is a hallmark of the Bush administration. Their intentions are pre-programmed but they never seem to plan for the consequences of those actions. It's not just Iraq. Or Katrina, for that matter. It's also pandemic flu:

When you ask federal officials around the country if they are prepared for a pandemic flu, the answers are unsettling.

"It is kind of a train wreck if we get into a pandemic because if it hits the entire country at once, if it spreads at lightning speed, it has the potential to overwhelm us," said Ray Morris, executive director of the Minnesota Federal Executive Board. "I would agree that even though a lot has been done, a lot more needs to be done." (Amy Doolittle, Federal Times)

It's not that there is no disaster planning. It's that there is no effective planning for the kind of disaster a pandemic would be, widespread absenteeism, not localized, prolonged, a stressor that will break the brittle medical care system and other social services. Coping with this takes forethought. And planning. But:

The government's current national response plan for a pandemic flu does not identify which organizations are responsible for coordinating and practicing agencies' responses.

But unofficially, that responsibility has fallen upon the Federal Executive Boards (FEBs), which are regional associations of top federal career executives.

"We would like to see [FEB] executive directors devote at least 50 percent of their time toward pandemic and other emergency preparedness efforts," said Kevin Mahoney, associate director of OPM's human capital leadership and merit system accountability division, at a recent Senate hearing.

But neither OPM nor the Federal Emergency Management Agency has yet provided the 28 FEBs across the country with guidance and standards on how to help feds prepare for a pandemic.

As a result, FEBs lack clear direction on how to practice and coordinate preparedness among federal agencies in their regions. And they lack the authority to force state and local governments to work with them, officials say.

One obvious way to keep an agency or business or school functioning, at least minimally, is to consider telework, work from a remote location like your home. Not everything can get done that way, but a lot can -- if you think ahead. But many federal agencies have no such plan. Which ones? Agriculture, Commerce, Defense, Education, Energy, Homeland Security, Housing and Urban Development, Interior, State, Transportation, Treasury and Veterans Affairs (Federal Times story linked above). Oh. Those.

At least the FEBs -- some of them, anyway -- are on the case, even if the agencies aren't. Some FEBs are even working on table top exercises, an excellent way to reveal gaps in the system. Unfortunately, many people have household budgets bigger than the budget of an FEB. The budget of the Los Angeles FEB is $10,000 and its director had to send out an email to members asking for donations to pay for the $7000 exercise. In Boston, the office is one person.

Iraq? Katrina? Veteran's care? Pandemic flu?

Same old, same old.

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the main problem is still, that
they don't know what to plan for.

H5N1-pandemic ? CFR > 10% ?
You rarely find people (officials) to be willing
to even talk about it.

So, the strategy is usually to keep things unclear.
To talk without being specific.

The main problem is there is so much to do that it will take a very long time to get even a half-way decent system in place. We are talking about the kind of catastrophic event that, for example, in 1918 killed more people than the worlds that many countries put the whole of their national efforts in. We are talking about the kind of event that no country has ever planned for, and therefore there are no institutional structures in place to facilitate it. Almost everything has to be built from the ground up, and based on no previous experience and very often with little solid data or evidence.

Right now, the amount of effort, resources, attention, including public attention which drives political will, is miniscule.

So yes, it is not enough, but if we do not think of government as a monolithic entity but consisting of myriads of players, then it's clear to me that there are some, in fact many, who are working on this day and night to the best of their ability and the resources available. But the external realities including political ones are such that this problem does not carry priority in the national consciousness.

That to me is the crux of the matter. Plus the sheer amount of work that needs to get done.

Well, agencies, businesses, and schools do rely on the people who work in offices and at computers, but it will be the hands-on workers who will be sorely missed. The computer/office workers are, after all, providing a service for the people who actually produce the end result. By ordering supplies, tracking hours, etc., the office employees are really the support staff. It will be the blue collar workers and nurses, doctors, police, fire and rescue, utility, sanitation, electricians and so on who will step up and know how to improvise, by-pass, make do, and get the community through, even if the computers are not running. And they can't do that from home. I hope there are more mechanics and plumbers in my neighborhood than computer geeks.

peggy: You are of course correct. In a sense telework is the easy part. And they haven't even done the easy part, which is what I was trying to say.

A small clarification - the feds may not have much done (operationally) but the main burden for this rests at the local level anyway. Most cities and counties across the nation are deep into planning. There is little that the fed government will be able to do in a pandemic, so stressing FEB misses the way the system is supposed to work. Locals respond first, then the state, then the feds.

Joel: This post was about the federal agencies themselves.

Revere- There are times when I think you are a litte off base and this is one of them.

Pandemic of any kind would be a monstrous tasking of the US and probably do just about ever other country out there. We would be hit and hard and all things that we know now would change forever. Standards of living, healthcare, socio-economic upheavals all would roll in like an Indonesian tsunami.

So what have we done? Many millions of dollars have been spent and actually more than we have spent here have gone over there to try to stop it. The bent nowadays is okay, they are going to get what they deserve e.g. Indonesia and the witholding of just about everything relating to BF. So let them eat it. No more money apparently geared towards Indonesia.

May 21st OSHA announces HCW guidlines for Pandemic flu http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=NEWS_RELE…

June14 -Two contracts awarded for flu vaccine capabilities expansion. Ragged on the government because they gave it to Sanofi and Medimmune. Who else are they going to get to do it?

July 17 HHS announces almost 1 billion aid to the states for pan flu preparedness. (Now I know its really coming-they are spending a box load of money on it. Anyone got the number to Halliburton Health?)

http://www.hhs.gov/news/press/2007pres/07/pr20070717c.html

July 21-Administration produces progress report on Pandemic Flu. Lots of holes, but they are starting to be covered. Remember, this would take almost 1 trillion dollars overall to just keep things going.

http://www.whitehouse.gov/homeland/pandemic-influenza-oneyear.html

August 21-North American Pandemic Plan released

http://www.pandemicflu.gov/plan/federal/stratergyimplementationplan.html

August 30 Federal Government released an additional 75 million to the states for preparedness. Remember they already got 200 million. Some bought cars with it. Not a good idea of course but the states are block granted with the money and they decide how it gets spent. The bigger states are going to get hammered and hard if this comes. I bet their casualites are going to be much higher as a result of just good old red tape.

Sept 4.-WHO revises the procedures for lab detection of H5N1 in cases... Tamiflu subdues the PCR-

Sept 21-Checklist released for prisons and law enforcement in dealing with panflu... I recommend you all read it. LE checklist

http://www.pandemicflu.gov/plan/workplaceplanning/lawenforcement.pdf

Katrina happened because of the law and anyone who understands it knows that this is true. Federal law prevented intervention in a states rights issue. Blanco's incompetence was laid as it was for Andrew for GB 1 by Lawton Chiles. They used the law to insinuate that the government was responsible for stupid citizens.

They will use the same laws to blame pandemic flu response on the president at the time it comes. The planning is there but money is always the issue. The war in Iraq would have happened sooner or later. I like sooner when it doesnt kill so many people. OUR people. Saddam was like a kid in a dime store buying up munitions and weapons by the tons and we would have eventually had to fight our way in there against those weapons.

Its not GWB Revere and its okay to hate him. I hated Blowjob Billy just the same and I blame HIM for 9/11.

Anon >10%. We all know that even with a precipitous fall of CFR's from officially 61% to even 1/2 would be a miracle.... Pure bullshit.

And the beat goes on...

By M. Randolph Kruger (not verified) on 18 Oct 2007 #permalink

And PLEASE, forget the telework option. The betting on telcoms networks and Internet is that they will stay up for 3-5 days max.

There are so many businesses that imagine they can just default to the net that, assuming they all did, they would overload the system in a heartbeat. But the real killer is MTBF. All components fail on a regular basis and we have developed good tools for predicting, testing and replacing those that are due to cark shortly. When was the last time that an air crash was due to a failed component? But if those parts are not replaced they WILL fail, some in the first few hours after the quarantine regs go into force.

After that, its just a matter of a little time before the system goes dark.

If the systems are really on the ball, the message about the outbreak of the pandemic will be about the last message that travels down the pipes.

Brother Earl should know, he is a communications guy. For those of you who dont know what MTBF is its Mean Time Between Failure. Some of the gizmos that go bad would and will need maintenance along the way and any single event can cause a cascade of events into the major event. Revere loses no opportunity to Bush Bash and Earl isnt a fan but he cuts straight to it. And that is that the system that we all have come to expect and enjoy will not be there if its high CFR. It simply will shuffle off in the night.

Remember, the entire US depends on coal and/or gas for electrical power. There is no way that the system in the winter could be expected to handle the electrical needs of the people. Lose the power, lose the country. The power grid is not very well linked to the west and east and its very sensitive to problems. Storms, cold, normal failures. Load shedding would occur, then it starts to tumble. The nukes while effective are generally offline during the winter for maintenance and who would be doing it? Everyone would be at home waiting it out. Even two nukes offline is a big deal and a major deal in the summer.

The states would be doing what they could but it requires people to make it function. Things actually would get better AFTER everyone was infected because there would be no isolations and goverment could get on with the things that are more important. I hear that the people are starting to finally get the message about BF and what it can/could do and that the prep rate is now at a whopping whole 8%! Add in the suggestion that flu is now carried on the wind or the perception of it and this system shuts down about a week to two weeks after it arrives.

Earl has done some interesting thing about this and I think he told me about a certain financial institution that lasted only a couple of hours into their pandemic exercise. They say that the mail moves the country, but the financial institutions run the world. How does a hospital accept Visa/Mastercard in a pandemic when the power is off? What do they do about your records or making requests for testings? How do they make it available to doctors? How do you pay for food even if it were available? How do they order it when it is?

These questions and others will be answered likely soon in a pandemic coming to your town or city in the near future.

What have I done about it? I still keep a 56Kps modem computer in the closet. Solar panels and a battery array wait to be activated. A electrolytic hydrogen generator waits to be used. Three SatCom phones and an HF radio. Thats the short list. How short is your list when it comes to your family? Start asking questions now so you dont have to on game day.

By M. Randolph Kruger (not verified) on 19 Oct 2007 #permalink