FEDS: "not there to pluck you off your roof"

Summit on flu nation's largest

Published Saturday, April 15th, 2006

Herald Olympia bureau

TACOMA -- "State and federal officials walked a shaky tightrope Friday hoping to encourage preparedness without striking fear in the masses during the nation's lar-gest pandemic flu summit this year.

Gov. Chris Gregoire urged about 1,000 health, emergency management and other local government representatives meeting at a downtown convention center not to "scare the dickens out of them" but "arm them with information."

But the very subject matter, the prospect of a pandemic that could kill thousands in Washington, promises to make that difficult. It's an event health officials believe is inevitable that could be years or decades off and with an unknown severity.

The emergence of the H5N1 avian virus, still almost exclusively restricted to animals, has inspired a new wave of preparedness for a flu pandemic akin to the one that killed more than 20 million worldwide in 1918.

"Pandemics happen; we are overdue and we are underprepared," said Alex Azar, deputy secretary for the U.S. Department of Health and Human Services.

It is expected the federal government will be unable to immediately provide vaccines on demand once a pandemic sets in and people largely will be asked to care for themselves.

"The federal government will not be there to pluck you off your roof in a pandemic," said Jeffrey Runge, chief medical officer for the U.S. Department of Homeland Security.

It'll be up to local health departments and local governments to convince people to prepare for the inevitability and learn what to do -- cover your cough and wash your hands often -- should a pandemic occur.

On Friday they peppered state and federal officials with basic questions: Will there be enough vaccines for everyone? Should we buy masks? Are we willing to order people to stay home?

Answers were generally less direct as plans still are being developed and advice being considered. But officials hailed Friday's attendance, about a quarter higher than at any of the similar summits already held in 41 other states, as proof that Washington is in touch with the issue.


Officials said they're aware they may be accused of crying wolf and asked reporters to avoid sensationalizing the issue but said they won't apologize for issuing stern warnings.

"That is a risk we are willing to take," Azar said.

"We are erring on the side of caution," said Julie Gerberding, director for the Centers for Disease Control and Prevention.

Besides, it is believed preparedness efforts will help the country deal with other health events even if a flu pandemic never emerges. Efforts to beef up vaccine production, for example, would help prevent shortages to treat the common flu.

"If we can prepare successfully for a pandemic, we will make a quantum leap in preparedness for any biological attack," Runge said.

Governments already are identifying their shortcomings. Azar said he's less concerned about whether a large stockpile of vaccines and antivirals can be amassed as he is about developing a distribution network to get them into communities within 36 hours.

"Unless we can get pills into the palms of the people who need them, it won't make much difference how big our stockpiles are," he said.

And Mary Selecky, secretary of the state Department of Health, said the state learned during an exercise in Pierce County earlier this month that it needs to improve its translation capabilities and how it deals with overwhelmed hospitals."

"We are all in this together," she said.


http://www.tri-cityherald.com/tch/local/story/7628875p-7540484c.html

Edited by Rick - April 15 2006 at 6:04am

Pretty much the same thing was said at the National Hurricane confrence in Orlando this week.  Fema is pretty much telling Local Government, and by extension Gulf Coast residents, that no one should rely on the Federal Government as the first response team.  Local Government and INDIVIDUALS should be responsible for preparedness and initial response. 

I will be pleased if the government will just promise NOT to put me on the roof.

Therese,

You are right twoolf. There is only so much any of us can do. I will say that I am not mentioning my preps to anyone anymore. I am not responsible for the entire world, or even all my family and friends. I have warned them, and tried to educate them, but now I have only to prepare for myself and my children.

I understand that the federal gov. cannot be everywhere and everything. I have heard alot about what they are not going to do, what I dont see is what they envision there role being? they must have some sort of role envisioned.

Edited by janetn - April 15 2006 at 3:52pm

I agree with Annie, who posted early this morning.  I am going to email the article to my local paper, but also to the NY Times (I live in NY), and the major media news outlets.  I will include hyperlinks also to this site, CDC, etc.  This is one thing we can all do to try to raise the consciousness of people to the threat of bird flu. 

Blue Sky-

JaxMax --

I guess I do sound a little charitable because it was a really odd moment, like she wasn't herself exactly.  My impression of Dr. Gerberling was one of a real scientist  in the sense of needing to meet that "absolute proof" level encouraged by the scientific method.  Namely that in the absence of verifiable data, you don't speculate.  I also thought she had a real human reaction to the person that rather rudely zinged her from the audience.  Overall she gave the impression of someone trying to balance her approach.  I got no impression that she was simply following orders, instead trying to wrestle with a difficult issue.  I did also feel she was a little flat footed, of the primary presenters she looked a bit uncomfortable and had some nervous body language.  Seemed like something was a little off.  I've been thinking about it since yesterday and I can't tell if she was just having a bad day or what.

What is interesting to me is that earlier in the week I was in a workshop with a leading risk communications specialist.  This grey haired PH'd has consulted on everything from 3mile island to mad cow to influenza, on issues worldwide.  He specifically mentioned the challenges Dr. Gerberling has had with managing a clear, confident, and on target message.  He personally worked with her and characterized her sucess in the spotlight as mixed acrossed the different crisis during her tenure.  She did strick me as very intelligent (despite the slip) and if I were in charge I would want her on my staff getting things done, but I don't know if I would put her in the spotlight.

If she is getting bad advice and being told now to use a PR approach to communicating versus a stright forward risk communication strategy (which is where she has been), her message will become muddled and far less effective.

I do know this.  There is real study and expertise required in risk or crisis communication.  The person in front of group or at the podium or coming over radio must at the same time sound competetent and confident, they must sound like a leader (a rare quality), they must let their own humanity shine through (without looking out of control), and they must give real information to the public they serve.  From listening to her, she and many of the other leaders, are absolutely the wrong people to have at the microphone until they can come up to another level.

As for the other question, the surgeon general was not present, although he has been part of a couple of exercises I have been a part of.  What is important to note is that (politics aside) in a nationwide public health emergency, it traditionally is the Surgeon General that takes the helm.  In the few Video teleconferences I seen him on, he has struck me as articulate, with sound leadership and a solid trust of his staff.  There were representatives present.

Setting aside plans and available of resources like vaccines and anti-virals, in my opinion, the single most critical factor in determining how little or how great the social disruption to pandemic becomes, is who is talking to citizens in each community.  That one voice, or collection of voices, can either lessen or significantly decrease the public anxiety and behavior in line with the public good or directly cause a breakdown in the fabric of our communities.

Anyway, the dynamics of the different agencies and the key leaders gave more to think about than the content of the summit.

Blue Sky-

Edited by JaxMax - April 16 2006 at 10:50am