Do you know who's in charge if an avian flu pandemic hits? Neither does the government. In a sparsely covered story Tuesday, Michael Chertoff of Homeland Security (DHS) asserted it would his folks. That was met with dismay by Health and Human Services (HHS), who argued DHS had no expertise in the area (and privately had no qualms about briging up how the anthrax scare was botched from beginning to end):
HHS said it would take charge when "the resources of state, local or tribal public health and/or medical authorities are overwhelmed and HHS assistances has been requested by the appropriate authorities.
Homeland Security would assume authority when "the resources of state and local authorities are overwhelmed and federal assistances has been requested by the appropriate state and local authorities."
"The Department of Homeland Security has the responsibility for managing an incident," Chertoff said Tuesday.
As for the HHS plan, he said, "We are reviewing the plan now."
Russ Knocke, Chertoff's press spokesman, added that "at the management level, we would have the ball" in a flu pandemic.
"Homeland would be at the point from an incident management perspective, but HHS would be right there at our side providing invaluable expertise," Knocke said in a telephone interview.
Later, Knocke called back to say he had spoken with another official — whom he refused to identify — and sought to emphasize that "we will rely on our partners in the federal government to provide expertise" in dealing with a pandemic or other incident.
The Atlanta Journal Constitution said it simply and best:
The Bush administration needs to make it clear — and soon — that federal health agencies will take the lead if the country is hit by a human pandemic from a deadly new strain of avian influenza emerging in southeast Asia.
You post a lot about Avian flu. Who would you ask (or force) to guest post on your blog about the subject, assuming they would do it? And what specific points would you want those guest posts to cover?
This interesting question has a double answer: no one; and just about anyone that has something useful to say.
The bird flu theme on our blog is somewhat misleading. Ours is not a bird flu site, although for many months it was one of the few that mentioned it at all and during that time mentioned it very often: there have been around 150 posts on the subject. But the main topic remains what it was at the outset, public health, especially public health in the US. American public health professionals are having a difficult time. We have no effective leadership and the profession and discipline have become increasingly marginalized, dispirited and demoralized. Bird flu emerged as a theme initially because it seemed the perfect metaphor for this lack of attention by our political (and through them) our public health "leaders," and because it seemed it was a genuine emerging threat of major proportions that was not being attended to. Today, of course, we find frequent mention, both in the MSM and in the blogosphere, but for a long time we were among the few to discuss it and the only ones to discuss it in relation to the failure in leadership. Thus we have no specific need for anyone else to come along and add their expertise.
Almost anyone who has something useful to contribute:
However that doesn't mean we know all the answers. In fact it is clear we know hardly any of them. In our view a pandemic cannot be stopped by any conceivable policy options at this stage. What we require now is to prepare to manage the consequences if a pandemic of avian influenza should occur at some point. In that regard, there is a great deal of expertise but it is scattered among people who often don't know they have it. For example, in small but essential businesses, who are the key personnel and what are the choke points that would be affected if there were an illness with a 30% absenteeism rate? How would they work around it? If someone were the sole (material) support of an aged relative (did their grocery shopping, went to the drugstore and got their prescriptions), what would happen if that younger provider were sick for three or four weeks? If overroad trucking were disrupted by widespread illness among truckers, who would deliver the drugs to pharmacies or supermarkets who have "just in time" inventories? This kind of expertise exists, but it isn't in the public health community and isn't being harvested and marshaled for the purpose by planners. Our blog isn't the place to do this, but a "wiki" is. So along with two other bloggers (DemFromCt at The Next Hurrah and Melanie Mattson of Just a Bump in the Beltway) we started (with the amazing technical expertise of pogge of the pogge.ca blog in Canada) the Flu Wiki (http://www.fluwikie.com). It is an open site where any and all can contribute, edit and correct current entries, and take away much current information on planning for pandemic flu. It has been an amazing success and grows daily. We will need sources like this if we are to prepare to help each other in a crisis, rather than turn our backs on each other, retreat to a cabin in the woods, and guard our families with guns to avoid infected outsiders or those also seeking the staples of life. Cooperation is our strategy, not survivalist preparation and the Flu Wiki is one way to promote it. In a sense, everyone who participates there will be our "guest bloggers on bird flu."
Part II on Sunday.
Revere talks a bit about blogs and politics as well, but the thrust is the same. The Lord helps those who help themselves. Same as it ever was.