Tuesday, November 01, 2005

Bush on the Flu: Reinventing the Wheel

The national response to the threat of bird flu contains many sensible measures, but its compartementalization echoes that of our preparation for terror attacks. Rather than setting up a flexible infrastructure to deal with disaster, it focusses too much on a specific threat.

Firefighters, police, and paramedics know that they perform like they train. A disaster is simply defined as a situation where the needs exceed the resources at hand. When first responders find themselves outmatched by the situation, they (ought to) have a pre-arranged plan for bringing in support. They don't know ahead of time which particular diaster will call for activating this system--a hazmat spill, a train wreck, a multi-vehicle accident--but they know the same principles and systems apply. And by working together on daily problems, they are better able to work together as a team if a larger disaster strikes.

Our mistake after 9/11 was dividing agencies designed to address terrorist acts from those focussing on natural disasters, to the detriment of our day-to-day preparedness for a broad range of threats, as we saw in the Katrina debacle. Let us not make the same mistake in public health preparedness by getting avian flu tunnel vision, and leaving ourselves less protected from chronic infectious threats like TB, or emerging threats like arboviruses (eg West Nile). The response to avian flu should encompass a comprehensive emphasis on public health infrastructure--multiagency surveillance, vaccination, and containment. It doesn't make sense to ask the public health sector to reinvent the wheel with each wave of media attention to a disease threat.

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