A guide Mayors. How to assist, educate and guide Mayors and city councils before or during a pandemic.
Mayors are busy people taking care of event driven problems with high public visibility. Unlike a normal employee with a boss above and employees below mayors sit at the hub of four distinct groups. One internal and four external. One group consists of the multiple internal departments of a city. Planning, public safety, real estate, finance, HR, etc. One outside group is economic development which helps determine the life of a city and its growth. Real estate investors and business are lumped in with this group. They often exert pressure on the mayor. Another outside group consists of state, federal and court systems the mayor must abide by. From public health to federal wage compensation laws to military relations the mayor is given laws and mandates to implement in his city. Another outside group are citizens who parade through council meetings every week voicing their ideas, concerns and opposition to what the mayor and council is doing. Finally there is regional cooperation meetings to solve traffic water and economic issues for no city is an island.
A note about the emergency operations center. My limited experience shows they are often set up to manage the responders - not to train the public. They are responders not instigators. EOC may respond to health crisis but it is the public health department or mayor that determines if there is one and how bad it is. EOC have a wide list of emergencies of which a pandemic is but one. A remote one at that. Fire, flood, hazardous waste spill, black outs, riots, even biological hazard, dirty bomb or EMP pulse. Volcanic eruptions, tsunamis, earth quakes, wild firs, nuclear reactor failures and blizzards are more regional problems. The point is the EOC already has a full time job dealing with emergencies that are fresh in the publics mind. Pandemic preparations may not be on their mind. Worse, they may not be training for it.
Hopefully the EOC has done parts. Mass inoculations are good for bio-hazard anthrax attack. Hospital surge in needed incase of fire, accidental or terrorist explosion or radiation leak at a hospital. After 9-11 we should be prepared if the cities major hospital and trauma center was hit. Moving all the patients and those affected to other hospitals? This is all good but simple compared to a pandemic. Getting medication and following it or moving to another hospital is easier than sheltering in place during a four day power outage with kids out of school during a quarantine lock down.
The goal of this guide to prepare one or more pandemic preparation knowledgeable people to these groups. Knowing what a pandemic is and how the RNA of the virus is good but does little to train the public on how to survive. The analogy is "knowing intricacies of a jet engine does not let you fly a heavily laden cargo plane though a storm, but it does help you know what you have to work with." There are a lot of good scientists giving out great detailed information to leading officials but almost no one is training the public and local officials on how to fly through the storm of a pandemic. Guidelines to mayors, businessmen, and people have been issues but not step by step instructions.
Nor have people been trained to work together in a pandemic mode. A blackout requires more than just electricians. People have to be found in elevators and subways. Communication restored, restaurants and grocery stores monitored for food spoilage, riots controlled, the mass populous informed, situational reports given to news agencies. A pandemic will take these problems to new heights. Hence the ROI. If the people are prepared for a pandemic then they are also prepared for smaller emergencies.
Without known problems known solutions are impossible. Guidelines, best practices, lessons learned and drills are the best guide.
Sometimes "step by step" instructions are impossible. After September 11th, the Air traffic controllers found instructions where pointless against what a group of well trained people can do. The permutations and possibilities staggered the imagination yet on that day controllers and pilots performed in a few short hours what no dared imagine - the complete grounding and shutting down of all U.S. airspace.
Note: grounding airplanes across the country involved just a few thousand folks well trained adults in communication within an accepted hierarchy. Controlling a city of kids, teenagers, adults and elderly people who are untrained at surviving a pandemic with just general broadcasts will be more challenging. Here nimble minds of adults used to working together under a known hierarchy may prove invaluable. The key is a single vision un hampered by ego, un-entangled by mistrust or fear. Good working solution are not only possible but can be made probable.
Mayors and city managers are elected and paid officials running city or town of several hundred to several hundred or a few million people.
Because they are granted a monopoly over the citizens there is an ethical drive to protect the citizens and city under their care in the
most cost effective manor. To do the right thing. As Winston Churchill said 'Doing the right thing is easy for no one wants to get caught doing the wrong thing. Knowing what the right thing is beforehand when information is sketchy and facts are few -that is the hard part"
Some facts are known. Those who prepare suffer less than those who do not. This is balanced by what the people see as real and un-real concerns. Three things make all this interesting. There is a limited budget. People want to get elected or re-elected. Citizens often spend more time researching and watching a painter for their house or good plumber than elected officials. Few people participate in local politics after voting. Councils only meet once a week. Often the people on council have full time jobs and families. Time for them is short. Their expertise may lie elsewhere. Legal requirements come from multiple sources. State, federal and civic organizations pull on them.
They, not us, are responsible for the health of the city. Plans must be balanced against returns. What is the benefit of stocking up on
food or supplies that go bad before they are used or needed? The solution they see may be far different than the one we see. Lastly they may
be content with a promise. If the EOC, police, fire, EMS etc say they are ready then that may be the end of that.
What can be done.
Demming: "The only thing worse than training all your people and having some of them leave is not training any of them and having them all stay."
If your really believe you have nothing else to learn or the there is nothing out there to help you then stop here. Put the paper down
and leave. The rest of us have lessons to learn, ideas to share and work to do.
Informing and teaching the people is critical. Without people agreement nothing happens. We have laws against speeding but everyone does. We have laws against drug use and beating people up but it happens. We do not have a law against getting sick, loosing a limb or going insane yet people are motivated motto get sick, loose body parts or go insane. Yes, like speeding even the educated and informed are free not to prepare. May do so without reason nor cause.
Do not wait for all the people to be informed. Business, hospitals, schools, jails, fire stations, EMS, public safety, places of worship and municipalities have all been instructed to be ready. City governments have an ethical responsibility not to fail. Hopefully it will only take a few folks at town meeting to get things going.
Ahh this is the focus - get what going?
What are good preparations?
How much is enough?
Where should the lines between personal, city, state, federal and military support be drawn? During the last pandemic there was no U.N.
How do you help those who can not prepare?
What do you do with those who do not prepare but later come looking for aide?
Lets see what we are up against first: lack of experience with pandemics, wide spread sickness from a novel virus against which we have no defense and few medical solutions that slow down the effects, wide spread loss of income, differing opinions, uncertainty, world wide shortage of goods, about duration or scope, lack of outside supplies, a lack of internal training, disruption in power, water, transportation, communication school closings, mass death, possible increase in suicide rate, overwhelmed or collapsed health care, a mass outlay of money in excess of yearly budget and the gut wrenching site of watching the young slowly die in horrible way that only produces long term nightmares and possible financial collapse of many insurance companies due to a mass payout of life insurance payments. Worse the bad economic times could erode tax base from business closing a slow housing market and people shopping only for a few types of necessities.
Worse life will go on during the pandemic. Babies will be born, elections may happen, all along with wild fires, floods and the effects of global warming.
What is in our favor: We, our grand parents actually, have survived pandemics before. We have better technology, communication and medicines than ever before. We have time to prepare. A great resource are the people actively thinking, testing and working out ways to be safer during the pandemic. People from America, to the United Kingdom, Sweden, Australia, etc are coming together and sharing ideas, thoughts and fears. From these groups many things have come out. Our best asset is the way the public does understand and respond. For without them all is lost already. For they will do most of the suffering, dying, work and kindness during the pandemic for they are the doctors, paramedics, moms and dads.
Best of all life will go on during the pandemic. Babies will be born, elections may happen, all along with wild fires, floods and the effects of global warming.
Can we do it. The world has taken on impossible projects with out solutions only to make great strides for all. Cancer is a little understood disease that we have made great strides on. Global warming is a huge problem that individual people see their part in the solution. Nuclear weapons. Somehow we have held something far, far worse than H5N1, global warming and plague all put together. At least 6 countries have them and everyone has been smart enough not to use them. Lastly is AIDS. Once recognized as a world wide problem that will no die out and against which we have no defense people did not give up but acted.
Note: H5N1 is going to be different. It will act globally and hit locally. Most communities never get devastated locally - it always happens
somewhere else. We just might get our chance. Here is a more immediate payoff or ROI - mitigation. Lets say we are lucky enough not to take a direct hit or somehow cure H5N1 before it happens. Preparing a city for a pandemic also prepares the city for other emergencies. This is not a long term expenditure of time and money with no possibility of interim benefits.
Snow storms, fires, earthquakes, floods, power outages, droughts, heat waves and water borne illness have hit many cities. Having trained citizens who can deal with these relieves the strain un-prepared citizens put on
a city. It is in the cities best interest to have people capable and ready to care for one another. As Admiral Agwunobi said "I can not lead
people who are unprepared to follow." Prepared and empowered citizens also feel more in control and less scared than unprepared or un-empowered ones.
How do we do it? One size does not fit all.
First - if your city has a military base or national guard be prepared to support them not vice versa. Unlike Grand Forks flood or California wildfire or a simple Katrina like flood, pandemics hit not only whole countries but the world. In this case one should be more prepared to give assistance than receive it.
Second - are your citizens aware and do you want to make them aware? Why or why not. Leaders should cause action not panic. Here we wish to
offer solutions that average people can do, that civic groups can act upon and faith based organizations can consider.
Third - situational awareness. Most cities know where their fire stations, hospitals, haz mat or industrial areas, airports, doctors offices and jails are. That is the tip of the iceberg.
If half of the city workers did not show up because they where sick how would you back fill the positions? Do you have a list of plumbers
electricians, mechanics, HVAC mechanics, secretaries, admin staff, IT technicians, truck drivers, cleaning crews, animal control, security people, voter registration and cooks to call upon in order to back fill the positions?
If business started to shut down because employees called in sick could you help those business still open find employees that where
not sick? The business are Pharmacies, grocery stores, gas stations, hardware stores selling generators, gas grills, propane, video stores
camping stores, pet supply stores.
If the government gave you free ice, food or supplies where you distribute it from?
Do you have a primary and back location for doing TV news reports?
Do you have a primary and back location for doing radio news reports?
Do you offer a webpage to get reports/request for help from around the city?
Do you offer telephone support to get reports/request for help from around the city?
Do you offer HAM radio support to get reports/request for help from around the city?
Do you offer CB radio support to get reports/request for help from around the city?
Do you have a way not only to track and display water outages, road closures, power outages but needs for food, water, medicine,
doctors, diapers, N-100 masks, cleaning solutions, hand sanitizers, batteries, etc.
Do you have TDD stations for the deaf?
Fourth Knowing what the people need:
Imagine your city is all alone and you have one phone line to call in a daily supply drop.
What do you order?
Where do you put it?
How do you distribute it?
Fifth: Clean up.
Then there is the next question
How do you remove the trash?
How and where will handle and bury the dead?
Good question. By the time a hurricane, flood, earthquake, snow storm or volcanic explosion hits people should be evacuated. During a pandemic there is no place to run nor hide. As mayors, city council, city managers, EOC, police Fire, etc where can you go that is safer and still be in control? Can you evacuate the whole city, hospitals, jails, and nursing homes? When you evacuate a city then everything that city makes or handles shuts down also. Airports, transportation, manufacturing, any computer hosting or communication. If evacuate then know that others may want to evacuate to your city. Evacuation is out.
If not evacuation then preparation and mitigation. Prepared people suffer less than unprepared one. Mitigation against an invisible foe for which we will not have any defenses seems daunting. This is why governments are suggesting sheltering in place and working from home. Each home needs to be ready for disruptions in services provided that involve people. Power, cable, telephone, cell phone, food deliver, sewage, trash pickup, bulk waste, funeral services, gasoline, natural gas, radio and television. The largest prepared groups may be the Amish and those living on Indian reservations. Not a joke.
Three times to prepared.
1) wait for the emergency and then have folks run out and get stuff. The creates disruptions, long lines at grocery, hardware and other stores. Often shelves go empty and price gouging reports come in. Problems follow when people go home and use the stuff for the first time. Ethically it is problematic. Many live paycheck-to-paycheck or on SSI and can not prepare this way. Because it happens so fast the city is still blind about how well it worked and who needs help. Because the pandemic happens world wide and so many goods have parts that come from overseas there may not be enough to go around. People needing oxygen or additional prescription medication may not be able to get them.
2) Encourage people to prepare and train before the problem. This is ethically better. It gives people a chance to research what they need, form support groups, buy the supplies a little at a time and learn how to use those supplies safely. Business benefit in two ways. One they can manage their inventory and employees. Second they can use preparations to draw people into the store. Stores can even have preparation sales to help generate traffic in the store.
Those on low or fixed income benefit most from buying in bulk, from preparation sales, and not relying quite so heavily on city services. Cities and faith based organizations benefit from having time to asses the state of the community and their possible roles in the community.
3) Encourage people to prepare and have they test/use their preparations. One test drive is worth a thousand expert opinions. Professionals train. If a mock emergency drill seems pointless then look no further than the police, firemen, doctors, nurses, linemen, water departments in the community. They all train. Most fire and water departments even have their own version of a rodeo to compete for speed.
Most importantly having people test their skills moves others along to "keep up with the Jones's." This raises public awareness and their skill level.
The more warning people have to prepare the better things go. The less warning people have the worse things go.
This is why people, cities, states, the military and countries are preparing and running drills. Minnesota has run drills. The pentagon and other military bases have run drills for both military and civil servants.
Pandemic may not happen this year but for something this large people will need more than a year to prepare. There is an interim return on investment (ROI). People will be better prepared for the emergencies that do happen before the pandemic.
Money: Municipal bond rating.
Cities with strong infrastructure, good quality of life and low damage risks have better bond ratings than cities with decayed infrastructure, poor quality of life and high damage risks. Being pandemic ready is not just about pride and doing the right thing. It is about a financial gain as well on all three points
Point one - negotiating for better bond rating. It may not be much but it is something.
Point two - prepared citizens put less of a burden on municipal systems.
Point three - communities with pandemic mitigation will fair better and recover faster than those devastated by the same disease. This means the enormous strain on local authorities can be less and end sooner.
Cost: Expenses to the city
Municipal budget: Education, endorsement, training, PPE and drills. The endorsements come with little risk because the message comes from the World health organization, through the president, out through many
The departments include but are not limited to:
HHS - The department of health and human services.
OSHA - Occupational safety and health administration
DoD - Department of defense.
DoE - Department of Education
Endorsement empowers citizens and civic groups to do the education. Schools should be hit hardest because the two to 19 year old age range is most vulnerable. Not only are they most likely to spread and catch H5N1 but they are most likely to die from it. Ironically young healthy individuals over react to the infection only to slowly suffocate - "cycotine storm" effect.
Education - providing messages about groups (red cross) websites and public service announcements (PSA) concerning how to prepare. Not everyone has access to a computer or school so multilevel saturation across the different broad cast media is important. State the need and then support those who respond.
Community - The need of each community and level they wish to prepare for is different. However some basics hold true:
Hospitals are unprepared and too small for the possible influx of people.
Health care workers, municipal workers, etc must feel safe leaving family at home, traveling to and being at work.
School closures will create a day care burden that may keep some at home.
Closing of movie theaters, restaurants, malls, and slowdown in spending and construction will force some to lay off employees. These will seek Food closets or shelters will be overrun. The need for skilled veteran health care workers will skyrocket.
FEMA - Because a pandemic is not localized nor short lived like Katrina, major earthquake or volcanic eruption FEMA may not be of much help.
Cost Savings: Any reduction in civil unrest and additional social services is a reduction in expenditures, possible litigation, bad press, negative imagery and political standing.
Who is important? - for the umpteenth time its "We the people" Why? Mayors and city councils are judged not just for their actions but their performance is based on what happens to the citizens.
The old nursery rhyme is lost on most.
"For want of a nail a shoe was lost.
For want of shoe the horse was lost.
For want of a horse the message was lost.
For want of a message the battle was lost.
For want of a victory the war was lost."
What good is a company if it can not deliver its service or product because there are no employees. Ohh there where continuation of operation plans for all middle management and executives but not the floor worker. Hence the head of the company survived but the body did not. Then the head lost its job.
Let me say this in no uncertain terms.
Not all companies fail during a pandemic. Success will be decided by those who stay open and provide goods and services and those who do not.
Hence winners and looses will not be chosen at random. Winners and looses will be determined by those who succeed and those who fail. Please decide group you will help others to be in. If you decide to ignore this or do nothing then you are still having an influence on those around you and the events that follow. Municipalities are even more critical. Schools, stores and even power companies can shut down or have black outs. Leaders and governments should not.