Connecticut Communications Tabletop Training

the participants were grouped in tables of 6-8

and most of the tables/groups were grappling with how to describe school closures (not whether to, but how to communicate the decision). The high CFR made that a necessity.

It was nice to see everyone on the same page about that.

It was also nice to hear further exercises along the same line planned for later in the year. The more that participate, the better.

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by: DemFromCT @ Thu Aug 07, 2008 at 01:56:40 AM UTC

Thanks, Dem

This kind of drill marks a significant step in the right direction. Thanks for sharing it.

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by: InKy @ Thu Aug 07, 2008 at 09:48:57 AM UTC

[ Parent ]

Dem, I'm very glad to hear

they've moved on from the "do our radios work" issues to issues of what to say, at least to the public, now that the radios work.  That's a good move forward.

I'm also encouraged about one goal which you mention was part of the exercise, that of "telling the truth" in their communications to the public.  Did you feel that this was something they had a bit of resistance to, given that the CFR of the gamed virus was 20%?  How much internal reticence did the participants have to overcome in order to deliver the bad news?  

Also, beyond the issue of school closures (at 20% CFR the governor may just come in and handle the communications of that issue for them), what other strategies were they encouraging the public to undertake?      

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by: Pixie @ Thu Aug 07, 2008 at 11:03:09 AM UTC

there is not so much reluctance to tell the truth

as there is reluctance to accept the implications of something this bad. In other words, the natural tendency is to say " here's the upbeat parts of 22 million deaths to come" because to stare it in the face makes you cry.

It's day 7 and there are only 5 cases. Do you emphasize that there are only 5 cases (good job done by all), or do you emphasize that this is only the beginning, and while it might look good now, the 20% cfr overseas means "Hartford, we have a problem."

Interestingly, the scenario was that the Governor was taking it very seriously (attempts to close the state border imposed by NY and MA) with the onus on the small townships to take it seriously as well. So, to answer your last question, we were confronted with answering "what else can we do?" and "why didn't you do more sooner" and "see, that's why you prep now." Answers included closing down public gatherings, with public info sites and tel. numbers identified. Working out the "answer" was not as important as having participants wrestle with the question, because they go home with the issue squarely on their shoulders.

My advice for my small working group was 'work backwards' and don't say anything reassuring on day 7 you'd be sorry you said on day 14 (when fecal matter hits the fan.) Also, that CDC graph was great for visuals. We used in the press conference to explain why the draconian moves. "We do it when we are just getting to the peak, or it's too late.

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by: DemFromCT @ Thu Aug 07, 2008 at 12:54:55 PM UTC

[ Parent ]

border closings were theoretical

by the way, and added for drama. You can't close state borders, and that is not 'the plan'. The assumption was that we had the only 5 cases in the US and our neighbor states wanted us to move to the tip of South America asap.

Sidebars for discussion were how much/how little antivirals the state had purchased, and what if they don't work, etc. It was common knowledge that we have no vaccine and that was not even an option.

However point of distribution clinics (POD) are always going to be practiced, because some day we will have a vaccine.

Also, at our table we dicussed drive-throu alternate care sites because I told the officials where I was sitting that we assumed that hartford would scarf up anything that the feds sent, and we in Danbury would never see any of it. Now that's the advantage of my not being an 'official.' I can say stuff like that without getting into trouble. ;-)

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by: DemFromCT @ Thu Aug 07, 2008 at 13:01:19 PM UTC

[ Parent ]

As a member of the public :-)

Once a pandemic had started with as high a CFR as this I'd want them to be honest but positive.

The only way to beat a pandemic without a vaccine is for every man, woman and child to be on board. History proves that the impossible becomes just very difficult when people know what they should be doing and really, really want something bad enough.

To get people on your side you can't wrap them in cotton wool, you have to tell it like it is. OK people will panic but when people know what to do they calm down.

An appropriate quote about the Anthrax letters.

http://www.washingtonpost.com/...

"people were legitimately anxious. They really didn't know what the scope of the problem was," Fischhoff says. "They responded the way they usually do -- responsibly, bravely and somewhat nervously.

Communication was handled pretty sloppily," Fischhoff notes. "It wasn't clear whether people were being told the truth. There appeared to be a double standard -- a privileged status for some groups. People wondered, 'Am I a postal worker or a senator?' " The lack of credibility surrounding the later color-coded warnings hardly helped.

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by: UK - Bird @ Thu Aug 07, 2008 at 13:37:28 PM UTC

[ Parent ]

"honest but positive"

UK-Bird,

 Yes it would be rather bad to reassure folks their coffin has been ordered, has arrived and is quite comfy! 100% customer statisfaction - no complaints, not one peep!

 For I too am a member of the lay public.

 Though I jest with UK-Bird the point is sound. "We did it before - we can do it again" 1918, 1957, 9/11, Katrina more people will survive H5N1 than not (ok I'm optomistic on that) and here is how. Here is how: ......

 The "how" part is critical in my opinon.

KObie

 

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by: Kobie @ Thu Aug 07, 2008 at 21:04:08 PM UTC

[ Parent ]

"(attempts to close the state border imposed by NY and MA)"

I'm wondering, having lived in the Great (little) State of Connecticut, if the states of NY and MA would realize just how many people commute to work in those states from CT. And vice versa. Thousands? Tens of Thousands? I know that trains run all day, every day along I95 into NYC.

Not only will closing the state borders hurt the commuters, but also the businesses that those people work at if telecommuting is not an option, the transportation system that depends on income from those commuters, the businesses that will be closing because the closed borders are keeping their employees away, and on down the line.

I don't see how states can even think about closing borders with other states on their own, especially in the NorthEast where each state depends on the others for survival...

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by: Bronco Bill @ Thu Aug 07, 2008 at 13:43:02 PM UTC

[ Parent ]

they can't

It was a little drama thrown in to deal with a situation no one agreed with, and yet had to be able to explain.

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by: DemFromCT @ Thu Aug 07, 2008 at 17:05:53 PM UTC

[ Parent ]

Scenario

"...the scenario was that the Governor was taking it very seriously...with the onus on the small townships to take it seriously as well. ...we were confronted with answering "what else can we do?" and "why didn't you do more sooner" and "see, that's why you prep now."

I really like the 'down to the very local' approach of this-it really is what needs to be stressed more.

It is better to look ahead and prepare than to look back and regret.

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by: Grace RN @ Fri Aug 08, 2008 at 01:12:29 AM UTC

[ Parent ]

Well this:

Answers included closing down public gatherings, with public info sites and tel. numbers identified. Working out the "answer" was not as important as having participants wrestle with the question, because they go home with the issue squarely on their shoulders.

is why I feel that there has been such a terrible failure of duty on the part of so many in public health.  

We were here, right here, back in January of 2006. I attended Leavitt's panflu summit.  This is where we were then.  We understood back then the need to close down public gatherings.  That we have not moved beyond this level of idea generation in 2 1/2 years is really just not acceptable.  

Blue-skying possible "answers" is not funding dependant.  "Thinking" is part of the job description for a public health official yet little innovative thinking beyond "avoid crowds" has emerged.  It's terribly disappointing.          

If they meet the pandemic in this condition, one relatively unchanged from 2006 and unprepared, yes, they will cry.    

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by: Pixie @ Fri Aug 08, 2008 at 22:36:36 PM UTC

[ Parent ]

No further ahead

Pixie,

 I agree with you.

 Even if answers where not given at the table top, they should be found when they get back to office.

 Well as soon as they answer phone, the emails - oh another request and class. Opps! another emergency and then there is what is for dinner (point aimed at men and women)

 How many of these people have sat down with local business and citizens to say "this is what we need to do."

 Pixie, we where there then and we are here now.

 If we are pandemic crazies then harness our desire to blog and write and come up with answers. That way we look like fools - for a while.

 IMHO the first question will be "This ain't a fire, flood, tornado or chemical spill. Hmm what do we have to work with and who decides what?"  

 Sorry, I'm steppng back from the keyboard ;-)

Kobie

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by: Kobie @ Sun Aug 10, 2008 at 18:27:18 PM UTC

[ Parent ]

Un equal suffering.

DemFromCT,

 Did they deal with the unequal burden of H5N1?

 The poor who live in tighter quarters with fewer rescources and limited communication may suffer more than those in large houses, with plenty of technology, backup power and food?

Kobie

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by: Kobie @ Thu Aug 07, 2008 at 21:17:34 PM UTC

nope

this was a very limited and directed exercise. We did not really go over urban vs rural challenges, or vulnerable populations specifically.

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by: DemFromCT @ Thu Aug 07, 2008 at 23:33:54 PM UTC

[ Parent ]