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HHS Conference Notes

by: DemFromCT

Thu Jun 14, 2007 at 20:51:20 PM EDT


( - promoted by DemFromCT)

see also The End of The beginning on the HHS blog.

There's been so much commented on, I almost hesitate to put up yet another diary. But I do want to gather some thoughts together.
DemFromCT :: HHS Conference Notes
Overall, this was, I think, a worthwhile and positive experience. We got a lot of olive branches from HHS. It's up to us to accept or reject, but it'd be hard to ignore all the overtures and say they didn't happen.

Admiral John Agwunobi in person happens to be gracious and engaging, and took his lumps in better spirit than I would have. I was meeting him for the first time, and came away thinking he felt he could have done better on that first blog post, and (most importantly) others in and out of HHS think he's really trying to mkae this work.  And not just he, but virtually everyone at HHS and CDC said the right things at conference time when they had the microphone. Everyone was gracious and welcoming. Believe me, they didn't have to be, but they were.

This is about outcomes and not about making nice to HHS. I don't expect anyone to pull their punches if they fairly and honestly see an issue (and there clearly are issues, particularly speed and scope of prep efforts). But I'd also hope that criticism is constuctive and able to grasp that while everyone sees panflu prep as necessary and needed, not everyone has the same sense of urgency, and that doesn't make them the enemy.

We don't have much tolerance for folks in officialdom who don't see the need to prep, and if you think that the chance of H5N1 going pandemic is <1%, fine, as long as you understand that the precautionary principle applies. Further, prepping for a 1918-style pandemic should help prepare for milder ones.

Now some important points that were stated as fact:

  • H5N1 has a 60% cfr right now
  • 1918 is not 'the worst case' (H5N1 is worse) but it can be used for planning purposes as 'the worst case that happened in recent memory'.
  • I heard 'at least two weeks' rather than two weeks at least once, and it struck me as an improvement
  • this was not a prepackaged rolled out message, and there is concern for vulnerable populations, language issues, etc, that will slow down an actual downloadable toolkit
In my view there's no reason to stop working on other projects, just because HHS does this. But there's also no reason to reject anything that comes out of this just because it's HHS. These are tools; adapt them to your own needs.

Lastly but importantly, the interactions with others (Lions Club, civic and community folks) was really a great experience. Just like online here, they all have something to offer, and also help us to see this through the eyes of the unconverted and uninstructed. That's very important, IMHO. Soemtimes we speak a language others have trouble relating to, and we forget what we were like when we were first starting out.

Leave your thoughts here, and I will be happy to address whatever's on your mind.
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HHS Conference Notes | 132 comments
HHS vs CDC - Source of Message
Did you get the sense that the two organizations (HHS and CDC) are both on the same page (or at least in the same chapter)?

I am concerned, especially if CDC takes an overly reassuring tone, that many who look to the CDC as the bottom-line threat assessors will not really buy into anything produced by HHS.

Something stripped of nuance and inference needs to come from the CDC, espcially for the healthcare world. 

I got the same reaction the focus group did when I first spoke to my personal Doc - I'll get concerned when the CDC tells me to get concerned.  That was last year in the spring.

And unless the personal docs are at least not rebutting our message, we will have a tough time making headway. 

Also, what was the thing you heard from the NGOs that most surprised you (positively or negatively)?

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

Style or Content
There appears to be a movement in style of communication, mostly from the HHS presenters, and as Dem said I detect even some sign of olive branch being offered. I am however very disappointed that CDC chief Dr. Gerberding's stance. At the end of the day, I am looking for the Content of the official message from the CDC, which is what the pubic looks to for validation.  If that doesn't change, no good will gesture towards our community will mean any thing. We need to remain vigilant, frankly to make sure the CDC is sending the right message in the Marketing , as described by Dr. Gerberding.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.
[ Parent ]
that's fair
I don't expect tangibles until later (summer through fall maybe).  One work product is toolkits, downloadable, to be used with different sectors.

what's in a toolkit? Why and how to prep, i suppose (we don't have details).

this is from the slideshow:

Before trying to motivate others to prepare for a pandemic, participants would want confirmation of the threat from a trusted source. Across all groups, participants mentioned CDC most often as an example of a trusted source.
local leaders need national support
Participants wanted low-cost or no-cost ways to share information that could be sent through organizational listservs
Blog: Vigorous discussion
Themes are emerging
Community/local-level preparedness
All-hazards vs. pandemic specific preparedness
Public awareness concerns and ideas
Health care concerns for nurses
The potential threat of TB
Stockpiling concerns and ideas
www.blog.pandemicflu.gov

[ Parent ]
well, LDS surprised me for its comprehensiveness
and for how well it was received by other denominations - and I was expecting them to be good!

I made a particular point, as I commented somewhere, about spending time talking to ASTHO and AAP about making sure that local health officials and pediatricians did not shut down people's questions about panflu. And yes, that message from CDC would help.

So, as far as CDC and HHS, same chapter and not yet same exact page. But Dr. Gerberding's presence at the summit and the fact that HHS is CDC's parent agency should smooth that out. There's pandemicflu.gov, and CDC uses that as the primary info site (btw, I had a very friendly conversation with the site manager for pandemicflu.gov), so similar enough message.

I would love to see 'at least two weeks' become policy instead of 'two weeks' of preps.

[ Parent ]
I thought you said
someone said 'at least two weeks'.  If this is an official saying it on the record, then it's policy, as far as I'm concerned!


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...
[ Parent ]
separate conference, but on record (recorded, even)
this conference as part of conversation, heard by others.

But not on pandemicflu.gov.

[ Parent ]
also
http://blog.pandemic...

At a press conference that followed the forum, Stephanie Marshall, director of pandemic communications for HHS, said the agency would launch two more personal-preparedness promotion efforts in the months ahead. Later this summer officials will release tool kits, tailored to four different sector (business, healthcare, faith, and civic), that leaders can use to teach people more about pandemic flu and what they can do to prepare.

Marshall told CIDRAP News that the forum yielded ideas that will help HHS tailor the tool kits for each sector....


[ Parent ]
Start at two weeks work toward 12.
The 'at least' is really easy to lose.

I know we need to move them one step at a time, so I'll say 'at least' is the least they need to say. 

I'd like it better if it was 'Start at 2 weeks.  Work towards 12'.  At least the early adaptors would have the higher goal.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
LDS
LDS comments are something new to non LDS folks, but to the faithful(or not so) it`s old news. It`s how they have worked for many.many years. They take care of their own, and discourage their down and out from applying for state bennies.They offer a hand up, not a hand out. You are expected to work at the cannery or as a handyman or whatever will help the ward to get the bennies.
 

There is no pleasure in having nothing to do; the fun is in having lots to do and not doing it." -Mary Wilson Little
[ Parent ]
Preparedness
  The LDS did not suprise me - good people. Infact I was expecting more details. Preparedness has been a part of a way of life since Joseph Smith had the revelation.

  You may also find the Mennanites, Amish and Beeches have a similar take. Though three months of food is not comon.

  Its a good time to learn from each other.

  Things like PARVE - means no meat for all the vegitarians and veagans out there trying to stock up.

Regards,
Kobie

[ Parent ]
It took me a while to post
over at the blog and then I had to back off after I felt myself start to get overly frustrated.  Part of it was the medium we were working with and part of it was the very real feeling that some of the people involved had a little more love of talking than they had of doing.

Later, I didn't post because I didn't want to heap coals when others were already saying what I was thinking more constructively than I could have at the time.

What continues to worry me a bit is that there is a whole lotta talking and not a lot of push for people on the ground tobe doing.

Its not like they need to reinvent the wheel or anything.  We've been making lists and working on plans here in flublogia for over two years. I'm not saying they have to quote us or anything, but they certainly don't need to start from scratch to get the message out.

And they don't need to do anything before they offer the topic some real and broad legitimization in the media.  If the latest crop of celebutants can pull strings to have their "statements" read by their PR people, surely HHS can do more than they are currently to get the message out there to the general public.  Those of us in flublogia already get it ... they don't nee to preach to the choir.  We would do a lot of their work for them if they would just open the channels for us to be heard.

Overall, yes, the HHS blog was a good thing.  I think that some of TPTB were surprised at how informed and erudite some of the joe citizens are  here in flublogia.  It would have been nice to have had more John Q Publics posting, but there you have it.  It is what it is.

Never doubt that a small group of thoughtful, committed citizens can change the world, indeed it is the only thing that ever has. -- Margaret Mead

Dem,
What continues to worry me a bit is that there is a whole lotta talking and not a lot of push for people on the ground tobe doing.

can you explain again what these 'leaders' have been tasked to do?  Were they given specific instructions as to what to do next? 

Thanks!


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
they helped develop
sector specific concerns. they committed to take the summit info back to their sectors. they were asked to participate on the blog. They were asked to look for the toolkits and told there'd be more about that. They were asked to be receptive to further contacts.
[ Parent ]
great point
"Overall, yes, the HHS blog was a good thing.  I think that some of TPTB were surprised at how informed and erudite some of the joe citizens are  here in flublogia.  It would have been nice to have had more John Q Publics posting, but there you have it.  It is what it is."

I couldn't agree more. And if we do back off, who else posts?

[ Parent ]
'Who else posts?'
No one.

We post for our own sakes,that our loved ones, and for the nameless/faceless Jane and John Q. Public who are not currently listening to us. And may choose to never listen to us. But at least someone was talking to them.

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

[ Parent ]
re invent the wheel.
KathyInFl,

  Glad you posted. Glad you also restrained.

  You get more with sugar than vinager.

  I am most frustrated that we are re-inventing the wheel.

  Just today I was talking wtih my bank manager about H5N1. She said teh Feds keep changing the rules on "contaminated money" They want it special bags, the feds provide, then that is put in a larger bag and sent to the main office where it is shipped off to be cleaned. Then it is shipped back for ciculation.

  Can you imagine all teh banks doing this?

  You will laugh when I say each bank should have a washing machine for cleaning bills. It should be run on new incomming money. Some Japonese banks already do it.

  The propblem is retail stors. There money comes in, sits a drawer and goes right back out to another person.

  BTW - no word from the main office on gloves, face masks, shields or customers wearing a mask at the bank.

  DemFromCT - thanks for the dilbert cartoon. It made them laugh.

Kobie

[ Parent ]
Precautionary principle.
Dem,

Was the Precautionary Principle stated by any official as policy?

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

no, but I brought it up
and I certainly heard echoes of it in the am talks and presentations. And of course, i wrote about it on HHS blog, and I know it was read.
[ Parent ]
to be more specific
we talked far more about communication than policy.
[ Parent ]
The reason why I keep asking about Precautionary Principle
is because I think it should be policy not only within HHS, CDC, but should also be a matter of ethics followed by all health care professionals in their communications to the public. 

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.
[ Parent ]
the phrase Precautionary Principle
is problematic in certain quarters in the US.  It is associated with what they perceive as over-zealous environmental regulations in the EU.  So, it's better IMO to avoid using the phrase but use the same principle.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...
[ Parent ]
it's a US principle
that Europeans adapted. I am sure your observation is correct; this is where politics intrude.

Can anyone come up with something better? distributive justice has been suggested as a better term than rationing, and student dismissal is better than school closure (building stays open for meals, alternative use, maintenance, etc.).

(Of course, being a native New Yorker, despite a few name changes I call the Wildlife Conservation Society's park the Bronx Zoo).

[ Parent ]
You'll lose people with excessive
political correctness.  The real meaning of the term will be so buried under polite phrasing that the true meaning will be hidden from large sector's of society.

Just say what it is.  Just say what it means.

It will keep things a lot more honest and open and therewon't be as much left open to interpretation which will allow loopholes to form.

Never doubt that a small group of thoughtful, committed citizens can change the world, indeed it is the only thing that ever has. -- Margaret Mead

[ Parent ]
that is exactly why
we can comunicate better than the feds  most times. other times, we leave communities behind. That's why it's a partnership.
[ Parent ]
one suggestion is to use risk assessment
Risk assessment is smarter

In the absence of clear "scientific acceptance" (95% confidence interval supporting a hypothesis, 19 times out of 20) it makes sense that scientific study should be pursued. Risk assessment is a preferable decision making alternative to PP as it aims to compare consequences of the action against the consequences of no action, according to available evidence and the rules of science. Risk assessment is also more useful as it will help determine the threshold for either accepting or denying action. [1].

http://en.wikipedia....

[ Parent ]
Too open to individual interpretation.
We need a Guiding Principle that every one in the chain of communication will adopt, and not deviate for political expediency. There is too much wiggle room with "risk assessment". The last thing we need is HHS coming up with "individual should assess their own risk", such as with what is being said now by the Admiral in the latest version on how long to stockpile. This is otherwise known as abdication of moral responsibility.

A Principle is exactly that. We shouldn't call it some thing else just because it is not popular in some quarters.

The main point of having a Principle is to make sure that officials have a moral Duty to Advise impending danger, if the impact is a matter of life and death, no matter how uncertain the scientific knowledge is.  This is about the sanctity of life - well I know we don't want to go to pro life or pro choice, but in the case of the alerting the public on the need to stockpile, both pro-life and pro-choice principles will end up with the same result - officials have the Duty to Advise.

I tried "Prudence", and on googling, I ended up looking at accounting practices. :-)

If the President can sign this:

http://www.whitehous...

there is no reason to not give Administrative Guidance if a judiciary one (Precautionary Principle) is inconvenient.

I agree with you the discussions about the threat of pandemic should be non-partisan.

Finally, one concept is Right to Know:

http://www.epa.gov/e...

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
The Spin Room at fedflublog
The after-party is still going on over there.  Some shots going on about enough and too little and can't we ever be satisfied (or civil.)

Since the concepts apply here as well, thought I would cross-post here:

Sometimes we see the light.
Sometimes we feel the heat.

Sometimes it?s Kumbaya.
Somteimes, not so much.

It would probably do all of us some good to ?get over ourselves?, but calling for it that way is usually about as effective as telling someone they ?need to calm down?.

I don?t think the passion of Flubogia is a bad thing. There is always a need for the goad, the occasionally less than civil or polite nudge that takes us out of our comfort zone and out of our rut, asking the impossible and by doing so forcing us to rethink what is possible.

One thing you learn in the Blogosphere is that fanning the flame does little to put it out. Addressing the underlying issue is often more helpful than allegations of either ill intent or limited capacity. Both approaches tend to breed more of the same.

This blog and the leadership conference represent something new and we all hope that this start continues to gain force and momentum and that we see real change in the consistency, force and urgency of the message that comes from the government on the need to prepare.

But to go back to Michael?s analogy, no one should think the blog and conference could magically get us from where we were before to where we think we should be. HHS can not be held to that ?Repairo? standard.

But neither can we say that these preliminary steps have magically satisfied the need to create and focus on that message or to more fully engage the citizens of this country on this issue. And in saying so, Flubogia should not be held to the Repairo Standard in failing to immediately set aside its complaints and frustrations.

Trust and respect are earned commodities, occasionally purchased more dearly from some than others. While some may consider this payment in full, others may look at it as a small down payment. Most are somewhere in between.

For instance, I am still waiting to see how the government intends to ask the public about this issue and the new decisions we will all face.

We have had pandemics before, but not with this JIT global economic system, not with so much of society this deeply dependent on high technology, and not with our jet-aged world filled with so many densely populated mega-cities. And not with a virus that kills like H5N1 does.

Even if the virus becomes more benign, this situation is new. If we are to protect our country we have to act in new ways.

What we saw here is one of those ways. It cannot be the last.



ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 
great points
as usual.
[ Parent ]
I agree... good points
This is my first post here so be kind (Hopefully I don't make any Admiralish type mistakes ;) )

I was one that posted "Get over yourselves" on the HHS blog that Into the Woods refers to above.

Coming onto the HHS blog site and also Fluwiki is very eye opening but also very frustrating for me. I can see the disconnect in communication between the government and the rest of us.

I just want to tell you all that the word is getting out and THIS "Joe Public" has come aboard. Your efforts are not in vain.

Keep doing what you are doing. But also, please remember that you all can be very intimidating in your passion. I was much more comfortable posting my comments on the HHS Blog than here. This passion that you have can be viewed as ego, rightousness, or just plain wacky ;) by those outside of your circle. A tempered message may win more people over but that is each persons call to make.

Thanks!


If I do good, I feel good. If I do bad, I feel bad. And that's my religion. ~Abraham Lincoln

[ Parent ]
Heidi
I've been posting at least two years and the science talk will still throw me for a loop on occasion.  Don't sweat it.

I participate where I can and when I can.  Please feel free to do the same!  LOL!  We all can add our bits and pieces to reach a broader audience.

Never doubt that a small group of thoughtful, committed citizens can change the world, indeed it is the only thing that ever has. -- Margaret Mead

[ Parent ]
Hi, Heidi
Welcome to Flu Wiki.  And thanks for some great insights!  ;-D

It's true that sometimes we are too passionate to slow down and explain ourselves properly, so it's good to get a reminder every now and then! 

OTOH, without an official government agency like the HHS as 'host' (read 'target' lol!), you will likely find that we are much friendlier than you imagined! 


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
you are most welcome
it is a balance we all strive for, and sometimes fail at ;-(
[ Parent ]
Heidi welcome
Heidi:

I am not an expert, nor an "activist".
Just one of the average Joes who is concerned about the pandemic and mostly lurks on the websites.

I use these sites to gather info, and particulalry the old
Fluwiki is very helpful in prepping and gathering tips for surviving if things really go worst case.

This site and Pandemic Flu information (https://www.singtome...) are the best two on the net, although I lurk on others as well.

We recently have been obsessed and very passionate about the HHS blog.  It was finally a way that we might get the word out to our fellow Americans who pretty much dismiss us as wackos.  I am an mild mannered accountant very stable and not a wacko, just very concerned for my family, but most people do not listen.

I believe the passion is a good thing for us, but please do not feel intimidated and please contribute to the various portions you find of interest.

The news sections are really important because it is the latest world news from our news hounds.  It is my first early warning of what is going on a day or to or weeks ahead of the media.

Please join us.  They will be kind to you as long as you are respectful to them.  They are a patient group, unless you say things in an official capactiy for the world to hear, ie the Admiral and send us all off the deep end  because we know he was really off base.

We felt he had set us back on the mission of getting the word out from an official source.  We need "officialdom" to stand up with us on this, then we can run with ligitimacy and our friends, family, neighbors, and local officials will listen to us.

Again welcome to Heidi and other lurkers.  Join in the fun.

Be Prepared. Better safe than sorry.

[ Parent ]
Thanks for the welcome!
Wow!

SusanC Your right! Fluwiki is friendlier than I thought it would be.

NJ Jeeper, I see your point about being passionate to finally get the word out through the HHS website. And just so you know, every accountant that I have met has had an inner party animal in them somewhere ;) I'm sure I will be lurking with you.

KathyinFL... your "Better Story To Be In" was my first Hotlist item. I'm looking forward to reading more.

DemfromCT, your reasonable, intelligent, responsible communication is what drew me here.

Thanks everyone =)

If I do good, I feel good. If I do bad, I feel bad. And that's my religion. ~Abraham Lincoln

[ Parent ]
welcome
you are welcome here

There are a few grouches like me, but most of us are nice.

Be Prepared

[ Parent ]
Welcome, HeidiInMN.
Yeah, and a few more grouches like me too.

BTW (by-the-way) I just posted something about Minnesota distance learning here:

http://www.newfluwik...


You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
Hi Heidi - Welcome
I live somewhere between concerned and alarmed, but I'm pretty harmless.  :)

Glad to have you here - I'm a moderator at curevents.com, that has a Flu Clinic portion (that's just full disclosure guys, not trying to drum up business!), but things are friendly enough in our cyber-world that many of us participate in more than one online community.  That's just so you know that you'll run into the same people at more than one site - and we share information.  It usually isn't very long after new information is posted at one site before it begins to appear on the others, as well.

We're a diverse and eclectic community, and tend to treat people as assets rather than liabilities.  I hope you'll enjoy getting to know us. 

[ Parent ]
what Clawdia said is actually true
we tend to (I think) use our same screen names wherever we post, so pseudonymnity is not anonymnity. Clawdia is Clawdia everywhere ;-)

And we do tend to be on pretty good terms with all the flu boards, though the 'feel' and personality is a bit different at each one, mostly due to software and mod differences.

[ Parent ]
funny thing about pseudonyms
I thought about using my real name on the HHS blog.  I would have been happy to, but frankly, for the group that was involved and actually reading there, NO ONE would have known me at all if I used me real name (except my mom).  I actually have a reputation on pandemic flu issues as ACM, and felt more accountable for what I posted than I would have with my real name.

Pandemics are "Wicked Problems". - Average Concerned Mom
[ Parent ]
BTW, ACM -- your reply to the Admiral
was right on target for all us Moms out there.
[ Parent ]
thanks libbyalex!
You know.... there's no reason moms out there couldn't quote parts (or all as far as I'm concerned) of what I wrote on behalf of moms everywhere, and post it on their mom-network listservs -- with a link for more info as to questions that may soon be of concerns to moms... and more.... just thinking out loud!

(-:

Pandemics are "Wicked Problems". - Average Concerned Mom

[ Parent ]
anonymnity ?!?
I'm having a bit of trouble here...how do you say that word?!?

Is it anything like mnemnonics? :-P

[ Parent ]
an-o-nim'-ity
I think that's it phonetically - or close.

And actually, Dem, I have been "Claudia" once in a while - but I'm still obviously me, whichever way it's spelled.  :)
For some reason, I signed as "Claudia" at the HHS blog - I guess it was a subconscious attempt to keep my claws retracted.

[ Parent ]
Ya mean I said it wrongly?
I figgered it might be an-o-nim-nitty, but then again, I learnt my English in Kahleefornia! ;-)
[ Parent ]
Welcome to the Forum...
HeidiInMN...you'll find a ton or more of great information here. Enjoy...and don't forget to swing on by the Wiki itself--- http://www.fluwikie....
[ Parent ]
Well, 'wacky'...
...certainly describes me anyway!  :-P

Welcome aboard, Heidi!  Good to have you here.  :-)

Proud FAF-er.

[ Parent ]
Heidi - Hi!
Welcome.

  Yea I get the wacky look often.

  Be honest - maybe gental - and we will be.

  My frustraion was at "HHS leaders should be leading, not being brought up to speed. They should be way ahead of me." I did not get that feeling.

  Yes - I do get up from the computer. Yes I could be wrong. Yes H5N1 might not happen. Still, being prepared is good. Learning to make break and sting popcorn as a family is good. Teaching kids the right way to build a fire and then tell stories around it like some Norman Rockwell picture is good. These are just a few benifits of preppping.

  KathyInFl recepie list is another. Hearing all the different points of views.

  Plus the news here !!!!!

Kobie

[ Parent ]
Welcome Heidi
I'm not a science type at all, but after a while you read it all written different ways and it starts to make sense. I am amazed at what I understand now about flu in general and H5N1 in particular. I hope you will have some time to explore all the areas Fluwiki- there is so much info here. It always seems to me that no matter what a person's question is, someone here has an answer. I don't think there is any subject dealing with prepping that hasn't been covered in depth by people with experience in so many different areas. I learn something new every day here, and hope you will too. Glad to have you on board
Institute for Healthcare Improvement
I'm still reading and digesting all of the information on this site, so if this is redundant information, I apologize for having missed it.

I had mentioned to DemFromCT that one possible place for timely, effective and powerful (influential) assistance might be with the Institute for Healthcare Improvement.

It lists patient safety and healthcare quality topics that are related to flu preparation, and its mission is to prevent deaths and complications from healthcare practices.  It might be worth SusanC, DemFromCT and other Flu Wiki gurus a conference call session to see if they would take on pandemic flu preparation for the healthcare sector as a topic and as a national campaign.

Their claim to fame is in being able to bring together stakeholders with competing interests and moving toward statistically significant improvements in care practices and patient outcomes.  They are good at the people skills end, the networking and the evidence-based demonstration of best practices.  I have used this agency in several quality improvement initiatives in three different hospitals - and all projects had marked improvements in nursing and physician practices, as well as in patient outcomes, patient satisfaction and family satisfaction.  That's a lot of accomplishment.

I emailed Dem to let him know that my blunt criticism of Ogilvy and HHS are in no way a reflection on the Flu Wiki contributors, but rather, I want at least one citizen's protest on the record for historical purposes if the HHS uses the Pandemic Flu Leadership Blog as a political weapon to excuse inaction and ambiguous and ineffective public messages around preparedness.  Although I do not have the diplomatic skills I wish I did, I tried to register complaints based on observable patterns of evidence and behavior and not at people.

Based on my experience as a nursing administrator who had staffing office duties, I know how difficult it is to fill in for nursing short staffing situations on a regular non-emergency daily basis.  When an emergency situation arises and nurses perceive threats to their own health, I anticipate devastating absenteeism rates.  There are no fall-back cadres of nurses available to call upon. No nursing organization or state board of nursing is addressing this, as far as I can ascertain.  Nursing employers have not included nurses in COOP decision-making for the most part.  When I discussed COOP at a nursing supervisors meeting a year and a half ago at a large urban teaching hospital, none of the supervisors - who serve as off hours hospital administrators - knew what COOP meant, nor did they have any understanding about what their role would be in the event of activating a COOP or in light of being inundated with patients and having to triage care and available resources.

There isn't much in the nursing literature that makes me think that this is being given serious and wide-spread attention.

Sorry to have rambled on - in summary - check out IHI and see if it could intervene.

Thanks-

i know it's not meant personally
I just disagreed with some of the criticism ;-)

[ Parent ]
I understand
and I appreciate your insight. =^)
[ Parent ]
Will CONL trump COOP?
N=1: This is one of the key "Phantom Bridges" between plans and reality.  We are just assuming that a miracle occurs and they all come to work.  Butif you factor in their higher personal risk and potentially higher absenteeism, you cut their numbers 'at least' in half.

It is even more absurd, because there are things we could be doing about this part of the problem but as far as I can see these things are not getting done. 

I wonder if Continuity of Nurses' Lives will trump Continuity of Operations?  Especially if they feel that their employers (or society) made a conscious decision to not prepare - not provide them with readily available PPE, education/training and family support that would address at least some of their concerns. 

Multiple studies conducted in the last few years are telling us very clearly that we should expect health-care absenteeism at least as high and potentially higher than the 40% predicted for the general workforce.  (It is difficult to tell what portion of the absenteeism predicted by these studies would be over-and-above that base-line.)

Some of the studies provide 'reasons' for the self-predicted absenteeism shown in the studies and suggest that addressing those concerns today could reduce the absenteeism. 

Does anyone know whether there are any signficant efforts being taken to follow those recommendations on a federal, state, local level or by specific health provider associations or providers?

For some links to the referenced studies:
http://www.newfluwik...

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
that was the first thing i brought up
in my panel discussion. i told the story of 'I'm very ashamed but' which was the Old Yeller thread on nurses not reporting... and how non-HCWs on the thread thought they were obligated to, and that nurses were highly paid professionals who must show up. Well, none of that went over well with nurses, studies confirmed etc.

I made the point that that's where flublogia had made a great contribution to understanding reality, for planners, if they paid attention.

[ Parent ]
American Nurses Association
Thanks for your comment, Into The Woods.  I had hoped that Rebecca Patton, the panelist on the HHS blog who is the president of the American Nurses Association, would share just what you are asking.  As far as I can tell, the ANA has not taken any stance on pandemic flu preparedness.

Nursing gets very little, if any, mention by mainstream media in healthcare reportage save the nursing shortage.  I don't have the impression that many nurses are aware of te pandemic flu preparation, or even what shetering in place means.  I'm even less sure that employers have included nurses in COOP decision-making.  Most nursing employers run nursing departments short of full staffing normally, which means that in the event of a patient surge, there will not be enough nurses - even if they all reported.  With a significant absenteeism event, my guess is that patients would have to be cared for by their families - and that hospitals would be refusing to accept patient admissions.  But that's only a guess.

The American Hospital Association doesn't have much to say on its website about pandemic planning, either, and most hospitals use a just in time materiels management system, so I think that staff and supplies will run short very quickly - just my .02.

[ Parent ]
they needed a jumpstart
we wanted them to include nursing. ANA was there, rebecca patton did some blogging, nursing questions came up at the summit, i addressed some in my panel discussion, and all we can do is create the opportunity and see what they do with it.
[ Parent ]
Was ANA represented at the seminar?
I can't find the attendees list - is it on the PFL Blog anywhere? Do you remember who was there as a representative for nurses?  And in what capacity?  (private citizen, professional organization representative, etc.)

I also tooled around the IHI website a little more and found this page which addresses system change for public health officials.  I don't know if this is specific enough to be helpful, but it does lead to some good tools and some methods by which to assess the extant situation and to identify preferred futures - in essence - to identify what you want the situation to look like and then plan for the needed resources and methods to achieve that aim.

I love the project management "stuff" so this looks comforting to me as it feeds my own biases.  What does everyone else think?

[ Parent ]
I think rebecca patton was there
and, of course, on the blog. At least one nurse stood up and from the audience echoed some of your concerns.
[ Parent ]
thanks for that info!
It might be worth SusanC, DemFromCT and other Flu Wiki gurus a conference call session to see if they would take on pandemic flu preparation for the healthcare sector as a topic and as a national campaign.

and, just to clarify, we have no hierarchy here, and there are no FW 'gurus'!  We're all rather free-spirited people each doing our own thing, and we get together here to swap ideas and help each other out.  So anyone who finds any information useful or want to start a project can just go ahead and do it, and if they need help, we'll all jump in for a bit, with whatever each can do.

For example, the Pandemic Flu Awareness Week 2006 was started by a couple of people and everyone else jumping in. 

Or, from a while back, a classic example of how one person can start a project and get help from everyone one!  Average Concerned Mom needs Nutrition Help


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Question re: new groups activities
Thanks, SusanC For clarifying.  Except that I guess I'm still confused about how you actually are making progress without a structured approach....  In other words, do the members of Flu Wiki task other members when there is a project that's too big for one person?  How does this process work?  I'm a task-oriented, and structure-oriented kinda person, so I'm having difficulty understanding the nuts and bolts and gears and pulleys, if you will, of the Flu Wiki activism process, for want of a better term.
[ Parent ]
someone writes a diary
and suggests a project. people self-organize and volunteer (like with the newshounds on the Indo diary, or the daily news thread, started by MaMa and Heather and now continued by others).

Sometimes an idea does not get picked up on, sometimes it does, sometimes it does the second time round.

Susan or Melanie or I can promote an idea a bit, but it's up to the community what flies.

[ Parent ]
Lack of structure . . .
I can see where you'd have problems understanding how the flubie community functions, here and at other boards.  For the most part, if someone needs help with something, they ask for it and receive it, and that's the way it works.  The process itself is unstructured, except for the structure of the software, as far as I know.

We don't really have gurus or leaders, as such, although of course Susan and Dem created FW (thanks, guys).  Some here are highly educated, and some are not.  For example, Susan is an MD, and I didn't finish college - there are those with more education than she, and less than I. 

I think the common goal is what makes FW and the other  boards run, and it's what keeps us all going in dark moments.
It boils down to something so simple as "enemy of my enemy is my friend", and H5N1 is seen as the enemy. 

Don't be afraid to ask questions, and don't worry about asking for help - that's the whole purpose. 

[ Parent ]
It's becoming clearer....
Thanks, Clawdia, for explaining. I'll keep reading the archives, too - do you all realize how much richness is here?

It's amazing, but overwhelming - at least to me.

[ Parent ]
You're welcome!
Your question - yes, I think many of us do realize the depth of the knowledge/information available here and at the other flu sites.  That's one reason we find it so frustrating.  I've said before that I believe we are the greatest unused resource when it comes to dealing with H5N1, and a resource that is literally begging to be put to use, at that. 

I'm sure it is overwhelming - I think a lot of us tend to forget that, since we have seen it accumulate slowly over the past year and more.  Still, there are times when a day or two away from the flu sites serves as a good reminder - it's hard to catch back up after a two day absence.  Fair warning.  :)
 

[ Parent ]
Hope this is OK to do:
I submitted a request to the IHI, and I copied it for your perusal.  Please let me know if I overstepped any boundaries:

I would like to request that the IHI investigate the feasibility and interest of leading topic content around pandemic flu preparation.  I am participating in the five week blog hosted by the HHS titled Pandemic Flu Leadership Blog.  It is clear that the mission, vision and objectives by the leaders at the HHS, CDC, US Public Health Service and healthcare providers such as hospitals, physicians and nurses are not clear, are sometimes in conflict with one another, and that the advice being given to prepare is inconsistent, and is often at odds with the science and the available research.

Moreover, the just-in-time materiel management systems in place in most hospitals and nursing homes do not provide for the 90 day stockpiling that is being advocated.  Nurses have not been included in COOP decision-making in any programmatic way, and as far as I can ascertain, no national healthcare professional organization has taken a public stance and is providing the educational and advocacy tools to nurse,s physicians, hospitals and other healthcare providers needed in order to plan effectively.

On top of that, there is little, if any, patient teaching, counseling and coaching being done around pandemic planning.  Tens of millions of people in vulnerable populations are not able to shelter in place due to the lack of stockpiling resources and the inability to stay away from the workplace.

The contributors of the Flu Wiki website - grassroots activists and private citizens with professional expertise, are interested in the IHI's ability to work across multiple stakeholder groups.

I am hoping that this urgent issue is of interest to the IHI as it is congruent with patient safety and best practices.

Thank you for your consideration.  I look forward to your reply.  Please let me know if I may be of assistance at any time.


[ Parent ]
pass along anything you get
that looks interesting. Noe of us can 'speak' for Flu Wiki but you are right that the contributors and commenters can speak for themselves.
[ Parent ]
Of course I will
If this appears twice, I couldn't find the first response, so sorry for any redundancy.

Sarah Lawrence College has a masters program in health advocacy - I emailed the director, Dr. Hurst, to see if there is interest for student involvement or a course around pandemic flu preparation.  I also emailed the National Patient Safety Foundation to see if it would be interested in getting involved.  I will copy and paste any and all replies that I receive.

And Dem, Laura Caramanica, the VP for nursing at Hartford Hospital, leads the CT nursing research alliance - she might take pandemic flu preparation and move it forward.  She has many national nursing leadership ties, and she is a forward thinker.  Would you be interested in making contact with her as a fellow Nutmegger?

[ Parent ]
of course!!
always happy to talk to a Nutmegger.
[ Parent ]
Arrows and olive branches
DemFromCT,

  With all the arrows slung I am glad there where some olive branches.

  The room seemed kinda small. I really wish more was happening.

  I was not expecting a "Where are we starting from and who is here" kind of meeting. That is my impression and it may be wrong. In my arrogance I want to hold a meeting of flobogia "and show'em how its done" However - slow and steady wins the race. Complete each task before another.

  I hope FluWiki, Pandemic, FluTalk, FluTrackers etc are invited to the next one and that we all get together to review the HHS tool kits *before* they go out.

  Each blog has its own rules, flavor and therefore crowed. There is a time to work together and benefit from each other.

Kobie

 

new posts from Dr Raub
representing HHS policy.

see especially:

http://blog.pandemic...

Many commenters have asked about a recommendation to have a 90-day stockpile. The statement in question is not an expression of federal government policy. The statement appears in...

Here's my response
still awaiting moderation!

Dr Raub, as Greg said, thank you for the clarification.

Many commenters have asked about a recommendation to have a 90-day stockpile. The statement in question is not an expression of federal government policy.

May I ask respectfully then what IS the federal government policy at this point in time with regards to recommendations for best practice for personal preparedness?

DOES a policy, in fact, exist? If yes, may I request that the federal government comes out clearly to tell us EXACTLY what it is? If not, can we ask WHEN there might be a clear set of recommendation given out as federal policy?

Apologies for being a little confused here, but we seem to have come across various ways of expressing this, such as this one from Adm Agwunobi

We at HHS believe that two weeks is an effective compromise that can get all American families thinking about their own needs.

which, to be honest, leaves me scratching my head as to whether this was a goal, an affirmation, a policy, or just the good Admiral thinking out loud!:-)

The conference brought together diverse stakeholders to address developing best practices and model protocols for use by State, local, tribal, and territorial personnel in preparing their pandemic influenza plans and conducting associated activities. The conference report is a synopsis of input received from Federal, State, local, territorial, and tribal emergency medical services (EMS), fire, emergency management, public works, and sector-specific participants. The intent of the conference was to help inform pandemic influenza preparedness.

Thank you. I appreciate that the conference was sponsored by the Department of Homeland Security and not DHHS, but, based on your expert opinion, can you hazard a guess as to whether the participants of that conference were collectively competent enough to be in a position to give inputs for best practice for the federal government to adopt? If not, is the DHHS going to collect even more expert opinions before coming out with such recommendations? What might the timeline for that process look like?

Allow me to clarify by saying that I?m not talking about what is actually achievable by individuals or communities, because that will depend on the availability of resources at various levels. I?m talking about simply giving out a piece of advice, to give some direction to the public so that they can get started as quickly as possible towards the eventual goal of being fully prepared.

Thank you once again, and looking forward to your answer!

Susan Chu MD
Editor, Flu Wiki
Posted June 15th, 2007 at 6:09 pm


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
I'm reminded of what Tom DVM said
http://www.newfluwik...

Politicians have conferences and meetings...lots of meetings, and then they have tele-conferences and more meetings...and then they pass it up through layer upon layer of supervisors to decide who can 'pass the buck' and not be responsible for the decision...and then they have more conferences and more meetings...

...and if things go really well...no one will make the decision that they can be held accountable for!!

Leaders assume the first casualty of the war is the plan...and plan accordingly




All 'safety concerns' are hypothetical.  If not, they'd be called side effects...
[ Parent ]
Most excellent, Susan!
Good questions in search of answers.

Excellent advice, as well, that they should give the public direction.  I do believe the majority of people require that advice to be official before they'll take action.

[ Parent ]
well, my observation is
that they are just procrastinating.  Don't know why, but that's what I see...


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...
[ Parent ]
I think the same thing. n/t

[ Parent ]
Got Lifepreservers? A Parable On Clear Messaging
Upon boarding a 200 passenger boat for a dinner cruise, the customer asks "Are there life preservers on board?".

The answer is "Yes.  We have life preservers for one kind of incident.  Since no such incident has started nor seems imminent, we have the life preservers stockpiled in a safe location.  They will be distributed by the crew if needed."

Now, if you were that passenger what would you think that answer means?

Would you be disappointed if they only had enough life preservers for the crew and maybe one or two of the 200 passengers?  Would you become even more disappointed if these life preservers were only designed to work in salt-water (and here you are out on a deep, fresh-water lake)?

With this parable in mind, let's look at the recently revised (May 8) H5N1 dicussion on the CDC website:

Questions and Answers About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus

Is there a vaccine to protect people from some strains of the H5N1 virus? Updated! May 08

Yes. On April 17, 2007, the U.S. Food and Drug Administration (FDA) announced its approval of the first vaccine to prevent human infection with one strain of the avian influenza (bird flu) H5N1 virus. The vaccine, produced by sanofi pasteur, Inc., has been purchased by the federal government for the U.S. Strategic National Stockpile; it will be distributed by public-health officials if needed. This vaccine will not be made commercially available to the general public. Other H5N1 vaccines are being developed by other companies against different H5N1 strains. For more information about the sanofi pasteur, Inc. vaccine, visit http://www.fda.gov/b.... For information about other H5N1 and pandemic flu vaccine research activities visit http://www.pandemicf...

What is the benefit of the FDA-approved H5N1 vaccine produced by sanofi pasteur Inc? Updated! May 08
The H5N1 vaccine approved by the U.S. Food and Drug Administration (FDA) on April 17, 2007, was developed as a safeguard against the possible emergence of an H5N1 pandemic virus.  However, since the H5N1 virus is not a pandemic virus  since it does not transmit efficiently from person to person, the H5N1 vaccine is being held in stockpiles  rather than being used by the general public .  This vaccine aids H5N1 preparedness efforts in case an H5N1 pandemic virus were to emerge.

(Emphasis added.)
http://www.cdc.gov/f...

OK.  Lets assume you are an ordinary citizen looking for information on the pandemic threat.  The only information you have on the threat is what you have seen in the mainstream media news in the past 6 months.

After reading this,  would you think there was a stockpile of vaccine that would protect us all from a H5N1 pandemic?

And we wonder why people are not preparing.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

Some follow-up
If you were not sure the vaccine would be effective against the H5N1 virus strain that might take pandemic form, why would you spend the money on it?  (Woud most people assume it is because we are so desperate that we are willing to pay lots of money to get a bit of something that might, just maybe reduce the severity of the symptoms - or might not work at all.)

If they can produce enough seasonal vaccine to create lots of left-overs (like this year), is there any reason a member of the generally uninformed public would assume that there would only be a very limited amount produced of the H5N1 vaccine that is intended to safeguard against the possible emergence of an H5N1 pandemic?

Is there anything in the CDC description that would lead a member of the public to believe that the referenced vaccine's effectiveness (even on the current H5N1 strains) is significanlty lower than the seasonal vaccine and requires much higher concentration in two seperate doses?

If the headline is false or misleading how much can we count on the general public to read the whole section? 

How much can we rely on them to go past the section and read linked material or other material available on the web? 

When weighed against the credibility of the CDC, how much impact can we expect those other sources of information will have on the public? 

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
CDC Pattern of Unclear Communication on Vaccines/Antivirals
http://www.newfluwik...

How can we convince people to prepare if they are convinced they don't need to because vaccines will be available?

I hope this is one of the 'take-aways' for the CDC from the HHS conference. 

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
Prepping the local guv'mints
Howdy, folks.  I come to Flu Wiki Forum from time to time, but my daily routine is a round of FireDogLake and DailyKos. Anyway, I thought I'd mention that I just finished a 2,500-word op-ed that will be published on Sunday in the Opinion section of the Register-Guard (in Eugene, Oregon).

The gist of it is that our local governments and bodies (county, city, school districts, university) are under-prepared, non-transparent, and unfocused.  Actually, I don't use any of those terms, but that's what it's about.

The task that I first set for myself was to try to find pandemic flu plans from each of those (and of course from the state as well).  Almost nothing is on the web pages of these bodies, so there is no easy way for the public to know whether planning is proceeding or not, and is good or not.

Finding nothing, I started out by finding the e-mail addresses for mayors, city managers, and university folks (later also school districts and county folks) and asking them about their plans. 

Some told me their plans were confidential, while others shared them; some had none.

Soon I was engaged in e-mail discussions with planners, filing one freedom of information request, and mostly looking for one thing:  does a plan deal with social distancing (shutting down schools, etc.), does it have triggers, who has legal authority, and who takes responsibility for action when needed as compared to who says that decisions will be made by others?

In short, I was critiquing lack of transparency, lack of participation, and some individual details.

Finally, I spent time assembling it all into a relatively coherent narrative, titled "IS EUGENE-SPRINGFIELD READY FOR PANDEMIC FLU?"  I sent a version to the local newspaper with footnotes but a promise to remove them (so they understood I had a basis for what I was saying) and to my surprise, instead of asking me to cut it to 850 words (the standard for an op-ed piece) they scheduled it for Sunday as a super-sized opinion piece.

As the deadline neared, I sent it out to the various people in agencies and departments with whom I had earlier communicated and asked them to make any corrections or suggest additions.  This was a crucial step.  It has allowed me to sidestep easy criticisms and to sharpen my aim.  Some recipients were pretty upset, complaining to one another (someone inside sent me some of their e-mails!) about how I was harrassing them and wasting their precious time.  Others wanted to help me get things right (such as a top state official).  Others were pleased that another means of alerting the public was in play (and "we'll take our hits if they're deserved").

I'm not saying it's great or that I am.  I went through all this simply to suggest that doing this kind of analysis (investigative reporting, really) is in the range of each of us in our communities, and the traditional media may find it interesting.  My goal is not just to state an opinion, but to offer a stream of facts about the state of preparation and the issues.  Some of my judgments are going to rub some officials the wrong way; others are intentionally restrained.  And when I found a particularly good official who wrote something quite quotable, I praised him and used it near the end as a wrap-up.

I wonder if others have done this kind of work in their communities.

i haven't
I have been trying to work with the officials rather than around them. I have some sympathetic types, so that's been okay for me, but it doesn't work everywhere.

Send us the link when it's ready for our news section!!

[ Parent ]
Yeah, I guess I'm trying to leverage
some outrage into a more powerful force, a sort of multiplier effect.  The time that it would take to persuade all these folks, one-by-one, to do something real makes the task seem overwhelmingly Herculean.

Or maybe it's just my style.

Actually, I have also worked up a graphics- and picture-laden PowerPoint show and within my much smaller workplace community I am trying the "get more flies with honey than vinegar" approach.  To put it another way, I want to persuade my unit to prepare for closure and alternative tele-working, even if the rest of the community and its officials sit on their hands.

By the way, one constant refrain I heard from folks was "We don't have any money for planning and we have immediate other needs crying for our time and attention."  I wonder whether others have that experience.

The link will be available, I was told at 12 noon Sunday PDT, 3 pm EDT.

[ Parent ]
there's a discussion at pfi
I've been having, trying to explain (limited success) about all hazard approach. Some organizations need to call it that. Do it, but justify the bucks because it'll come in handy for a windstorm, blizzard, etc.
[ Parent ]
they have other needs and issues and projects...
yes, that's what the people thought in the times before the Boxing Day Tsunami, Hurricane Katrina, (or before WWII for that matter)...

And I'm sure all the places in history with depopulating plagues had many local concerns of seemingly great personal importance, until Nature knocked over their little chessboards.

Local populations are going to be upset when hindsight shows their leaders had plenty of warning and chose to ignore it. It costs nothing to tell the public, if officials want to tell what is going on.

Public -some of it- would redirect their personal and community resources if they understood something could start at any time that threatens their childrens' lives, that govt has given notice we'd get no outside aid for (and normal, local aid, might even be impossible).
The people that would prepare, if they knew what we know, deserve a chance to hear what the situation is.

One Flew Over, have you though of putting some sort of presentation online; "multiply" it on the internet?

[ Parent ]
this was posted on the HHS blog in response to Leavitt
http://blog.pandemic...

Mr Secretary,

Thank you for sharing your experiences and insights. I agree with you that countries should support the Global Influenza Surveillance Network and work towards full compliance with the International Health Regulations. At the same time, I would suggest that we also need to see this from the developing countries' points of view. Until the Indonesians started holding the world to ransom, there was no political will to ensure that these countries have access to a pandemic vaccine. Essentially, we were just going to take their patient samples (yes, folks, that's what they are! Ultimately, the virus samples came from real people!), and make vaccines to save our children and leave theirs to die!

As my good friend Dr David Fedson said, "We should have seen this coming, folks!"

We know that with existing egg-based technology, there is no way we can build enough capacity to make a pandemic vaccine enough to cover developing countries as well as our own needs for the foreseeable future. We know that we need to develop new cell-culture based vaccines to overcome the problem. We know that we need to do that quickly.

The US government is commendably willing to invest in development of such new technologies. However, the system, as always, is only as strong as the weakest link(s).

Please correct me if I'm wrong, but it is my understanding that current regulatory requirements are such that the serologic end-points required for licensing for a pandemic vaccine is similar to that for seasonal vaccine, which IMHO creates an unnecessarily high hurdle since the goal of seasonal flu vaccination (protection of the vaccinee) is substantially different from that in a pandemic (development of herd immunity to stop the spread of the virus).

Secondly, it is also my understanding that companies can only submit a BLA licensing application for a pandemic vaccine if they already have a seasonal vaccine licensed using the same technology. Since all existing licensed seasonal vaccines are egg-based, this in essence means that to develop a pandemic vaccine using new technology, a company needs to develop not one, but 2 products, consecutively, and have them both successfully go all the way through the licensing process. I am guessing, and please tell me whether I am correct on this, that this adds between 5-8 years to the process.

Is that really necessary? I understand the importance of ensuring that we do not make a pandemic vaccine that does more harm than good. I know that many in the profession still have not gotten over their nightmares from the 1976 swine flu vaccine complications. But this is 30 years later, and we are facing a virus which is much more virulent, widespread, and persistent than the one that attacked handfuls of soldiers in one army camp in 1976. Isn't it time that we get out from under the shadow of the past and look at the problem with new eyes?

Furthermore, again please correct me if I am wrong, it is also my understanding that the US government has a policy of not funding the research of 'novel' vaccine technologies and/or companies that do not already have a licensed product approved by the FDA. Which in essence tilts the playing field heavily in favor of existing big conglomerates against some small but innovative companies. At the very least, this has the potential of excluding from contention some perfectly good products simply by reason of their 'accident of birth'?

Mr Secretary, the world desperately needs to have the ability to make enough pandemic vaccines fast enough to make a difference to the outcome should we have a pandemic.
The Indonesians may be misguided and irresponsible in threatening to not share virus samples. But they are also doing us a favor by awakening us to the need to abandon our fixation to 'tried and true' ways of doing things and start afresh!

At the end of the day, what is the use of having a virus sample if we cannot make the vaccines that will make a difference to the number of people who will die in the next pandemic?

Susan Chu MD
Editor, Flu Wiki

ps these issues are explored in more depth in this diary Enough Pandemic Vaccine for the Whole World?
Posted June 15th, 2007 at 10:09 pm


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

Question for Dr. Raub - post 60 (Awaiting moderation)
http://blog.pandemic...

#64 anon.yyz Says:

Previewed comment:

#60 Dr. Raub,

I found this on pandemicflu.gov

Pandemic Flu Planning Checklist for Individuals and Families

http://pandemicflu.g...

QUOTE

To plan for a pandemic:

1. Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.

END QUOTE

I also found this Update 3:

http://pandemicflu.g...

On page 11 of 13, a CERC table top assumption was made that a pandemic wave will last 6 - 8 weeks in a community.  It is also said on page 10 that:

QUOTE

There is a video on www.pandemicflu.gov that models how a flu pandemic could spread across the United States. The model advances roughly two days per second. Forty-four seconds into day 85, virtually every county in the country is bright red, meaning more than three percent of the population is ill. If the flu is highly contagious, that happens in 64 days, and more than half the population will ultimately be affected.

What this says is that every state, every county, every community will be affected, and they could be affected over a short period of time. There would be little opportunity to shift resources from one part of the country to another, highlighting the priority of preparedness at all levels and by all sectors of society.

END QUOTE

Questions follow.

Which Federal Agency is responsible for or has committed to guaranteeing that a two week supply is adequate before it is restored in every community across the country?  Is it the DHHS?

Since the HHS recommendation to stockpile has been out for quite a while, how many percent of the population has committed or completed the HHS recommendation of 2 weeks stockpile?  What has HHS stockpiled to back fill  this target of 2 weeks per person, and what are the distribution capabilities of HHS to distribute the supplies to a large number of localities near simultaneously across the country?

If DHHS is not responsible for supply chain resiliency, stockpile and distribution, would it be the DHS? In which case, has DHS provide the guarantees that DHHS will not?

I found this blog by IdahoEM - post # 18

http://blog.pandemic...

QUOTE

If the pandemic approaches/exceeds 1918 levels, we anticipate degradations/failures in the critical infrastructure: healthcare system, electrical, municipal water, wastewater and transportation. Resource shortages and economic stress are right behind. Several triggers for qualification as an ?incident of national significance? are met ? a national disaster. The Secretary HHS contacts the Secretary DHS, and the National Response Plan is activated. DHS is now the lead for overall pandemic management (dealing with the infrastructure issues mentioned), with HHS heading the medical aspects. Two weeks of supplies are found woefully inadequate.

END QUOTE

Can you please let us know whether the characterization in this blog entry was consistent with Policies, Standards, Guidelines or Procedures (please indicate which level) as established?

Thank you for taking the time to communicate with us.

Posted June 15th, 2007 at 11:11 pm

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

Post-conference
For me, the most pressing issue is lack of presence by more local leaders ie governors and mayors in going very public with the need to prep now.

No one can promise that the next flu pandemic will NOT occur this winter or next; nor can they promise that it will.

This vexes me more that the time frame to prep in that better that a percentage of people prep for 2 weeks than no percentage (other than flublogia) have prepped at all.

I emailed my governor Jon Corzine of NJ with the link to the National Governors Association "Preparing for a Pandemic Influenza" (7/2006) and asked him to call my mayor, and to ask all mayors in NJ to do what is on page 16, section under "Governors' Consideration.."

"ask...local governments to do the same (provide essential services)"

http://www.nga.org/F...

It's been over a years since this was produced, yet our governor has yet to do this. It will be interesting to see what response I get. He has been very helpful in the past when I've emailed him on NJ resident health-related issues, so I am optimistic. (Emails also went to the governors of our bordering states NY, Pennsylvania and Delaware.)

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

yes, and it's intersting
This is an interesting comment:
http://blog.pandemic...
comment #11, right after yours:
Sandra RN, BSN Says:

Dr. Dworkin,
I think I heard you comment at the Fred Friendly Pandemic Flu seminar this Tuesday. You sounded quite expert to me. By commenting you make it possible for our voices to be heard.
I brought an RN colleague with me to the seminar. It was the first time she had her attention focused on the ramifications of a pandemic flu. She was almost overwhelmed. ?This is scary,? was her comment. Maybe it just takes the strategic raising of awareness amongst key individuals to bring about change.


That was a simulated exercise run by the Columbia School of Journalism. Lowell Weicker played the President, and NJ's Tom Keane played the Governor hosting a super bowl one week after an H2H outbreak started in indonesia. President weicker was advised by Tony Fauci of NIH and Rajeev Vankayya from the WH (real people), the Governor by real state people (advising him not to cancel the super bowl). Media and bloggers covered the scenario. Jeff Greenfield (CBS news/CNN) was the moderator, and the exercise took 2.5 hours.

A disparaging remark was made by the news people about 'irresponsible bloggers', even though they picked up the story several days before the news people, who refused to run prep stories (it's not news, and the likelihood of pandemic is low). Some attitudes were scripted and some were not, and you could not always tell. It was very well done. And it was recorded, so i hope to see it on PBS.

Anyway, I asked the first question, introduced myself as an irresponsible blogger, then rattled off my creds (MD, sits on local and city panflu task forces, runs a web site reviewed favorably by Nature, Harvard B-school, etc) and asked how the panel recommends closing the gap between official alphabet agencies and 'the people'. The answer from the California PH person was 'the way you do it now, great job, we applaud you'. Note that a blogger had a seat at the table for the exercise.

My rambling point is that there's progress even if it seems incremental. When you think about it (the exercise showed it) the WH can order HHS and CDC to do something but they can't order the governors and the President really can't easily close schools. and whereas CDC is highly respected throughout the country, DHS and Dept Education is not seen in the same way.

That tape should be must-see viewing for every governor and state DPH.

[ Parent ]
Message.
Grace RN,

  Hi. I would have liked to see more folks - utilities, commerce, banks, energy, distribution, trains, food, etc.

  However the meeting seemed to be ice breaker of who is who adn what message to give to teh next meeting.

  Yes - much frustration was vented at Tic toc, Tic toc the clock is running down. As the song goes "We have a long way to go, and a short time to get there."

  Waiting is not a good plan.

Kobie

[ Parent ]
HHS Blog
I had to stop participating in the blog.  I found it way too nonspecific and frustrating.  Kinda like the The Far Side cartoon of what a dog hears when a human talks: "Blah, blah, blah...". 

I am finding that many healthcare workers (HCW's) are as uninformed as the general public when it comes to AI.  I am genuinely concerned about HCW's staying home.  There are things that can be done to help mitigate that likelihood.  I'm very glad I've found this forum in which to learn and share.

the blog will be a start point
and an archive, but it won't replace what we and others have. it was helpful/is helpful for the summit participants to read. But it's merely a tool.

For example, you can link to any post (like my SARS and the precautionary principle) and then also link to a practical page like this:

https://www.coderead...

from MN state govt in an email. What you've got now is a .gov and a state practicum to send along. For some, they need that authorititive stamp to move.

[ Parent ]
What do your co-workers say?
We have talked about the various studies about potential health care worker absenteeism, but I am wondering whether there has been any change on the ground - with health care workers knowledge and attitude towards a potential pandemic.

I also wonder whether the health care employers are doing even paper compliance - to say nothing of stockpiling necessary supplies. 

What's your experience?

http://www.newfluwik...

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
What do co-workers say?
I find 2 main themes among staff: either they are very uninformed and uninterested in hearing about a potential for a pandemic, or they are aware enough of the threat that they are fearful and are in denial of wanting to deal with it unless they absolutely have to.  Both reactions are not conducive to attendance, should a pandemic occur.

I am very concerned about lack of attendance.  I think there are things that the employer can do to help the situation--
  Mandatory education on influenza pandemics that includes how a pandemic is derived, the current threat of H5N1, and what meaures staff should be taking at home in order to prepare.  Staff also need to be aware of the employer's expectations:  i.e., Will I be caring for pandemic patients?  Will I be expected to work extra hours?  Will I be expected to remain on-campus?  Will I be expected to work in different areas or take care of ventilator patients? 

  Staff also need to be informed of what protection/support will be provided to them on the job.  Will antivirals be provided prophylactically? (Where I work, we are being informed that there will be no prophylaxis--only if we become ill will antivirals be given to patient caregivers).  Who will get vaccine?  What kind of PPE protection will be provided, and will that supply be assured? 

  Staff need education on correct use of PPE's.  Many HCW's do not know the correct technique of donning mask, gown, and gloves without contaminating themselves.  Many also are not aware of the care needed to take with the N95's to make sure it is an effective device. 

  These are just a few... 

Statistics/surveys are not promising specific to a contagious, deadly illness.  Support staff/nonprofessionals are even less likely to attend. 

[ Parent ]
Things change -
and even if people are assured of getting antivirals and appropriate PPE, there is absolutely no possible way to guarantee the availability of either in a pandemic situation.

You can say - we have XXX number of masks, or XXX courses of Tamiflu, but no one can say how long those amounts will last, nor can anyone say with certainty that when existing supplies are used there will be any available replacements.

Guarantees in a situation such as pandemic won't mean much.

[ Parent ]
I'm helpful, but I'm not stupid
When the PPE's are gone from work, so am I.
[ Parent ]
Bingo! We have a winner!
I think that's exactly the point - it won't be long before PPE is gone, and antivirals, and by that point, I think most people will have the same response as you, and they'll be gone as well.

That's just one more reason that I do not expect, in the event of a high CFR pandemic, that any medical care will be available to the vast majority of people after the very beginning stages.

[ Parent ]
with PPEs and a dedicated staff
or, sooner without, there's no medical institutional care for the majority of people.
[ Parent ]
BTW: Have these training modules come out?
http://www.newfluwik...

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 
[ Parent ]
HHS BLog Abandoned?
Except for Dem's post and flublogia commenters, the HHS blog hasn't been updated since June 15.
[ Parent ]
it's in its final week
there'll be a few more posts (I've got one for the last week) and then it is closed but not removed.
[ Parent ]
can/should we copy the stuff to the wiki, just in case? hhs.*?


You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.
[ Parent ]
if you want
I'm assuming it stays. but as a .gov, it's free for the taking.
[ Parent ]
I think we should - to preserve the record. n/t


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 
[ Parent ]
I agree.
This entire "experiment" should be recorded.

Absolutely. 

[ Parent ]
Kobie that was a beautiful post
I just saw your post this morning on the HHS blog here:  (Your post about local government.)  I thought it was very apt and well written.  Just wanted you to know!

http://blog.pandemic...

Pandemics are "Wicked Problems". - Average Concerned Mom

Yes, Kobie, hope the admiral reads it too.
Also, Slainte's post:

This is not a ?RSVP?? EVENT we are planning but ?A COME AS WE ARE?.  Maybe this should be on a bumper sticker, after TPTB finally go public (otherwise I wouldn't advertise on my own car). 

Pandemic is a "come as you are" long-term event!

http://blog.pandemic...

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
confounded quote marks!


"The truth does not change according to our ability to stomach it."  Flannery O'Connor
[ Parent ]
HHS blog has new post from Admiral Agwunobi
You can find it at this URL.

http://blog.pandemic...

Yes, he does, and I already
commented on his notion of how very "engaged" we all came away from this experiment feeling.

Don't now if it will post -

[ Parent ]
Clawdia
I added to your comments that "engaged" was the last thing that I felt!

Humoured

Patronised

Condescended to

Ignored

Despairing

Take your pick from any and all of the above!

[ Parent ]
Cool - Great!
I posted too quickly - read it, got ticked off, and posted without saying everything I wanted.

Thanks for helping say more of the things I was thinking!

[ Parent ]
Elona -
Your post has not yet shown up on the HHS blog.

[ Parent ]
I posted a reply to the Admiral,
but the "awaiting moderation" comment is on the Pets blog.  At least, I think I put it on the Admiral's blog.  It's confusing.  I should have taken note of the number in the address.  Also, it's hard to find the posts I haven't read yet.  Another reason to take notes; I guess it would save time overall.  Wish there were a table of contents or something.  (Or did I miss it?)

"The truth does not change according to our ability to stomach it."  Flannery O'Connor
[ Parent ]
Shift in policy?

No one can predict with certainty what the next pandemic will look like. There are no guarantees or promises that can be made regarding its impact on society. The next pandemic may be mild, as in 1957 and 1968, severe, as in 1918, or somewhere in between. The next pandemic could even be worse than 1918. There is simply no way of knowing.

I have not seen anything this clear or strong before from any official.  Remember we have been objecting to vague references to 2% CFR forever and this is the first sign that an official is listening enough to say it in public. Words like these should not be discounted as just mere talk, because whoever utter those words know that there will be follow up call for "where is the action".

While we don't see everything we asked for in terms of action rather than talk, we also run the risk of talking about the talk than trying to move it forward.

I may be dreaming in technicolors, but I think some in the Feds are using us (which is fine by me) to counter either internal or external (e.g. main stream media) lack of interest or obstructions in encouraging pan-flu prep.

Since he asked for ideas, we could bombard him with OUR ideas of how to make it happen, with specific documents, mining from our Wiki pages.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
That line is enough to be head line in main stream media
The next pandemic could even be worse than 1918.

and now we have official word if any deniers say it is not going to be severe.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

[ Parent ]
Admiral's New Message Has Some Gems
If you take the message contained in the Admiral's new post on its own (not weighed down with the failure of the fedflublog to meet our expectations or the government's stated goals) his message is much of what we have been asking for.

...Advanced preparedness is critical and individual preparedness and a culture of self sufficiency are essential. No one can afford to wait until after an emergency begins in order to prepare.

No one can predict with certainty what the next pandemic will look like. There are no guarantees or promises that can be made regarding its impact on society. The next pandemic may be mild, as in 1957 and 1968, severe, as in 1918, or somewhere in between. The next pandemic could even be worse than 1918. There is simply no way of knowing.

It?s important to know that the Federal government alone cannot respond to and address the unique challenges brought on by a pandemic. We are urging a sense of shared responsibility, as it is the only way we can help each other, those less fortunate, and ourselves....

People can learn.  People can improve.  People can do better and rise to the occasion.  People deserve recognition when they do these things. 

If we place our first impressions of people into cement, we lose the opportunity to work with them to make things better.  That does not mean we change our standards, it means we acknowledge both when those standards are met and when they are not.

In this case, if you compare the Admiral's first post with his last, there is a world of difference in tone and a much sharper, more honest message.  That deserves both our support as well as our encouragement that those parts of the message be carried to the wider audience of the general public.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
Oops.
Add virtual end of quote after "ourselves. ..."  Remainder is mine.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 
[ Parent ]
I admit it sounds better . . .
but I think we have to remember that's part of his job - to sound better when necessary.  I do think he's learned a thing or two, although I'm not convinced he's learned the things we'd prefer to teach.

I do believe that as long as he persists in the belief that we have been "engaged" that he still hasn't heard the whole message, or having heard has not comprehended.

[ Parent ]
Clawdia, the lesson for me
is to always take them at their word.

And if you like their words, then keep quoting them everywhere.

If you don't like them, well, we've had several weeks' practice of using words in our own way too!

:-)

Here's my post to Agwunobi:
Dr Agwunobi,

Thank you.

Advanced preparedness is critical and individual preparedness and a culture of self sufficiency are essential. No one can afford to wait until after an emergency begins in order to prepare.

No one can predict with certainty what the next pandemic will look like. There are no guarantees or promises that can be made regarding its impact on society. The next pandemic may be mild, as in 1957 and 1968, severe, as in 1918, or somewhere in between. The next pandemic could even be worse than 1918. There is simply no way of knowing.


Let me second this excellent suggestion

#1 C Mundy a.k.a. - Snicklefritz Says:

Perhaps you would consider submitting your post here as an editorial in the major print media outlets.

May I also suggest that this would also be the perfect opportunity to introduce the idea of personal pandemic preparedness on national TV networks.  I believe you are a good candidate for a round of talk shows and TV interviews, :-) to start planting the seeds for a national preparedness movement.  This will IMHO help ?prime? the public for the subsequent launch of official PSAs and other public education activities from DHHS.


Best wishes,
Susan Chu MD
Editor, Flu Wiki


  Posted June 21st, 2007 at 2:24 pm
 


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...
[ Parent ]
Susan, how wonderful!
I don't know if they use the phrase "You're a hoot!" where you live, but it means you're funny in a really good way, and in your case I think fiendishly clever and funny while being deadly serious is better than just 'funny'. 

"Hoist on his own petard" is the phrase that comes to mind,
and perfectly executed.

I need to take lessons!


[ Parent ]
thanks, clawdia
I'm glad you found it funny!  I meant it, though.  In all seriousness, he DOES have the personality to do well on talk shows!

Wonder if he will take my advise?... ;-)


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Defining Engaged - there's the rub.
To many public officials, on this issue and others, 'engaged' means they have taken time to listen to us.

To 'engaged' citizens, on this issue and others, being 'engaged' with your public officials means an interactive and dynamic two-way conversation.

Different standards will lead to different assessments of success.

I share your concern that public officials should not assume that what occurred on the fedflublog was 'engagement' of the public, but it was more than we had before.  It is a step in the right direction, not a completion of a journey.

One underlying conceptual conflict that should also be addressed is that the purpose of 'engagement' is not to 'satisfy' flubogia, or appease the general public through spin or perception-management.  Engagement, true engagement, will provide both the public insight and support that will be critically necessary for pandemic response plans to succeed.

I also think this same kind of conceptual conflict operated on the blog operations.  It would not surprise me at all that in order to get this kind bloggy-thing approved by TPTB that one of the key conditions was of limited time and effort by the individual PTB.  So it is entirely possible that the plan was approved and that individual government bloggers were recruited with promises that "You will only have to post X number of 'diaries' which the blog participants will then discuss.  It's not like you will be tied to your computer for days and weeks." 

Just saying that their perception of what constitutes a blog is probably very different than ours. 

I am not at all diminishing the substantive shortcomings of the messages that they conveyed or their failure to respond to comments on their blog posts (even with one large response that addressed various issues), but part of the problem may be their serious lack of experience with this kind of medium - which in many circles is still viewed and understood poorly.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
I agree
with most of what you said.  I personally feel that "engaged" at least implies that one has interacted with those who were engaged; however, I also have serious doubts that we were listened to sufficiently, if you make that the other definition.  And - when it comes to this -

"So it is entirely possible that the plan was approved and that individual government bloggers were recruited with promises that "You will only have to post X number of 'diaries' which the blog participants will then discuss.  It's not like you will be tied to your computer for days and weeks."

I can see how that might happen.  I've been a government employee in the distant past.  BUT having to do something is one thing, and doing something because you see the need that it be done, and realize that you are in a position to fulfill that need, is different. 

It may well be that they were told they didn't have to work real hard at it, to spend a limited amount of time on it, but in no way, shape, or form should that have prevented anyone involved from realizing the gravity of the potential threat and going beyond the minimum effort expected.

[ Parent ]
Underwhelming - not what we need. Agreed
What I did find promising however, is that the Admiral, the blog operators, and espcecially the NonGov posters all responded to many of our concerns.  Not necessarily in ways that aleviated the concerns, but many of the participants did not just post and run and ignore the board.

The Admiral in particular after a poor initial post, came back with his second post admitting that his first was not what it should have been and now has produced something much better. If we have been asking for a top US pandemic offical to verify the need for early prep, verify that worst case does not stop at 1918, and verify that while the feds cannot do everything, they are an intergal part of the response - it is all there in his message. (He would send a huge message if he actually posted a couple of times on his latest one.)

It's not much, but its the camel's nose under the tent for us, and that's more than we had before. 

Even if they share exactly our view of the gravity of the potential threat and feel the need to go beyond their official job descriptions to address the threat - the issue for our relationship with them is whether they think that fully engaging us (or the general public) will move the ball forward. 

That, more than anything was the postitive aspect of both the blog and the forum (I hope) - that government realized how helpful and insightful the NGOs and flubogia can be to tease out not just problems but solutions. 

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

[ Parent ]
excellent points
and therefore I will steal some of them for my next and last blog post there.
[ Parent ]
someone at WHO said it could be bad and then someone else said "no predictions" - was it Dr Nabarro?


You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.
[ Parent ]
Clawdia
They posted my comment and I am post 3 - there is also a great post from kobie!
[ Parent ]
just posted this on "p=103"
here

lugon Says: Your comment is awaiting moderation.

Hi, again. We could get used to continuing the conversation. :-)

A conversation it is, if we keep it going.

You say We intend to continue engaging the public in pandemic flu communications and planning. Your ideas are always welcome.

Please, let me, in a friendly way, nitpick on what you say, constructively. It?s an oportunity to go on with the conversation.

1. Engaging the public. That shouldn?t be too difficult. It may be more difficult to engage those who work in the govsphere. What you say would be more effective if there was more engagement from your higher ups. If this is not an international security issue, I don?t know what is!

2. Communication and planning. I know those two things are good, very much needed first steps. But any pandemic virus worth its salt will laugh at all our communication and all our planning. We need preparedness: that?s the final step. We can?t stop until we get there. And I?m not talking about the ?2 or more weeks?, but rather about getting ready to ?not need help? and to ?give help? instead.

3. Your ideas are always welcome. So are yours, really ;-) And, excuse me, the ?always? doesn?t instill the same sense of sustained urgency as the rest of your message. Which is fully appreciated and quoted above, so thank you and let?s keep going.

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

Oh Where Should I Begin?
First, I want to admit that I was on the HHS Blog lamenting about the lack of specificity in the leadership.  I couldn't even stand to read leaders' blogs anymore because all they would do was raise my blood pressure.

I am a peon (I had to check spelling--meaning "low guy on the totem pole) who works in a hospital.  I volunteered to be on our hospital pandemic committee and attended on my own time and "dime" a state-run biopreparedness seminar which occurred over the last 3 days.  It was an eye-opener for me in many ways, and provided confirmation to me about many things.  I sat elbow-to-elbow with many individuals who live throughout our state.  Some were hospital-based, some were public health, some were law enforcement, and some were from the State Health Dept.  The general theme to the conference was emergency planning, but a majority of content of the various sessions had to do with pandemic planning.  There was a good representation in the audience of both urban and rural seminar participants. 

I spoke with individuals from each of the above entities.  I listened to the state-prepared information, which was carefully designed to be disseminated by the attendees to their own locales and various audiences.  I left with the following impressions and conclusions:

There are many individual differences and capabilities in sending and receiving the information that we, the public, need to hear about pandemic planning.  There won't be any one effective individual or forum which will mobilize the masses to act. 

A credible source and consistent message is important, but credibility is in the eye of the beholder.  It is affected by age-group, ethnicity, socio-economic status, education level, to name a few.

If a person truly cares about his/her community and wants results, don't expect any one individual or entity to help. It's like spitting into the wind.  That person needs to roll up his/her sleeves and help.  If the masses need educated, pick an audience and help educate them.  There are resources on-line that can be used to teach the basics.
(In basics, I'm talking about educating what AI is, stock-piling, and ill-care at home).  The audience could be any kind you like.  Anyone you talk to, you may have just saved their or their loved ones' life.

There's a Chinese proverb: ?Never try to teach a pig to sing; it wastes your time and it annoys the pig.? ... 
Don't bother asking the distant leaders what they are doing to help the public prepare. Contact your local hospital or health department and ask them what the plans are and what you can do to help get the word out to different groups.  I can guarantee that there will be different levels of response, and even some evasiveness.  The evasiveness, I believe is out of fear of letting anyone know how little progress has been made.  Be supportive and offer help, and not point fingers or be accusatory of lack of response.  The people saddled with the job of getting the word out wear so many other hats and are often responsible for so many other things, it's remarkable.  Many times they are the man-in-the-middle, having all of the information and no authority or decision-making capability, subject to higher administrative beings who don't have a full picture.

Contact the press yourself.  Ask them what they know about AI, and why aren't they (the press) informing the public?  If enough people ask, it could very well prompt the local press to do something about your inquiry.

Yep, some of the big guys get it (or give it, I should say) wrong.  I found that I was aware of some information they weren't.  No one is perfect, and no one is going to get it all right all of the time, no matter how much we expect them to.  I think we just need to add to the info if we can, and not point fingers at the messenger. 

We're all in this together, and are going to have to get by the best we can with what we have when it hits.  The more we ALL work together and try to help each other, and begin to act as much as we talk, we'll get a lot farther. 

I challenge us all to do so.  Tell us what YOU are doing in your community.  Inspire us by your actions.

 

I so agree.
Want to know what I do? I work online after hours and i work offline when i can.

I give talks and organize meetings in my area to local business, groups (e.g., library talks), school boards, hospital and public health groups. No charge, ever. I'll talk to anyone who asks me to.

I attend every state meeting I can to stay up to date on what they know and add to the info that they have, and to learn what's being done.

I correspond with the people I've met re bird flu, and with people I know otherwise.

I try to keep up with the web sites.

More here:
http://www.newfluwik...

Is everyone in my area, hospital, block, etc ready? Nah. But over the last three months, there's been progress.

[ Parent ]
Thank you!
You are a wonderful example.  Anyone else?
[ Parent ]
Clawdia
I just posted another comment that is awaiting moderation.

I told the admiral that i was sorry if he thought we were "engaged" but as he had not made any announcements, booked the minister - set a date etc - the wedding is off!

Followed up with the point that in the case of pandemic flu which is even a tenth of what indonesia is facing , with an 80% fatality rate - society could not cope.

Also pointed out hospitals and medical services would be overwhelmed very quickly - there would be shortages of supplies and services as a lot of people would be either ill or looking after their families.

There would be no one "riding to the rescue" as they woulf be fighting the pandemic themselves.

This has the potential to be a "katrina" situation in every village, town, city and state!

[ Parent ]
I see it got posted ;-) n/t

[ Parent ]
Dem
I doubt if he will read it - if he does he will probably just think he has a "stalker!" lol!
[ Parent ]
HHS Conference Notes | 132 comments
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