FROM THE FLOOD TO THE FLU: COPING WITH NATURAL DISASTER

The fall symposium of the NCCIA was held at the National Defense University (Washington, DC) on 25th & 26th October 2005. The symposium bought together a diverse group of past NCCIA attendees and some new faces that included folks with direct experience of the impact of Hurricane Katrina (the most recent critical incident) and folks who are actively engaged with the possible next critical incident – a pandemic influenza episode.

A full report will be posted shortly but the experiences discussed at the symposium and the timeliness of some of the points raised by the symposium participants’ merit a quick report of the highlights.

To view the symposium agenda click here.

The imminent publication of the national plan for response to a future pandemic influenza episode also provides a backdrop for reporting some of the excellent work that was accomplished at the symposium.

In a future posting we will discuss a ‘model’ for critical incident analysis that has proven value in our work over the past years. A central component of that model is the issue of the trust that exists between the government (at all levels) and its citizens. That trust can be either reinforced or eroded during critical incidents and remains a prime focus for understanding why some incidents remain of limited impact while others achieve the status of incidents that materially affect our society in an irreversible manner. It was felt at the symposium that some of the aspects of the response to Hurricane Katrina were intimately linked to this issue of trust and that in any future pandemic influenza episode the trust between the government and its citizens would again be a crucial factor in determining the outcome of the incident.

For more information on the issue of trust click here.

The symposium also addressed a wider range of issues that included significant overlap between Hurricane Katrina and a possible future outbreak of pandemic influenza. Many of these were posed as questions to the symposium participants. They elicited some informative and innovative answers and in future postings this will be fully explored for now the list provides a good example of the breadth of discussion and the breadth of experience that came together to discuss a past and a possible near-term future critical incident.

To view the symposium questions click here.

Some of the other key issues that were raised and that will form the basis of the report from the symposium included:

• After Hurricane Katrina, it is even more evident that any response to a disaster starts at the local level. This is especially true of an influenza pandemic which will affect multiple localities at the same time. It may be days (or even weeks) before federal resources are able to mount an effective response. Self-reliance by individuals and resilience in our communities will be essential components in the initial phase of a response to a pandemic episode.
• Pandemic flu planning in the United States has largely been left to the medical and public health officials. These officials are often untutored in the reality of the other systems (e.g. schools, prisons, tourism, airlines, food production, and distribution) that will be massively affected. The medical focus for the majority of the planning for a pandemic will undermine our ability to mitigate any outbreak, and slow our recovery for the following reasons:
  • Vaccines and antivirals have been massively overemphasized (they represent 90% of the discussion in state plans);
  • Closure of schools would effect more than 25% of the population (parents, children, suppliers, school personnel). Large numbers of first responders would not be available due to new childcare responsibilities.
  • The planning for social breakdown is not apparent in the current plans, merely contagion control, which arguably is of lesser importance depending on how simply the virus spreads.
  • Basic supplies - food, water, electricity - will be more important than medical responses for at least 6 months. These sectors have not been ‘hardened’.
  • Macro-economic analysis is wanting (particularly post-Katrina where poverty was seen to be a determining factor in mortality).
• There is an urgent need for identifying national and local spokespersons who can effectively communicate with the public in terms of the threat from a pandemic episode. The symposium discussed several options in this respect including:
  • Risk communication and public communication will be key aspects of a pandemic response plan. Several suggestions were made about improving these areas and will be reported by NCCIA shortly.
  • An expanded role for the media including broadcast, print and Internet sources.
  • The creation of ‘communication task forces’ focused on national, regional, local and special population needs both before and during any future outbreak.
  • The possibility of creating a Council of Surgeons General, to include the Surgeon General of the United States and his counterparts from the armed services.
  • The need for test beds of messages (and messengers) for the diverse populations within the United States – no one person or message will provide sufficient clarity for all who need to hear.
• The symposium included considerable discussion of the roles and responsibilities that the military would have in any future response. This topic will be expanded on in future postings to this site.
• Considerable emphasis was placed on understanding and addressing the psychosocial and psychological responses to a future pandemic. There was universal agreement that this was an under researched and discussed topic but one that would play a crucial role in how the pandemic response is managed and the immediate and longer-term effects that it would have on our citizens.
• The needs of special populations were also emphasized. The abilities and strengths of these populations are frequently over-looked. There is much that can be learned from how they cope with everyday crises that can be applied to the wider population during a crisis. The needs of special populations are often emphasized and sometimes forgotten but they can teach us all about resilience, courage, and demonstrate many of the skills that we may all need to apply in a future critical incident.

These are just a few of the topics that were discussed and that will be reported on in future postings. The fall symposium was a good start on this topic but much remains to be done and NCCIA looks forward to doing its fair share of the work.