Three points about bird flu to tell others

Today a colleague called to say she was asked by her local Board of Health (of which she is member) to educate them on bird flu. In five minutes.

She is a scientist and knows a lot of the technical basis for influenza and the town is a well-to-do bedroom suburb with many professionals. But that just made it more difficult to boil down the message to five minutes. So she asked me for help. Here's what I told her.

I suggested a message of three major points.

• We don't know what the biology of this virus has in store for us. But if it has the makings of a pandemic agent, nothing we will do between now and then will be able to stop it. Thinking that we have the ability to stop a pandemic is a waste of time and a dangerous distraction.
  
  
• This means the major task ofher community is managing the consequences of a possible pandemic. It will have to cope on its own, because all the communities surrounding it and the ones surrounding those will be facing the same problem. There is no "outside" from which to get help in a pandemic. The federal government has already said it can't help.
  
  
• The major consequences are not the "obvious" ones of vaccine distribution or even ones that are primarily medical or public health. They are the effects on essential functions of prolonged and widespread absenteeism. Many of these are things they probably never thought of. She should give an example. If hourly employees have to have their time sheets totalled and submitted (a "turnaround"), what happens if the person responsible for tunrarounds is out sick for weeks or worse? The town can anticipate this and show others how to do that function or arrange to have those employees converted to salaried employees for the duration. I suggested this only as an example of a "non-medical" prep that can be planned for in advance. There are many more.

Three points are plenty, especially if you want to get some action. But there are other things she could suggest later as a member of the Board of Health. A few select town officials and citizens (say the health director, the veterinarian or animal contol officer, a member of the Chamber of Commerce) could meet every couple of weeks for an hour to go over recent developments and try to anticipate what they might mean for their town. If they were to do that today they might discuss the discovery of H5N1 infected cats. What if people started letting their pets loose out of fear, or started vigilante round-ups of loose or feral cats and dogs? What policy should the town have in such a circumstance, even in the absence of human cases? This situation is already a reality in Europe. It isn't a stretch to imagine it here.

These easily visualizable circumstances are the foot in the door for talking about everything else. Once a mind set is established, people become self-motivated and they begin to involve others.

Finally, I told her it would be good to remind everyone that the cities and towns that coped best in 1918 were the ones whose citizens were prepared by credible sources of information. In those towns neighbors helped neighbors and they got through it with the least pain. San Francisco is John Barry's example. Most other places, where the news media and public officials lied and kept the very existence of the epidemic from their readers, neighbors fled neighbors and the pain was terrible.

A lesson about civic life from 1918.