Wednesday, May 03, 2006

In a pandemic information is good

With the feds releasing their continuity of operations plans for pandemic flu today (it has been leaked so copiously there is nothing new to report) let's look at another other kind of planning that may or may not be going on. A recent pow-wow at the Clarion Hotel in Millbrae, California (Alameda CountySan Mateo County) featured a panel of "experts" opining on how the whole thing might come down.

There was the now familiar scenario and it was scary, all right. Not because of the scenario itself, but the lessons some of the panelist drew from it.
"The fragile hope is we can pounce on this early and contain it," said Dr. Anthony Iton, public health officer for Alameda County, who served on a panel at the event. "If we miss that opportunity, all bets are off."

By the fifth day of a hypothetical outbreak of a pandemic-caliber flu virus — one that spreads easily and is far deadlier than usual — public health departments might declare a state of emergency, Iton said. The leading candidate for causing such an outbreak is a now-famous flu virus called H5N1, which is carried primarily by certain bird populations.

Companies with affected employees would temporarily shut down, schools might close their doors, and federal health officials would jet into town to help control the outbreak and screen foreign travelers. Hospitals could face a run on their services and supplies, and public health workers would be working themselves to exhaustion. Patients would be kept in isolation, and all those potentially exposed kept under quarantine.

All this by Day 5. (Oroville Mercury-Register)
Um, excuse me. Will somebody tell them what the word "pandemic" means? It means disease that is sweeping the globe, not just Alameda Country in California. Do they think they are going to stop it there? Since they're in California, maybe they think they can get Dustin Hoffman to reprise his role in Outbreak. In truth they must be living in some kind of Parallel Universe. There is worse:
By the fifth day, eight other employees working at the hypothetical firm, called Manufacturer, Inc., develop respiratory illnesses. Between the fifth and the sixth day, four of the sick employees are hospitalized. Two employees die that day, as does a janitor at the company hospitalized with a severe respiratory ailment.

A laboratory confirms four of the fictional cases are H5N1. Local health departments and Manufacturer Inc. begin receiving calls from the media worldwide, and it temporarily closes its doors. Word spreads of the disease, and workers at other companies start staying home to avoid the virus. An employee at the stricken firm also starts a blog, chronicling the illnesses.

To confine the outbreak to just these unfortunate few, health officials would have to move swiftly, invoking laws rarely used since polio and smallpox outbreaks in the first half of the 20th century.

"These legal tools haven't been dusted off in 50, 60 years," said Iton, who also has a law degree.

"We're also in an era of civil liberties," Iton added. "The balance of power has shifted much, much further away from government power and much more toward individual liberties, which is not a bad thing."
No, civil liberties are not a bad thing. I hope they remember that when they are dusting off the old tools.

And while they are dusting off the old tools, I hope they also remember information isn't a bad thing either.
Communication, Iton emphasized, is also crucial during an outbreak. A priority is communicating with politicians early, he said, to prevent them from inflaming the situation with misstatements.

"We don't want them saying stupid things," Iton said, as the participants laughed.
Echoes of the worst impulses of health officials. Don't release information for fear of "inflaming the situation." Of course, if the entire global epidemic is starting in Alameda County, that's different.

Significantly one of the non-public health panelists "got it."
Key in controlling an epidemic is media outreach, another panelist added.

"The blog doesn't bother me," said Jeffery Tanenbaum, a partner with the law firm Nixon Peabody LLP, referring to the hypothetical employee blog. "I'm operating on the principle that information is good."
Yes, the blog. Information is good.