White House to Hold Flu Summit Next Week

DolceVita, ADN, BSN, RN · Jul 2, 2009

I think it is a prudent measure. Don't you?

indigo girl · Jul 2, 2009

Absolutely! The sooner, the better.

I would like to see them really start to prepare the public, and not just offer reassurances.

People need real information about what they can do to protect their families. They also need to tell them to how to prepare for a period of time when they might not want to go food shopping or can't because they are sick.

There is so much that people could be doing but won't if they think that the govt is going to do everything for them or tells them not to worry about anything.

You have to have enough faith in people's ability to understand that some of us are going to die, but most of us are not. They need to know that lots of people are going to get sick, but most will recover.

DolceVita, ADN, BSN, RN · Jul 2, 2009

Agreed!

indigo girl · Jul 2, 2009

The Government Is Preparing for the Worst While Hoping for the Best - It Needs to Tell the Public to Do the Same Thing!

http://psandman.com/col/swineflu1.htm

Some advice from a famous risk communicator, who is very familar with pandemic preparations. Ths was written before WHO declared that the pandemic had started.

...whatever the situation is like by the time you read this, that won't be the end of the story either. A mutated virus (more virulent or more transmissible or resistant to antivirals) could come roaring back a few months later.
The CDC's biggest failure: not doing nearly enough to help people visualize what a really bad pandemic might be like - while helping them also to hold in mind that it's only one of many possibilities - so they can feel the knot in their stomachs that everyone on the inside is feeling, get past this adjustment reaction, gird up their loins, and start preparing.
It is especially important to get this message to business and community leaders, who have prep work to do ASAP in case things get worse.
But individuals also have prep work to do - logistical as well as emotional prep work. All that preparing will stand us in good stead even if The Big One isn't right around the corner yet ... and it'll be essential if it is!
For the ordinary citizen, the U.S. government has so far recommended only hygiene, not preparedness. It has told people to stay home if they're sick, cover their coughs, and wash their hands a lot. It hasn't told people to stock up on food, water, prescription medicines, and other key supplies. Two years ago HHS Secretary Mike Leavitt was crisscrossing the country with that advice. These past few days Acting CDC Director Richard Besser kept evading questions from journalists about whether it's still good advice.
I don't fault Dr. Besser for looking and sounding reassuring. The gold standard in crisis communication is to say alarming things in a calm tone, and he is doing exactly that.
The problem is that he isn't giving us anything to do except practice good hygiene.
From the start of the swine flu crisis, I believe, there was a decision - probably a very high-level decision - to take the situation extremely seriously but to hold off on asking the public to do the same. The result is almost surreal. The federal government has already released one-quarter of the Strategic National Stockpile of antiviral drugs to the states, so there will be millions of courses of Tamiflu ready to deploy if there are millions of sick Americans requiring medication. But it hasn't yet asked those millions of Americans to stock up on tuna fish and peanut butter.
I have been here before. In 2005, the pandemic influenza threat came from an avian H5N1, instead of the current swine-avian-human hybrid H1N1. (Lest anyone forget, H5N1 is still around too.) The CDC and HHS were similarly convinced then that the risk was serious, similarly committed to aggressive preparatory action - that's why we have that Strategic National Stockpile of antivirals - and similarly disinclined to alarm the American people. The feeling was that people had been alarmed enough by 9/11 and the ensuing wars in Afghanistan and Iraq, and that the government had pretty much exhausted its quota of scary utterances. There is much the same feeling today about the economic meltdown.
I was in the minority then, as I am now, urging officials to involve the public in its pandemic preparedness efforts. In February 2005, I was invited to give a day-long seminar on my recommendations to a high-level conclave of CDC and HHS infectious disease experts and officials. They heard me out, sent me home, and reaffirmed their policy of quiet preparedness.
In order to avoid frightening the public, this past week, the U.S. government has avoided clueing in the public that we should all be preparing for a possible pandemic - not just the feds.
Why are officials so leery of describing the worst case vividly and urging people to prepare for that possibility? Here's why:
There is a virtual terror of frightening people excessively (as if that were easy). Although crisis management experts have known for decades that panic is rare, officials routinely go into "panic panic" - either predicting that the public will panic if told alarming things or misdiagnosing orderly efforts to prepare as panic. A Google News search this morning for "swine flu panic" netted over 8,000 hits. Some of them were urging people not to panic (unnecessary and condescending advice); a few were pointing out that people weren't in fact panicking, not even in Mexico City.
Officials who imagine that the public is panicking or may soon panic often feel impelled to make over-reassuring statements, to suppress alarming information, and to belittle those who are frightened as "irrational" or "hysterical" (or "panicky"). These official preemptive strikes leave frightened people alone with their fears, and persuade them that their government has betrayed them and cannot be trusted. The result is an increase in public anxiety, which officials cannot properly channel into effective action because they have already delegitimized the fear and because they are unwilling to involve the public. During the 2003 SARS outbreaks, for example, the Chinese government denied that Beijing was seeing SARS cases and SARS deaths. These false denials led to actual panic in Beijing. Why did the Chinese government hide the truth? To allay panic.
To its credit, the CDC has not made over-reassuring statements, suppressed alarming information, or belittled people's fears. For several days before the first U.S. swine flu death this morning, Dr. Besser continually predicted that there would soon be U.S. deaths. That's excellent risk communication. He's not understating how bad things are or how bad things could get. His failure (of skill? of nerve? of policy?) is subtler than that: He is creating the sense that the CDC will do whatever needs doing to protect us, and that we need do little or nothing to protect ourselves. I think this is intentional, aimed at avoiding what he or his superiors consider excessive public alarm.
Already the same officials that I am criticizing for under-warning the public are being accused by others of over-warning the public. And of course if the virus recedes and this pandemic never materializes, these critics will consider themselves vindicated ... as if the fact that your house didn't burn down this year proved the foolishness of last year's decision to buy fire insurance. It is dangerous nonsense to imagine that warnings are justified only if they are followed quickly enough by disasters. People who don't take precautions often escape injury. That makes them lucky, not wise.
The risk communication solution to this quandary is to issue warnings that are simultaneously scary and tentative. Public health officials need to learn how to say "This could get very bad, and it's time to prepare in case it does" and "This could fizzle out, and we'll probably feel a bit foolish if it does" - to say them both at the same time, in the same sound bite.
Of course we don't know anything yet about the relative probabilities of different swine flu outcomes. Flu experts say the way things look right now is the way a disastrous pandemic could look at this early stage - and it's also the way a false alarm could look at this early stage.
Warnings about swine flu are particularly difficult in another way as well: bad precedent. The problem is partly grounded in the 1976 swine flu fiasco, when the U.S. prematurely launched a vaccination program that caused more illness than that no-show pandemic did. But the bigger source of official hesitation, I suspect, is the 2005-2006 bird flu scare. Public health authorities then seemed to be implying that the bird flu virus was expected to mutate and launch a human pandemic by next Tuesday. But the virus remained (and so far remains) confined to countless millions of birds and a few hundred profoundly unlucky people.
(There are some key differences between the two pandemic threats, other than the fact that one is still theoretical and the other looks imminent. The H5N1 bird flu still hasn't learned how to spread easily from person to person, a skill the H1N1 swine flu has amply demonstrated already. On the other hand, H5N1 has killed over half the people it has infected, whereas the new H1N1 looks comparatively mild so far ... though not as mild as early U.S. reports implied. Another difference: In the U.S. and most of the developed world, we now have a sizable supply of antivirals that are known to work - so far - against the swine flu virus we're facing.)
It's a calming experience to prepare. As psychiatrists sometimes put it, "action binds anxiety." Having things you can do that seem likely to improve your situation gives people a sense of control; it builds self-efficacy, which leads to determination, calm, and even confidence. It's not that taking action makes people less fearful; rather, it makes people more able to bear their fear.
Those who have been working hard not to worry about the pandemic that might be looming will feel more in control after they have taken some concrete steps to get themselves and their family ready.
The other psychological effect of precaution-taking may matter less to the CDC right now, but it matters just as much to the country's prognosis if a pandemic happens. Some people - a lot of people, in fact - are not yet very worried about a possible swine flu pandemic....
When officials urge people to take precautions, that doesn't necessarily pierce the apathy - but it helps. Each time officials repeat the advice, more people take it. Some of them take it skeptically, but take it nonetheless.
As social psychologists know well, attitudes follow behavior far more reliably than they determine behavior.
In other words, we learn from what we do. If the CDC can get insufficiently concerned people to stockpile supplies against a possible pandemic, the mere act of doing so will make them more attentive to swine flu news and more concerned about pandemic preparedness.
So urging people to prepare is a twofer: it calms those whose concern is excessive and arouses those whose concern is insufficient. Not to mention the benefits of having the right stuff on hand if it becomes dangerous to go out in public, or if supply lines are disrupted and the stuff isn't available anymore.
Our thinking about pandemics has been conditioned by H5N1, the bird flu virus that has killed more than half the people it infected. We have become accustomed to assuming that any pandemic would be a catastrophic pandemic. 1918 genuinely was catastrophic, even though its case fatality rate was only 2-3 percent - lower than the apparent rate for H1N1 in Mexico so far (not to mention the appalling rate for H5N1). The other two twentieth century pandemics, 1957 and 1968, were mild, not catastrophic; for most non-professionals they were non-events. The Pandemic of 2009 could be just as mild.
Or it could be catastrophic. Or somewhere in the middle.
So the key question is what to say to the public when a pandemic may well be imminent, but may still fizzle or stay poised at the brink or turn out anticlimactically mild.

Morning-glory · Jul 2, 2009

Amazingly well presented. Thanks for posting it, Indigo.

indigo girl · Jul 2, 2009

Senate Subcommitee on Homeland Security and the Pandemic Flu

Thanks to a flutrackers member we have this google cached video of this meeting.

http://74.125.95.132/search?q=cache:PbK2c5148yUJ:hsgac.senate.gov/public/index.cfm%3FFuseaction%3DHearings.Detail%26HearingID%3D6c228b70-8e79-41af-aa3f-893317c92c86+senate+homeland+security+pandemic&cd=1&hl=en&ct=clnk&gl=us

(hat tip flutrackers/possibilities)