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Are public health officials crying Chicken Little over the bird flu?

Emergency Management Alert, February 14, 2006

Dire predictions from the New York Times that the arrival of the bird flu will result in the breakdown of society and the swift demise of-well, of just about everybody-may be premature, if you measure the Times' report against disaster-planning coverage in January's Annals of Emergency Medicine (AEM).

Let's look first at the Old Gray Lady. Despite the mention that "human infection is still rare," the article titled "States and Cities Lag in Bird-Flu Readiness," said that "the nation's 5,000 state and local health departments are rushing to plan for an epidemic of avian flu, but they say they are hobbled by a lack of money and guidance from the federal government."

Among the concerns mentioned by health officials in the February 2 story are these: 'Tabletop' drills are ineffectual; the stockpiles are down; hospitals won't be able to handle surge; and, after trickle-down, the $7.1 billion President Bush requested from Congress to fight the bird flu would result in only $70,000 for each of the nation's public health departments. Quoted was Dr. Harvey V. Fineberg, president of the Institute of Medicine, the medical division of the National Academy of Sciences, who said, "We're completely unprepared."

Centers for Disease Control and Prevention Director Dr. Julie Gerberding is quoted as saying, "If we prepare now, we may be able to decrease the death rate and keep society functioning."

This view differs from the AEM analyses, which urge the use of resources already in place. (This is a trend we'd noted in the December 6 edition of EMA. We mentioned a Journal of Homeland Security and Emergency Management article by Tee L. Guidotti saying that occupational medicine specialists--with their experience in impairment evaluations, hazard evaluations, etc.-- are an "under-utilized resource" in emergency response.)

In "The Myths of Disaster Education," by Jonathan L. Burstein, MD, and "The Importance of Evidence-Based Disaster Planning," by Erik Auf der Heide, MD, MPH, the authors acknowledge that in many emergency departments, disaster readiness is inadequate. But, they say, response may be improved by changing one's perceptions of disaster response and planning. For example, among the myths Burstein busts: "It is impossible to be prepared"; "The government will take care of it"; and "People need to know 'special' things for disasters."

The articles may be accessed at the AEM site at www.annemergmed.com.

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