Public Engagement in Pandemic Preparedness and Response
by Monica Schoch-Spana, PhD, October 13, 2005 [download PDF] Public Education and Outreach Should Begin Now An education campaign is essential now to depict the potential health crisis realistically, explain the types of interventions the government might take, describe personal protective actions, and help desensitize the population to pandemic flu -- an extraordinary, unfamiliar, and invisible hazard. Recommended Action: HHS, in collaboration with DHS and in consultation with a diverse national advisory panel, should prepare and disseminate standardized guidance and messages about medical and nonmedical strategies to manage the pandemic, the rationale and benefit of such measures, and the legal rights of citizens in the event of their implementation.
Efforts to Contain the Spread of Disease, Care for the Sick, and Protect the Well Must be Rational, Practical, and Equitably Applied Fear of loss of income was the most common reason given by Toronto residents who met the eligibility criteria for home quarantine during the city's SARS epidemic but who did not act on this knowledge. Recommended Actions: HHS and CDC should issue national guidance, with full disclosure of rationale, to health departments and healthcare systems about prioritized use of antivirals, vaccine, and other critical medical resources, and they should provide a consultation mechanism to aid local medical and public health officials in tailoring generic advice to evolving local conditions. HHS and DHS, in consultation with DOJ, should review existing federal statutes and emergency management programs to identify and/or recommend payment mechanisms for compensation to individuals and small businesses that experience undue economic hardship as a result of complying with official epidemic control measures.
Frank and Frequent Crisis Updates will be Essential in a Crisis Faced with profound uncertainty (e.g., who will get sick, when will the pandemic end), people will need frank and frequent information about the crisis so they know the extent of the problem and the efficacy of interventions and can make sense of their individual and collective losses. Authorities often opt to withhold information, wanting to "shield" people from frightening developments (e.g., anthrax letter attacks; post-9/11 air quality in New York City). When authorities act on the erroneous assumption that people will panic, they undercut their own credibility and diminish the public's ability to weather the crisis. Recommended Action: Secretaries of Health and Homeland Security should plan for informed spokespersons to hold regularly scheduled press conferences to provide the nation with an overall picture of morbidity and mortality trends, their informed judgments as to the course of the pandemic, and updates on federal activities.
Systems to Support Volunteer Networks Must be Established in Advance of a Crisis Many members of the public, including health professionals, will want to provide humanitarian relief; volunteers will be invaluable for helping to remedy acute and/or extended periods of demand on professional responders, hospitals, health departments, and other critical institutions. During the 1918 pandemic, visiting nurses worried about the interruption of home care that they normally provided to chronic invalids, disabled children, and undernourished infants. They enlisted volunteers, who did not wish to expose themselves to influenza, to assist in caring for these patients. Recommended Actions: HHS, in collaboration with DHS and in consultation with a diverse national advisory panel, should oversee the design, implementation, evaluation, and dissemination of protocols for training, mobilizing, and protecting citizen volunteers during an infectious disease emergency. HHS, in consultation and collaboration with DHS, should award grants, contracts, and agreements that encourage both government and nongovernmental organizations that have a role in disaster preparedness, response, and recovery to broaden their scope of work to include large-scale outbreaks of disease.
Prepared by the Center for Biosecurity of UPMC, for a briefing on Capitol Hill, October 12, 2005, co-sponsored by Trust for America's Health (TFAH), Senator Barack Obama (D-IL), Senator Olympia J. Snowe (R-ME), Congresswoman Nita M. Lowey (D-NY), the Infectious Diseases Society of America (IDSA), and the Center for Biosecurity of UPMC.
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