Director of Health for the City, Kansas City, MO
The Gulf Coast hurricanes of 2005 taught the nation how essential it is to pre-deploy assets needed to respond in advance of a disaster and to have realistic plans for how those assets will be used. During the Gulf Coast hurricanes, transportation for evacuees, shelter, safe water and food, and maintenance of health care were among the most critical needs. They arrived too late.
Pandemic flu is another type of catastrophic national disaster that will require pre-deployment of different types of assets. Should an outbreak occur, it will be too late to manufacture vaccine and antiviral drugs, arrange isolation facilities and medical care for the sick, and cobble together care for those quarantined in their homes. We need to stockpile vaccines, drugs and extra medical equipment in advance. Just as critically, we need to plan who will do the work, neighborhood by neighborhood, to give people flu shots, to get food and medicine to people in their homes and to care for the sick.
The real work to contain an epidemic and keep people as healthy and safe as possible occurs at the local level. All the vaccines, drugs, and medical equipment in the world will be useless if there are not local personnel in place who know their communities and can use those assets effectively.
Do we have all these assets pre-deployed and ready for use by well-staffed local public health departments? No. Could we? Yes, but not without the political will and commitment of sufficient resources to develop and deploy the tangible assets — drugs, vaccines, medical equipment — and to hire, train, and exercise a local workforce on the ground that will do the real work of getting shots into people's arms and stopping or controlling the spread of a disease that is resistant to treatment. To ignore this reality is a recipe for social and economic chaos when a frightful pandemic occurs. Remember the words of George Santayana, "Those who do not remember the past are condemned to repeat it."
Dr. Rex Archer, MD, MPH is Director of Health for the City of Kansas City, Missouri and President of the National Association of County & City Health Official, representing 3,000 local public health agencies. He is recognized as a Public Health Leadership Institute Scholar by UCLA/CDC and as an authority on civilian bio-defense. He completed his medical degree at the University of Kansas, and his General Preventive Medicine Public Health Residency and Masters in Public Health degree at the University of Michigan, and has served as Physician in Charge-Employee Health Programs for Ford Motor Company.