The view from here

As this story from the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP) web site describes, there's been a great deal of governmental and academic interest in grass roots efforts to prepare for pandemic flu and other natural disasters. After Katrina, everyone is interested in getting it right.

Governmental plans for an influenza pandemic are missing an important opportunity to improve US preparedness, according to two new reports: They are not reaching out to communities and grass-roots groups that could refine plan details and increase public support.

Meanwhile, ad hoc communities and preparedness alliances are forming—in the real world and online—with minimal input from government planners. And, confirming the reports' concerns, some members of those communities say they have networks and resources to offer to official efforts, but are frustrated by their inability to make themselves heard.

The first report, "Community Engagement: Leadership Tool for Catastrophic Health Events," was published Apr 4 by the Center for Biosecurity at the University of Pittsburgh Medical Center (UPMC). The report, which sums up the findings of a 27-member panel convened by the center during 2006, asserts that official planning incorrectly assumes the public will panic and create a "secondary disaster."

"The civic infrastructure—comprised of the public's collective wisdom and capability to solve problems; voluntary associations (both virtual and face-to-face) that arise from shared interests or a public good; and social service organizations that look out for the well-being of various groups—is essential to managing a mass health emergency," the report says.

"US homeland security and health emergency policies, however, do not adequately reflect the civic infrastructure's proven contributions in catastrophes. Nor have most top officials yet realized the potential value for local and national communities—and for themselves—of preparing knowledgeable, trained networks of constituents who can mobilize in a crisis." ...

The second report, "Citizen Engagement in Emergency Planning for a Flu Pandemic," was published Apr 13 by the National Academies Press and sums up the findings of an Institute of Medicine workshop held Oct 23, 2006. It says that seeking community input about policy decisions and setting up channels through which residents can talk back to government has been critical to the success of recent environmental-action and public-health campaigns and should be folded into pandemic planning as well.

Flu Wiki is prominently featured both in the article and in the academic papers:

"The central cyber-site for pandemic planning is the FluWiki, a sprawling collection of thousands of collectively assembled posts that has garnered 1.5 million visits in its 22 months."

but the important concept is the use of interactive blogs and wikis (aka Web 2.0) to influence and be part of the dialogue. To the extent that the public participates, existing institutions are strengthened. To the extent that the public is ignored, institutions are likely to make wrong choices unaccepted by the 'stakeholders' (i.e., we the people). Public health institutions at the highest level are beginning to sign on to the idea.

It's no different than what we've learned here about politics. Citizen participation is what makes politics work, and the web is a powerful tool to engage citizens. And there's little about Web 2.0 that you do not already experience.

It's nice to see the reality we know be accepted by the institutions we are trying to influence. That sort of dialog can only be good for America (and everywhere else these principles are adopted). Oh, and in case you didn't know, there's more to bird flu risk assessment and preparation than what you see on cable TV. If our public health infrastructure can be rebuilt to prepare for that, it should serve us well for everything else that comes (and I include mental health and health care as part of public health). Those issues will resonate in 2008. But that, of course, is another story for another day. For now, check out the American Red Cross's panflu prep page.

• Family Preparedness Guide Fact Sheet - Available in
  English and Español
• Preparing for a Flu Pandemic Pandemic: Coping and Emotional Well-being
• Pandemic Flu: Self-study presentation

Step by step 'what you need to know' information is there. They'll even provide slide shows and instruction for you to prepare your neighbors and community.

Why is the Red Cross interested in this? They were there in 1918, and they haven't forgotten.

Labels: flu, preparedness