Alexandria thinks ahead

There was a story about prepping for a pandemic in the Washington Post a couple of weeks ago I made note of but didn't get to commenting on. Now's my chance.

When Alexandrians opened their June FYI newsletter, out slipped a slick brochure with a photo of a stern-faced crowd staring out from the cover. "Be Ready, Alexandria!" the boldface type warned, "For a Pandemic Flu Outbreak."

[snip]

"We must take this risk very seriously," Mayor William D. Euille said in an interview. "If a pandemic were to occur, we are going to have a lot of people infected. People are going to die. Some people are going to have to be quarantined. Events are going to have to be canceled. Schools are going to have to be closed. It's a serious state of affairs.

"Rather than wait until something happens and be reactive, my position is to be proactive," he said.

So seriously have Euille and city leaders taken the threat of a flu pandemic that they have gathered representatives from government, business, hospitals, churches, nonprofit groups and other organizations for meetings. They have been meeting since November 2005 to figure out how to respond to an outbreak. Eight work groups are considering such matters as how government would continue to function, where emergency health stations could be set up, how to keep the supply of groceries flowing and, most soberly, finding warehouse space for bodies should fatalities overwhelm local mortuaries.

[snip]

The main message to residents is this: If the worst happens, you have to be able to fend for yourself. Wash your hands. Stay home if you have flu symptoms, unless the situation becomes dire. Don't expect grocery stores to have as much food as usual or restaurants to be serving. Have medicines and a supply of water and canned and dry food on hand.

"People are going to need to do some of this themselves," said John Clizbe, emergency planner for the city's Health Department. "There isn't anything that the government or the private sector can do to assure people that everything is going to be like it normally is, because it won't be.

"The important message in that brochure is, people need to start thinking how they are going to be accountable for some of their own health care," he said. "There are things people are going to have to do differently if a pandemic comes." (WaPo)

This is a long article with much I wish to comment on, but let's start with the pull quote, above. First it must be said, planning and thinking ahead is the right thing to do. Taking the risk seriously, even if the risk is small, is also the right thing to do because it is a high consequence event. I don't see anyone in Alexandria panicking or unduly frightened. I see a city government doing what it is supposed to be doing.

I am more hesitant about the projected notion there are only two possibilities: the health care system and government take care of you or you are on your own. There is a lot of room between these two extremes. A third alternative is that we work to take care of each other. A description of the eight working groups the mayor has set up -- groups such as one that looks at government continuity of operations in the face of widespread absenteeism or the one looking at how isolation and quarantine would work, show none explicitly oriented to the organization and efficient use of volunteers, the organization of non-governmental groups or similar techniques to promote community resilience and cohesion. I am sure this is part of the discussion in one or more of the working groups. I'd like to see it as a front and center objective.

Some of the groups are also of dubious value, or worse, for example the isolation and quarantine working group.

Another working group is studying how isolation and quarantines would work. How would a mandatory quarantine work? (It wouldn't, Clizbe said. At least not once the numbers became overwhelming or the deputies guarding the houses got sick.)

So some people get it. The mayor apparently doesn't. The distinction between quarantine and isolation -- quarantine the explicit segregation of people who are well but possibly exposed, isolation the segregation of the sick -- is not just terminology but of practical significance. Quarantine won't work. Isolation will be relatively easy. We are past time when these two terms should be confused.

There is a lot government can do in advance of a pandemic event, even if its active role during a pandemic will be reduced because of general absenteeism. So what Alexandria is doing is good.

But there is room for improvement and clearer thinking. Most importantly, there is a need to get citizens involved. Some of them are no doubt already way ahead of their leaders.