Wednesday, May 13, 2009
Now that we have had some time to react to the swine flu, Professor Bard has some thoughts on the way in which health officials have responded and are responding to this public health threat. She writes,
There is a Yiddish saying which translates as “man plans and God laughs” and another that describes “any problem that can be solved with money” as “not a problem.” In the case of the past few days’ media frenzy over the discovery of a new strain of influenza, H1N1, it is easy to misunderstand these messages. Clearly, the dire predictions about the deadly “swine flu” did not come true and although highly infectious, this new strain of flu doesn’t seem particularly lethal. But no one’s laughing with relief. Instead, many members of the public, media and government are reacting to this wonderful news with outrage. How dare the media and the public health establishment frighten them with unsubstantiated hype? Have we all been victims of some sort of hoax or joke? How can we spend money, especially now, to plan for something that probably won’t happen. I suggest that this is entirely the wrong message.
Until the mailing of anthrax spores to politicians and media figures in the weeks following 9/11, the threat of either bioterrorism or pandemic flu were ignored and those who tried to raise the issue dismissed as alarmists. Was the world in any greater danger of either natural pandemic or bioterrorism after 9/11 than before? Absolutely not. Did that scare make us more ready? Indeed it did. For the first time in more than 40 years, since the end of the terrifying polio epidemics, federal, state and local governments started assessing and rebuilding their almost nonexistent public health infrastructures. Today, almost every business, school and government agency has a pandemic flu plan, yet the infrastructure to address a true pandemic doesn’t exist. . . .
So what should be our take-home message? Well, the idea that we can really plan against doomsday is laughable. But the notion that we won’t spend the money to plan for a lot of very bad things that are actually relatively likely to happen but might not because of disaster fatigue isn’t funny. There are plenty of threats that we do have the ability to address with adequate resources and H1N1 is a perfect example. Within days scientists were working on a vaccine and the CDC was distributing stocks of antiviral drugs all over the country. It’s a problem we can solve with money. The threat of pandemic flu and other disease is as real today as it was in 1918 when ten times as many Americans died of influenza at home as on the battlefield in World War I. Consistent funding for planning and maintaining the public health infrastructure is what can prevent disaster. Lets not let what looks like a narrow escape turn out to be an excuse to stop spending money on public-health infrastructure. Planning isn’t anything to laugh about.