The Decline of Public Health Preparedness?

In the years since 9/11, we have seen great progress in the fields of public health preparedness. We have better systems to detect biological attacks, better labs to isolate these agents, and trained personnel who understand the threat and how to respond. Additionally, many of our largest cities received funding to increase readiness, conduct public outreach and responder training, and provide additional planning resources.

This is a great piece by Rick Russotti that all EM practitioners and educators need to read. It lays out his observations that all our progress is in danger of disappearing.

Why? Because we have prepared, prepared, prepared…. And nothing has happened. Not since 2001 (Both 9/11 and Amerithrax) have we seen a major public health disaster event, and that hurts the field. This is a simple governmental truth… Money is tight, and needs to be spent where it is “needed”. Since the apparent need for disaster public health preparedness is low, those programs are in danger of getting cut or eliminated.

Avian Flu and H1N1 did nothing to help the case. We spent a lot of time and money preparing for these pandemics, and they had very minor real world impacts. This trickles down into public perception, and drives the feeling that maybe these funds could be better spent elsewhere. This type of rationalization is common in most aspects of emergency management, and will remain a real risk for any response or preparedness assets that go ‘unused’ for too long.

The problem here, or course, is that while Swine Flu was a dud, the next disease may not be. The next bioterrorism attack may be even more effective that Amerithrax. The next hurricane may create as large a public health crisis as Katrina did… The list drags on, and if we cripple our public health preparedness and response programs, we run the risk of encountering unpleasant outcomes.

Emergency management is all about changing the outcomes of events we can’t prevent in the first place. Sitting idly by and hoping and praying for a better result is seldom an effective way to do that. We need to stay proactive, and we need to stay ahead of the threats, and we need to spend the money needed to maintain our preparedness.