The view from inside major medical centers
BURKE: So the key is to find the similarities in preparation for each of the scenarios and focus on those and expend our resources there.
KELLY: We want to leave some time for questions here. I'm going to ask one last question of everyone. Short answer – I wrote down what wakes you up at 5:00 in the morning? And I realize you're all doctors; you're already up at 5:00 in the morning. I'm not, but so what wakes you up at 3:00 in the morning – one thing that you sit and, say, bolt upright in a sweat and say, boy we're not ready to do this or boy if this ever happened. What's the one thing? Tom.
BURKE: I think to sustain my staff for an extended period.
KELLY: Ron.
KAHN: I guess my major concern, coming from a diabetes center is that people with chronic diseases like diabetes, hypertension, heart disease, asthma, severe arthritis, represent a lot of this country. They represent 90 million people now. They'll represent 150 million people in the year 2020. And they all are at special risk when we have a disaster, whether it be an emergency of Katrina's nature or a pandemic, some other type of medical problem or exposure to toxic waste. These are the people who are going to be most vulnerable to have the worst consequences. And I think that we have a healthcare system that doesn't really give enough attention to how we deal with them first, or at least with special attention that they need because they are going to be the most vulnerable people. They often include women and minorities, the underinsured. So that's the thing that keeps me up at night.
KELLY: Ed?
MILLER: No surge capacity whatsoever. Hospitals are filled, can't empty them fast enough, and then some very important ethical issues about who you will treat and who you will not.
KELLY: Yeah, Tom?
PEACOCK: Yeah, after my daughter woke me up at 3 with a cough, that was the issue. No, the surge capacity is clearly it. Having that been said, I'll say smallpox, because if that ever got out, we would be screwed.
KELLY: Vicki, any more good news?
RUNNING: Well, I think for me it would be the long-term effects of a disaster. I think we drill and we practice to the short term. When we drill and when we practice, we do it for four hours or eight hours. It's the long haul. These events are not short term. As we've seen with Katrina, they go on and on and on, and it's years before you can mitigate and get back to business as usual. So what keeps me up at night and in the morning is thinking about how we can better ensure that we can go on.
SALEM: I guess waking up at 5 and the E-mail not working, had there been an electric disaster of some sort would wake me up a little faster than normal. But I would say that from the sounds of this panel, we're just not ready yet – very straightforward.
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