Lessons learned from Katrina, 9/11, SARS, and other disasters
SHUTE: Dr. Low, what would you want to fix?
LOW: I think it would be leadership. We had responsibility divided between two individuals, and then, of course, federal government. But I think that we needed somebody outside of the chief medical officer of health or outside of emergency planning to be in charge of this outbreak and to have the resources to do what they had to do. We needed to be doing research. We needed to know what treatments worked and what didn't, and we could have done that very early on. We needed information about how was this thing being transmitted, what were going to be the rules regarding quarantine, who was going to go on quarantine, who didn't have to. These were things that just didn't happen, and I think mainly because of a lack of leadership and people trying to cover their own areas, making sure they didn't make mistakes, but not somebody to look at the big picture.
SHUTE: Where would you look for that kind of leadership? Would it be within public health? Would it be in a hospital? Would it be a politician? Where would you look?
LOW: It's the person. You just have to have somebody that you recognize in the community that is a good leader. It doesn't have to be someone who is an expert in the field, just a good leader. And I think we were able to identify, and we had long arguments over the phone about this late into the night, about trying to get the will to do that. And government wasn't willing to do it. I think it would have been losing face, and unfortunately it happened at a time when it looked like things were coming under control, not realizing we were making the biggest mistake of our lives in taking down our guard, because the thing just ramped right back up again. So I think that could have been overcome if we had had that proper leadership. So you've got to identify somebody in your community or somebody outside the community that comes in and takes that. And you have to put your trust in them.
SHUTE: Dr. Weisfuse, you had a great communicator, a great leader. What else would you like to have on your list?
WEISFUSE: Well, since both events were in New York City, I think peace on Earth would be a really good request.
You know, I think that the New York City Department of Health and Mental Hygiene is a very atypical local health department. We are very large. We cover a very large, complicated urban environment. But if you look around the country, many local health departments are tiny. I think the average number of employees in a health department around the country is about somewhere between thirteen and fifteen. And the idea that Secretary Leavitt really emphasized over and over again this morning about it's a local response, and you're going to put that kind of pressure on those thirteen or fifteen people to carry that load, I think the fix that not New York City needs, but that the country needs is sustained infrastructure building for public health at that county or city or village level.
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