Progress for tomorrow: Preparing for the next disaster
INGLESBY: Can I just completely second what Art just said, and in addition, say that as an indicator of how far out the inner circles of preparedness, the healthcare system is, of the $3.5 billion or so that was appropriated by Congress last year for pandemic flu preparedness, there is really no indication yet of any particular monies going to the healthcare system to prepare for pandemic flu, even though that is where all people would go for healthcare. So far it's basically off the radar screen as one indicator of hospitals not being at the center of preparedness.
HEALY: Which may be one reason why we might talk about it. Yes. Okay, we have some questions.
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Q: I am Jane Bourbon, and I have two observations/questions. The first one is that I haven't heard any reference here today to tapping into the resources of organized labor, not withstanding the fact that a lot of the first responders in New York were union members. They tend to be – unions tend to be fairly hierarchical and command-and-control oriented; they are really good with phone trees and stuff. And I don't know if reaching out will happen on the federal level, but perhaps on the state level something like that can happen. Unions have county labor councils and state federations and I think you would find them receptive to folks in medical care.
And then the other thing is I kind of get anxious when I hear a lot about individual responsibility because I start to think about guns. I think a big difference between now and 19 – between now and 1918 is how many folks are at home with firearms. I don't know if – words went around in California earlier this year that homeland security officials were having meetings with bank managers and the managers were being told that in the event of a national emergency, people would not be allowed to remove firearms and precious metals from their security boxes. I don't know if that is true; it's just what I heard and I'm a reporter by training.
I personally fear that in case of a big emergency, folks would go home and start drinking and cleaning their guns and then say –
HEALY: I don't think that is on our list. Why don't we –
Q: Well, Dr. Kellerman, what happens in the emergency room?
KELLERMAN: One of the most important groups that we have to make sure that we provide personal protective equipment to, anti-virals if necessary, vaccination, is our security personnel. I mean, working in the ER is a dangerous occupation. The key for any disaster is engaging and informing the public and doing our very best to prevent panic Purposeful, directed activity yes; panic no.
Other questions?
Q: Avery Comarow, U.S. News. This is directed at Dr. Kellerman primarily because he raised the issue, but I would be interested in hearing other responses, and it addresses the ER and trauma capabilities that are stretched, as you said, like a piano wire. I would like to know two things. First, could you lay out a scenario for us, a realistic, not minute-by-minute, hour-by-hour scenario, but tell us what would actually happen at the doors of your ER if there were some sort of disaster, whatever the kind. And secondly, if you had the resources that you felt you needed to address this sort of major surge capacity, wouldn't you be over resourced, over staffed? What would happen to that capability during the 99.9 percent of the time that it was unnecessary?
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