Progress for tomorrow: Preparing for the next disaster
I really think it's about engaging the public and really giving them practical ways to get prepared, you know, making up a bunch of lists - which it's good that we have lists - is only one step. But one of the things I've learned from my many years in practicing public health and working with community groups is that you really need to reach out and engage those folks and show them how to do it, help them how to do it, and tell them why they have to do it. And until you do that, we won't be prepared.
HEALY: Dr. Kellerman.
KELLERMAN: What keeps me up at night is the knowledge that our trauma and emergency care system in this country is absolutely stretched like a piano wire. We have been pushed absolutely to the limit in terms of capacity to the point that they're giving nights, and I'm not sure we can handle an average night's 9-1-1 calls, much less a terrorist strike or pandemic influenza. Four years ago, U.S. News & World Report published a very important story on this problem. They gave it the priority of a cover story. It was entitled "Crisis in the ER: Turnaways and Delays are a Recipe for Disaster. What you Can Do." That issue was published on September the 10, 2001.
Nothing has been done about this problem since then. Now we're talking about international terrorism, now we're talking about pandemic flu, and yet on any given night, we have admitted patients in hallways at private ERs as well as public hospitals. We are diverting one half million ambulances a year because your emergency room is on diversion because it's too full. And we're having speeches and pronouncements about how we're better prepared today than we were yesterday, and we've not come to grips with the fundamental problem, which is where are the casualties going to go?
HEALY: Dr. Inglesby?
INGLESBY: I would say what keeps me awake at night is - on occasion; I try to be Buddhist about it and not stay awake late nights thinking about it – but if I have to think about it, I think it's the prospect of large-scale epidemics, be they from SARS or avian flu or other natural causes or bio-terrorist attacks and the potential that they could change the way that the country moves forward beyond those epidemics. They could be events that permanently change the way that we work together as a society. And so in short, I think it's the prospect of epidemics changing things in inalterable ways and the missed opportunities that we have now prior to those epidemics to try and ameliorate or become more resilient to those kinds of problems.
HEALY: I'm hearing a little bit of a disconnect in terms of the intellect and the passion or the emotion, which maybe Dr. Benjamin you got at in terms of not having engaged the individual, I think you said. Maybe you've engaged them intellectually. I suspect if you talk to anybody on the street, they'll say, yeah, I've heard of that pandemic flu or I certainly know about 9/11. But somehow or other, have we engaged them emotionally? And I'm going to ask you why is that? You know, if you look at disasters, and we all have had our different perspectives on disasters, when the public looks at CNN, turns on the television, looks at any TV station and sees people suffering in a flood, whether it's the tsunami halfway across the world, whether it is what happened in Katrina, happened in 9/11, there is an enormous outpouring of passion and commitment, and people open their pocketbooks – money is never an issue. Why is it that the preparedness that we've been talking about today hasn't captured the individual?
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