Pandemic Exercise with Bloggers

We routinely hold readiness exercises at HHS on various emergency scenarios. Typically, people from various parts of the emergency management community sit around a square table, and a moderator paints a picture of a disaster unfolding. It is like a reader’s theater. As events are described, each actor assumes their part, describing what they are thinking and doing to respond.

Slowly, the moderator heightens the stakes and intensifies the nature of the problems, throwing out more complicated circumstances, and challenging the reasoning various players use. It is an excellent way to learn and refine emergency protocols.

Monday, we had another exercise on pandemic influenza. Included in the exercise was a group of journalists, including bloggers. Not amateur bloggers like me. Real pros, people who have built reputations with their readers for innovation and speed.

We invite journalists to participate in our exercises because managing their needs for information is a part of crisis management. We need to learn more about how bloggers would react and interact.

Television reporter Forrest Sawyer was the moderator. He has done several of our exercises and he’s very good. He laid out a set of facts that represent routine health news from around the world and laced it with a few interesting tidbits that could attract the interest of people following the flu world.

Turning to public health officials at the table, Mr. Sawyer asked if they found any of the news that day interesting or concerning. He did the same with the journalists, asking what they would do to get more information and how big a story they thought it was. As the facts became more concerning, several observations came to me.

I found it reassuring how important accuracy was to those that attended our session. They were willing to report rumors but made a point of distinguishing them as such. Many of them said they had separate sections of the page for rumors.

The blogs represented at our session tended to be rather specialized and the bloggers knew a lot about the subject matter. It made them better at challenging the facts they were given. I suspect in a major emergency we would be dealing with a broader range of understanding than in our exercise. These people knew their stuff.

I was surprised how much interaction there is between online communities. They seem to share information, monitoring one another’s sites.

More than one of the blogs talked about the way they use traditional news sources but provide added value. One example is translating foreign news articles into English.

I enjoyed watching the interaction between traditional media and blogs. It’s clear television, major radio and newspapers are monitoring blogs all the time. It is also evident most of them are starting to use blogs to supplement their own reporting. The unlimited supply of space and time is appealing to traditional journalists.

The exercise went most of the day. I was only able to stay until noon, but it was a morning full of learning.

The bottom line for me: Government needs to understand the blog world better, and factor it into the way we interact with people. A growing part of the world relies on bloggers for unvarnished information; something they are not sure they always get from us in government.

Comments

I appreciate that both HHS and CDC included bloggers in their recent panflu exercises. I followed the reporting of DemFromCT on Fluwiki as he participated in the CDC two-day exercise last week. I was wondering if and how the issue of vulnerable populations came up in the HHS exercise on Monday or the CDC exercise last week. I am curious if issues related to vulnerable populations are included in updates that are given periodically during such exercises.

Posted by: Deborah Robinson | March 20, 2008 at 02:26 PM

Is there some point at which information will be passed down to the local level?

The administrator of a municipal EMS corps told me his health bureau said he did not need to worry about pandemic flu because the only way to become infected was to travel to Asia and have close contact with infected birds.

There are no Community Planning Committees in my area.

Local officials really do not know that they should be planning for this because no one is telling them.

There is nothing in our local papers - the public literally does not know what pandemic flu is let alone what they should be doing to prepare.

Are we going to actually tell people or are we going to continue on this way until it hits?

Posted by: aurora | March 20, 2008 at 02:47 PM

The HHS session didn't have time to focus on that important population, but in Atlanta the CDC had a duty officer focused in on and assigned to that beat.

The idea is to build relationships with community groups that serve vulnerable populations, and during a crisis keep in contact to convey info (two way, not one way) in ways beyond the internet or usual government sources.

It's a powerful argument for rebuilding public health infrastructure so it's there when you need it ;-0

A more neglected population are those with special needs, such as children with disabilities. We all need to do more work here, though there have been the beginnings of that which I have seen at recent emergency preparedness conferences.

Those are my observations as an outsider; Secretary Leavitt may have more to say.

Posted by: DemFromCT | March 20, 2008 at 03:40 PM

While mainstream media prunes down their stories to 30 min show jokingly driven by "if it bleeds, it leads" blogs enjoy more freedom.

ComputerWorld has once again published another blog on H5N1 without mentioning compters, VoIP. SOA, etc.
http://blogs.computerworld.com/why_you_should_care_about_indonesia#comment-87261

Along with fluwiki2 (http://www.newfluwiki2.com/frontPage.do)

are some really good state websites like Florida's
http://bpr.state.fl.us/pandemic/

Thank you for the webcast, and the archive. We look forward to April 2nd's webcast.

Regards
Kobie
"They never said life would be easy, just worth it"

Posted by: Kobie | March 20, 2008 at 05:13 PM

Thanks, DemFromCT, for your response. I also look forward to hearing from Secretary Leavitt. I should have used the term “Special Needs Populations” (SNPs) as that is the term the National Response Framework (NRF) utilizes as well as other government entities like the Assistant Secretary for Preparedness and Response. Their definition of SNPs from an all-hazards approach misses a number of groups that should be considered vulnerable or as having special needs during an influenza pandemic. In addition, there is a disconnect between the definition of SNPs and the general population groups identified in the draft Guidance on Allocating and Targeting Pandemic Influenza Vaccine. My concern is that preparedness planning and pandemic exercises will only focus on those groups defined by the NRF as SNPs and ignore important other special needs populations. I hope that the Interagency Workgroup on At-Risk Individuals and Pandemic Influenza is looking at this issue. Finally, I would like to suggest that representatives from a broad range of organizations who work with SNPs be included in future HHS and CDC pandemic exercises.

Posted by: Deborah Robinson | March 20, 2008 at 08:40 PM

Thank you again, Mr the Secretary,
TO persevere at reaching out.

Your approach granths more and more a sense of Hope, Security.

Now
…back to the Future…

Since it is ‘’there’’ that we intend to spend the rest of our lives.

I would first express my HeartFelt Gratitude,
… to Policies Executives and Policies Leaders, for their ‘’Reaching Out’’
Towards our Dedicated Group of Pionniers, Newshoud, Moderators, Coordonnators, various Forums and Blogs, concerned and active in resolving grim perspectives.

The Humility of the Politics, Medical Institution, Peer Reviews Journal, Governments, Journalists, Lurkers and of our members, give now rise to a realistic Hope of Wise Courage that become more and more Efficient.

Will the National Powers Distribute to their People
Printed Documentation on how to ‘’Cope’’,
If so, When ??

Would the government subsidise the production from the Forums & Blogs Printed Documentations for all citizens entitled ''How TO Cope''.

Of course this first version will be adapted by the Public Institution. Can we set a scheduled to this documentation sent at each Home would be done so in September 2008.

Our Individuals Pre-Dispositions,
Our Mutual Informal and Formal Agreements
Have created, informal & formal Regional Consensus,
And quite Efficient InterRegional interfaces.
Will all these be Welcome, Respected and Support
By National Powers ???

These are the questions, and Hopes that I have.

Profound Thanks to all to have made this possible.

Snowy,

Mr Leavitt

Posted by: Snowy Owl | March 21, 2008 at 12:08 AM

Thank you for inviting FluTrackers.com to participate.

Sharon Sanders
Supervising Editor & President

Posted by: Florida1 | March 21, 2008 at 01:41 AM

As a concerned citizen I track many of my interests and concerns via an aggregator of blogs. Specifically, I subscribe to blogs hosted by pandemicflu.gov and the WHO - both great sources of information and updates. I believe this type of medium to be a powerful and direct way to quickly communicate updates to the public. I hope the agency continues to expand and improve their use of blogs and all future technologies widely used and accepted by the public.

Thanks to all those who make these sites and functions possible. If the unfortunate happens there is no doubt these sites will save many lives.

Thanks Again!
Scott
Houston, TX

Posted by: Scott | March 25, 2008 at 01:07 AM

The Government needs to communicate with the public is a meaningful and effective way that the need to prepare is Now. 3 days, 2 weeks? Not enough.

Families need at least 3 months of supplies on hand to weather the first wave of a severe pandemic.

This message is NOT being communicated.

We bloggers know YOU know and You have chosen to NOT tell the public.

Posted by: Goju | March 25, 2008 at 08:56 AM

So did any of the bloggers involved write something about this? I would love to read their entries. How about sharing some URLs? Thanks

Posted by: michele | March 25, 2008 at 11:54 AM

Highland cancels pandemic portion of heath fair

Highland will hold an emergency preparedness fair this weekend but without any discussion of pandemics.
Resident Melvin Miller said he was part of a volunteer group who organized the event, and was caught by surprise when the city ordered him to cancel a presentation by the County Health Department on preparing for pandemics.

Miller said city staff told him the presentation could not happen because it would cause panic among residents.

http://www.heraldextra.com/content/view/260000/3/

Posted by: Aeolus | March 25, 2008 at 11:41 PM

Unfortunately pandemicflu.gov and WHO website are not great sources of info for the public because the public does not know that they should be seeking informaton about pandemic flu.

Websites are not the answer.

And "community leaders" will not be able to convince the public that panflu is a real threat when the public is not hearing from the President, the CDC, HHS, HLS, or our Surgeon General.

Someone offical is going to have to step up and speak to the American public loudly, clearly and often.

We have to stop worrying about scaring people and start worrying that the public has no idea that "bird flu" is still a problem.

Posted by: aurora | March 26, 2008 at 05:55 PM

The message of personal preparation needs to become so infused into the lives of Americans that they routinely talk about their preps in the carpool, the elevator, and around the watercooler. The message simply has not gone out. (I'm NOT saying that the message has not gone far enough. It has not gone out, period.)

The government will have taken real steps to notify the American public of a pandemic threat when it has placed a comprehensive booklet about avian flu into every mailbox in the country. Public health authorities--from the feds on down--will have done their jobs when each citizen can specifically read about how to store food, medications, cheap alternate light sources, etc. When people have "quarantine" signs ready in their desk drawers, and can express their knowledge of how to sequester in place, and can tell each other where the "flu only" entrance for the local clinic will be, then the country will be ready. Until then, the message has not gone out. Blogs and meetings involving federal and state public health officials are meaningless if actions to seriously communicate with the public have not happened, and repeatedly, because real preparations--resulting in calm response--will not happen at state, federal, or even local levels. They will happen in the home.

It would be appropriate for the government to purchase huge stocks of appropriate stable food preps and sell them at a steep discount to the public, along with appropriate storage. I would gladly pay for a food-grade five-gallon bucket full of shelf-stable food.

How will you know when the message has been adequate? When people stand around the water cooler, joking about how they bought 150 pounds of spaghetti and 30 cans of sauce, and trade recipes.

Years ago, there was a big hoopla over whether or not people should be taught to respond at car accidents, because it was thought that they could not be trained. Fortunately, people have been taught as "first responders", and they have saved many lives. Serious notification and training of the American public is much the same. Every trained "responder" who is prepared to handle the epidemic-- because appropriate preps have been completed--is one less victim, and one more potential rescuer.

The message must go out from the federal government. Now. AnnieRN

Posted by: AnnieRN | March 28, 2008 at 09:23 AM

Dear Secretary Leavitt:

Your comments breathe hope into me. You said, "The bottom line for me: Government needs to understand the blog world better, and factor it into the way we interact with people. A growing part of the world relies on bloggers for unvarnished information; something they are not sure they always get from us in government."

One place that Medicare seems to be completely absent from is WikiAnswers. There a many, many questions related to Medicare but no one from Medicare checking in. An example is this question and answer: http://wiki.answers.com/Q/Does_Medicare_cover_the_shingles_vaccine

Best wishes for success in all that you do.

Sincerely,

Joe Smith

Posted by: Joe Smith | March 30, 2008 at 12:10 AM

As a former professional chessplayer,this would be my "strategy" against the approaching pandemic.The efforts from the "top" must meet the efforts from the "bottom"(grassroots education) and meet in the "middle" where the millions of unprepared Americans currently live from day to day.
This could MOST EASILY happen by executive declaration (or reasonable substitute) of an impending compromise of American security.Why must the pandemic have a "Pearl Harbor"drama to it before the government and media step up to the plate??

Posted by: Greg Blesch | April 02, 2008 at 06:54 PM

On weaknesses in the pandemic flu vaccine program:

An adequate supply of an effective vaccine is among the most important defenses against a pandemic, as all agree. Under the HHS's current plans (described in Pandemic Planning Update V), vaccine manufacturers will be ready for a pandemic in a few years. Even so, after the start of a pandemic there will be a delay of six months before there is enough vaccine for the U.S. population.

As a Staff Scientist at the Project On Government Oversight (www.pogo.org) I'd like to ask about correcting certain weaknesses in the vaccine program. Other readers, too, may be interested in your response.

A report on POGO's website at
http://www.pogo.org/p/socialservice/so-080306-flu.html
suggests some possible improvements in current plans. For example, BARDA (the government unit that administers the vaccine program) still does not have a permanent Director. It should be someone well known and respected in the business and public health communities, someone willing to go directly to the White House or the Congress to press for needed resources. As you know, the campaign to eradicate smallpox was successful in part because of its extraordinary leader, D.A. Henderson. Such a person, as Director of the flu vaccine program, might examine the program and see ways to improve it. Do you plan to recruit a permanent Director for BARDA?

Another weakness of the vaccine program is lack of transparency. Yes, www.pandemicflu.gov has an enormous amount of useful information, but much important information is missing. For example, the government's contracts with vaccine manufacturers are not posted online, but they should be. Other kinds of information that should be posted are described in the POGO report noted above. It would be worthwhile if the details of the program were more open to examination and constructive criticism by non-government experts. Do you plan to deal with this easily corrected weakness?

I wish you success in keeping up with all the posts and hope you'll reply to this one.

Ned Feder, M.D.
Project On Government Oversight
Washington, DC
nfeder@pogo.org

Posted by: Ned Feder | April 07, 2008 at 02:25 PM

Thanks for the interesting blog post. As a former wire service reporter, and now a blogger, I have been surprised at how quickly bloggers have become such a huge influence in our society. Unfortunately, many government agencies and public institutions are still slow to understand this new media. I guess you really can't teach some old dogs new tricks.

Posted by: Jim Purdy | April 13, 2008 at 11:43 PM

Thank you.

As April 15th comes around people ask "What have I gotten from my government?" We can say HHS has opened the door on many subjects - not just my favorite of Pandemic flu.

I hope parts of the general public seem well informed and connected. Please help us. People will seek out answers. We can learn the answers from you or we can learn then on the street. If the pandemic is real then lets take it seriously and go with more drills.

I hope that future ones involve the "great unwashed masses" called the public for three important reasons. 1) It builds rapport which will make working together easier. 2) It will help government people see what they have to work with. There is more available than just what is in the catalog. 3) I trains us, the public, to be better and more helpful victims. It will be us the public who will do most of the dying and suffering. If there is something we can do to make your job easier please let us know.

As AnniRN pointed out you know people have part of the message "When people stand around the water cooler, joking about how they bought 150 pounds of spaghetti and 30 cans of sauce, and trade recipes." For it is not just the message, but action that helps.

Regards,
Kobie

Posted by: Kobie | April 14, 2008 at 10:22 AM

Two veterinarians came to the house yesterday for our large animals. One has been a horse vet for many years, the other will graduate next week and is moving to the northern part of the state to work in a mixed "farm animal/small animal" vet practice. At the end of the visit, I asked them both what they've heard recently about the issue of avian influenza. They both looked blankly at me, then the older one slowly said, "I haven't heard anything for a very long time--either from the state Dep't. of Ag or anywhere else. Why?" Then she turned to the younger one and asked her what she's been told at school (as they should have the most recent info. The school runs a huge vet clinic on-site.) The student said, "We haven't heard anything either." I proceeded to try to catch them up in "five minutes or less", telling them about current epidemics in South Korea, India, etc. and other places where AI is now considered endemic (Egypt, Indonesia, etc.) Then I told them about my conversation last August with a veterinary epidemiologist (same vet school) who told me that she's strongly urging citizens to personally prepare to sequester in place for three waves of up to two months each, and that our family's long-term preps are completely appropriate. (The vet/epidemiologist went on to tell me that she is one of the experts sent to nations with current outbreaks to help with culling management, etc.)

This is why I say that the message has not been adequate. If vets don't have the message--and they will be the first line of defense if it first goes through birds--then the average person on the street has no way of getting prepared. PLEASE--send every mailbox that booklet on AI preparations. Thank you very much for this forum, and for your hard work for American families. AnnieRN

Posted by: AnnieRN | April 25, 2008 at 08:20 AM

hi im personally scared of the bird flu i have three kid's is there a vaccine for kid's and should we be preparing for it? and is there a vaccine for adult's i don't want to die and my hubby say's don't prepare that it is in God's hand's email me at [edit].

Posted by: Ginger Lautner | May 16, 2008 at 01:59 AM

I used to believe that the Government wasn't giving the public enough information about the threat of panflu, but over the past several months I have changed my opinion. They are not giving courses in panflu prep but I see T.V. ads (the first ten things to go) with the web link to the government site on AI. Mr Leavitt has been very vocal about letting people know that they need to prepare for this and the media has covered it. There have been countless news reports of bird flu in this or that country AND that it has done a few human to human leaps that were self terminated. I think that people have to have a "trigger" to get them to start seeing what is in front of their noses. My trigger came in 2005, and I honestly don't remember what it was. I do believe that it is up to each individual to decide what news is applicable to him or her and act upon it. That being said, we all have an obligation to try and inform and educate our friends and families about preparing, be it for bird flu or any other catastrophic event.

Posted by: Jo | June 19, 2008 at 08:38 AM

The Indonesians either do not want to tell us how many human cases they have had since the end of Feb or they do not know. I read this somewhere and I agree, WHO should declare Indomesia in Phase 4 until they prove otherwise. How do we know they are not? Wreck their little tourism thing in Bali and that will take that stupid grin off her face.

Posted by: Nanoflower | June 20, 2008 at 12:05 PM

As a 3rd World Country, thanks for the opportunity to share experience and knowledge. Even though we have enormous limitations, our spirit of colaboration is high and strong.

Looking forward to meet you in person at the Panamá gathering on June 27th.

Best regards,

From El Salvador
Carla Schonenberg, MD. MBA

Posted by: Carla Schonenberg | June 23, 2008 at 04:33 PM

So months later and what?
NOTHING!

a huge presidential campaign and did they mention Pandemic once?
NO!

So it is up to us... the people to get the message out... it is like blowing into the wind as long as WHO and CDC play the entire high CFR Pandemic down and allow countries like Indonesia and China to hide their H5N1 outbreaks and cases.

Unless the Gov changes it's tune under Pres Obama, all will be lost.

Posted by: Goju | December 29, 2008 at 12:04 PM