Jakarta Pandemic, The (71 page)

“Are there any successful international models?”

“Very few, Kerrie. Most developed nations face the same issues as the United States, lack of budget and very little political will to allocate time and resources to a so-called doomsday project. Most European, Asian, and African countries are under the WHO’s thumb, so there is little hope for these nations to develop coherent internal plans. The situation is a mess worldwide.”

“Dr. Ocampo, the situation in the developed countries sounds bad enough. What is your assessment of the developing areas?”

“Do you really want to know the answer to that question? Of course you do. As you can imagine, the situation in developing regions of the world is even more desperate. With no national food reserves and, in many cases, a near complete dependence upon food importation or aid shipments, the populations of many developing nations would face an immediate food and clean water shortage. Survival in a region currently threatened with even moderate drought or famine would be close to impossible for both infected and non-infected alike.

“A general loss of essential services and scarcity of basic survival needs will combine synergistically to escalate the death rate and catapult many regions into disastrous civil disorder. Given the likelihood that most national, regional and local civil protection capability will also be drastically diminished, an incendiary situation could develop, further adding to the chaos of the pandemic environment. ISPAC experts point to examples of civil chaos seen during the 2008 avian flu pandemic, specifically in Pakistan and Yugoslavia, where a near complete loss of civil order occurred in vast geographic areas, creating nearly impossible environments for local, national and WHO pandemic efforts. In both Yugoslavia and Pakistan, casualty rates rose drastically when flu cases quickly overwhelmed the health system capacity, further rising when a near complete loss of essential services followed. ISPAC predicts that the disasters seen in Pakistan and Yugoslavia would likely be repeated everywhere in the world, even in the most modernized nations, in the face of a severe pandemic.”

“This is indeed a grim prospect, and one that our political leaders need to make a high priority. Dr. Ocampo, what is standing in their way?”

“High pressure international lobbying on behalf of the WHO. Most federal money budgeted to pandemic disaster preparedness heads overseas to the WHO to help build a better castle wall. It would be helpful to see more of that money available to our own federal and state government. It would be even more helpful if the pandemic disaster budget was increased and that money stayed here in the United States, for use by the Department of Health and Human Services, the CDC, and local state and city governments.”

“Dr. Ocampo, thank you for your time. I hope that the situation in China does not expand into a world health crisis because it would appear that the world may not be prepared for the full impact of a flu pandemic. Good luck to both you and your organization.”

“Thank you for the opportunity to educate the public, and if I may, your viewers can always obtain the most updated information regarding our current investigation, or general pandemic flu tracking, on our website, ISPAC.org.”

Morning View
interview with U.S. Department of Health and Human Services Director

Early November 2013

“Good morning. The news dominating the thoughts and concerns of all Americans today stems from Southeast Asia, where fear of a new pandemic virus is starting to rise. Early this morning, a startling development was unveiled by the Chinese during a late afternoon press conference in Beijing. The Chinese government signified that an unidentified disease has caused several major outbreaks, mostly limited to the southern coastal regions of China. They have confirmed that the cases are not caused by a strain or variant of the H5N1 avian flu that swept the world in 2008, but that this is definitely a pneumonic illness, or an illness causing serious respiratory problems. This description is causing quite a reaction among the scientific community, where fear of a new pandemic is circulating.

“China has also agreed to cooperate fully with the international community, and we have received word that WHO and CDC teams have already entered China to start the process of containment and mitigation, and to identify the currently unidentified cause of these cases. No reports of casualties have been issued. Fear of another pandemic is now front and center in most Americans’ minds. Thomas McGreggor joins us this morning to shed some light on these developments. Thomas, welcome.”

“Thank you, Matt, please call me Tom. I appreciate this opportunity to talk about the recent developments in China.”

“First, could you describe the Department of Health and Human Services’ role in preparing and responding to a pandemic.”

“Gladly, Matt. This department has many roles, all critical to our nation’s robust capability to deal with a pandemic. First, our encompassing goal is to implement the national strategy to prevent or slow a pandemic flu’s entry into the United States, to limit the domestic spread of the disease, and to mitigate disease suffering and death. All while sustaining the nation’s economic and essential services infrastructure. The bottom line is that DHHS is responsible for building an infrastructure to detect and respond to an outbreak.”

“Tom, that sounds like a momentous task. How is it possible for a department of the government to implement and monitor such a broad-reaching goal? Frankly, some experts just don’t think it’s possible for one department to accomplish these goals, or they question whether your department has the reach and authority to enforce the national plan.”

“Well, you’re right when you state that we can’t possibly do this alone. It would not be possible for us to oversee implementation of every aspect of the national plan, or enforce it, as you say.

“DHHS directs each state, county, city and organization to create their own strategies and procedures, aligned with the goals of the national pandemic response strategy.”

“You’re talking about the 381 page national plan?” Matt asked.

“Yes, the very one. Our department empowers local governments to build partnerships with health care facilities and community leaders, and to develop an effective communications infrastructure for the timely dissemination of information. This will also be a critical aspect of a pandemic response, and DHHS has recently completed a major upgrade to the communications components. One that will facilitate communication on a local level. First, a national emergency satellite broadcast system just came online a few weeks ago, which will give anyone with access to a GPS receiver, GPS-enabled cell phone, satellite radio or home satellite service full access to national emergency information. Best of all, each state will have the capability to stream information to the satellite system for rebroadcast to local responders and civilians. This system was spearheaded by DHHS and will play a major role in the event of any emergency. Matt, almost every cell phone built today is GPS-enabled. This puts the information right at everyone’s fingertips.”

“This certainly sounds like a major improvement over radio and television broadcasts, which could be subject to power failure. Given the current situation, when will information regarding this system be given to the public and local government?”

“Already in progress for local and state governments. The full send and receive capability should be rolled out to them within the next few weeks. As for the public, they can find all of the information they need on the DHHS website at dhhs.gov under accessing emergency satellite broadcast.”

“Tom, back to the idea of delegating implementation to local governments. We’ve heard from several experts who all agree that the national plan is solid, but argue that very few of the recommendations have been implemented because federal funding is simply unavailable. We’ve heard some sobering statistics. Some citing a compliance rate of less than 10% with national plan recommendations. Most states, cities and towns don’t seem to be able to find the money within their own budgets to implement your recommendations, and little money is flowing down from Washington. Critics also suggest that most of the money that the Congress and Senate is willing to allocate to pandemic response is heading overseas to fund the WHO.”

“Certainly these critics like to point fingers at Washington whenever they can, but several reviews and accounting estimates conducted by our department indicate that implementation of these strategies would costs very little in terms of money. Are they time intensive, requiring the cooperation and effort of numerous local organizations and governments? Absolutely. A pandemic is a complex emergency, requiring an effective and coordinated response on many levels. Preparation for a pandemic is similar in scope. The bulk of the costs occur once the pandemic strikes, and when this occurs, each state and local area will receive disaster area level funding to ensure continuity of pandemic response operations.”

“I don’t know if I agree. Let me read directly from the DHHS manual. ‘Ideally, states develop a multilayered strategy that delineates responsibilities at all levels of society to ensure the viability of government functions and services, such as energy, financial, transportation, telecommunications, firefighting and public safety. This strategy will assist businesses and utilities with continuity of operations, collaborating with the healthcare sector on issues like stockpiles, available beds, isolation and quarantine plans, surge capacity, personnel protection, communications links and pharmaceutical supply and distribution. It will coordinate offsite treatment and triage locations, medical stations, and implement a mass fatality plan.

“Tom, this sounds like an expensive proposition. My parents’ hometown can barely scrape together enough money to repair minor damage to its roads. If not from the federal government, where will we get this money?”

“Well, first, I don’t agree with the statistics that claim only 6% of national plan is implemented. We’ve seen amazing progress throughout the nation, without reliance on more federal money. An appropriate level of funding is available at all levels, for implementation of the plan. However, this is not the first time we’ve heard this criticism, and as a department, we are working hard to increase funding of these grants. Our goal is to develop and implement a comprehensive national pandemic response strategy, and if more money is required, then we will take the case to Capitol Hill.”

“I hope that the system, as it stands today, will be effective enough to deal with a crisis, if one arises.”

“Matt, since 2008, our nation’s pandemic response capability has been vastly improved. From vaccination production and research capability to antiviral stockpiling. We learned a lot from the avian flu and applied those lessons to the national plan in place today.”

“Speaking of today. What is DHHS’s primary goal or concern today regarding the crisis in Asia, and what part of the national plan is being implemented?”

“We are working in close coordination with the CDC and WHO to receive real-time information regarding any and all aspects of the crisis. Our number one priority will be to prevent this disease from entering and spreading in the United States. Currently there is no indication that the disease has spread outside of China, though we have activated passive foreign traveler detection protocols. In essence, customs officials have been alerted to identify and track any travelers arriving on foreign flights that appear ill.”

“Will these travelers be detained?”

“Not under passive protocols. Active protocols require a massive personnel increase, as you can imagine, and are implemented when it is certain that a pandemic-grade illness is headed to our borders. Passive protocols will flag these travelers and their destinations, so that they can be contacted if they are later suspected to be infected by a pandemic disease.”

“Has DHHS considered the possibility that the mystery disease has already entered the U.S. in considerable numbers? For nearly three days, travelers have left China for the U.S. and hundreds of other locations abroad. If the disease originated in China, this seems reasonable. If the disease originated somewhere else, like China claims, then the same theory applies.”

“We’ve definitely considered this, however, the number of passengers traveling to the U.S from China in a two-day period is small. We are tracking all of these passengers and taking steps to ensure that if any of them are sick with this disease, they will be treated immediately. The travel ban on China is still in effect, given the circumstances, which ensures that we are dealing with a finite number of passengers that we can track. DHHS, along with the WHO, feels confident that disease is limited to China. China’s own detection and response capability is first rate. We have been assured by the Chinese that only essential travelers departed China during the time in question, and that these passengers were screened prior to leaving the country. Even if their screening didn’t catch all of them, our screening will, as will the efforts of our neighboring countries. Right now, we are taking the appropriate steps given the information available. And the information is flowing much more effectively than in 2008. The Chinese, in particular, have stepped up and taken responsible steps to ensure unfettered access for international response teams and to open critical lines of communication between our nations.”

Morning View
interview with ISPAC Co-Founder

Early November 2013

“Welcome back to the show. Unfortunately, Dr. Gustafson had to cut the interview short to handle an emergent development. However, in the brief segment before commercial, it became clear to our viewers that two clearly opposing viewpoints exist regarding the current pandemic threat. Where does your organization plan to go from here?”