Swine Flu Crisis Management

Friday, May 1, 2009

My first "real job" as a new university graduate with a freshly signed degree in biology and public health was with the Orange County Florida Health Department working as an epidemiologist tracking down communicable diseases. These diseases ranged from outbreaks of gastroenteritis (food poisoning) to social diseases and highly contagious diseases like cholera, flu and plague. I remember that there was significant casework to be done for each reported case, and each type of disease had its own specific protocol for handling investigation and followup with patients (victims) and those with whom they had direct contact. There was also a rather elaborate system of notification and oversight by the feds (Center for Disease Control - CDC).

In short, all reported cases of a highly contagious disease were handled with a plan for identifying the source and all contacts as quickly as possible WITHOUT creating public hysteria. We were always mindful that the best work was done quietly behind the scenes with science and good detective work rather than publicly through the media. The reason for this was quite simple: people can panic when they cannot fully understand the threat of disease or when they get hype about the possible results without a clear perspective. We were mindful not to cry "Wolf" unless there was a one at our throat.

Today's news brings us a report of an airliner that was diverted in-flight because a female passenger complained of flu-like symptoms inflight. The result was one passenger tying up an ambulance and EMT crew with a cold and the other 244 passengers stranded, sitting on the tarmac in isolation wondering how they were going to get home or to their business meeting. One can only wonder what the cost of this will be. Worse yet, this "case" was plastered all over the media without confirmation that it was anything more than a common cold.

The point here is this: Just going on anecdotal opinions of someone's state of health provided by non-professionals is a risky business and might mask a more serious problem. Airline flight crews are not trained medical professionals. They are not epidemiologists. It would be far better to follow the path of the disease by tracking people, contacts and places where known cases have been documented. Then an assessment of the severity of the disease could be made and prophylactic treatment developed. In short, there needs to be a trained adult who can make a reasoned assessment. Otherwise, we risk crippling our country through fear and innuendo.

A quote from Thomas Paine comes to mind: I love the man that can smile in trouble, that can gather strength from distress, and grow brave by reflection.

Meanwhile, if you are flying commercially anytime soon don't be surprised if someone steps up to you wearing a surgical mask and sidearm and says "Book 'em Danno!".

The Wild Weasel