Countermeasures, Social Distancing and the Last Mile
The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.
By Nathan Myers
April 18, 2020
There has been an ongoing effort to remove the term natural disaster from the emergency management lexicon. The rationale is that events like hurricanes, earthquakes and ice storms will happen, but it is the manner in which we prepare or don’t prepare for them that contributes to loss of life, property and wealth. This includes not developing realistic evacuation plans, failing to institute stronger building codes or opting not to build redundancy into the supply chain, to say nothing of failing to address the economic inequities that leave millions of Americans vulnerable every day. This movement even has its own hashtag: #NoNaturalDisasters.
President George W. Bush and President Barack Obama both warned of the threat of a coming pandemic, but even prior to the Trump administration, preparedness funding waxed and waned. Meanwhile, throughout the last two decades, there have been numerous pandemic plans, exercises led by the Center for Health Security, reports from organizations like Trust for America’s Health and panels held by the Bipartisan Commission on Biodefense which indicated America’s lack of readiness.
Much attention has been given to the management, distribution, and dispensing of medical countermeasures. In fact, some federal government workshop reports saw getting vaccine to the people and getting them to take it as the one of the biggest challenges of public health emergency response. It was referred to as the last mile.
The concept of improving capabilities to go the last mile addresses the notion of community resilience in terms of bolstering health infrastructure and educating the public about vaccines. In their report on building community resilience and health security, Chandra, et al. noted education, engagement and partnership among their characteristics of community resilience. However, it should be noted that access, wellness and self-sufficiency are highlighted as well. While much writing, including my own, has focused on the former themes, COVID19 and this period of social distancing show the importance of the latter.
Social distancing is something that has been regularly noted as a possible tool in documents like the National Health Security Strategy and recommendations from tabletop exercises. However, in regard to federal and local preparedness efforts, the logistics and communication requirements involved in mass social distancing do not seem to have received the same attention that countermeasure distribution has.
Government, prior to an emergency, must take stock of all the reasons why the public would not be able or refuse to comply. In the case of pharmaceuticals, it may be fear or lack of access. For social distancing, it may be socioeconomic vulnerability, pre-existing poor health or an inability to take time off from work due to lack of adequate financial resources. Academic research by scholars like Baum, Jacobson, and Goold speaks to the reservations that many average Americans may have about social distancing. Coordinated messaging developed and disseminated by partners at the state and local level can help overcome some of these obstacles. However, messaging during the response must be preceded by community investment in the health, well-being, and economic security of its citizens.
In 2011, FEMA formally introduced the idea of the whole community approach. Significant policy focus has been placed on how to get the general public more invested in preparedness efforts. Few if any imagined that when a devastating pandemic came, the most effective action most people could take was to stay isolated in their homes. Exercises are about taking action to respond to a crisis, but it turned out that pandemic preparedness for most is about being in a position to be inactive when it comes to work and a host of other social activities. However, for those with serious physical, psychological or emotional vulnerabilities, or those not in a position to forego a paycheck, sitting at home could mean deteriorating health, self-harm or hungry families.
Historian Alfred Crosby wrote that Americans seemed to develop a collective amnesia after the 1918 pandemic. While the consequences of COVID19 will be with us for years, in a decade we may start to forget again. We must encourage the American people to be more engaged in preparedness in their community. Getting all people to comply with vaccination and social distancing in a public health emergency is truly the last mile. To traverse the last mile, communities must reckon with economic, social and health vulnerabilities and work with partner agencies to address them and realistically plan to mitigate them during a public health emergency. Expecting people to comply with government recommendations at the cost of their well-being or the well-being of their family is a recipe for an unnatural disaster.
We cannot always predict the threat, whether it be a virus, storm or manmade disaster. But we can anticipate the ability of pro-social behavior to blunt the damage. Public health emergency preparedness over the last two decades has emphasized vaccines, anti-virals and other countermeasures as the “net” that would save us in in pandemic. But, as Dr. John Dreyzehner said during a Senate hearing, “Many people think equipment or supplies are the net, but if you remember nothing else from my testimony today, please remember this: people, not things, are the net.”
Author: Nathan Myers an associate professor of political science and public administration at Indiana State University. Among other research in the area of public health emergency preparedness, Myers recently published the book Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies. Twitter: @nagremye1980.
(No Ratings Yet)
Loading...
Countermeasures, Social Distancing and the Last Mile
The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.
By Nathan Myers
April 18, 2020
There has been an ongoing effort to remove the term natural disaster from the emergency management lexicon. The rationale is that events like hurricanes, earthquakes and ice storms will happen, but it is the manner in which we prepare or don’t prepare for them that contributes to loss of life, property and wealth. This includes not developing realistic evacuation plans, failing to institute stronger building codes or opting not to build redundancy into the supply chain, to say nothing of failing to address the economic inequities that leave millions of Americans vulnerable every day. This movement even has its own hashtag: #NoNaturalDisasters.
President George W. Bush and President Barack Obama both warned of the threat of a coming pandemic, but even prior to the Trump administration, preparedness funding waxed and waned. Meanwhile, throughout the last two decades, there have been numerous pandemic plans, exercises led by the Center for Health Security, reports from organizations like Trust for America’s Health and panels held by the Bipartisan Commission on Biodefense which indicated America’s lack of readiness.
Much attention has been given to the management, distribution, and dispensing of medical countermeasures. In fact, some federal government workshop reports saw getting vaccine to the people and getting them to take it as the one of the biggest challenges of public health emergency response. It was referred to as the last mile.
The concept of improving capabilities to go the last mile addresses the notion of community resilience in terms of bolstering health infrastructure and educating the public about vaccines. In their report on building community resilience and health security, Chandra, et al. noted education, engagement and partnership among their characteristics of community resilience. However, it should be noted that access, wellness and self-sufficiency are highlighted as well. While much writing, including my own, has focused on the former themes, COVID19 and this period of social distancing show the importance of the latter.
Social distancing is something that has been regularly noted as a possible tool in documents like the National Health Security Strategy and recommendations from tabletop exercises. However, in regard to federal and local preparedness efforts, the logistics and communication requirements involved in mass social distancing do not seem to have received the same attention that countermeasure distribution has.
Government, prior to an emergency, must take stock of all the reasons why the public would not be able or refuse to comply. In the case of pharmaceuticals, it may be fear or lack of access. For social distancing, it may be socioeconomic vulnerability, pre-existing poor health or an inability to take time off from work due to lack of adequate financial resources. Academic research by scholars like Baum, Jacobson, and Goold speaks to the reservations that many average Americans may have about social distancing. Coordinated messaging developed and disseminated by partners at the state and local level can help overcome some of these obstacles. However, messaging during the response must be preceded by community investment in the health, well-being, and economic security of its citizens.
In 2011, FEMA formally introduced the idea of the whole community approach. Significant policy focus has been placed on how to get the general public more invested in preparedness efforts. Few if any imagined that when a devastating pandemic came, the most effective action most people could take was to stay isolated in their homes. Exercises are about taking action to respond to a crisis, but it turned out that pandemic preparedness for most is about being in a position to be inactive when it comes to work and a host of other social activities. However, for those with serious physical, psychological or emotional vulnerabilities, or those not in a position to forego a paycheck, sitting at home could mean deteriorating health, self-harm or hungry families.
Historian Alfred Crosby wrote that Americans seemed to develop a collective amnesia after the 1918 pandemic. While the consequences of COVID19 will be with us for years, in a decade we may start to forget again. We must encourage the American people to be more engaged in preparedness in their community. Getting all people to comply with vaccination and social distancing in a public health emergency is truly the last mile. To traverse the last mile, communities must reckon with economic, social and health vulnerabilities and work with partner agencies to address them and realistically plan to mitigate them during a public health emergency. Expecting people to comply with government recommendations at the cost of their well-being or the well-being of their family is a recipe for an unnatural disaster.
We cannot always predict the threat, whether it be a virus, storm or manmade disaster. But we can anticipate the ability of pro-social behavior to blunt the damage. Public health emergency preparedness over the last two decades has emphasized vaccines, anti-virals and other countermeasures as the “net” that would save us in in pandemic. But, as Dr. John Dreyzehner said during a Senate hearing, “Many people think equipment or supplies are the net, but if you remember nothing else from my testimony today, please remember this: people, not things, are the net.”
Author: Nathan Myers an associate professor of political science and public administration at Indiana State University. Among other research in the area of public health emergency preparedness, Myers recently published the book Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies. Twitter: @nagremye1980.
Follow Us!