A rant from March 30... Health care vs Emergency Management

Sorry.  I just have to get this off my chest and then I will shut up again. 

I love our calls but they are rather heavy on the healthcare worker side and I come from the emergency management side.  It's not even really political but I can't figure out how to say this on our call without everyone getting mad at me.  

When I think back to my FEMA days we were always butting heads then with the health officials during planning exercises over when to shut things down and how long to keep things open too.  The docs generally tended to be much more alarmist than anybody else in the meetings and there were fireworks then too.  Not that they were necessarily wrong, but they tended to ignore all other needs besides the health side.  Like economies.  Like food supplies.  No perfect answer for sure.  Guess I should be happy.  The last pandemic exercise I ran was a swine flu scenario involving so many deaths that not only did they overrun the morgues but health officials predicted there would not be enough coroners and there would be bodies decaying in homes and possibly something like cholera or whatever you get from decaying bodies as a secondary...  They were looking at the government taking over grocery trucks for body storage and debating the possibilities of mass graves...  Now that was fun.

From that same emergency management experience I have to say I don't think you would have convinced anybody to actually do the social distancing necessary until people started dying.  Even well into the first week of official lockdown people were still having playdates and football games in the park.  The CDC was putting out guidance as much as two weeks earlier telling people to start reducing outings and to stock up on supplies.  I know and I went out and started buying supplies then but no one else I know paid it any attention.  But looking at say hurricane preparedness, how many times over and over have we seen people ignore the warnings and refuse to evacuate and then there we are rescuing them?  I don't know if it is a function of how sensational our news has become in general, but when we have real warnings it's so hard to get people to heed them for anything.  So they can blame the federal government all day long, but who would have listened?  They keep saying the danger was downplayed but honestly I didn't get that.  I heard it.  Glen heard it.  And there were mixed messages but there always are at the beginning of a big disaster when we're gathering information.  We've never had a disaster like this in our country and it takes time to get a handle on any disaster.   

I'll go the step further since I am ranting and say that it's false to say that because the one pandemic planner or even team at the CDC was fired there was no planning going on or we likely would have had a different response.  Pandemic planning has been happening at the federal, state, and local level for literally over a decade.  Our regions have plans.  Our states have plans.  Our locals have plans.  Our hospitals have plans.  But emergency managers and planners make decisions every day regarding what we can do to prepare for a threat based on the probability that it will occur and the level of impact that will happen.  Katrina didn't happen because someone made one decision.  Katrina happened because many people at all levels of government made many decisions to plan and prepare for other, more likely disasters.  They chose to use funding elsewhere (and also to steal some of it, but that's a different thing.)  This is an unfortunate side of planning.  You can't have it all.  There is not enough money or people or resources to do it all.  No one in a million years would have made a decision to stockpile 100,000 or more ventilators over say funding for schools and roads, or even to stockpile that much PPE.  We have generators.  We have communications equipment.  We have food and water and blankets and medical equipment.  We even have freezer trucks equipped as morgues that came out of all that planning.  IMO no one would have chosen that specific piece of equipment without knowing the specific threat.  E-bola requires a totally different set of response equipment.  We did have an obsolete system for testing but again IMO no one would have gotten any leverage overhauling that system without this happening.  

Plus all disasters start local.  We can say the federal government should have been doing...  But every response has to start locally.  Governor Wolf has been doing (in my opinion) a good job and that is how it is supposed to happen.  When President Trump says the governors should be doing it, he is right and I have personally sat in on calls in the past where the governors told the president to butt out of their disaster response until they called for help.  That's how our country has always worked.  Most of the time we are perfectly happy with it that way.

OK, I am done now.  Sorry but thanks for listening.