Friday, July 10, 2009

Flu Preparedness: Body AND Mind

Last Fall, the Quarterback attended a meeting of local CISM teams and local public health officials to discuss planning for a public health emergency, such as a biological terrorist attack or avian flu. It was quite informative and interesting, and gave me a lot of insight when H1N1 "swine" flu came around at the end of April. One moment in particular really stuck with me:

We were discussing plans to set up "triage centers" around the county. The idea was that, in a major health emergency, hospital resources would be used solely to treat the very sick. Because we know that roughly 80% of people who seek health care in these situations are actually the "worried well," we don't want those people overwhelming hospital emergency rooms. By setting up remote centers, health professionals can figure out who is actually sick and send them to the hospital, those who are panicked but not sick can get some support, and the hospital can concentrate on healing. The media would be used to let people know that they should go to their triage center, not the ER. Great.

The Quarterback, being an impudent sort, asked what seemed to me like an obvious question: What are you going to do about the people who go to the ER anyway. The response? People will be told not to go to the ER. But what about the people who do? They will have been told not to.

I bring this up, because the Department of Health and Human Services had a big flu preparedness summit yesterday, and kicked off a public contest to create a relevant Public Service Announcement on preventing the spread of influenza. The Quarterback tries, really tries, not to be cynical, but I can't help but think that for all we learned from our practice run back in April with H1N1 "swine" flu, there's a lot we still haven't learned. I have ranted at some length in a previous post about the failures of communication and the failure to take mental health into consideration this spring. The message may be cleaner and smoother now, but it is still pretty much the same.

The stance of the Obama administration seems to now be that if we tell people "Don't panic, just prepare" and we give them things to do to prepare, they won't panic. It's not that there's no truth to this. Panic is in part caused by a feeling of powerlessness, and giving people something useful to do combats that feeling. As my regular readers know, our minds desperately want to feel like the situation is under control, and certainly being useful helps with that.

But that's not all our minds need. Our minds need good information, and our minds need to feel heard. It is all well and good to tell us not to panic. Many if not most people won't, just as most people won't go to the ER if we tell them to go to a triage center. But just as we have to have a plan to deal with the people who come to the ER anyway, we have to plan for those who are panicking when they don't need to.

In the Quarterback's humble opinion, it would help the panicking folks a lot to hear, "We totally understand why you might be anxious about this. We are confident that we are ready, and here is why. If you are feeling really anxious, here are some things you can do to help yourself and your family deal with the stress." We know some people are going to overreact. Are we ready to deal with them preemptively as well as reactively?

The administration is telling schools to get ready to be "significantly impacted." As someone in the front lines of that battlefield, the Quarterback appreciates the heads up. But mostly what they are talking about is preparing for school closures, significant student and staff illnesses, and possibly administering vaccine on site. That's all important, but that's not what I'm preparing for right now. While the nurses at school work on that side of things, I'm thinking about how we can best prevent panic among our parents and staff. Last year, we had parents asking if we were going to stop serving tacos in the lunch room (which is both racist and incredibly, incredibly stupid) and teachers refusing to teach kids who had vacationed in Mexico. Telling those people not to panic is not going to be enough. Telling them what to do about their panic might help.


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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