He told the Summit audience that the public needs to ”understand their roles and responsibilities” in advance of disasters which will allow responders focus on what they do, safety, rescue and recovery. But he said “far too many folks who could have and should have been prepared do not and then force those who aren’t as fortunate to compete for resources in the aftermath of a disaster.”

FEMA Administrator Craig Fugate (Photo: Shashi Bellamkonda)

Fugate often brings up the public’s “responsibility” in speeches including a keynote address I heard at the University of Colorado’s Natural Hazards Workshop:

“a recent survey found that only half of Americans have put together an emergency kit, and less than half – only 40 percent – have created a family emergency plan. I cannot emphasize enough just how problematic this could prove in a catastrophic environment, not only to the households, but to the efficacy of the overall incident management effort. Every family that fails to take even the most basic preparedness actions, such as having sufficient water and non-perishable food to support the family for at least 72, is a family that will pull responders and critical resources away from those who truly need such assistance, both the casualties of the disaster, and our most vulnerable populations, such as persons with disabilities and children…

Having a family disaster plan, keeping supplies for basic survival needs, and staying informed are the responsibility of every American.”

And, in fact, President Obama made that same point last year at the beginning of hurricane season when he said that preparing for disasters was a “personal responsibility” for Americans and a responsibility of citizenship:

“We just saw some statistics coming out of Florida indicating that a huge percentage of people in hurricane areas simply don’t make plans. They don’t have a plan, they don’t have a set of contingencies that will allow them to respond in an effective way. Those people who have the capacity to plan, they will thereby relieve some of the resources that the government has to provide and we can stay focused on those folks who are most vulnerable and have the most difficulty dealing with a storm. So I hope that message of personal responsibility sinks in…As we enter into hurricane season, I hope that everybody who’s watching is going to be paying attention and take seriously their responsibilities as citizens so that the entire country is ready.” [my italics]

President Obama presides over a FEMA hurricane preparedness meeting last year (White House photo: Pete Souza)

But despite the strong — and I would agree appropriate — rhetoric about personal responsibility and responsibility of citizenship, that approach has not become a major thrust of government’s primary preparedness messaging to the public, including on Ready.Gov and other local emergency management websites. Instead of telling people to prepare because it is a responsibility (you need to do this), government has used a softer ask when it comes to trying to get the public to prepare. To me, the it is time to try to do more “telling” and less “asking”.

The soft sell approach actually dates back to the creation of the Department of Homeland Security (DHS) and Ready.Gov. In an NPR “On The Media” story from 2003, I examined the government’s initial public service announcements that featured the first DHS Secretary Tom Ridge:

To ultimately be the victor in the war again terrorism we need all Americans to be engaged, down to the point where we ask mothers and fathers to think about doing some simple things at home to protect themselves and protect their children. [my italics]

In the PSA, Ridge is only asking Americans to think about doing — not telling them to do. Ready.Gov took a similar tack, which has continued to this day. The website’s “Make A Plan” section currently states: “You may [my italics] also want to inquire about emergency plans at places where your family spends time: work, daycare and school. If no plans exist, consider volunteering to help create one.”

Yet, if the government believes it is important for people to create an emergency plan both to help themselves and to make the job of first responders easier during a disaster then the web site should be willing to say something stronger than they “may also want to inquire.”

For the NPR story in 2003, Tom Ridge’s spokesperson Susan Neely told me that focus groups had indicated that people wanted to be engaged on this scary topic in a “constructive way, not a mandate kind of way.” It was understandable to try that approach then. But seven years later with the needle on citizen preparedness having not moved very far, it is time to add another communications angle.

If indeed preparing for disasters is a responsibility of citizenship (which I think it should be), then it should been positioned that way highlighting the fact that you are preparing as much for others as yourself. PSA’s saying that people are imperiling the lives of first responders and their fellow citizens, particularly the vulnerable (ie. the elderly, disabled) not to mention your own family might be treated with a little more urgency.

As has been discussed often on the blog, when the nation wants to change social behavior it uses a carrot or stick. When it comes to preparedness, a carrot is more appropriate than “Click It Or Ticket”. However, a sterner “responsibility message would add a little oratorical “stick” to the mix. This new approach would not preclude still using the current softer approach, but it would add another arrow to the readiness quiver and signal this issue should be treated as a priority by the public.

The need for a stronger “responsibility” message is shared by most top officials of both political parties who have worked in citizen preparedness that I have spoken to. However, there has been a hesitation to use it in mass communications to the public where I think it would be most useful.

Former U.S. Homeland Security Secretary Michael Chertoff echoed the other leaders in an interview I did with him last Fall that preparedness was a new responsibility of citizenship of the 21st Century. President George W. Bush’s Terrorism Adviser Fran Townsend told me: “It should be every parent’s responsibility to make sure that they know their children’s school emergency plan and have a communications plan for their family.”

And, former FEMA Administrator R. David Paulison in an interview told me that FEMA and local authorities are relying on the public to do its share: ”All the states, local communities working together cannot take the place of personal responsibility for taking care of yourself,” notes Paulison. ”If individuals don’t take that responsibility, this country is not going to be ready and be able to take care of everyone.”

Another potentially useful messaging approach was suggested to me by former Miss Utah Jill Shepherd, who used citizen preparedness as her pageant platform. It can (and should) be included in the preparedness pitch that readying yourself and your family for disaster at home is a way you can contribute to the nation’s resilience complementing the work and sacrifice of those in the military. I believe that could be an effective approach.

I don’t believe the government should be afraid to explicitly tell the public that each of us can either hinder or help relief efforts by what they decide to do before and during a disaster. And, that it’s up to each of us to choose. I think that’s a choice and a challenge that might get people’s attention and maybe lead to action. And, since the other approaches being used to address this issue clearly have limitations, it’s definitely worth a try.

So, of course, this blog must ask what kind of activity/photo-op could President Obama undertake to promote citizen disaster readiness for National Preparedness Month which starts in just two weeks? I think it would be great for the President to undertake a similar high profile event (also ideally involving his family in some small way).

My suggestion: have the President create a mock family emergency communications plan.

President Obama and daughter Sasha show they are not afraid of the post-oil spill Gulf water in Panama City, Florida. (Photo: White House)

Obama will undoubtedly issue a proclamation at the beginning for National Preparedness Month. But he — like his predecessor George W. Bush — has not done a public family preparedness event to promote the issue with the media and the citizenry.

One activity that might make sense is for the President to start on a rough mock family communications plan as a model and inspiration for other American families. This would be very appropriate since his FEMA Administrator Craig Fugate said in an interview with me on Friday that if he could get the public to do one thing this National Preparedness Month it would be create their own family communications plan.

It’s actually a topic he’s raised before. During a visit to FEMA last Spring at the start of hurricane season, the President made a very strong statement calling preparedness a responsibility of citizenship and specifically urging Americans to make a family emergency plan:

“…one of the most important things we can do is make sure the families have prepared appropriately. We just saw some statistics coming out of Florida indicating that a huge percentage of people in hurricane areas simply don’t make plans. They don’t have a plan, they don’t have a set of contingencies that will allow them to respond in an effective way. Those people who have the capacity to plan, they will thereby relieve some of the resources that the government has to provide and we can stay focused on those folks who are most vulnerable and have the most difficulty dealing with a storm. So I hope that message of personal responsibility sinks in.”

Now, obviously the President of the United States does not have to worry about an emergency communications/evacuation plan (as he happens to have an entire agency, the Secret Service, dedicated to that exact challenge). But the other 112 million or so  American households do not have that support system in a disaster, and it can be daunting to begin that process themselves.

But if Obama raised went through the disaster planning process even in a very broad way it would significantly increase the profile of the issue and the task. He wouldn’t need to get into his own family’s personal specifics at all but just go through the some of the steps recommended on Ready.Gov “Make A Plan” section, including:

setting up an out of town contact, learning how to text message, subscribing to local alert services, trying Ready.Gov/Ad Council’s online planning tool, picking places where your family will meet, both within and outside of your immediate neighborhood, checking with work and school (no mention of the Obama kids’s school of course) about their emergency plans, and planning for your pets.

Having the President do something rather than just say it would signal to the public and the media that he feels the objective of family preparedness is really important. Now, I understand there are sensitivities about bringing the First Family into the public discussion, but this would not be an actual plan and could be done very generally and half tongue-in-cheek (Obama could say that I’m hoping I won’t need to use this for six more years not two!)

And, as I have written recently, there is a real need for the emergency management community to include far more personal stories and modeling in its disaster preparedness messaging in order to more directly and effective engage and guide the public. This would personalize preparedness from the top.

In the almost nine years I have covered the issue of citizen preparedness, one of the things that has confounded me most is how political leaders have generally ignored the issue. There is not one major elected official who has identified public disaster readiness as one their top issues (despite the fact that even the smallest interest has a political backer in Washington). To me, it’s amazing that no one has taken up leadership considering the number of major emergencies that have either occurred or threaten the nation, and the fact that preparedness — unlike most issues — should be a bipartisan, community-building, patriotic apple pie issue. So, in the absence of political, media and public focus at present, to have President Obama take the time to do a high profile event would be hugely helpful in jump starting citizen interest and action.

In congressional testimony last year, FEMA’s Fugate underscored the importance of political commitment to preparedness:

“I’ve said it time and time again, and I will continue to say it: personal disaster preparedness is and must be a national priority, and every elected and appointed official at every level of government must make it a priority.”

Obviously, the President already has many pressing issues on his plate, but if he does indeed feel that preparing for disasters is indeed “a responsibility of citizenship” as he said last year (and I totally agree with him) I would think it is worth a public appearance and a high profile photo-op demonstration. And as an added bonus, it will give him a chance to get a start on the civilian-life Obama family communications plan whenever they end up needing it.

From a citizen engagement/preparedness perspective, the Strategy document offers some encouraging objectives. However, there are few specifics on what and how the Administration plans to attain them, particularly in the area of informing and engaging the general public on terrorism.

In some ways, the public is central to overall document. A major theme of the Strategy is that the stronger the nation when it comes to our economy, educational system, ability to innovate, and civic values the stronger and more secure we will be. But on the more specific topics of citizen involvement in homeland security, there are several points in the section, “Strengthen Security and Resilience at Home”:

Empowering Communities to Counter Radicalization: Several recent incidences of violent extremists in the United States who are committed to fighting here and abroad have underscored the threat to the United States and our interests posed by individuals radicalized at home. Our best defenses against this threat are well informed and equipped families, local communities, and institutions. The Federal Government will invest in intelligence to understand this threat and expand community engagement and development programs to empower local communities. And the Federal Government, drawing on the expertise and resources from all relevant agencies, will clearly communicate our policies and intentions, listening to local concerns, tailoring policies to address regional concerns, and making clear that our diversity is part of our strength—not a source of division or insecurity.

This type of targeted public outreach has been going on to some extent particularly in areas with significant Muslim populations including here in New York City.

Improve Resilience Through Increased Public-Private Partnerships: When incidents occur, we must show resilience by maintaining critical operations and functions, returning to our normal life, and learning from disasters so that their lessons can be translated into pragmatic changes when necessary. The private sector, which owns and operates most of the nation’s critical infrastructure, plays a vital role in preparing for and recovering from disasters. We must, therefore, strengthen public-private partnerships by developing incentives for government and the private sector to design structures and systems that can withstand disruptions and mitigate associated consequences, ensure redundant systems where necessary to maintain the ability to operate, decentralize critical operations to reduce our vulnerability to single points of disruption, develop and test continuity plans to ensure the ability to restore critical capabilities, and invest in improvements and maintenance of existing infrastructure.

Steve Flynn, president of the Center for National Policy, whose views on these issues I respect enormously had this positive reaction to that part:

“I applaud President Obama’s inclusion of resilience in the new National Security Strategy. This marks an important step forward by acknowledging the vital role that citizens, companies, and communities can and must play in dealing with the evolving terrorism threat highlighted by the recent Times Square attack and the ongoing risk of natural disasters. I sincerely hope this new strategy inspires a revitalized national effort to better integrate the role of everyday Americans and the private sector into security and preparedness planning.”

A third part of that section relates to all members of the public:

Engage with Communities and Citizens: We will emphasize individual and community preparedness and resilience through frequent engagement that provides clear and reliable risk and emergency information to the public. A key part of this effort is providing practical steps that all Americans can take to protect themselves, their families, and their neighbors. This includes transmitting information through multiple pathways and to those with special needs. In addition, we support efforts to develop a nationwide public safety broadband network. Our efforts to inform and empower Americans and their communities recognize that resilience has always been at the heart of the American spirit.

As I have written previously, the Administration has definitely said the right things and has made initial efforts to communicate and reach out to the public. The challenge will be to concretely determine what “resilience” means for the average citizen and to make good on the promise of “frequent engagement” to provide “clear and reliable risk and emergency information to the public.”

The Obama Administration’s “National Security Strategy” document released last week.

The Oklahoma City National Memorial

At 9:02 am, fifteen years ago today, a truck bomb detonated in front of the Alfred P. Murrah Federal Building in Oklahoma City, Oklahoma killed 168 people and injured over 800. President Obama issued a proclamation designating April 19th as a National Day of Service and Remembrance for Victims and Survivors of Terrorism:

There is no greater evil than willful violence against innocents. On this National Day of Service and Remembrance for Victims and Survivors of Terrorism, we pause to remember victims of terrorism at home and abroad, we honor the heroes who have supported them, and we redouble our efforts to build the kind of world that is worthy of their legacy.

Fifteen years ago, terrorists bombed the Alfred P. Murrah Federal Building in Oklahoma City, killing over 160 men, women, and children, and injuring hundreds more. Even before the dust settled, heroes had emerged. First responders, medical professionals, clergy, relief organizations, local leaders, and everyday citizens stepped forward to help victims and their families.

Again, when terrorists struck on September 11, 2001, and thousands of Americans –- and scores of foreign nationals — perished in New York City, at the Pentagon, and in Shanksville, Pennsylvania, Americans made a historic effort to assist all those affected. The dignity of those who were attacked — and the courage of those who came to their aid — reaffirmed the strength of our Nation, and the human spirit.

Much of the focus of the Summit is to continue to monitor and improve the control of nuclear materials from around the world and keep them out of the hands of terrorists and rogue nations. The hope is that this work will prevent the actual use of a nuclear weapon. However, as this is such an important issue, I would argue that the government should also be doing more to inform and prepare the public for a possibility of such an incident. Because contrary to popular opinion, there may be concrete steps that citizens might be able to do to mitigate the impact of such a disaster.

Last summer, I wrote a post about an Institute of Medicine report, “Assessing Medical Preparedness to Respond to a Terrorist Nuclear Event: Workshop Report.” It said that while a home-made nuclear bomb detonated in U.S. city would likely kill hundreds of thousands of people, there are actually things that can be done to increase the survivability for many others. That is, the committee argues, if the public is informed of those steps in advance. According to an article in New Scientist magazine:

as catastrophic as such an attack would be, it would not level an entire city, and a timely response could save many lives. Recent advances in techniques for mapping the path of radioactive fallout after an attack, combined with novel therapies for treating radiation victims, will improve survival chances, the report says.

“Clearly there would be loss of life, but it’s not hopeless,” says Georges Benjamin, head of the panel of doctors and public health officials that was convened by the National Academy of Sciences to assess the nation’s level of preparedness for such an attack. “We feel that there are things that one can do to mitigate it.”

Just knowing about the value of ’shelter in place’, for example, could be a lifesaver, according to the report:

For many people, the safest option would be to seek shelter in buildings or underground. Just staying inside could slash the immediate death toll from radiation by up to a factor of 100, or even 1000, [Fred] Mettler [of the New Mexico Veterans Administration Health Center] says. However, people must be told this in advance. “Without prior education, it would be a horrible issue,” he says.

President Obama At The Nuclear Security Summit (Reuters Photo)

In 2008, the Senate Homeland Security Committee held a series of interesting hearings on nuclear preparedness which also produced some tangible things people might be able to do in the event a nuclear attack. I wrote in a post, “What You Should Do If A Nuclear Bomb Explodes Nearby“:

The headline might strike some readers as tongue in cheek — as if you can really do anything if a nuclear bomb explodes nearby. And, clearly if you are too close, there is little you will be able to do. However, it is less well know that there are things that to you can do if you are in the vicinity that might help you and your family survive such a catastrophe.

That was the message of a number of witnesses at a Senate Homeland Security Committee hearing in April, which is part of the same series of hearings on nuclear preparedness mentioned in the last post. Since I just argued that there was a need for more public education in that area, I decided to do a little of it on the blog.

Though the hearings have fargely focused on the policy and implementation issues around the work of first responders, there have been some helpful tips for the public discussed as well. And I thought I would pass them on.

I don’t expect anyone to commit every tip and instruction to memory. But I think it can be very helpful if people have heard some of the advice at least once. I think it’s even helpful to know that there are actually some actions to mitigate the impact of a nuclear explosion, which is not what many people think.

In fact, the Committee’s ranking Republican, Sen. Susan Collins (R-ME), said during the hearing that she thinks Americans have “gone backwards” since the 1950s and 1960s when it comes to knowing the facts about what to do in the event of a nuclear attack.

One important point that came up in the hearing is that fleeing a nuclear blast is often not the best strategy. According to an article by CQ’s Daniel Fowler:

“The natural inclination is to flee and what they’re going to do is they’re going to get caught in gridlock,” said Cham E. Dallas, director of the Institute for Health Management and Mass Destruction Defense at the University of Georgia. “They’re going to get caught in gridlock because everyone else will be fleeing, and that is not viable. Most people should not flee” because they won’t be affected.

Ashton B. Carter, co-director of the Preventive Defense Project at the John F. Kennedy School of Government, echoed the sentiment. “Certainly most of my friends and family who don’t do this, they think that a nuclear weapon levels an entire city and that anybody nearby better get out of the way or they’re going to get covered in radiation,” Carter said after the hearing. “That’s just not true.”

In fact, Dallas’ written testimony said, “The highest impacts of radiation generally occur when people are caught in the open, or are tied up in traffic jams trying to escape in vehicles which provide little protection against fallout.”

As part of his testimony, Dallas presented visuals of the impact of a 10-kiloton (kt) detonation near the White House. He said the bombs dropped on Hiroshima and Nagasaki were only slightly larger. Both Dallas and Carter said 10 kt is the standard reference.

“It could be expected that there would be at least 150,000 serious injuries and that at least 70 percent of these could involve fatalities,” Dallas said in his written testimony. “Depending on the resources made available at the time, it is likely that there would be an attempt to evacuate as many as 500,000 people from the area, though the efficacy of such an attempt is dubious.”

“This would be the worst disaster to befall the country, but it’s not the case, as many believe, that the entire city would be destroyed,” Carter said after the hearing. “Most of the people in this city would be unaffected — and those that were affected but not killed would have a great chance to save themselves.”

Carter said most Washington residents wouldn’t need to leave their homes even if the nuclear weapon went off downtown “because the radioactive debris would be carried downwind from them.”

In response to a question from Chairman Joseph I. Lieberman (I-CT) about what the most important thing the federal government can do to be prepared to respond the day after a nuclear attack, Dallas said his priority would be to get the truth out about the limited, but serious, impact of such a scenario.

“The misconceptions of the public about radiation are incredible,” he said.

Clearly, the first priority in nuclear security is trying to prevent the use of the weapons as is the objective the Summit. However, as part of the nation’s nuclear preparedness some attention should be paid to informing and readying the public just in case.

Health officials concern about the workplace and H1N1 is the subject of an article by Stephen Greenhouse in today’s New York Times, “Lack Of Sick Days May Worsen Flu Pandemic”:

Public health experts worried about the spread of the H1N1 flu are raising concerns that workers who deal with the public, like waiters and child care employees, are jeopardizing others by reporting to work sick because they do not get paid for days they miss for illness.

Tens of millions of people, or about 40 percent of all private-sector workers, do not receive paid sick days, and as a result many of them cannot afford to stay home when they are ill. Even some companies that provide paid sick days have policies that make it difficult to call in sick, like giving demerits each time someone misses a day.

Public health experts say policies like these encourage many people with H1N1, commonly called swine flu, to report to work despite official warnings from the government and most companies that they should stay home.

“For people who are really caught on a weekly income, if they can’t make a go of it, they might say, ‘I’m desperate. I’m going to do what I have to do, and I’m going into work even though I’m sick,’” said Robert Blendon, a professor of health policy at Harvard.

He warned that this might spread disease, and that these financially squeezed workers might send their flu-stricken children to school, infecting others.

Well before President Obama declared H1N1 a national emergency, the federal Centers for Disease Control and Prevention was emphasizing that businesses should adopt “flexible leave policies” to allow workers with the flu to stay home. In one advisory, the C.D.C. encouraged employers “to develop non-punitive leave policies.” Despite such recommendations, some employees say they have no choice but to go to work sick.

As has been suggested previously on the blog, one way officials at local, state and federal levels — including President Obama — could be helpful is by highlighting businesses of all sizes who are already making plans for their workforce. This attention would provide guidance, encouragement (and, in some cases, pressure) for other organizations.

Using the bully pulpit in that way would underscore how seriously the government takes this and make special planning/policies for H1N1 seem like the norm not the exception. The media can also play a constructive role here by examining what is and is not being planned by organizations in their areas.

The proclamation, which Obama signed Friday night, will make it easier for U.S. medical facilities to handle a surge in flu patients by allowing the waiver of some requirements of Medicare, Medicaid and other federal health insurance programs as needed, the White House said in a statement.

The U.S. Centers for Disease Control and Prevention said on Friday that H1N1 swine flu has become widespread in 46 of the 50 U.S. states, a level comparable to the peak of ordinary flu seasons but far earlier and with more waves of infection expected.

The White House statement said the declaration was intended to prepare the country in case of “a rapid increase in illness that may overburden health care resources” and was similar to disaster declarations issued before hurricanes hit coastal areas.

“Preparedness is an essential element of a resilient and secure Nation. My Administration has made preparedness a top priority, and we are working every day to ensure our country stands ready to respond to any disaster or emergency — from wildfires and hurricanes, to terrorist attacks and pandemic disease. Our goal is to ensure a more resilient Nation — one in which individuals, communities, and our economy can adapt to changing conditions as well as withstand and rapidly recover from disruption due to emergencies.”

Though much of the proclamation contains normal preparedness boilerplate, particularly striking is the prominence of the concept of ‘resilience’ which is clearly becoming a central principle of the Administration in this area (It also has a new central place in the latest Dialogue on the Quadrennial Homeland Security Review.)

Administration officials announced that an H1N1 vaccine is expected to be ready in October and that more vulnerable populations, such as school age children, pregnant women and individuals with underlying illnesses will be the first in line for vaccination. There was also an announcement of increased federal funding for state and local preparedness initiatives and the launch of a one-stop government website, Flu.Gov. Particularly interesting for this blog was that much of the discussion focused on getting the public ready and informed — whether it be family preparation, school/workplace policies, mass vaccination and risk communications.

I thought it would be helpful to outline some of the key issues/questions regarding the public that were discussed during the Summit. In addition to attending the panels, I spoke to officials to find out what they want the public to do as well as their concerns, obstacles and challenges in getting Americans prepared by the Fall. (I videotaped a few interviews and include them below.) This is a long post; I hope it’s useful.

At the Summit, federal officials offered a clear message to the public to start preparing for a possibly more lethal H1N1 outbreak in the Fall. However, they are still working out the policy and logistical questions that citizens would face in the event of a serious outbreak. The gathering was an opportunity for local officials to ask questions, provide input, and relay on-the-ground concerns to the feds as they will ultimately be responsible for implementation in their communities. The Summit addressed many of the concerns raised by the experts that I spoke to and blogged about earlier this month, though the answers are still being worked on.

Cabinet secretaries Arne Duncan, Janet Napolitano and Kathleen Sebelius listening to their boss, President Obama, speak to the Summit via phone from Italy.

To get an overview of the Summit (in addition to this blog post), you can check these articles: New York Times‘  “Obama Warns Of Return Of Swine Flu In The Fall”, the Associated Press’ “Swine Flu shots at school: Bracing for a Fall return”, or for a state/local perspective the Rutland Herald’s “State Officials Attend H1N1 Summit”. You can go to Flu.Gov for the Summit press release and panel schedule. The Health and Human Services’ (HHS) social media Twitter feed, FluGov, live tweeted the Summit with a guest blogger, David Hale. Heidi Splete of Medical News Net also tweeted the proceedings. You can also check the #09fs Twitter tags to read about activity both at the conference and in the blogosphere. There was also a conference call during the day in which top officials answered some good questions from bloggers around the country, including Greg Dworkin from Flu Wiki and Daily Kos, Mike Coston of Avian Flu Diary, and Sharon Sanders of FluTrackers.com. A transcript can be found here. Videos of the sessions are available here.

The day began with cabinet secretaries Kathleen Sebelius, Janet Napolitano and Arne Duncan along with White House Homeland Security Advisor John Brennan speaking to a standing room crowd at NIH’s Natcher Conference Center. President Obama called in from Italy where he was attending another summit, the G-8. (Ironically, he was in the town of L’Aquila, the site of a recent natural disaster, last year’s earthquake). After the initial plenary, there were panels and smaller breakout sessions largely focusing on schools, work place issues, vaccine distribution and communications. The focus was on examining the lessons and experiences from the Spring — what worked and what didn’t — in a largely open, self-critical manner.

Federal officials outlined their initial plans and raised the questions that they are currently trying to figure out (e.g. what should school closing policy be?); it was both a briefing for state and local officials and a way to bring them all into the planning process. In addition, the day served as somewhat of a pep rally for health leaders across the nation who have had a challenging spring and may have an even tougher autumn and winter. It was also a way to get media and public attention that H1N1 was not going away as a problem, and that the government was still on the case.

I thought I would highlight a few of the overarching themes I heard throughout the day regarding public preparedness for H1N1:

* Preparing Not Scaring — In his remarks, President Obama said: “We want to make sure that we are not promoting panic, but are promoting vigilance and preparation.” And throughout the Summit, speakers looked for ways to underscore the seriousness of the potential situation (”We’re planning for the worst case scenario”, “It’s a deadly threat”, “Time is of the essence” were some of the phrases used), but in the same breath emphasize that to date the illness has largely displayed only mild virulence. The hope is that the public is able to hold  that balance in their minds going forward. One of the goals of the Summit was to get Americans’ attention that H1N1 was a threat (and underscore their responsibility to prepare) without frightening them. Towards the end of the day, Sebelius summed up the message: “It’s not about panicking people or striking fear but motivating Americans to prepare.” That approach is useful not only for pandemic preparedness but emergency preparedness in general.

* Giving The Public An Information Inoculation: “Be Prepared To Be Surprised” – Secretary Sebelius said that when it comes to this flu we should all “be prepared to be surprised.” It was a phrase repeated throughout the day. New Centers for Disease Control (CDC) Director Thomas Frieden noted in his remarks that influenza is among the most unpredictable of illnesses. As an example, many speakers mentioned that in most of their pandemic plans there was the expectation that the flu (most likely Avian) would come from another part of the world rather than just south of the border. And as a result, we would have more time to prepare. John Brennan called it a “very dynamic situation” with a lot still unknown. I think there is great value in putting that word out in advance to the citizenry in order to sensitize them to expect — and not be shocked — by change, and that we need to be prepared for whatever eventuality and be able to turn on a dime. It is almost as if this Summit was the first round of an information vaccination protocol which hopes to build up resistance and resilience in each of us by the Fall.

* Help Wanted: Leading & Listening – Officials repeatedly said that they did not have all the answers and would need to engage all aspects of society, including the public, to help them in preparing and responding to an H1N1 outbreak in the Fall. “We can’t do this alone,” Sebelius said. Brennan offered an honest but reassuring “we don’t have all the answers, but we’re committed to finding them.” Obama ended his remarks by saying: “If there are any issues we haven’t raised, please let us know.” I think that this kind of leading and listening — we’re doing all we can but we can use your help and input — is a winning communications strategy. As part of that approach, Sebelius urged state and local officials in the audience to convene ‘mini-summits’ at home; that sounds like a good forum to engage and involve the public.

The National Institutes of Health, site of the H1N1 Summit

* Top-Down & Bottom-Up — Most of the decisions in a pandemic are made by local and state authorities, but they need clear guidance on tricky issues that have far reaching effects (e.g. when to close schools) from the federal government. One of the goals of the Summit was to get everyone in public health on the same page. To me, this top-down and bottom-up approach echoes the optimal manner of dealing with other emergency preparedness challenges: most disasters are local responsibilities but there are things that only the federal government can do and say in a crisis. In the case of the Spring H1N1 outbreak, information was coming not only from feds but also from other governments and even an international body, the World Health Organization. In this era of unfamiliar, potentially serious threats as well as a new media environment, local officials cannot do it alone. It needs to be both the grass roots and tree tops working together.

* You Can’t Spell TEAM Without DOE, DHS, HHS, ASTHO, ETC. – One of the challenges I have found in the area of emergency preparedness is that it tends to blend different disciplines — emergency management, health, public safety, critical infrastructure — that have different languages, approaches and org charts but which must work together on challenging issues, sometimes in a crisis situation. Having the three top Cabinet officials jointly oversee this Summit underscored the need to deal with H1N1 across agencies and stove pipes at all levels both vertically and horizontally. Brennan called it a “team approach,” and you did feel that spirit in the Natcher building on Thursday.

* Not A Waste No Matter What Happens In The Fall – Secretary Napolitano made the important point that the preparation that government, business, schools and the public undertake for H1N1 will be useful even if the flu turns out to be not to be severe. Preparing for a pandemic will only increase the public’s (and in turn the nation’s) resilience going forward for other emergencies. Again, this is an idea — preparation is worth the time because it will come in handy sometime for something — that is the rationale for all citizen emergency preparedness. I would suggest that H1N1 citizen preparation be integrated into activities for the Department of Homeland Security’s National Preparedness Month this September. In fact, I would urge federal agencies involved in citizen preparedness to consider tying their communications to the public in this area more closely together. For example, many of the same preparation and response recommendations for a pandemic would be made for a bioterrorism attack (obviously, there are differences: washing your hands may be effective for the former but not the latter.)

* Using Viral Media To Take On A Virus (Thanks for that headline to Chris Thoman) – Social media played an important role in the government’s H1N1 public education efforts in the Spring and that will only increase in the Fall. In addition to the comprehensive Flu.Gov site, Secretary Sebelius announced a new H1N1 video PSA contest (YouTube announcement below) with a prize of $2500, hoping to tap the “creative ideas of average citizens and young Americans.”

HHS Secretary Kathleen Sebelius announces new 2009 Flu Preparedness PSA Contest.

Between sessions I spoke to Richard Besser who, as Acting Director of the CDC, earned widespread praise for his leadership during the Spring outbreak. I asked him what the public should be doing now to prepare for the Fall (n.b. the button on my Flip camera was sticking so the video continues a little bit beyond the end of the actual interview, and I haven’t yet learned how to edit — but I will soon):

Dr. Richard Besser advises the public what to do regarding the H1N1 Flu.

As Dr. Besser, who heads the CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response, says on the video, officials are now reassessing school policy. It is one of what are called “community mitigation” steps. One of the nation’s leading public health policy analysts, Jeff Levi of the Trust for America’s Health, told me last month that the U.S. does not have in place the social and economic policies that can support the significant public health recommendations which might be necessary in a serious outbreak. During the Spring, there were numerous reports of citizens with flu symptoms who went to work because they would not be paid or feared losing their job. Similarly, the costs of closing schools — in child care needs or school lunches — turned out to be more significant than expected (in Chicago, for example, 80% of public school children are eligible for a federally subsidized meal at school).

I thought I would take a shot below at outlining the big policy and implementation questions that the public should know about:

Do School Closings Work? — “We’re reassessing” was a reoccurring comment when it comes to the decision on schools and H1N1. There was a consensus among most speakers that the school closing policies need to be clearer in the Fall than they were in the Spring. Typical was the comment of Belinda Pustka, superintendent of Texas’ Schertz-Cibolo-Universal City Independent School District, during one of the panels which was addressed to the feds: ”What I need from all of you is an idea of when it is best to close, when it is necessary to close and when it’s not.” New York City Assistant Health Commissioner Marci Layton said her department is currently surveying schools to determine the economic impact of the closings and see what kids did with their free time (going to the mall wasn’t going to help stop the flu). On another panel, a Chicago school official said the city only closed two schools but instead focused on “exclusion” (ie. keeping sick students home) rather than closing while a Texas educator  said he felt that their district shutdowns were effective in slowing the flu’s spread. Federal officials are now, in the words of Secretary Napolitano, “working the problem.”

One thing I think that needs to be part of the approach is that the public should be included in the discussion over the effectiveness of school closings and other community mitigation steps, such as preventing large gatherings and distributing masks. It is my sense that most Americans believe that closing schools and other mandates were effective in slowing the virus. If that is not true, then the mythology should be debunked so in the Fall there will not be public calls and pressure from political leaders for measures that are really useless and disruptive.

Another goal of the Summit was to bring in grass roots practioners to offer feedback from the spring. One speaker, Mary Pappas, the school nurse at St. Francis Prep in Queens, New York, diagnosed the Big Apple’s first H1N1 case in April. In her comments, she highlighted the value of student cellphones in quickly alerting their parents about the news from school (and recommended every school have a registry of the mobile numbers of all parents). And she drew laughs when she offered this ‘from the trenches’ tip on what she told students: “If it’s wet and not yours, don’t touch it.” (By the way, the often unsung school nurse received a lot kudos during the day.)

Will Workplace Plans Work? — While the H1N1 did not have as much impact on business as it did in schools this Spring, that might change this Fall. At the Summit press conference, I asked Napolitano about what the government was doing in regard to businesses and their employees, and what citizens should be doing and asking in their workplaces. Her answer is below:

Secretary Napolitano answers a question I asked at the Summit press conference about business/employee preparedness for H1N1.

While bigger companies often have contingency plans, will smaller companies be able to cope? You could never expect a seamless private sector net, but it seems as if there might be significant holes which could be very problematic during a major outbreak. In addition to reaching out to big companies and trade groups, I think the government will have to use a robust bully pulpit, putting societal pressure on the private sector that in the event of a significant crisis sick leave and telecommuting, where possible, is the norm.

Another potential vulnerability in the planning was raised during one of the sessions by Paul Jarris, executive director of the Association Of State & Territorial Health Officers (ASTHO): undocumented workers (a worry in other disaster responses as well) not wanting to volunteer to participate in a vaccination program and how that could impact the H1N1 public health effort.

Will A Mass Vaccine Distribution Work? – Officials say that they hope to have a vaccine in October (though it may take longer) and will embark on a voluntary vaccination distribution program. A big concern among some experts I spoke to is the scope. How will such a mass vaccine be distributed? Will the public have concerns about participating? Will there be ample supply? Will October be early enough? Federal officials acknowledged that the logistics of the vaccination program will be a Herculean challenge with schools, medical facilities and other retail locations possibly having to dispense both 100 million-plus doses of regular winter flu vaccine – and H1N1 shots. “We know a mass vaccination program of even modest scale will involve extraordinary effort on your part,” Sebelius told the Summit.

I spoke to Anne Schuchat, director of CDC´s National Center for Immunization and Respiratory Diseases, after a breakout session about what the citizens need to know about the vaccination program. (My camera stuck on this video as well so the end runs on a bit beyond the interview.)

Dr. Anne Schuchat talks about what citizens should know about the H1N1 vaccination.

Can Public Risk Communication Work As Well Again? — Though the federal government’s communications throughout the Spring outbreak was widely applauded, there were some issues being discussed at the Summit for the Fall. In her remarks, New York City’s Marci Leyton said that improvements were needed in getting messages out to the “non-afffected” (ie. the ‘worried well’ who jammed hospitals); reaching citizens in higher risk groups (e.g. pregnant women, asthma sufferers) who required treatment; as well as better explaining policy differences between local/state government actions and CDC  recommendations (whether that be on schools, N95 masks or public gatherings). It is a challenge: one local official said that the key for health officers in the field and the public is “communication, communication, communication” from federal officials, but that the communication needs to be “meaningful, quick, accurate”.

In the day’s last panel, Barbara Reynolds, a CDC communications adviser and Dr. Besser offered some very interesting communications advice for the state and local officials based on the experiences of the Spring. Among their recommendations: be first; be right: don’t be afraid to give out information in chunks (Reynolds said Twitter had made it more acceptable to parcel out information in stages since you only get 140 letters); be credible;  be empathetic; give people things to do; don’t give out mixed messages; don’t be paternalistic. Don’t treat people like children (”invite public into the process”) counter rumors and don’t turn down media requests. Besser, a pediatrician by training, said he spoke at press conferences as if he was talking to a parent in his office. He said you should acknowledge the public’s fear and uncertainty but then turn it into planning and action.

I had met Dr. Besser last year in Atlanta during a pandemic training session at NIH, and I had participated in a mock press conference as a reporter to test officials like him who might have to brief the media in the event of a pandemic. And in fact, one of the stakeholders that will be central to the communications challenge but did not get mentioned much during the Summit is the media (both mainstream and ‘new’). There is obviously no way to fully coordinate or manage the press’ coverage of H1N1. But the more knowledge and information the media has, the less likely it will stoke panic among the public. I imagine that officials will be briefing them soon on the same issues that were discussed at the Summit.

I asked Rear Admiral W. Craig Vanderwagen, who has been the HHS Assistant Secretary for Preparedness for the past three years, for his take on how citizens should be preparing for the Fall:

Dr. Craig Vanderwagen speaks about how the public and its institutions should be dealing with H1N1.

I also asked Paul Jarris, who oversees the state health officers association, what he recommended to the public in advance of the Fall. He said it should begin with some extra supplies:

Paul Jarris from ASTHO talks about making sure Americans are prepared for a possible H1N1 outbreak.

The value of the Summit may have been best summed up to me by California Public Health Officer Dr. Mark Horton (below) who said he had come across the nation with low expectations thinking that it would be just a bunch of public health officials talking to each other but he was struck by how much he learned.

Dr. Mark Horton, California’s Public Health Officer discusses the H1N1 Summit.

The challenge going forward, however, is not only to educate and persuade the public to prepare but it is to make sure that the institutions — ie. schools, businesses, public health and other government areas — are set up to make it easy for the public to do so. One way will be to have the kind of discussion with the American people that occurred at NIH on Thursday. This blog will continue to cover this unfolding story and the work being done on the federal, state and local level on behalf of the public. If you have comments or questions, I’d love to hear them.

“True preparedness means having federal and state and local governments all coordinating effectively, and as you just heard, one of the most important things we can do is make sure the families have prepared appropriately. We just saw some statistics coming out of Florida indicating that a huge percentage of people in hurricane areas simply don’t make plans. They don’t have a plan, they don’t have a set of contingencies that will allow them to respond in an effective way. Those people who have the capacity to plan, they will thereby relieve some of the resources that the government has to provide and we can stay focused on those folks who are most vulnerable and have the most difficulty dealing with a storm. So I hope that message of personal responsibility sinks in…As we enter into hurricane season, I hope that everybody who’s watching is going to be paying attention and take seriously their responsibilities as citizens so that the entire country is ready.”

(President Obama confers with Homeland Security adviser John Brennan at the conclusion of a hurricane preparedness meeting at FEMA headquarters in Washington Friday, May 29, 2009. At left is Homeland Security Secretary Janet Napolitano. Official White House Photo by Pete Souza)

Obama’s visit was to check on and highlight the federal government’s planning as hurricane season begins. However, his strong language about the role and responsibility of the public in that planning process was terrific to hear.

He says he hopes President Obama will take the lead by urging Americans to prepare: “The President has the bully pulpit to encourage preparedness in the same way he has done on public service.” Thompson also thinks the government should provide citizens with more info about the range of homeland security threats as part of the preparedness process: “The public needs a constant flow of information so they know what to do to protect themselves.”

Thompson remembers that on September 11th, 2001 there was chaos on Capitol Hill, even with all the law enforcement there. But he observes Americans are not all that much better informed almost eight years later on what to do if something happens. Though the Chairman cautions that the public education has to be done in a careful, balanced way: “You don’t want to scare people to death to get prepared.” 

According to Thompson, there is a need to bring back the preparedness ethic of the Civil Defense-era, updated for the new century, including integrating a preparedness curriculum into U.S. schools. ”When I was a kid we had civil defense drills in school, so we knew what to do.” Though he notes that while ‘duck and cover’ would not have done much good in response to Russian missiles during the Cold War, there are things that citizens can do now to mitigate the impact of potential threats. The Chairman explains that citizen preparedness should not be seen as something unusual or drastic but just part of our normal life which will strengthen our communities’ readiness for emergencies small or large, natural or man-made. 

U.S. House Homeland Security Committee Chairman Bennie Thompson (D-MS)

In the interview, Thompson also emphasized the importance of the public’s role in assisting authorities in homeland security: “We can’t buy enough equipment to prevent every terrorist attack. We need your eyes and ears.” He says the U.S. can learn from elements of the “Israeli model” for public readiness and engagement and making preparedness part of everyone’s responsibility.

In sum, Thompson says that the more prepared the public is, the more resilient the nation will be. (His committee held an interesting series of hearings last summer, titled “The Resilient Homeland” with an terrific group of witnesses, which focused on “the Nation’s ability to quickly and effectively bounce back from large scale disruptions.”)

The new positions would be focused on particularly challenging national problems: tackling the dropout crisis, strengthening schools, improving health care and economic opportunity in low-income communities, cleaning up parks, aiding efforts to boost energy efficiency, as well as dealing with disasters and other emergencies.

A provision in the legislation would also establish September 11th as a “National Day of Service and Remembrance.” According to a sponsor, Senator Charles Schumer (D-NY), “September 11 should not only be a day for mourning — it should be a day to think about our neighbors, our community and our country.” I agree and hope the subject of citizen preparedness (which is such an important legacy of 9/11) plays a role in the Day of Service’s activities.

The House of Representatives have passed a similar version of the “Serve America Act”, and President Obama yesterday expressed his intent to sign the legislation when it gets to his desk.

The last things President Obama will want to confront in his first year in office are the bodies of dead Americans and complaints of ineffective government response following a terrorist attack within the United States. His predecessors both faced terrorism in their first year in office: President Clinton on February 26, 1993 at the World Trade Center and President Bush at the same location and at the Pentagon on September 11, 2001. President Obama may well face a comparable attack.

However, a recent Washington meeting co-sponsored by the Centers for Disease Control and Prevention and Harvard’s National Preparedness Leadership Initiative…brought together homeland security, public health, and hospital officials from Boston, New York, Washington, Chicago, San Francisco, and Los Angeles, U.S. cities with subways and mass transit systems that are “soft targets.” They met with their counterparts from Madrid, London, Tel Aviv, Islamabad, New Delhi, and Mumbai, cities hit by mass casualty conventional attacks that left thousands dead and with preparedness and response systems that learned a great deal from the experience.

Colleagues from Pakistan and India described the panic and resulting chaos that reverberated in hospitals following suicide attacks. They reported on measures taken to restrict hospital hallways to those needing care and limiting the access of anxious relatives and eager politicians who descended on the hospitals and impeded efficient medical care. What should President Obama and other leaders take from these lessons?

Three of the six “lessons” directly involve the public:

3) The real “first responders” are not fire, police, and EMS professionals. They are the second wave of help. It is the crowd of fellow passengers who jump into action, on the scene, and who are able to assist and support victims in those critical first moments following injury. President Obama must ask himself how he can galvanize the populace so that they know what to do if they are present and physically able to help.

4) While official plans outline a well orchestrated series of compliant actions on the part of the population and responders, the immediate aftermath of such a tragedy is pandemonium. People do not wait for ambulances to get to the hospital. The “walking wounded” victims get there on their own, creating a first wave of moderately injured victims. Those who are severely injured and cannot walk, the “horizontal victims,” take longer to get onto stretchers, into the ambulance, and to the hospital. By the time this wave of critically injured patients arrives at the hospital, much capacity has already been consumed. One lesson from abroad: distribute less severely victims to more distant hospitals that are less likely to be overrun by the injured.

5) Think resilience. The intent of these bombings is to bring people down, to destroy our confidence, to foster fear, and to shatter our economy. We know the period after a new President assumes office is one of greater vulnerability. We must all be vigilant. If you find a suspicious package or observe suspicious behavior, report it to authorities. This is a time to be safe, not sorry. Be prepared to get back on your feet if we are hit. It will be difficult. However, returning to normal living is the most defiant of acts following a terrorist bombing. 9/11 was a wake-up call and we have been fortunate that, to date, there has not been a repetition. However, time dulls our memories and complacency sets in with its own dangers. Now is the time for our homeland security, our preparedness, and our response officials to turn their attention to what is a more likely set of threats. While we have little experience here, there is much we can gain from that of our friends abroad, and in the name of humanity, they are generous in their willingness to share what they learned.

I had a chance to interview Dr. Hamburg about public preparedness in Washington last year. She said that “the public is key” to emergency readiness and response. She told me that governments need to more to educate citizens in advance on such bioterrorism questions as evacuation vs. ’shelter in place’. She also believes that making preparedness more personal and underscoring the role of the individual citizen is a more effective communications strategy in breaking through to the public. In fact, Hamburg mentioned that as a parent she approached her children’s school about its emergency plan which led to improvements in it.

In his address today, the President focused on preventing recent outbreaks that were responsibility of food making process – contaminated spinach in 2006, salmonella in 2008 and bad peanut products this year. But it will also be very helpful to have an knowledgeable, articulate expert in bioterrorism with experience both in local and national government in a major public health leadership position. Hamburg’s appointment underscores the important relationship between food safety, public health and emergency preparedness.

  President Obama’s Weekly Address — March 14, 2009

In his remarks today, Obama said: 

I’ve often said that I don’t believe government has the answer to every problem or that it can do all things for all people. We are a nation built on the strength of individual initiative. But there are certain things that we can’t do on our own. There are certain things only a government can do. And one of those things is ensuring that the foods we eat, and the medicines we take, are safe and don’t cause us harm. That is the mission of our Food and Drug Administration and it is a mission shared by our Department of Agriculture, and a variety of other agencies and offices at just about every level of government.

The men and women who inspect our foods and test the safety of our medicines are chemists and physicians, veterinarians and pharmacists. It is because of the work they do each and every day that the United States is one of the safest places in the world to buy groceries at a supermarket or pills at a drugstore. Unlike citizens of so many other countries, Americans can trust that there is a strong system in place to ensure that the medications we give our children will help them get better, not make them sick; and that a family dinner won’t end in a trip to the doctor’s office.

But in recent years, we’ve seen a number of problems with the food making its way to our kitchen tables.  led to hundreds of illnesses and cost nine people their lives – a painful reminder of how tragic the consequences can be when food producers act irresponsibly and government is unable to do its job. Worse, these incidents reflect a troubling trend that’s seen the average number of outbreaks from contaminated produce and other foods grow to nearly 350 a year – up from 100 a year in the early 1990s.

Part of the reason is that many of the laws and regulations governing food safety in America have not been updated since they were written in the time of Teddy Roosevelt. It’s also because our system of inspection and enforcement is spread out so widely among so many people that it’s difficult for different parts of our government to share information, work together, and solve problems. And it’s also because the FDA has been underfunded and understaffed in recent years, leaving the agency with the resources to inspect just 7,000 of our 150,000 food processing plants and warehouses each year. That means roughly 95% of them go uninspected.

Obama said he is creating a Food Safety Working Group that will:

bring together cabinet secretaries and senior officials to advise me on how we can upgrade our food safety laws for the 21st century; foster coordination throughout government; and ensure that we are not just designing laws that will keep the American people safe, but enforcing them. And I expect this group to report back to me with recommendations as soon as possible.

Bogis argues that the bottom-up, community-driven organizational approach of the President during the recent campaign (and in some of his previous work in Chicago) can — and should be — employed by the Administration in the area of homeland security. In his piece, Bogis argues:

To improve homeland security, the administration must reach out to citizens and provide real education about the threats they face. Engagement with the public on a scale not yet seen can be accomplished, but will require a new type of “ground game” exemplified by Obama’s campaign.

Efforts to utilize both the existing grassroots structure and tools are underway, though as an independent non-profit organization separate from the government. Early indications are that the initial focus will be on helping drive the new administration’s initiatives. There is speculation that a national service component might be included that could assist in the aftermath of natural disasters. It and related activities should include efforts to foster preparedness by applying an Obama organization mantra: “respect, empower, and include” citizens in homeland security.

This will require expanded use of social networking tools such as Facebook and Twitter, as well as traditional communication means. The administration should also heed the suggestion of a recent government commission that recommended empowering citizens beyond the role of Chicken Little, asking little more than preparing for the sky to fall. Instead, as the chairman former Senator Bob Graham put it, if citizens are informed about the dangers they face they can hold their elected officials responsible for preparing and make vital choices themselves, such as voting to appropriately fund local emergency medical services to meet potential threats.

As I come at the issue of homeland security from the point of view of a citizen and parent, I appreciate Bogis’ suggestion for Obama to use his ”community-organizer strategy” in this area. If the President follows the advice, it would put citizen preparedness and engagement in the forefront of homeland security policy. To me, citizen preparedness offers the President the type of non-partisan, constructive, grass roots opportunity for Americans to strengthen their communities while giving back during a time of war that he spoke a lot about during the campaign.

1) New Responsibilities Of Citizenship:

“What is required of us now is a new era of responsibility — a recognition, on the part of every American, that we have duties to ourselves, our nation and the world, duties that we do not grudgingly accept but rather seize gladly, firm in the knowledge that there is nothing so satisfying to the spirit, so defining of our character than giving our all to a difficult task. This is the price and the promise of citizenship.”

As has been discussed a good deal on this blog, emergency preparedness should be viewed as a responsibility of citizenship in the 21st Century. And the fact is that the more prepared and engaged we all are, the stronger our communities will be before, during and after whatever disasters we face in the future.

 2) Role of Citizens In Their Communities:

“For as much as government can do and must do, it is ultimately the faith and determination of the American people upon which this nation relies. It is the kindness to take in a stranger when the levees break…”

Emergency preparedness offers Americans many opportunities to help out in small and large ways to strengthen their communities and in turn the country  – whether that is taking in a stranger when the levees break or checking in with an elderly neighbor beforehand, giving blood, or volunteering for CERT or the Red Cross.  

3) Security And Civil Liberties: 

“As for our common defense, we reject as false the choice between our safety and our ideals.”

One of the great challenges for the nation going forward is to determine the balance between security and civil liberties. It is a question that the government cannot answer alone and will need the input of the public. However, to do so Americans need to be better informed about the key issues, tradeoffs, threats and priorities. 

Obviously, the nation faces many challenges in the months to come, and citizen preparedness is not a front and center issue. However, I believe that an effort to improve public readiness and engagement can be very helpful in reaching President Obama’s objective of a more informed, involved and responsible public.