The Florida “Refill Bill” partially addresses an impediment for citizens trying to fully prepare for disasters. Practically every government preparedness site recommends that people store an extra supply of the prescription medicines they use in case of an extended emergency. For example, the Department of Homeland Security’s Ready.Gov site suggests that every American, as part of their emergency home preparedness kit, have an extra supply of:

“Prescription medicines you take every day such as insulin, heart medicine and asthma inhalers. You should periodically rotate medicines to account for expiration dates.”  Ask your doctor about storing prescription medications such as heart and high blood pressure medication, insulin and other prescription drugs.

But the problem is that most insurance plans and HMO’s do not allow customers to purchase extra medicine. So, you have officials instructing the public to stock medicine that many cannot get even if they wanted to. Unfortunately, this kind of situation is too often typical of citizen preparedness information campaigns — telling people to do something that isn’t possible let alone cost or time effective for them and then not helping them in any significant way to deal with that obstacle. As a result, it should not be surprising that so few people are actually prepared.

It is good to see the Florida legislature addressing the medical refill obstacle for their residents, many of whom are elderly with significant prescription drug needs. As Bowen smartly notes, “simply telling people to ‘be prepared’ is not enough. Sometimes you’ve got to remove obstacles for them. This law is a good example of that.”  

This is something that needs to be addressed in other states and by the federal government. And, it should be part of a broader, more complete effort to better educate and equip civilians to deal with their own (and their family’s) health needs during major disasters. Another aspect of that issue is how civilians will be provided medicine in the event of a significant public health crisis (such as a bioterror event or a pandemic). One possibility, as discussed in my previous post, is distributing emergency in home medical kits in advance.

The refill issue also illustrates the need for government emergency preparedness officials to take a new look at all the obstacles the public faces in the preparedness process. And then they should work with various stakeholders, including the private sector (in this case the health care industry) and the public itself, to figure out ways to address them. I think we would find that dealing with the obstacles to public readiness is less a matter of more government money than it is focus, creativity and effort.

It was a wide-ranging, back-and-forth discussion about the state of U.S. disaster preparedness, during which the role of the citizen came up often. The roundtable was called specifically to discuss DHS/FEMA’s plans for hurricane season. But the conversation also delved into the subject of preparing and informing the public for other threats, including terrorism and pandemics.

Secretary Chertoff does not often speak at such length and depth about the topic of citizen preparedness and engagement, which I think is important to him but he has found somewhat vexing during his time at DHS. Paulison has expressed similar frustration on this subject (when I interviewed him last year, he told me that the level of civilian preparedness was a ”pet peeve”). Therefore, I was particularly interested to find out what they have learned during their tenures about the challenge of citizen preparedness and what they would suggest to their successors. 

“This Is Going To Be The Smoothest Transition I Think Anyone’s Ever Seen’

In fact, at the start of the discussion both wanted to make it clear that they intended to make the nation’s first transition for a Department of Homeland Security as seamless as possible no matter who wins the election. Said Paulison: ”I’m going to make sure that nothing gets dropped from one administration to the next, regardless of who gets elected. So, this is going to be the smoothest transition I think anybody’s ever seen. We worked too hard to let the ball drop for lack of cooperation from one administration to another.”

Do Ask, Do Tell

So, with that in mind, I asked them what kind of advice they might hand off to their replacements when it comes to citizen preparedness. I’ve excerpted a lot of the raw roundtable transcript below. But I would characterize their comments overall as recommending what I might call a ‘Do Ask, Do Tell’ policy in regard to the public emergency preparedness – that is, ask more of us citizens as well as tell us more. Both men believe progress has been made, but also readily admit they will fall far short of the ultimate objective of a prepared and engaged citizenry. Nevertheless, their suggestions — which I have organized into three general areas and explained below — should be considered by the next Administration as they develop their citizen preparedness plans:

1) Give The Public More Information And Responsibility When It Comes To Their Own Emergency Preparedness

By:

a) Redefining Emergency Preparedness As A New ’Responsibility of Citizenship’

b) Broadening The Public Preparedness Discussion Beyond Hurricanes & Not Being Afraid To Raise Scary Topics

And In Order To Help Accomplish Both Those Goals: 

c) Consider Distributing Anti-Terror, Anti-Pandemic Medicine Home Kits Directly To Citizens In Advance

2) Learn From The Success of Fire Safety & Global Warming Campaigns

By: 

a) Getting Kids & Schools Far More Involved In Emergency Preparedness

b) Getting The Media & Hollywood Far More Interested In Preparedness

3) Accelerate Use Of New Personal Communications Technology And Social Media For Emergency Preparedness & Response By Public And Government

===

1) Give The Public More Information And Responsibility When It Comes To Their Own Preparedness 

Both Chertoff and Paulison believe a major objective for the next Administration should be to shift and share some of the disaster preparedness burden with the public when it comes to both information and responsibility. But they realize it will not be an easy transfer.

a) Redefining Emergency Preparedness As A New Responsibility of Citizenship

At the start of the roundtable, Chertoff and Paulison made their usual pitch for advance individual preparedness with the Secretary calling it a ‘civic responsibility’ of every citizen.

Chertoff: “The cornerstone of preparation is individual preparation. Have a plan, know how to get the information about what you need to do in the event that a hurricane looms on the horizon. Have some water and food and medicine and a radio, so if you wind up getting caught in a situation where there aren’t supplies for 48 or 72 hours, you have the capability to sustain yourself. None of this is rocket science. It’s the same steps you would take to make sure your house is prepared against a fire or some other kind of more predictable problem. And if people will make individual preparations, they make it easier for the responders, who then can first focus on people who can’t help themselves, either because they’re sick or old or poor. And those people need to get help first. So people who have the wherewithal and the capability to help themselves, I think have a civic responsibility to do it.

Paulison: “The federal government, the state government, the local government, the tribal governments, all of us working perfectly in sync cannot make up for a community or a group of citizens who are not prepared themselves. You simply can’t feed the entire country. You have to take some personal responsibility for yourselves and your family. And like I said, it’s not that difficult for most of us. Some of us can’t. Some of us don’t have the fiscal, the physical, or even the mental capacity to take care of ourselves. Those are the ones governments should be focusing on the first few hours.

When it comes to increasing personal responsibility, Paulison pointed to his own personal experience:

Paulison: I know what I saw in Hurricane Wilma, which went over the top of my house. I saw tens of thousands of able bodied people lined up for MRE’s, a bag of ice and a couple bottles of water. And that’s really stressed the system to the point that it cause a lot of problems at the state level and the local level. That should not have happened.

Chertoff:  “This was when the grocery stores were open.”

Paulison: “Yeah. Exactly. And there was tap water in Dade County. So that really sent a message to me that we’re not - I say we, including you guys, are not getting the message out. After Hurricane Andrew, we saw a tremendous amount of preparedness on the local public side. If a hurricane even came off the coast of Africa people run to Home Depot, they run to Wal-Mart, run to the grocery store. But then as we got further and further away from that storm, we saw less and less of that. So I’m hoping that what we saw in Katrina and the fact that we are really pushing very hard. Your article that you wrote is one of those things that people read that hopefully and will get - eventually just work our way back to that.”

Michael Chertoff

Chertoff: “Another test is whether the people obey evacuation orders. I mean, I remember even after Katrina. I think it was Wilma. Only a certain percentage of people on the Keys evacuated. You know, some people are just convinced they’re going to ride it out. And we didn’t have any real false alarms in the past seasons, but if we have a significant hurricane headed for the coast this season it’s going to test whether people are willing to obey those orders…Now, when somebody has an automobile, and they’re perfectly healthy, and they don’t listen to an evacuation order and they have to come and get rescued, you’re taking a first responder who might have to deal with someone who can’t help themselves, and you’re having that person spend their time on someone who could have helped themselves but they didn’t feel like it. I think that’s wrong. And that’s why we have a lot of emphasis on people who can take care of their own needs attending to those needs.”

b) Broaden The Public Preparedness Discussion Beyond Hurricanes & Don’t Be Afraid To Raise Scary Topics — And if the public is going to be asked to take more responsibility for its emergency preparedness, it should also have more information, according to the officials. While this particular roundtable was called to coincide with the start of the hurricane season, I was curious how they would suggest expanding the preparedness discussion with the public to include other more sensitive threats, such WMD terrorism. Chertoff acknowledged that they had not been able to effectively engage the public on those subjects yet, due largely to two different yet related reasons 1) a concern about being accused of scaring the public and spreading fear and 2) the fact that much of the public doesn’t take the subject of citizen terrorism preparedness seriously.

Chertoff: “There is one thing we’re going to have to tackle, which is the hardest part, which goes back to my predecessor, who was ridiculed because of this idea that somehow talking about duct-tape and things like this was a big joke. If the perception is that it’s a joke to talk about preparedness, we’re in big trouble. I guarantee it won’t be a joke when something happens. That will not be funny…So part of this is we’ve got to find a way to acculturate ourselves to the idea that talking about things that may be remote possibilities isn’t fear-mongering. I got, like all of you probably - I got polio vaccine when I was little. I don’t think it was likely I was going to get polio, but it was understood that public health - you tried to vaccinate as many people as possible. So this ability to have a serious discussion above and beyond the basics, I think that’s the key to moving this forward.”

But as a new Administration will likely get a ’reset’ with the public in regard to communicating on these issues, there is a need to take advantage of it early on.

And in order to help accomplish the above two goals:

c) Consider Distributing Anti-Terrorism, Pandemic Home Medical Kits To Public In Advance

Chertoff raised a subject that may be one way of beginning a new public discussion on citizen responsibility and information – distributing an in-home medical kit with antibiotics which would be used in a major public health event, such as an anthrax attack or pandemic. Of course, it is still in early stages of discussion and there are many questions to be addressed — ie. What medicines would be in the kit? How would it be distributed and to whom? How much would it cost? When it would be done? And will it be effective and comprehensive enough? I saw a prototype when I visited the Centers for Disease Control in Atlanta, and I attended an Institute of Medicine workshop early this year, which examined some of the distribution logistical challenges. Chertoff said it is a priority for him that by the time he leaves his post that some movement will have been made on this initiative, though he understands the obstacles:

Chertoff: “I’d like to see us by the Fall have some kind of a proposal to make. It may have to begin with something we do internally in the department. I know the first responders are interested in getting information about this. We’re discussing now what ought our approach to be to this idea of people preparing medical supplies for themselves. They probably have to go to the doctor and get a prescription, but getting this set up in advance. Could we prescribe kind of a set of counter-measures that everybody ought to have as their basic counter measures? And I’ve got a list of things that I want to try to get done or at least out on the table before I leave and this is one of them….Now, to make that happen a couple of things would have to occur. First, we’d have to be confident that the public would properly use it, would safeguard it until it’s required to be used, wouldn’t lose it or cannibalize it. Second, we’d have to confront what is a cultural bias on the part of the medical establishment against people self-medicating. You know, they want you to always come and see a doctor. That makes perfect sense, but if you’ve got a city the size of New York and you were worried about anthrax and you need to get people antibiotics, you’re not going to get 7 million people to be seen by doctors in 24 hours. It’s not going to happen. And so we would have to have this discussion out there. No doubt there would have to be a lot of lawyers in there making sure no one’s going to be held liable. I think these are all important discussions to have. I think later this year we’re going to try to move the discussion beyond the basics into some of the area like medical countermeasures and things like that… “

Some might say that Chertoff is ’scaring’ Americans by raising a concern – getting antibiotics distributed quickly in the event of a bioterror event like anthrax — that many experts worry about but don’t often discuss openly. But I would argue that the public should be aware of this concern, because they 1) deserve to 2) should know as citizens what their government is worried about 3) may have to deal with these problems themselves in the event of an emergency. Yes, this means raising some frightening possibilities. And, scaring people irresponsibly for political reasons is reprehensible. Yet shouldn’t mean that we avoid discussing bad case scenarios entirely. Preparing for the 21st Century will require every American face the spectre of a major catastrophe happening to them, if only momentarily — which is exactly what we already do when buying life insurance, listening to a flight attendant’s cabin instructions or participating in a fire drill.

Chertoff: “And how do you say to people, let’s say get a med kit. Get these kinds of things. It doesn’t mean that we’re afraid of an attack next week. What it does mean is that there are a series of things that could happen that would require you to use this. Acquire it, put it in a safe place, leave it alone. Now, it doesn’t strike me that that’s a bizarre thing to do. If you go to other places in the world - Switzerland, Israel, it’s part of the culture of those countries that people are used to having certain things on hand for an emergency. Part of the reason they do that, to be honest with you, is because those tend to be countries with universal service. So everybody’s trained and you’re used to bringing your firearms home. You have to have them because you’re on reserve duty. And so it’s accepted in part of the culture.”

Chertoff noted it is more challenging to create a culture of national service without some sort of national service.

Chertoff: “We don’t have that culture. And a question that’s been debated to some degree is whether a culture of national service - not just military service, but national service - would have as a useful byproduct training people. I think the more familiar people became with the need to have some basic understanding of how to handle yourself in an emergency, the less forbidding it would seem and the less culturally antagonistic people would be to this discussion.

2) Learn From The Success of Fire Safety & Global Warming Campaigns

By

a) Getting Kids & Schools Far More Involved In Emergency Preparedness

Paulison suggested that the inroads that fire safety had made over the past four decades in schools and among young people was a good model for trying to increase emergency preparedness in the U.S.

R. David Paulison

Paulison: “I remember we did the “Learn not to Burn” program, and every kid came home with a homework assignment to draw a fire plan, how do you get out of the house, and where you’re going to meet once you get out of your house, and is mommy or daddy going to check the smoke detector, make sure it’s working. And that’s been a tremendously successful program. We’ve had case after case where the fire department has showed up and the family is outside and it was just last school term that their six year old brought that homework assignment. And I know Home Safety Council, some others - maybe we should do something like that. Because once you get to the schoolchildren, and they have to take a homework assignment home, and ok, what do I have? Do I have three day supply of food and water in my house, you know. Do we have a plan? What’s going to happen if I’m in school and there’s an evacuation notice, whether the adults believe it or not…”

Chertoff: “…because of the experience that we had with 9/11 where kids - the parents, in some cases didn’t come home. In other cases people were stranded. Then we had the sniper. There was a real bump up in school preparedness, and everybody had a plan about notifying parents and keeping kids sheltered in place. So that did cause a spike up in preparedness. And I suspect there’s been some increase in preparedness in general sense all these events, but we haven’t had anything really recently. Now you could look at what’s going on in China and Myanmar and say, by the grace of God, it could happen here, and the answer has got to be to prepare yourself. But you really have to - it’s almost a marketing issue.

Chertoff: “So this, to come back to your earlier point, I think maybe is a good new initiative for a next administration to tackle. I think if you look at people in their 20’s now, there’s a lot of debate about what that generation is thinking. I think that they actually are pretty public spirited. They’re interested in current affairs. They seem to be interested in all kinds of public things going on overseas - aid to China and whatever. It wouldn’t be the worst thing in the world to harness that and find a way to get the schools to harness that as they do now with recycling programs and other things…”

b) Getting The Media & Hollywood Far More Interested In Emergency Preparedness

Chertoff acknowledged looking with respect and envy how the global warming issue engaged the public and the media, and he believes that it offers a model for citizen preparedness.

Chertoff: “…you know. I tell you what’s fascinating. If you look at like this whole global warming thing. At some point, it captured the imagination of somebody and it became a big media thing. And then all of a sudden, every kid was coming home with information about global warming. And I wish we could get that media attentiveness in the area of preparedness, so that kids come - because this - actually, this is an area where it could make a difference if everybody had the plans and the kit and everything. You could actually see every individual could make a difference. So I would like to see that - someone pick up and cajole the media on this issue, because I think that would be a very big step forward.”

To help with marketing (not a government expertise), Chertoff believes emergency preparedness needs more attention from the media and the tv/movie industry.

Chertoff: “I wish some of the guys in Hollywood who are focused on some of these other things would actually pay a little bit of attention to this. We could maybe get a real boost.”

3) Accelerate Public Use Of New Personal Communications Technology And Social Media For Emergency Preparedness & Response

Chertoff and Paulison understand that new communications technology will play increasingly important role in emergency preparedness and response during the next Administration. During the Roundtable, they highlighted and pushed the Integrated Public Alert and Warning System (IPAWS) which:

Chertoff: “goes beyond the typical radio and TV-based alert system to one that allows Internet-based warning and cell phone-based, text message based, warning with an opt-in feature. We piloted this system last year in the Gulf. It worked very well. It is not terribly expensive. We are going to be encouraging the governors of the states in the hurricane areas to sign up for this system…we’re providing them with a tool that will enhance their ability to reach out to the members of their community - particularly people who may be hearing-impaired - and give them notice if there’s any kind of an event.”

And the growth of personal technology also offers great promise for individuals to help themselves during an emergency.

Chertoff: “So how do you train people to deal with an emergency? How do you train people to help other people in an emergency? You know, 21st century networking is about the power of the network. How do you harness text messaging, cell phones, internet?

These are some of the questions that Chertoff and Paulison realize their successors will be wrestling with in order to accomplish a goal – fully engaging the American public in their own emergency preparedness — that the two of them believe is very important but they have not been able to make enough progress on. Yet their experiences and advice offered above provide some helpful guidance. 

In fact, I have a suspicion that both men will speak a lot about the topic of public preparedness when they leave government. And it will be in their interest to do so because on January 21st, 2008 both will become members of that public. 

Since then, Buck has been working to get his translator Mohammed Maree freed from the prison. And, Robin Parker of Cross Blog just told me that Buck is also trying to create a Twitter network for emergencies.

According to a story by  the Industry Standard ’s Chris Tompkins:

[Buck] hopes to mobilize a Twitter-based network to respond to mobile messages sent from users in difficult situations or humanitarian crises. Twitter is a “microblogging” platform that lets a registered user send SMS and short Web messages to others who are signed up to receive updates from that user.

Buck hopes to create an SMS messaging group which allows a user in a situation like he experienced in Egypt to tweet a humanitarian group watching the specific region where the incident is occurring. Concerned parties could choose to help, or just pass on word to those who might be able to provide it.  

James Karl Buck

Buck recently met with Twitter management to discuss his idea. (Buck’s Twitter page can be found here). In addition to Buck’s example, Twitter’s value as a communications tool in emergencies was underscored after the Chinese earthquake earlier this year.

 

To me, a key take away from Buck’s story is not only the value of social networking media like Twitter in emergencies, but that you — and your friends and your family – have to be networked in the system before the emergency, so you communicate and be communicated to when something happens. And, as importantly, you also need to the capability to use the mobile technology — which until yesterday I did not.

 I have been on Twitter for several months and periodically send out ’tweets’ (or messages) from my laptop  which are seen by my ’followers’ (people who sign up to get messages from me). And I in turn receive the messages of those I am ‘following’. (Go to my Twitter page if you are curious to see what I am talking about and are interested in participating.)

In May, during the second Manhattan crane collapse, I tried to send a Twitter message to someone alerting him my CERT team was being deployed. But I could not do so because my new Blackberry indicated a Java script error.  

Yesterday, I went to the retailer where I recently bought my Blackberry. A salesperson adjusted the device to enable the Java script to run. So, now if something happens or I just want to communicate with others, I can get a ‘tweet” out.

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.

While we are on the topic, I thought I would add a few more tips to help address some of those misconceptions. They come from a recent San Francisco Chronicle article about a National Academy of Sciences conference this month on medical preparedness for a nuclear attack.

– If there is any warning, take cover - in a basement or heavily reinforced building.

– Lie flat on the ground and cover your head. If the explosion is some distance away, it could take 30 seconds or more for the shock wave to hit.

– Do not look at the flash or fireball, which can blind you.

– Avoid windows, which can shatter and injure.

– Listen to official instructions. If authorities say it is safe to evacuate, do so quickly.

– Otherwise, remain sheltered in place - even if you are many miles from the blast site, because wind can carry radioactive fallout for hundreds of miles.

To be precise, Lieberman asked the hearing witnesses to rate how ready the U.S. is for a nuclear attack (not specifically the public) on a scale of 1 to 10, with 10 being “totally prepared” and one being “totally unprepared,” according to a story by CQ’s Daniel Fowler:

“I would say . . . representing the locals that it’s probably in the four to five range,” said James H. Schwartz, chief of the Arlington County Fire Department, who was speaking on behalf of the International Association of Fire Chiefs. “And, I realize we’re being somewhat arbitrary here.”

At the other end of the spectrum was Federal Emergency Management Agency Administrator R. David Paulison, who gave the highest score of the three federal officials who testified. Paulison rated the preparedness to respond at a seven, while Health and Human Services’ W. Craig Vanderwagen said it was “probably around a six, maybe a five,” and the Defense Department’s Paul McHale ranked it at “probably a five.”

The officials agreed that a good deal of improvement in preparedness has been made since 9/11.

“I would say on Sept. 11, we would have struggled to be a two,” Mc Hale said. “Today, we are probably a five. And to improve our capabilities in the face of a challenge that is almost impossible to calculate, the consequences of a 10-kt nuclear detonation in the heart of a major American city, I think from a DOD standpoint, now that we have designed the right kinds of capabilities . . . we’ve got to bring an operational reality to the concepts that we’ve developed.” McHale suggested it would be possible to move from a five to an eight.

I mention this hearing, as it regards citizen preparedness, for two reasons:

1) If Lieberman’s question had been to rate the public’s preparedness for a nuclear explosion, I can’t believe any of the officials could have given anything more than a “1″. Though overall first responder readiness for such a major catastrophe has markedly improved since 9/11, the public’s knowledge and preparedness has not. It needs to, and these hearings are good first step towards determining what needs to be done in that area.

2) The fact that the Defense Department’s McHale only promised making the level of preparedness an 8 is a good lesson for the public. We should not expect 10’s either in preparedness or response. We should expect competence and strive for excellence, but we are not going to stop every attack and respond perfectly to every catastrophe. Even if it was possible, it would cost too much. We should not be promising 10’s to the public, and they should not expect it.

Though it is now two years old, the Report is a fascinating and incisive study whose overall conclusions about the lack of attention to the public in emergency preparedness and planning are important on both sides of the Atlantic. In fact, the report contains some of the most direct and profound insights about citizen preparedness that I’ve read in a government report. 

A London bus where terrorists set off a bomb July 7, 2005

According to the Review Committee report:

“{Emergency] procedures tend to focus too much on incidents rather than individuals, and on processes rather than people. Emergency plans tend to cater for the needs of the emergency and other responding services, rather than explicitly addressing the needs and priorities and the people involved.”

The Report further recommended:

“London’s plans should be re-cast from the point of view of people involved in a major or catastrophic incident rather than focusing primarily on the point of view of each emergency service. A change of mindset is needed to bring about the necessary shift of focus from incidents to individuals and from processes to people.”

A followup report in 2007 indicated that the British authorities had made improvements in their response plans, particularly in regard to the public. However, the idea that there needs to be a “change of mindset” and the emergency plans should be “re-cast” to take the interests and the point of view of the  ”people”into consideration is a lesson that we here in the U.S. must learn as well. I would argue that we have not yet.  

First, Amanda posted an excerpt from her book and Time cover story with recommendations on how to refine your own “disaster personality”. She lists five areas — Attitude, Knowledge, Anxiety Level, Body Weight & Training — where you can actually improve your resilience in advance in case you face an emergency.

Second, she posted an article she just wrote for Time.com, which points out and then explains the phenomenon of why more men die in floods than women

“In the floods that have swamped the U.S. this month, at least 12 people have been killed. Nine of them were men: in Iowa, three men, ages 33, 35 and 50, died in the floods; three middle-aged men perished in Indiana; Wisconsin, West Virginia and Minnesota lost one man each.

The ratio, it turns out, is typical for storms. Men are more likely than women to die in floods, year after year, all over the country. A study of U.S. thunderstorm-related deaths from 1994 to 2000 found that men were more than twice as likely to die than women. Of the 1,442 fatalities, 70% were men, according to research by Thomas Songer at the University of Pittsburgh’s Graduate School of Public Health. Most of the deaths happened outside the home during flash floods or lightning strikes. That is partly because men are more likely to be outside for their jobs. But men are also more likely to take risks of all kinds — which can be a fatally bad idea in ugly weather.”

Amanda also lists some helpful tips for men (and women) faced with flood waters

I am lucky that the first subject I asked to participate in the series, Col. Randall Larsen, USAF (Ret.) agreed to do it, because there isn’t a more informed and accomplished commmunicator in the area of preparedness. Among many other credentials, Randy is the host of the public radio show, Homeland Security Inside & Out, which I have written about previously. 

In his segment (below), Randy suggests everyone consider keeping a N-95 dust mask and a small head lamp (or other kind of mini-flashlight) with them at all times — he carries them in his briefcase. As Randy points out, both are very light and inexpensive, but potentially can be very useful for a range of possible emergencies which he has experienced first hand.

RANDY LARSEN, “WHAT SHOULD WE TELL THE PUBLIC?”

Randy and I just spent a couple days together as part of a Aspen Institute/Ford Foundation/McCormick Foundation roundtable on homeland security preparedness in Chicago, and we shot this just after yesterday’s session at the University of Chicago’s Gleacher Center. (A regular and practiced media professional, Randy finished his answer exactly at the 60 second mark.)

I hope you like this feature. (though the camera work will be a little iffy in the beginning as I learn how to use the new portable Flip camera I just got as a birthday present from my kids.) I will be collecting and posting all of the segments on the site.

If you have any suggestions on people to interview for this feature, or if you would like to submit a video of your own that I can post, please email me at jsolomon@incaseofemergencyblog.com.

The three-day Aspen workshops bring together the area’s leading officials and experts from the government, business, academic and non-profit sectors to present and discuss the status of preparedness.

The project is described on the Aspen Institute website:

Thanks to a generous grant from the Ford Foundation, the Aspen Institute’s Homeland Security Program has launched a two-year project that will assess five cities’ (namely, New York, Los Angeles, Chicago, Houston, and New Orleans) preparedness for another 9/11-scale terror attack and another Hurricane Katrina-scale natural disaster. Moderated by program director, Clark Kent Ervin, the first of several roundtable discussions (at least one in each targeted city) was held in New York City on December 3-5 at the Ford Foundation’s offices.

Among the speakers and panelists were New York City Police Department Commissioner Ray Kelly; Deputy NYPD Commissioner for Intelligence and former top CIA official David Cohen; and the top FBI counterterrorism official in New York City, Mark Mershon. The invited guest list included homeland security think tank experts; foundation representatives; area university representatives, and key congressional staffers.

A report will ultimately be prepared that will identify best practices in these cities that can be replicated elsewhere in the nation. Gaps in preparedness will also be highlighted in this report, along with recommendations for closing such gaps. The report is intended to help set the homeland security/counterterrorism agenda for the new president and the new Congress taking office in January, 2009.

The Houston and New Orleans roundtables will be held later in the year.

The workshops are off-the-record so I cannot quote anything here. But the information I learn at the these discussions already have and will continue to help inform my work on this blog. 

The episode is wonderful – informative, funny, inspiring, frank, and beautifully shot. There are many interesting moments throughout the show (as a father of two young daughters, I was particularly taken by the stories of the women serving in so many capacities on the ship). But for the purposes of the blog, I want to highlight one theme that comes through right from the start that I think is very much applicable to citizen preparedness back here at home.

The first episode opens with a stirring three-and-a-half minute video overture accompanied by a song from one of my favorites, The Killers, called ”All The Things That I’ve Done”. (You can view the segment at pbs.org/weta/carrier/full_episodes.htm). Towards the end of the opening montage, a senior fighter pilot tells the interviewer about the ship’s prevailing team-oriented, management philosophy:

“All the departments are vital to make a jet fly off a carrier to put a piece of precision ordinance onto a target…without one department, without religious ministries, without the legal department, without the reactor department, without supply department, without hot water cold water and steam for the catapults none of it works.”

During the show, that ethic comes through repeatedly from the top levels of the ship, and it filters down throughout the Nimitz — that an aircraft carrier is only as strong as its weakest link and the enterprise will be strongest when everyone is doing their job all down the line. Further, and maybe even more importantly that objective can be compromised by anyone at any level. We need to bring that same approach in communicating with the public about our homeland security

, t 

The deck of the Nimitz from Carrier

I have had the opportunity to interview many political leaders, homeland security and emergency management officials, as well as first responders. And almost all of them tell me how important the public is to preparing, preventing and then responding to emergencies.

If they really believe it (and I think they do) then the first step is for them to more actively tell us how and why we are important. In fact, I would argue that should be a priority of the next President to tell us exactly that – both encouraging and challenging us to take on that responsibility. Understandably, people aren’t going to take on responsibility if you don’t tell them why and how they should.

Obviously, a kitchen dishwasher is not as vital as a Navy top-gun airman to the ultimate objectives of the carrier. Nor is the average citizen as crucial as a first responder to preparing and responding to emergencies. However, as we see over and over, most recently during the recent floods, the public is a key element in dealing with disasters. And we also have the ability to hamper that process as well. It may well be partially propaganda but you get a clear sense in Carrier that even the lowest ranking person on the Nimitz still feels part of a team.

Obviously, we have military — and uniformed responders – that are on the so-called point of the spear. But the rest of us have a role too and right now our talents, energy and spirits are not being tapped fully. Our leaders need to tell us how and why we are important in order to foster the same team mentality at home that, at least according to Carrier, the leaders of the Nimitz have successfully done on the water.