The U.S.may perhaps have vaccination and antivirals for the whole population, even though the storage and management of vaccination for millions of people must be quite an undertaking, nevertheless the utmost responsibility and primary role of the government is to protect its citizens and keep the people safe from enemies foreign, domestic, or in this case enemies of highly infectious nature and spread (yes, an infectious event most likely brought on by one or the other enemy mentioned above)

So to answer the above question if I dared to make a political decision for such program…? Yes! …but I am not a career politician…they make decisions differently – and for very obvious reasons.

Should that be a part of my job and a part of my professional expertise and my professional recommendation, should that be my decision-making responsibility – then yes, of course, I would make a decision and I would accept the responsibility.
In fact, that was exactly why I was “there” occupying that office and that position, to lead as leaders are sorely needed! So if in spite of knowing all about the small pox sentinel  event scenario had I accepted this (fictitious) appointment or a position then yes, it would be my decision, my recommendation and my responsibility for such scenario and for the people – whatever the decision may be, either do something or do nothing.

That’s my final answer, Alex (doesn’t that sounds familiar … ??)

While the crises analysis and projection of impact studies can be (and hopefully are) low on probability, and we all do hope so, it is still the responsibility of the government and its appropriate agencies to discuss, debate and plan for varied scenarios and call different “plays” all in order to prepare for such – even if – unthinkable event.

As I stated in my previous post, I am not an expert on the likelihood of small pox epidemic event or on the effectiveness or amount of US vaccines or antivirals, so I will not be delving into those issues.
However, what I am an expert on is emergency response, efficient administration, effective organization of people and key infrastructure – including the level of preparedness and skilfulness to deal with basic human behavior in crisis + panicked public (and they would be PANICKED, trust me!) and dealing with the complexities of emergency response management of such massive scale (I am still using the scenario of a sentinel event here).

Let’s be honest, when this hits, we will not have few days (or a week) of luxury to watch and wait “for the water to go down to save people from their rooftops”- aka Katrina emergency response. So while perhaps almost an unlikely event – great, we won! However, should any level of this event occur and we would not respond in the right, correct and specific way – we would be in deep Katrina waters, I mean in deep troubles.

Few years back I was a part of a sentinel event disaster and emergency response exercise in a regional hospital that had a central command center set up. We are talking seasoned medical and nursing professionals who make life-or-death decisions and see things every day the rest of the population doesn’t even know they exist, and yet the underlying panic, the hesitancy to give orders, the miss-communication, and the lack of feed-back to properly assess the ongoing developments – it was eye-opening for everybody. GOOD! That’s exactly why we have these exercises and preparation sessions – to learn!

So overall, it was a successful day even though the staff did not look like “success” at the end of the day. Again, these were highly motivated, educated, experienced professionals and senior staff members in an acute care setting, you would think they know what to do in an emergency as they deal with almost every possible scenario on daily basis…
But as I was told by one old and revered ER physician in the hallway: “You know young lady, there is an emergency, and then there is an Emergency”.