You Can't Pick Your Poison

At an afternoon session on the preparedness of state health care systems to respond to a disaster, a facilitator from the National Conference of State Legislatures asked representatives from about 10 states how many believed that their states were prepared, based on communications planning and procurement, to respond to a large scale catastrophe. Many hands went up, but then one member of the group asked what kind of disaster she had in mind.

The facilitator responded by suggesting a pandemic Avian flu outbreak, and all of the hands quickly dropped. As nervous laughter spread across the room, someone said, "You gave the wrong kind of disaster."

In spite of that rather disheartening moment, the session was largely encouraging, as various persons spoke of lessons learned in the aftermath of hurricane Katrina. While some of the criticisms were interesting, it was perhaps even more enlightening to hear state officials note that they had learned that the "top-down" model (federal-state-local) of disaster planning and response did not work. Instead, they are now emphasizing the importance of local planning as foundational, with state and then federal planning being of supplemental importance.