Public health plans lacking, although stakes are high

Despite the 9/11 attacks and the subsequent anthrax scare, the United States, said Nicole Lurie, M.D., M.S.P.H., has become complacent about public health. “Just when we were in danger of going back to sleep we had SARS and then the nightmare of Hurricane Katrina,” said Lurie, a former official in the U.S. Department of Health and Human Services, and now an analyst at the RAND Corp.

In the 9th annual Samuel O. Thier Lecture at medical grand rounds in January, Lurie said public health preparedness lacks consistent standards, often has insufficient emergency plans and has flawed communications between health departments and providers. To assess local responses, Lurie and her colleagues phoned in feigned emergencies, such as plague symptoms, only to be told to call back later. They also conducted more than 30 table top exercises around the country. While some responders were “absolutely terrific,” Lurie said, “you see things that are really terrifying.”

Local responses are critical, she said. “A weak link is going to have major consequences for the country and the world.” Lurie called on the faculty and students to make personal preparedness plans, and to become involved with their state and local health departments in preparing for public health emergencies.