Journal of Homeland Security and Emergency Management - Preparing for the Real Storm during the Calm: A Comparison of the Crisis Preparation Strategie

[Giuseppe]

Journal of Homeland Security and Emergency Management - Preparing for the Real Storm during the Calm: A Comparison of the Crisis Preparation Strategies for Pandemic Influenza in China and the U.S.

Preparing for the Real Storm during the Calm: A Comparison of the Crisis Preparation Strategies for Pandemic Influenza in China and the U.S.

Zongchao Peng, Tsinghua University

Abstract

Humanity is facing the rapid spread of avian flu and the potential severe threat of a future global pandemic flu.

The World Health Organization (WHO) and the governments of various countries and regions have proposed plans for managing a pandemic flu.

China and the U.S. also issued their own preparation plans in September and November, 2005, respectively.

This article asks whether there are vulnerabilities or shortcomings inherent in either preparation plan, and if so, what measures should be taken to improve them.

The article first provides a theoretical analysis of the issues of crisis preparation, chiefly from the perspective of a real crisis.

Second, it does some crisis analysis of a pandemic flu and proposes preliminary preparation strategies to deal with it.

More importantly, it compares the United States and China concerning their crisis preparation strategies, including the process of forming strategies, cognition of risks, choices of goals, basic principles, framework, and implementation.

Finally, it concludes by making some suggestions for crisis policy formulation regarding a pandemic flu.

Recommended Citation
Peng, Zongchao (2008) "Preparing for the Real Storm during the Calm: A Comparison of the Crisis Preparation Strategies for Pandemic Influenza in China and the U.S.," Journal of Homeland Security and Emergency Management: Vol. 5 : Iss. 1, Article 47.

Available at: http://www.bepress.com/jhsem/vol5/iss1/47​

<cite cite="http://www.bepress.com/jhsem/vol5/iss1/47/">Journal of Homeland Security and Emergency Management</cite>

 

[Giuseppe]

Re: Journal of Homeland Security and Emergency Management - Preparing for the Real Storm during the Calm: A Comparison of the Crisis Preparation Strategies for Pandemic Influenza in China and the U.S.

An excerpt:

INTRODUCTION
Our world is faced with the rapid spread of avian flu among wild species and the potential severe threat of a future global flu pandemic among humans.

In response, the World Health Organization (WHO, Aug. 2005) and many countries have formulated plans to prepare for potential pandemic flu.

In 2005, China and the U.S. issued specific plans according to the requirements of the WHO.

As two of the largest and most influential countries in the world, China and the U.S. will surely play critical roles in the global strategy to prepare for a pandemic flu.

Are they fully prepared?

It is highly important to identify any strategic vulnerability or shortcoming in the plans of these crucial countries.

Moreover, should strategic vulnerabilities exist, how should these two nations deal with them?

Recently, there have been many discussions about pandemic flu in the medical and health fields, but there have been only a few academic studies on the preparation for pandemic flu in the U.S., mainly from the perspectives of public health (Whitley, et al., 2006), social psychological and behavior adaptation (Reissman, et al., 2006), and risk management (Achampong, 2007).

Also, there have been some research on pandemic flu preparation in China (Zeng, 2005; Cui, 2006), and there are a few basic comparisons of the preparation in the U.S. and China (MOH/CDC/Information Center, 2005; Li, et al., 2006), mainly from the perspective of public health.

Still, there is a lack of specific comparative research on the entire preparation strategies for pandemic flu in the U.S. and China from the perspective of what would happen during a real crisis (see the later definition).

This paper first analyzes crisis preparation from the theoretical erspective of a real crisis, presenting a general framework for understanding crisis events and response.

Second, it discusses the potential crises of pandemic flu and the possible
basic preparation strategy for it.

Third, it compares the strategies of the U.S. and China, in particular their policy formulation process, risk cognition, choices of goals, basic principles, framework contents, and implementation.

Finally, the paper offers conclusions and suggestions for the strategic policy-making for pandemic flu of both countries.

CONCEPTUAL AND THEORETICAL ANALYSIS
Crisis management has attracted increasing attention in recent years from
policymakers and academics alike (Pearson & Clair, 1998; Burnett, 1998; Xue, Zhang & Zhong, 2003; Boin, Hart, Stern & Sundelius, 2005).

However, confusion remains over basic concepts, such as crisis, crisis management and routine emergency, emergency management and emergency preparedness.

Only a few research publications have clarified the differences between disaster and catastrophe (Quarantelli, 2005), and the differences among normal response, routine emergency and crisis (Leonard & Howitt, 2007).

However, these studies do not address the issue of a potential disaster or crisis, and the issue of how a real crisis develops from normal problem, potential crisis and routine emergency.

This paper will first give a primary analysis of crisis and crisis preparation from the perspective of a real crisis.
(...)
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[Giuseppe]

Re: Journal of Homeland Security and Emergency Management - Preparing for the Real Storm during the Calm: A Comparison of the Crisis Preparation Strategies for Pandemic Influenza in China and the U.S.

Another excerpt:

(...)CRISIS ANALYSIS AND STRATEGY DESIGN
As we know, pandemic flu is a kind of influenza (flu), but is not the same as seasonal flu and the avian or bird flu.

It usually occurs from a new variant of the human flu virus, with the potential for global outbreak due to the high transmissibility between human populations.

It can result in severe human illness and even death because of the lack of natural immunity against the new virus.

In recent years, some scholars have become worried that the coming pandemic flu might result from the possibly further changed highly pathogenic H5N1 avian flu virus or a new one combined with H5N1 and other sub-viruses among animals or humans (Thorson & Ekdahl, 2005).

The H5N1 virus is highly infectious among wild and domestic birds, and has affected humans since the Hong Kong case in 1997.

It is particularly worrisome because it has caused a high death rate for
humans (over 63% up to June 19, 2008).

There have been many occurrences of pandemic flu throughout history, but none in recent years. Historically, pandemic flu has broken out once every 10-50 years with an average of every 30-40 years, and the last outbreak appeared in 1968 (Patterson, 1986; WHO, Jan., 2005).

After 40 years, it is reasonable to expect another pandemic flu occurrence soon.

How severe is the threat of future pandemic flu to the human population?

Seasonal flu causes 250,000 to 500,000 deaths globally each year. After analyzing the history of pandemic flu, the WHO estimates that 25%-35% of the global population may be infected during an outbreak, and a death toll of 2 million to 7.4 million would be a relatively mild estimate (WHO, Jan., 2005), with modest and severe estimations of 14 million and 142 million people, respectively (McKibbin & Sidorenko, 2006).

Experts from the Norwegian University of Life Sciences (Christophersen et al., 2006) offered their worst estimation that mutated H5N1 could be one monster with four heads: one head represents a death toll like that of
the pandemic flu in 1918, and four heads mean the monster could cause 98-99% human fatality (at least in poor countries with less than optimal nutrition).

Moreover, present vaccines cannot prevent pandemic flu. Usually after a flu virus is identified, it takes months to produce vaccine (WHO, Jan., 2005, pp. 31-35).

Therefore, the limits of existing medical science mean that it would be unrealistic to rely on the timely availability of vaccine and antiviral drugs in the early stages of pandemic flu.

In fact, the most realistic measures include containment and a reduction of social gatherings, but these measures could cause a series of derived
and transportation, which directly endanger economic function and social life.

Regarding the economy, some experts estimate that pandemic flu would cause a 0.8%-12% loss of GDP in a year for some countries (or conceivably 50% or more in the most severely affected countries) (McKibbin & Sidorenko, 2006).

Even in a mild case of pandemic flu, the rapid spread of inaccurate and incomplete information could amplify the negative effects of the core risk event (World Economic Forum, etc., 2007).

Figure 1, illustrating the paths of development of a potential pandemic flu crisis and the overall preparation strategy for it, provides a framework for a comparative empirical analysis of the U.S. and China.

The core area of Figure 1 shows the pandemic flu crisis, its derived crises and their origins, occurrence and development process. This can be divided into three simplified stages:

In Stage 1, pandemic flu has not yet occurred but threatens. It can be said to be in a ?pre-occurrence? phase. In this stage, animals and some humans are infected with avian flu virus H5N1, but H5N1 has not mutated so as to be easily transmitted among humans and hence is a limited threat. Nor has another human flu virus emerged to cause a pandemic. Nonetheless, the threat of pandemic flu ? whether caused by N5N1 or some other virus ? remains a serious one. Humanity must still be ready for new flu viruses, which are constantly evolving. The possibility of pandemic remains a major challenge to emergency management.

In Stage 2 pandemic flu has occurred and there is a global transmission. It usually has two potential trajectories of human infection and death: a low and a relatively high rate. If it is the former case, we will only need to consider it as a routine emergency. But if it is the latter case, we will have to consider it as a real crisis and pay much more attention in advance to it.

Stage 3 is the post-occurrence of pandemic flu, in which a severe pandemic flu has caused further crises, mainly concerning the economy, social order, political stability, and international relations. The economic crisis will mainly involve severe damage to normal economic processes, such as reduced production, changed consumption, altered markets, industrial crises, and so on. Social crisis will include serious social panic and unease, loss of normal gathering and social activity, degraded public safety, etc. Political crisis would mostly occur as public dissatisfaction with the government for its improper actions, policies and bad performance, and thus the reputation and image of the government could be destroyed. A crisis in international relations, which could be neglected, will chiefly concern aggravated international distrust over information sharing, fighting for scarce resources, and isolating affected individuals, including foreigners. (...)

 

[kent nickell]

Re: Journal of Homeland Security and Emergency Management - Preparing for the Real Storm during the Calm: A Comparison of the Crisis Preparation Strategies for Pandemic Influenza in China and the U.S.

Some more exceprts..

a real crisis in public affairs can be defined as: an urgent high threat to our social values with high uncertainty (Rosenthal, 1989) or novel characteristics (Leonard & Howitt, 2007).

Crisis preparation depends on but differs from routine emergency preparation. It emphasizes figuring out not only the routine emergency situation but also the worst real crisis situation, and conducting not only routine preparation but also non-routine readiness for a real worst-case scenario. Routine preparation only needs to satisfy routine emergency requirements using institutional means, while crisis preparation needs to consider the maximum requirements of a worst-case situation, and sometimes the minimum requirements of the mildest-case situation because of the high uncertainty of a crisis.

First of all, the best crisis preparation requires planning for the worst situation as well as the mildest situation.

Second, the best crisis preparation should consider the reasonable distribution of preparation costs among the government, market and society
.
Third, the best crisis preparation should occur as early as possible before a crisis or its derived crisis happens
.
Lastly, the best crisis preparation should include institutional arrangements as well as necessary non-institutional or flexible action plans.

Some experts have argued that established ways of organizing for critical decision-making would not suffice in the case of a catastrophic breakdown due to both the changing nature of the crisis and the stress of the immediate aftermath. An effective response would depend on the adaptive behavior of the citizens, front-line workers and middle managers (Boin & Lagadec, 2000; Boin & McConnell, 2007). Therefore, the existing institutional crisis preparation strategyafford on-the-ground managers the flexibility to adopt some non-institutional or completely new procedures or methods and to prepare for the novelty of a real crisis. Otherwise, crisis preparation might be the same as routine emergency preparation and could inevitably fail to efficiently deal with the challenges of the novelty of a real crisis.

The influence of traditional risk psychology and culture (Elsubbaugh et al., 2004) might be one of the most important independent factors. The traditional risk psychology and culture chiefly include the psychology of believing in good luck, the culture of wishful thinking, and the hidden rules of reporting not bad but good news in bureaucratic politics. With the influence of the former two traditions, many people usually care only about current risks, ignoring future risks because they do not represent a pressing threat. Also, they likely neglect low probability risk that has high threat, both at present and in the future; they are apt to have expectations of good luck rather than bad luck or may believe that bad luck will happen only to others. Additionally, if accountability is not clear and strict in the governmental culture, this may cause the bureaucracy to hide some risk information and delay crisis warning to upper government and the public,. Therefore, earlier and better crisis preparation is difficult to attain for both the government and the public.

US-NHC (2005, p.2) set three goals in its NSPI: (1) Stopping, slowing or otherwise limiting the spread of a pandemic to the United States. (2) Limiting the domestic spread of a pandemic and mitigating disease, suffering and death. (3) Sustaining infrastructure and mitigating impact to the economy and the functioning of society. These goals were obviously set up in light of the expected occurrence and development process of a pandemic flu crisis as shown in Figure 1. However, there seems to be a problem within the goal setting of the U.S., which has assumed that the pandemic will emerge first in other countries, and not in the U.S. This risk of a pandemic beginning in the U.S. is very small, but not completely nonexistent. Therefore, from the lesson of the lack of readiness for the Sept.11 terror incident in the U.S. in 2001, it is reasonable to worry about the possible huge cost if the U.S. is especially since a flu pandemic would be most detrimental to the country of origin because of its unexpectedness.

In my point of view, the biggest challenge to American emergency or crisis management would be the difficulties of coordinating the decentralized system of the U.S. Facing an uncertain and new threat of pandemic flu in the future, the US-NSPI has chiefly played a guidance role without strict compulsion for states and local governments, which legally have autonomy. Therefore, it remains to be seen whether all levels of government and all social sectors in the U.S can prepare for and respond to a flu crisis in accordance with the requirements of the federal government. In the 1918 pandemic flu, the states and cities performed very differently.5 In the 2005 Hurricane Katrina response, it became clear that New Orleans and other cities actually had very different performance because of their different preparatory coordination among their cities, states and federal government (Howitt & Leonard, 2006)

China should first update its current MOH preparation plan for pandemic flu, by having detailed crisis awareness about pandemic, paying much more attention to international cooperation, and noting the limitations of medical science and technology. Second, as soon as possible, it should improve its departmental strategy with an integrated strategy nationally and locally. Third, it should have the strategic goal of coordinating multiple actors, and should afford some supervision and guidance to them to draft and implement various detailed preparation and response plans for pandemic flu. Fourth, it also should carry out scientific, transparent, and efficient strategies in public communication and citizen education, especially to enhance civic risk education, release epidemic information in a timely and exact manner, and build a governmental accountability mechanism to avoid the traditional hidden rule of reporting only good news (For detailed policy suggestions, please see Peng, 2007.)

This paper was originally finished while the author was an Asia Programs fellow of the Mossavar- Rahmani Center for Business & Government (CBG), John F. Kennedy School of Government(KSG), Harvard University during Aug. 2006-Aug. 2007. It was presented at the ninth annual Tufts University Cross-Cultural Leadership Symposium on "Asia's Rising Giants: China and India"on Feb. 22-25, 2007 and at the 2007 International Conference on Crisis and Emergency Management Proceedings at Chungbuk National University, South Korea during Nov. 8-11, 2007.This research was co-sponsored by the 1:1 program for youth cadre talents of the China Scholar Council; the New World Fund of the School of Public Policy & Management (SPPM), Tsinghua University; the program of the coordination mechanism for governmental crisis policy-making in transitional China of the Natural Science Foundation of China; the research program of the coordination mechanism for urban departmental crisis policy-making of the Beijing Social Scienc Planning Office; and the research program of the Beijing economic emergency plan of the BeijingDevelopment and Reform Committee