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Those of us who have been preaching pandemic preparedness for years are extremely and understandably interested to see how this entire swine flu situation unfolds. For us, the societal impact and response is almost as important (and perhaps more important) than the actual spread of the disease.

One element of pandemic preparedness and (now) mitigation is risk communication, or what you tell the public. And I am not at all sure that the government's risk communication aspect has been handled as smoothly or as honestly as it could.

Not at fault (yet) is the media. I have been very impressed with the coverage and the quality of reporting from NBC, CNN and FoxNews. Fox and NBC have relied upon Osterholm; CNN has Gupta On the Ground in Mexico City, and Fox has Geraldo warmed up in the bullpen to close. NBC's Bazell has been spot-on. These three networks have been quite good at educating the public and relating history.

These networks, however, will not "go it alone" and recommend certain actions unless and until the government does.  They are in the business of reporting news, not making policy.

What people want to know is exactly what to do right now. People are concerned-to-scared. Few people now are openly scoffing at the headlines since the WHO raised the pandemic threat level. That act by Geneva was, in and of itself, an act of risk communication.  It was an excruciatingly calibrated decision for the WHO to make. But they made it.

Why the decision-making angst in Geneva? The WHO has resisted the urge to raise the pandemic threat level for years. This blogger, along with hosts of others, have actively called for a Phase Four designation based solely on H5N1 human cases. Now, with the expansion of swine H1N1, that designation has been attained. And that is serendipitous good news for all who wanted stronger surveillance for all potential strains. Therefore, one "peace dividend" of the raising of the pandemic threat level may be to catch more human H5, H7 and H9cases.

The other dividend was clearly meant to get more Earthlings to take this threat more seriously. And that is the opening, the entree, that we cannot squander. To not use this opening that the WHO has given governments would be criminal.

So what should we be telling people? We should be telling them to prepare and to learn more about influenza. I am not talking about the Romero-esque TV commercials that the Ford Administration ordered up during the 1976 swine flu scare. I am talking about telling people to get their "hurricane kits" or "earthquake kits" restocked and brought up to speed. It is time to re-educate the American people on previous pandemics and previous near-misses, such as 1946 and 1951, with viruses that were also H1N1 but were much more virulent and, some thing, either swine-like or were actual swine influenzas that jumped the species barrier back in the day.

Telling people to buy one to two weeks' worth of food, water and medicines to prepare for hurricane season -- an annual hit-or-miss proposition with a clear historical precedent of occurrences -- is not considered folly; it is considered prudent.

Likewise, to tell people not to prepare similarly, in the face of the greatest threat to public health since SARS, also with a clear historical precedent, is equally prudent.

So why is everyone afraid to do so?

That brings up another issue: I wonder if anyone is testing this new swine flu against the antibodies of people who went through 1946 and 1951? Those people and their entire age group may be partially immune to this new strain and we may not even be aware of it. That may help explain the reason why older Mexicans and others are not falling in quantity.

By now, you should have a clear plan of action for Phase Four, Phase Five and the dreaded Phase Six. Phase Four should include beginning your "hurricane kit," or your all-hazards kit. It should include two weeks' worth of food, water and influenza and intestinal medicines and Gatorade to restore electrolytes. The Bush Administration was preaching this for three years, with not panflu threat! Emergency managers, including my very good friend and soon-to-be FEMA head Craig Fugate, have been preaching this Gospel of Personal Responsibility action item for years and years.

Why we are not telling people to do this nowis bizarre.

At some point, we need to tell people to update those kits and to prepare. To have told the American people to stock supplies from 2005 to 2008 and then NOT tell people to do so in the face of a potential pandemic sends a mixed message which is bad, bad, bad.

What I will call "cafeteria-style" preparedness also won't cut it. If you had a plan for Phase Four, stick to the plan. If that plan meant stocking, then stock. If it meant fleeing to the equator, bad timing, unless that's where you were headed anyway.

I can tell you that in my own plan, as one detail, I order a stop to all vacuuming in Phase Five. That is because vacuuming will stir up particles that had drifted to relative harmlessness on the rug, to dry out and become inert. Vacuuming reactivates those particles, kicks them up back into the air where they can be re-inhaled. Business and political leaders would do well to order the same action -- but in Phase Five.

As I mentioned in my Computerworld blog of 2008: For hurricanes and pandemics, plan one category higher.you need to assume ahead of the experts, the government spinmeisters and the virus/hurricane/calamity itself. You will never go wrong if you plan one category ahead of the approaching event.

If nothing else, you'll have a great ravioli supply for those midnight snacks if we all stand down.

FoxNews is reporting that the World Health Organization has raised the pandemic threat level from 3 to 4. This, on a scale of 1 to 6.

This is not surprising, but it is disconcerting nonetheless.  Watch the cable networks for details.  MSNBC is preapred to show the press conference live at www.msnbc.com.

Some 30 children at a Bronx day care center have been tested for swine influenza. they exhibited flu-like symptoms.

A hat-tip to Flutrackers.com poster Legatillo. Link is: http://www.ny1.com/content/top_stories/98016/cdc-confirms-swine-flu-cases-at-queens-school/Default.aspx

The alert just went up:  The State Department has said Americans should not go to Mexico unless that travel is absolutely essential.  Stay tuned to mainstream media outlets for the news.

The only area in Mexico that appeared to be unaffected by the swine flu epidemic was the Yucatan Peninsula.

Was.

The local news is reporting (with a massive tip o' the cap to Laidback Al, poster of Flutrackers.com (is that like Nick Fury, Agent of S.H.I.E.L.D. or Bob, Agent of Hydra for you Deadpool fans?), who posted the story this morning.

At first, the local authorities said they had no suspected cases of swine flu. But when the press mentioned the French tourist by name -- well, denial gets a bit tougher.

Here is the story, from Diario de Yucatan. translation by Laidback Al's computer.

Denying a suspected case of influenza in Valladolid
26/Apr/09

VALLADOLID .- Although an attempt was made to deny officially confirmed yesterday that a French tourist with symptoms of influenza remains hospitalized in the hospital of this city.

Gustavo Lastra Diaz, director of the hospital in Valladolid, denied in principle that the alien was in the hospital.

No, no, no, "said the official in question by a reporter for the Journal.

However, when mentioning the name of the French tourists changed their version and confirmed that is hospitalized.

-Tomorrow (today), and with laboratory tests, will release official said Lastra Diaz.

The French were in Chichén Itzá after staying with a fellow group of several days in Mexico City.

The biggest concern many public health and homeland security fear is that all those Spring Breakers went down to Cancun, or Acapulco, and got more than a hangover. Many of us were breathing easier when we noticed there were no cases coming out of Yucatan.

But this disclosure, especially with the disclosure that such a popular tourist destination as the Mayan ruins of Chichén Itzá might be impacted, is especially troubling.