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I just read a Tweet from my buddy Mike Coston, aka FLA_MEDIC, blogger of great repute at Avian Flu Diary. He mentioned an article in Nature by Dr. Peter Sandman, one of the world's leading risk communication experts. I encourage you to follow the link and read it now. I'll wait.

OK, welcome back. Didn't that all sound familiar? Having deja vu? that is because it sounds similar to my blog of April 28th, titled Mixed messages, cafeteria-style preparedness won't cut it in swine flu fight. In that blog, I cover many of the same themes. But Dr. Sandman puts things much more succinctly and with much greater gravitas than I ever could.

I met Dr. Sandman in February 2007 in orlando at the CIDRAP pandemic conference. The man and his work are both highly valued and woefully underutilized, I am afraid.

The thing I most remember about then-HHS Secretary Mike Leavitt, a former governor of Utah, is his suggestion -- painfully repeated over and over and over again -- that the easiest way to stock up for a pandemic was "When you go to the store to buy tuna, for every three cans you buy, get a fourth and put it under the bed." Overall, the entire Bush Administration message on pandemic preparedness was (uncharacteristically) clear, sensible, and sage. It was borne of Bush's own reading of John Barry's seminal work The Great Influenza," THE history of the 1918 pandemic.

President Obama's administration seems to have completely disregarded the role that concise risk communication must play in effective management of a flu pandemic. The role of individual responsibility needs to be played up, not downplayed in favor of "nothing to see here, move along." the American people can take it: Tell them exactly what they need to hear. Especially the part they never want you to hear: government can do very little to ensure your personal safety or health during a flu pandemic. That itself may be anathema to their way of thinking, but the truth is the truth.

From Dr. Sandman's article:

Richard Besser, the acting director of the CDC, isn't understating the risk. He says he is "very concerned", but expresses his concern with a soothing bedside manner. He doesn't have that rumpled, exhausted emergency-manager look that the Nuclear Regulatory Commission's Harold Denton perfected in the 1979 Three Mile Island crisis. Denton left people feeling that the risk was serious and that they were in good hands. Besser says it is serious but leaves us feeling that he doesn't want us to worry much.

Still, I don't fault Besser for looking and sounding reassuring. Good crisis communication means saying alarming things in a calm tone, and he is doing exactly that.

The problem is that he isn't giving us anything to do except being hygienic. He keeps telling us, accurately, that the CDC is being aggressive in its response to the outbreak. But he is not asking the public to take further action. He needs to urge citizens, schools, hospitals and local governments to follow Leavitt's advice.

Instead, we have a surreal situation in which the federal government has released one-quarter of the Strategic National Stockpile of antiviral drugs, so there will be enough oseltamivir (Tamiflu) to deploy to millions of sick Americans. But it hasn't yet asked those Americans to stock up on tinned fruit and peanut butter.

It's time to talk peanut butter, tuna and bottled water. But not for swine H1; for any calamity. As I said in my late April blog:

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.

Great minds think alike.  Thank you for a great article, Dr. Sandman.