For whatever reason, the national media haven’t quite zero-zeroed in on the realities associated with H1N1, the vax, and high-risk groups. Certainly, the tone of local and regional coverage has shifted from cautionary optimism to creeping negativity.

Life-Saving H1N1 Drug Unavailable to Most
CBS News
OR, the currently fast-tracked H1N1 vaccine has received much of a legitimate trial period to verify efficacy and safety! Yet, the H1N1 vaccine has been …
See all stories on this topic

Whether the media gets it right or wrong at this point is unlikely to make a dent in the public perception of being at the heart of something wicked this way comes.

If you were to take a pulse of America right now, I believe you’d find it in tachycardia with a hint of all-out gallop as intense fear rides on the cusp of all-out panic.

The indicators for me arrive on the hour in the form of email queries from healthcare professionals, community leaders, and emergency management colleagues wanting to compare notes on what personal steps they can take to protect themselves and their loved ones from H1.

To further confuse and confound, there are mixed messages being sent by federal, state and county health officials to the public they serve, e.g. 1020 State officials understand and share frustration associated with H1N1 vax shortages [Massachusetts].

If you ever wonder how rumor generators get primed, read this piece out of North Dakota and imagine the news being transmitted on a national game of broken telephone: 1020 DoH recommends revax of some individuals against H1N1 [North Dakota].

With so many people with functional limitations [the vulnerable at the moment] mixed into the at-risk groups, this ongoing crisis represents a significant challenge for us all. How do we ensure a fully-inclusive response?

When I’ve tried discussing H1N1 with some of my colleagues, there has been tremendous pushback with an accusation of my ‘having given in to the hype.’ The claims of hype tend to fade as more people we know are affected by a nasty bit of influenza that has a habit of going hard after the very young.

Does H1N1 represent the perfect storm with an even more devastating legacy than that of Katrina? Katrina struck the Gulf Coast and still managed to impact an entire generation, create its own diaspora and continues to have a lingering effect on millions of people. Katrina had a beginning and is still looking for an end.

H1N1 is an ongoing evolving global crisis with nothing to link it to the episodic view we have for emergency management. And unlike all those other crises occurring out there – famine, civil war, genocide, malaria, HIV/AIDS – this one is affecting us right here in our homes. So H1N1 has our rapt attention and even with all eyes on the ‘prize’ we’re still unable to manage this ongoing emergency.

Sometimes it feels as if the professionals would rather not disturb the peace with discussions focused on what happens when the victims of emergencies or the emergencies themselves don’t act in ways predicted by the plan.

Were it only so easy if disasters had neither victims nor responders but only featured rulemakers who could wear funny hats.

It’s been a long while since this happened however it seems the story continues to have a serious impact on those with whom it’s shared.

And that’s interesting in and of itself in that several colleagues have approached me recently because they’ve heard this story presented at conferences by folks other than me claiming it as their own.

Except, of course, for the part where the presenters accept responsibility for making fateful decisions because in their telling of my story this happened to ’someone they know’ or ‘an unnamed colleague’ and they proceed to dis’ him for his lack of knowledge about their community.

I was actually very familiar with the community I served.

I was the director of Cote Saint-Luc EMS in January of 1998. The City of Cote Saint-Luc was an interesting place to lead a team of emergency medical services providers. There was a very high percentage of the population who were 65 years of age and older and embedded within that considerable slice was a large community of Holocaust survivors.

Our EMS department was innovative in its outreach efforts and in its expanded scope of service that made it more of a psycho-social service than a purely emergency medical services organization.

On January 5 the freezing rain storm began to take a toll on the power grid. At 05h00 on the morning of January 6th, dispatch began to become inundated with calls for assistance. There were reports from Hydro-Quebec that some 700,000 households were without power in a large swath of southern Quebec.

On January 6 we realized evacuations were likely to become a necessity. At 11h35 we received the first of what would be many calls for medical verifications. A 75-year-old man was on a home oxygen system and plans were made for his eventual evacuation.

We were sliding further into crisis. Our calls were multiplying while available resources were shrinking. People were finding it difficult if not impossible to find a hotel room anywhere in Montreal.

From crisis we went directly into the abyss. No need to pass Go. I called for assistance from the provincial government to assist with establishing shelters for the thousands of senior citizens and medically fragile residents we were evacuating from dark, frigid, carbon-monoxide-intensive apartment buildings.

You could not measure the depth of my despair when I realized no help was coming. That feeling of profound isolation was almost immediately replaced by the realization that we would have to take care of ourselves – no cavalry would be riding over the hill to come to our rescue.

On January 7 at 10h42 our crews began the assessment of a 10-floor seniors residence. At 10h46 the transport of the first 16 evacuees from the building begins. They taken to a shelter established at City Hall. The fire department is called to the scene to ventilate the building after fumes from the emergency generators circulate throughout the hallways.

On January 8, Hydro Quebec reported 950,000 households are without power.

I made mistakes.

We had many senior-centric highrise or multi-building facilities that had to be evacuated. Given the sheer number of evacuations and the limited humans available to carry out the task, we drafted police officers to assist with these mass evacuations.

As police officers, many in tactical or bulked-up gear due to the extreme weather conditions, went door-to-door in the darkened hallways, hundreds of Holocaust survivors flashed back to a time of forced evacuations and transport to the death camps.

When bubbies and zaidies* scream.

We had, of course, unintentionally made matters worse by providing the police officers with instructions to residents to gather their essentials into a bag as quickly as possible and then make their way to the lobby where they would be loaded into buses for the ride to the shelters.

At the shelters we had the standard line-up check-in procedure. The first round of evacuations resulted in dozens of cases of severe mental trauma and more than a few syncopal episodes.

When the plans failed, we adjusted.

We adjusted by having our medics accompany the police officers on their evacuation rounds, softened the approach, used as much light as could be hauled around, brought social workers into the mix on the buses and altered the check-in procedure to include large round tables where a social worker and a medic were assigned to each table to help residents acclimate to their new surroundings.

It became more like a last-minute social gathering. Thank goodness.

On January 10th, Hydro Quebec reported 1.4 million households without power. Water had to be boiled prior to consumption.

On January 11th, the army arrived with more than 11,000 soldiers on the ground. The Abbruzzesse Family had power in their kitchen in Montreal North. Huge trays of wonderful Italian dishes were transported across the city to feed our crews. Smaller army. Just as appreciated.

I remember a satellite phone conversation with someone at an agency considering lending us a hand during the disaster. We were evacuating another 100 or so seniors from a nursing home at the time. The gentleman on the phone said they might be willing to send someone to better assess the gravity of the situation. Right at that moment a large piece of ice dropped off the top of a 20-floor building and hit a parked car on the street behind me. There was a large crash. The man on the phone exclaimed, ‘What was that?!’

My reply, ‘Hell just froze over, sir.’

Be well. Practice big medicine.

Hal

*Bubby and Zaidie are the yiddush words for Grandmother and Grandfather respectively.

by Andrew Fielden

June 15th 2009 was a strange day. Hundreds of thousands, possibly over a million, people on the streets in Iran protesting over the election results that the protesters thought had been rigged. Is this the start of a revolution? I am writing this a day later and I do not know.

What I do know is that the way it was perceived here in the west was very different to how it would have been just a year ago and that was at least in part down to twitter. During the day there were accounts that had decent claims to being genuine voices from Tehran keeping the world updated on events and managing to get photo and video files out to support their claims. So persuasive were these voices that they were getting the traditional news media to follow what they were saying almost in priority to their own on the spot journalists and traditional sources.

This was the true revolution of June 15th. As information was coming out of Iran it was being viewed by thousands and then resent (retweeted) so that it would be viewed by even more. All of this in pretty much real time and it had nothing to do with the large news agencies. In fairness to the news agencies they are beginning to catch on however there is resistance to what they see as their position as the true arbiters of quality reporting.

This is a tweet from Jeff Jarvis from the afternoon of 15th June “I emphasized to a reporter today that Twitter is not the news source. It’s a source of tips & temperature & sources. Reporting follows.” Also from his site (posted June 15th) comes the following on the way that the NY Times operates “Because The Times’ brand hinges on it as a product that has been curated and edited and checked and polished – note editor Bill Keller’s language <

http://www.buzzmachine.com/2009/06/11/aged-comedy/> on The Daily Show about his package – it finds itself in dangerous territory trying to compete in real time with those whose brand expectations are entirely different.”

According to the Bio on his site Jeff is associate professor and director of the interactive journalism program at the City University of New York’s new Graduate School of Journalism <

http://journalism.cuny.edu/> . Well I have news for you Jeff, if you think that any news organisation can get it perfectly right and polished you are deluded and yesterday provided the perfect example.This is what the editor of the curated and edited and checked and polished New York Times <

http://bit.ly/26jjrI > had to say in the early hours of June 15th.”Leader Emerges With Stronger Hand

By BILL KELLER and MICHAEL SLACKMAN

Published: June 15, 2009

President Mahmoud Ahmadinejad’s victory demonstrated that he is the shrewd front man for an elite more unified than at any time since 1979.”

Whilst you would now have to subscribe to read the article I can tell you that it was proclaiming that it was a done deal and the middle classes were in Iran were resigned to their fate. Just how wrong can you get it.

So here is the news for you Jeff and for all of those journalists who wish to believe that they are a special breed gifted with superhuman insight and the ability to distill a story for general public consumption. The twitter community and its successors will beat you to the story every time. Furthermore, they will be the people who are the experts in the field and, shock horror, they may even be able to string a sentence or two together. Then the story will be out there and if it gains a following it will spread like wild fire.

This does not mean that journalists are an endangered species, just that they are going to be changing the way they operate in the future. As with any source of information there will be the good, the bad and the disingenuous – these will need to be checked and validated.

Following on from that, there will be the need to draw in comment from other domain experts who are not necessarily directly involved in the main proceedings, for example David Miliband, the UK Foreign Minister, was interviewed on BBC Radio 4 in the morning of 16th June for the UK government’s view on the events in Iran. This could not have been done via social networking systems on the Internet.

A news organisation and the journalists working for them can act as a ringmaster in an ever changing circus of events. Constantly watching the crowd to see the news as it unfolds and vetting the shouts from the audience to allow those who have something valuable to say to step into the ring whilst at the same time getting involvement from those who can be invited directly to the ring from outside. They can then step in and lead that conversation rather in the manner of an enormous audience participation show. That, I believe is the future of journalism.