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From Hysteria to Complacency, Then Back Again


I would like to remind DomPrep readers that the subject of pandemic is not new to us. Searching the word pandemic on reveals over 500 articles published on this topic. (As a reminder, click the small magnifier icon to open a search field.) I trust the panic and hysteria presented in the general media is not affecting local and state DomPrep readers too much. You are on the firing line, maintaining preparedness and resilience. Remember, only a couple weeks ago in the poll and comment report, 54% felt federal agencies were not able to fulfill their Emergency Support Function (ESF) roles and responsibilities in the current environment. So the current situation should not be a surprise to anyone.

Let’s also remember the axiom, “Don’t let a serious crisis go to waste.” Review Jim Rush’s recommendations presented in this article and pressure your leadership to break the hysteria-complacency cycle as we move forward.

Martin (Marty) Masiuk


With recent urgent stories about the coronavirus, it seemed to be just a matter of time for the nation to revert to hysteria. Instead of a calm, resolute culture of preparedness, there has been a “PowerGlide” of public sentiment. In the 1960s, many Chevrolet automobiles had a PowerGlide transmission with just two gears: low gear and high gear. Similarly, in the past eight years, society has had two collective mental gears: complacency and hysteria.

The fact is, it is too late to worry if the current coronavirus manifests into a worldwide pandemic. Supply chains are already being negatively affected. If the medical supply chains are impacted due to diminished supplies of cotton, N-95 facemasks, personal protective equipment (PPE), and generic pharmaceuticals, it may be a harrowing year in the United States. Thankfully, the Chinese government claims its manufacturing is coming back online. Things could improve and stay that way in the U.S. medical supply chain.

Sudden Changes in Gears

Prior to 9-11, the nation was in the complacent gear. Afterward, there was significant fear of subsequent attacks, so the nation transitioned immediately into the hysteria gear. Despite the high likelihood that there would be another attack, soon after 9-11, the nation reverted to its default gear of day-to-day business as usual (complacency gear again). Since then, little has been done to significantly improve the overall state of readiness to manage another 3,000-casualty event, let alone a 100,000- to 300,000-casualty event such as a 10-kiloton detonation on a population center or a 10-million-patient pandemic. Not thinking about it is the nation’s Achilles heel.

In 2005, thousands of people suffered and died during hurricane Katrina. Some with disabilities were slumped down dead in wheelchairs outside storefronts. Nurses were crying on hospital rooftops as they manually ventilated patients and waited for a medical evacuation helicopter. Bodies floated down streets in New Orleans – an American city, with corpses in the water.

The Centers for Disease Control and Prevention (CDC) has been saying for years that it was a matter of when and not if there would be a pandemic. Currently, there are just under a hundred thousand ill people around the world who have experienced far fewer deaths than the U.S. experiences in a normal flu season and yet people are about to dust off their living wills.

Shifting Into Overdrive

What is needed is a third gear – an “overdrive” that will take the nation into the future:

  • Develop plans based on actual capacities and capabilities of the healthcare organization, jurisdiction, or region to take care of real casualties.
  • Develop supply and equipment lists of all classes of materials – including mobile hospitals similar to the packaged disaster hospitals of the Civil Defense era – that people need for professional medical care and sheltering.
  • Ask the U.S. Department of Health and Human Services or U.S. Department of Homeland Security to purchase and manage these critical assets as federal reserve inventories.

Shifting between hysteria and complacency does not work. What is needed is a third gear – an “overdrive” that will take the nation into the future.

  • Look at the planning scenarios derived from the jurisdiction’s hazard vulnerability assessment and plan for the scenarios that will most likely occur.
  • Ensure packaged disaster hospitals that are supplied and equipped with 60 days of medical and nonmedical items without resupply.
  • Re-establish the Defense Logistics Agency’s war/contingency reserve medical inventories (Federal Reserve Inventories or FRI).
  • Revamp FRI with items that were drained as a part of the “peace dividend” of the 1990s, including food, water, medical supplies, equipment, pharmaceuticals, and PPE.
  • Enhance the Medical Reserve Corps (MRC) by contacting retired nurses, certified nursing assistants, physicians, laboratory and radiology technicians, respiratory and physical therapists, retired hospital support staff, psychiatrists, psychologists, and independent practice nurses to determine if they want to be a part of a revamped and very operationally active and paid MRC.
  • Connect communities and develop an effective disaster-ready community response. After all, the model in the Strategic Petroleum Reserve already exists.

If the nation can muster the will, good stewardship, and the funding to increase the national readiness posture, the first few steps can be taken toward full readiness to save hundreds of thousands of lives during the next manmade or natural disaster. It is too late for the current COVID-19 should it develop in the United States. However, if it does, it will stand as the “day complacency died” in America.

The nation needs to know that it did all that it could have done in preparing when the really big next one emerges. An extra gear needs to be inserted into the current two-speed culture. This gear is known as the readiness gear. Start shifting!

James M. Rush Sr.

James M. Rush Sr. has over 45 years of healthcare administration and community emergency management experience in the U.S. armed forces, the U.S. public-health community, and the nation’s civilian healthcare industry. He served as the Region III project officer for the National Bioterrorism Hospital Preparedness Program, and the CDC’s National Pharmaceutical Stockpile, always dedicated to assisting healthcare and public health organizations prepare for “all hazards” events and incidents. He is author of, among other published works, the “Disaster Preparedness Manual for Healthcare Materials Management Professionals,” and a self-published book “Unprepared.”



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