Op-Ed

We can’t wait for deadly disease to spread among us like the plague

In 2016, a groundskeeper at Pinecrest Gardens sprayed a pesticide to kill mosquitoes to help control a Zika virus outbreak.
In 2016, a groundskeeper at Pinecrest Gardens sprayed a pesticide to kill mosquitoes to help control a Zika virus outbreak. Miami Herald

Miami knows better than most what the spread of disease can do. Thousands of Chikungunya cases still plague the city, something it has in common with New York City and San Juan. The city was on guard for Zika before much of the rest of the country and its experience with biological weapons goes back to the anthrax events of 2001. The healthcare providers here in Miami and throughout the state are among the best in the nation. However, business as usual will not work against a widespread outbreak.

Former U.S. Rep. Jim Greenwood and I are taking up this issue at a meeting of the Blue Ribbon Study Panel on Biodefense on Jan. 17 at the University of Miami. We will address state, local, tribal and territorial ability to respond to large-scale biological events.

As former Secretary of Health and Human Services, I know that the federal government would move resources to affected areas throughout the United States. But those resources are already too few, and the federal government does not respond quickly to multiple locations in distress. Even if the contents of the Strategic National Stockpile are effective against a fast-moving and deadly infectious disease, continued reductions in funding for the stockpile do not make it a sole solution we can depend on. And nearby states, territories and countries likely will need their resources to treat their own people — similar to what happened when last fall’s hurricanes hit our region.

Our lives and livelihood will come down to resources — whatever we can get from the federal government, to be sure, but also the resources we already have here in the state. We will not be able to maintain the status quo when it comes to healthcare delivery, law enforcement, commerce, agriculture, critical infrastructure operations and protection, labor or transportation.

The artificial delineation between public health and all other professions will disappear. Everything will become public health.

These sorts of events are not beyond our imagination. Books, movies and television constantly illustrate the threat, our vulnerabilities, and the enormous consequences we will have to deal with. The press has made us aware of the increasing abilities on the part of our enemies to produce biological weapons designed to kill millions. We need to take up these scenarios and plan accordingly.

I am convinced that we can plan for an all-encompassing public health system before biological disaster strikes. This is not just a conversation between hospitals and the Department of Health. Every element of society needs to come to the table now.

That is why the bipartisan Blue Ribbon Study Panel on Biodefense was created — to assess the state of U.S. biodefense efforts comprehensively, and to issue recommendations to foster change. Hudson Institute serves as our fiscal sponsor. With fiscal sponsorship by Hudson Institute, our panel’s 2015 report, A National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts, identified capability gaps and recommended changes to U.S. policy and law to strengthen national biodefense while optimizing resource investments. I am proud to serve on this panel and continue to assess biodefense challenges, which is what we will be doing when we convene at the University of Miami.

We cannot decide what to do in the middle of the sort of outbreak that would require the enforcement of quarantine that exceeds law enforcement resources and the treatment of patients that exceeds hospital capacity. We need to look the biological threat squarely in the eye and prepare the state and nation to make public health its first priority.

Donna E. Shalala is a former U.S. secretary of Health and Human Services and former president of the University of Miami.

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