Iowa Public Television

 

Patricia Quinlisk and Tommy Thompson

posted on December 5, 2005

Borg: HOPING FOR THE BEST; PREPARING FOR THE WORST. IOWA JOINS THE NATION IN ANTICIPATING NATURAL DISASTERS AND THE POSSIBILITY OF PANDEMIC DISEASE. AN UPDATE ON IOWA'S PREPAREDNESS FROM STATE EPIDEMIOLOGIST PATRICIA QUINLISK AND RETIRED IOWA NATIONAL GUARD GENERAL TOMMY THOMPSON ON THIS EDITION OF "IOWA PRESS."

FUNDING FOR "IOWA PRESS" WAS PROVIDED BY "FRIENDS," THE IOWA PUBLIC TELEVISION FOUNDATION; AND BY THE IOWA BANKERS ASSOCIATION... FOR PERSONAL, BUSINESS, AND COMMERCIAL NEEDS, IOWA BANKS HELP IOWANS REACH THEIR FINANCIAL GOALS.

ON STATEWIDE IOWA PUBLIC TELEVISION, THIS IS THE FRIDAY, DECEMBER 2 EDITION OF "IOWA PRESS." HERE IS DEAN BORG.

Borg: SINCE 9-11 THE NATION HAS BEEN PREPARING TO COPE WITH THE POSSIBILITY OF A BROAD SPECTRUM OF POSSIBILITIES. DEALING WITH HURRICANES, EARTHQUAKES, FLOODS, AND OTHER NATURAL DISASTERS ADD TO THE CHALLENGE. AND NOW EVEN THE COMMON FLU AND THE POSSIBILITY OF A HIGHLY VIRULENT FLU IS MOBILIZING RESEARCHERS AND DISASTER EXPERTS. THE QUESTION IS: ARE WE READY? WE'RE ASKING TWO IOWA-BASED EXPERTS FOR PERSPECTIVE TODAY. DR. PATRICIA QUINLISK, FORMERLY OF THE CENTERS FOR DISEASE CONTROL, IS THE STATE'S EPIDEMIOLOGIST AT THE IOWA DEPARTMENT OF PUBLIC HEALTH. GENERAL TOMMY THOMPSON IS RETIRED AFTER A 43-YEAR MILITARY CAREER. HE HEADED THE IOWA NATIONAL GUARD DURING THE 1993 FLOODS, AND HE'S KNOWN FOR HIS EXPERTISE IN DISASTER PREPAREDNESS. WELCOME TO "IOWA PRESS." IT'S NICE TO HAVE YOU HERE TALKING ABOUT PREPARING FOR SOMETHING RATHER THAN HOW ARE WE GOING TO REACT TO SOMETHING THAT'S ALREADY HERE. ACROSS THE "IOWA PRESS" TABLE: "DES MOINES REGISTER" POLITICAL COLUMNIST DAVID YEPSEN AND "ASSOCIATED PRESS" SENIOR POLITICAL WRITER MIKE GLOVER.

Glover: GENERAL THOMPSON, LET'S START WITH YOU AND LET'S START WITH A FUNDAMENTAL BASIC TYPE OF A QUESTION. THE LAST MAJOR NATURAL DISASTER IOWA SUFFERED WAS THE FLOODS OF 1993. ARE WE READY FOR ANOTHER NATURAL DISASTER?

Thompson: WELL, THAT'S -- THE NATURE OF A DISASTER IS ALWAYS A BIT DIFFICULT TO ANSWER, BECAUSE AT THIS POINT IF IT WAS A FLOOD OR IF IT WAS A TORNADO, I WOULD SAY THE ANSWER TO THAT IS YES. WHEN WE START TALKING ABOUT A PANDEMIC, WE OPEN THE DOOR TO A COMPLETELY DIFFERENT TYPE OF EMERGENCY RESPONSE. AND THAT I WOULD SAY WE PROBABLY ARE NOT READY AT THIS POINT TO REACT TO IT.

Glover: DR. QUINLISK, THAT OPENS THE DOOR TO YOU. THE PANDEMIC THAT EVERYONE TALKED ABOUT IS AVIAN FLU.

Quinlisk: RIGHT.

Glover: EVERYONE IS TRYING TO PREPARE FOR THAT. WHERE ARE WE IN THE PREPAREDNESS FOR THAT?

Quinlisk: WELL, THE THING ABOUT ANY KIND OF PLAN IS THERE'S LOTS OF DIFFERENT PIECES.

Glover: SURE.

Quinlisk: OBVIOUSLY THE PIECE OF PUBLIC HEALTH BECOMES VERY IMPORTANT WHEN YOU'RE DEALING WITH SOMETHING LIKE PANDEMIC FLU. WE DO HAVE A PLAN. THE EXECUTIVE SUMMARY ACTUALLY IS ON OUR WEB SITE, IF ANYBODY IS INTERESTED. AND IN OUR PLAN, WE TALK ABOUT ALL OF THESE PIECES. BUT I THINK AS THE GENERAL SAID, NO PLAN IS EVER COMPLETE BECAUSE AS TIME GOES ON YOU LEARN MORE AND MORE AND SO YOUR PLAN SORT OF EVOLVES ALSO.

Glover: IF YOU LOOK AT THAT SORT OF HISTORY OF THESE FLU PANDEMICS, WE'RE DUE FOR ONE, AREN'T WE?

Quinlisk: RIGHT. THEY COME ABOUT THREE TIMES A CENTURY, AS NEAR AS WE CAN TELL. AND WE'VE NOT HAD ONE SINCE THE '60S. SO YOU COULD SAY THAT WE'RE PRETTY MUCH DUE FOR ONE ANY TIME NOW.

Glover: SO WHETHER IT'S THE AVIAN FLU OR SOME OTHER VARIATION OF THAT, IT'S LIKELY TO HAPPEN.

Quinlisk: WELL, IT'S LIKELY TO HAPPEN BUT, OF COURSE, THE QUESTION IS WHEN IS IT GOING TO HAPPEN, AND THAT'S THE QUESTION THAT WE DON'T HAVE AN ANSWER TO. IT COULD BE A COUPLE YEARS FROM NOW. IT COULD ACTUALLY BE FIFTY YEARS FROM NOW. WE JUST DON'T KNOW.

Yepsen: GENERAL, I WANT TO GO BACK TO THE QUESTION OF IS IOWA PREPARED. WE'RE TALKING ABOUT ALL DISASTERS AS WELL AS PANDEMICS HERE. IS IOWA PREPARED FOR AN EARTHQUAKE? WE SIT NEAR THE NEW MADRID FAULT. WE HAD AN EARTHQUAKE IN THIS COUNTRY IN 1813. HOW DO WE KNOW THAT WE'RE PREPARED FOR DISASTERS?

Thompson: WELL, NORMALLY THERE'S A SERIES OF PHASES THAT OCCUR IN PREPARING. THE FIRST IS YOU PUT TOGETHER A TASK FORCE THAT BRINGS ALL OF THE AGENCIES TOGETHER THAT ARE INVOLVED IN A RESPONSE, LIKE, FOR EXAMPLE, EARTHQUAKE. AND YOU LOOK AT THE VARIOUS AGENCIES, THEIR CAPABILITIES, AND YOU ORGANIZE TO RESPOND TO THAT EMERGENCY. NOW, THERE'S BEEN A LOT OF WORK DONE AROUND TORNADOES, AROUND FLOODS BECAUSE WE'VE BEEN THROUGH THOSE. AN EARTHQUAKE PROBABLY OPENS A NEW DOOR THAT PEOPLE DON'T CONSTANTLY PREPARE FOR. AND SO -- AND OBVIOUSLY THERE ARE CERTAIN RESPONSE AGENCIES OUT THERE, LIKE THE D.O.T., THE NATIONAL GUARD, AND YOUR HEALTH -- MEDICAL INSTITUTIONS, THAT ARE ALL TIED TOGETHER TO RESPOND TO AN EMERGENCY LIKE THAT.

Yepsen: HOW DO YOU -- GENERAL, HOW DO WE KNOW THAT WE'RE PREPARED? I MEAN DAVENPORT, FOR EXAMPLE, FOR YEARS DIDN'T HAVE A FLOOD WALL AND THEY'D GET FLOODED AND THEN PEOPLE WOULD SAY THEY SHOULD HAVE BEEN PREPARED. HOW -- YOU KNOW, IT WAS OBVIOUS THAT DES MOINES WATER WORKS WAS NOT PREPARED FOR THE FLOOD OF '93. HOW DO WE KNOW THAT WE'RE PREPARED FOR A TORNADO, A FLOOD, AN EARTHQUAKE?

Thompson: I THINK WHAT IT TAKES, DAVID, IS A CONSTANT REVIEW OF THE PLANS AND LOOKING AT ALL OF THOSE ALTERNATIVE VENUES AND ENSURING THAT YOU'VE GOT AN ACTIVE, ONGOING PLAN OUT THERE FOR EACH TYPE OF POTENTIAL DISASTER THAT YOU COULD EXPECT.

Glover: GENERAL THOMPSON, I'D LIKE TO PROBE INTO WHAT IS THE ROLE OF GOVERNMENT IN DEALING WITH THESE DISASTERS. I REMEMBER TALKING TO SOMEONE. DAVID MENTIONED DAVENPORT NOT HAVING A FLOOD WALL. I REMEMBER TALKING TO A GUY THAT LIVED ALONG THE MISSISSIPPI RIVER IN DAVENPORT WHO WAS FLOODED OUT, AND I WAS ASKING HIM HOW MANY TIMES THIS HAD HAPPENED. IT HAD HAPPENED LIKE FOUR TIMES. I SAID, "DO YOU HAVE FLOOD INSURANCE?" HE SAID, "NO. WHY WOULD I? I GET FLOODED AND THE FEDERAL GOVERNMENT REBUILDS MY HOUSE."

Thompson: THAT'S RIGHT.

Glover: WHY SHOULD WE DO THAT?

Thompson: WELL, IN FACT, AFTER THE FLOODS OF '93, I WENT INTO CONGRESS TO TESTIFY ON THIS EXACT ISSUE. THE PROBLEM IS THAT THE GOVERNMENT IS A LITTLE TOO QUICK, IN MY MIND, TO COME IN AND TO RESPOND TO BAILING PEOPLE OUT. IF YOU BUY A HOME IN A FLOODPLAIN, YOU'RE REQUIRED TO TAKE OUT FLOOD INSURANCE IN ORDER TO GET THE MORTGAGE ON THE HOME. BUT THAT'S ONLY ENFORCED AT THE TIME OF THE ACQUISITION. ONCE THE PURCHASE IS MADE, AFTER A YEAR, YOU LET THE FLOOD INSURANCE EXPIRE, AND THAT'S WHAT HAPPENS. AND THEN THE FEDERAL GOVERNMENT ALWAYS COMES ALONG AND GOES IN AND PROVIDES THE EMERGENCY AID TO THOSE INDIVIDUALS THAT WERE FLOODED OUT. SO THERE'S REALLY A MOTIVATION THERE TO NOT EVEN WORRY ABOUT HAVING FLOOD INSURANCE.

Borg: DR. QUINLISK, AS STATE EPIDEMIOLOGIST, ARE THERE CERTAIN CHARACTERISTICS ABOUT IOWA THAT MAKE YOUR JOB MORE CHALLENGING OR DIFFERENT FROM OTHER STATES? AND REALLY WHAT I'M GOING TO ASK ABOUT HERE IS IOWA'S LARGE NUMBERS OF LIVESTOCK, POULTRY AND HOGS PARTICULARLY. WE'VE HEARD ABOUT THE SWINE FLU. I'M WONDERING DO LIVESTOCK AND LARGE CONCENTRATIONS OF LIVESTOCK MAKE IT MORE CHALLENGING?

Quinlisk: WELL, OF COURSE, EVERY STATE IS GOING TO BE UNIQUE IN ITS PEOPLE AND WHAT ITS ECONOMIC BASE MIGHT BE DEPENDENT UPON. ONE OF THE THINGS IN IOWA, THOUGH, IS WE DO HAVE A LARGE NUMBER OF ANIMALS. AND OF COURSE, THERE'S ALWAYS CONCERN ABOUT ANIMAL TO HUMAN SPREAD OF DISEASE. BUT ONE OF THE THINGS THAT WE'RE VERY DIFFERENT THAN SAY, ASIA, IS IN ASIA INDIVIDUALS ALL OWN THEIR OWN CHICKENS IN THEIR BACK YARD. IN IOWA WE HAVE CHICKENS BASICALLY IN LARGE INDUSTRIAL FARMS THAT ARE A LITTLE BIT EASIER THEN TO BLOCK OFF, TO HAVE BARRIERS, ET CETERA. SO NOT ONLY DO WE HAVE A WAY OF PROTECTING PEOPLE FROM GETTING DISEASES FROM ANIMALS, BUT ALSO FROM THOSE ANIMALS GETTING DISEASES FROM PEOPLE. SO IN SOME WAYS, ITS EASIER IN PLACES LIKE IOWA THAN IT WOULD BE IN ASIA.

Glover: GENERAL THOMPSON, LET'S TALK ABOUT THE BALANCE OF RESPONSIBILITY HERE. WHEN KATRINA HIT THE GULF COAST, IT CLEARLY WAS A FEDERAL RESPONSE TO THAT. IF THERE'S A DISASTER IN IOWA, WHAT ROLE DOES THE FEDERAL GOVERNMENT PLAY, AND DOES THE STATE REALLY HAVE A ROLE IN ALL THAT?

Thompson: THE FIRST RESPONDER IS THE LOCAL COMMUNITY, BE THAT A COUNTY OR A CITY. LET'S TAKE DAVENPORT AS AN EXAMPLE THAT YOU ALREADY BROUGHT UP. THEY'RE THE FIRST RESPONDERS. AS SOON AS THEIR RESOURCES ARE COMMITTED AND OVER -- AND THEY'RE SHORT OF ADDITIONAL RESOURCES, THEY IMMEDIATELY THEN COME TO THE STATE. THE STATE THEN COMMITS ITS RESOURCES TO ITS CAPABILITY. AND ONCE THE STATE'S RESOURCES ARE EXHAUSTED, THEN IT GOES TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY, FEMA, TO RESPOND WITH THEIR FEDERAL RESOURCES. A BIG DISASTER LIKE AN EARTHQUAKE OR SOMETHING WOULD PROBABLY IMMEDIATELY OVERRUN EVERYONE'S CAPABILITIES WITHIN THE STATE. AND THEN YOU WOULD GO TO FEMA AND GET THE AID THAT YOU NEED.

Glover: DR. QUINLISK, IN DEALING WITH THE TYPES OF DISASTERS THAT YOU DEAL WITH, FLUS, OTHER KINDS OF PANDEMICS, CAN THE STATE REALLY PLAY MUCH OF A ROLE IN THAT? ISN'T THAT A FEDERAL OR EVEN AN INTERNATIONAL ISSUE?

Quinlisk: WELL, THERE ARE CERTAINLY ROLES FOR PEOPLE ALL ALONG THE WAY. OBVIOUSLY WATCHING WHAT'S HAPPENING IN CHINA IS FOR AN INTERNATIONAL -- THE WORLD HEALTH ORGANIZATION RESPONSIBILITY. BUT WE HERE IN IOWA ARE REALLY GOING TO BE THE ONES WHO HAVE TO DEAL WITH WHAT HAPPENS HERE, ESPECIALLY IF IT'S A PANDEMIC WHERE EVERY STATE IS BEING HIT AT THE SAME TIME. THERE'S GOING TO BE LIMITED NATIONAL RESOURCES IF EVERY SINGLE STATE IS HAVING TROUBLE. SO WE'RE GOING TO HAVE TO REALIZE WHAT WE'VE GOT AND MAKE THE BEST USE OF THE RESOURCES WE HAVE HERE IN IOWA.

Borg: LET ME ASK, IOWA PRIDES ITSELF ON LOCAL CONTROL. WHAT YOU SEEM TO BE SAYING, WELL, EACH STATE IS RESPONSIBLE. BUT AT WHAT STAGE DOES THE FEDERAL GOVERNMENT SAY, NO, STATE, YOU CAN'T DO THAT, OR DOESN'T THAT HAPPEN?

Quinlisk: THE ONE THING ABOUT PUBLIC HEALTH THAT'S A LITTLE BIT DIFFERENT IS PUBLIC HEALTH, BY OUR CONSTITUTION, IS A STATE RESPONSIBILITY. IT IS NOT A FEDERAL RESPONSIBILITY BUT, OF COURSE, THE FEDERAL GOVERNMENT, THE CENTERS FOR DISEASE CONTROL, ARE AN INCREDIBLE RESOURCE AND HAVE THINGS THAT WE DON'T HAVE AT THIS LEVEL, SO WE WOULD CERTAINLY ASK THEM. I THINK, THOUGH, IF WE HAVE PANDEMIC FLU OR SOMETHING LIKE THAT, THEIR BIGGEST ROLE IS GOING TO BE IN TRYING TO COORDINATE THINGS AROUND THE STATES, PUTTING OUT GUIDANCE FOR ALL STATES TO FOLLOW. FOR EXAMPLE, IF WE HAVE A VACCINE, WHO SHOULD GET IT, HOW MUCH VACCINE IS EACH STATE GOING TO GET. THAT'S GOING TO BE SOMETHING THAT WILL BE DECIDED AT A NATIONAL LEVEL. BUT WE HERE IN IOWA THEN WILL TAKE THAT AND THEN DECIDE HOW WE'RE GOING TO GET IT OUT TO THE COMMUNITIES AND HOW WE'RE GOING TO GET INDIVIDUALS TO COME IN TO ACTUALLY GET THE VACCINE.

Yepsen: GENERAL, WHAT LESSON DID IOWA LEARN OR SHOULD IOWA LEARN FROM WHAT HAPPENED IN KATRINA? YOU WATCHED ALL THAT UNFOLD DOWN THERE AS WE ALL DID. YOU HAVE SOME FAMILIARITY WITH WHAT WE DO AND HOW WE DO THINGS IN IOWA. WHAT DO YOU SAY TO POLICYMAKERS ABOUT WHAT LESSONS WE SHOULD TAKE AWAY FROM WHAT HAPPENED IN KATRINA?

Thompson: FIRST THING I WOULD SAY IS THAT YOU HAVE TO HAVE A PLAN AND THAT YOU HAVE TO FOLLOW THE PLAN. WHAT OFTEN HAPPENS AND I BELIEVE WHAT HAPPENED THERE, THEY HAD A PLAN FOR NEW ORLEANS. THEY DIDN'T FOLLOW THE PLAN. AND WHAT NORMALLY HAPPENS IS PLANS ARE DEVELOPED BY A SUBSTAFF OF PLANNERS. THOSE PLANS ARE NEVER APPROVED OR BLESSED BY THE LEADERSHIP, SO WHEN THE EMERGENCY COMES ALONG, LEADERSHIP THEN STEPS IN AT THE TOP LEVEL AND STARTS TO MAKE DECISIONS WITHOUT EVER LOOKING AT THE PLAN. AND SO WHAT YOU HAVE TO HAVE, DAVID, IS YOU HAVE TO HAVE A PLAN THAT'S DEVELOPED WITH THE LEADERSHIP PUTTING THEIR STAMP OF APPROVAL ON THE PLAN AND HAVING KNOWLEDGE ABOUT WHAT IS IN THAT PLAN SO THAT YOU CAN PROPERLY RESPOND.

Yepsen: GENERAL, HOW DO YOU FEEL ABOUT THIS QUESTION OF THIS POSSE COMITATUS LAW THAT SAYS MILITARY PEOPLE CANNOT JUST STEP INTO WHAT IS A CIVILIAN SITUATION. IT'S OBVIOUS THE QUESTION NOW IN THE WAKE OF KATRINA IS MAYBE THE U.S. ARMY SHOULD HAVE MORE AUTHORITY, THE U.S. MILITARY, TO MOVE INTO THESE CIVILIAN SITUATIONS. I MEAN, GENERAL, I REMEMBER WHEN YOU WERE WEARING A UNIFORM AND I WAS WEARING A UNIFORM AND YOU SAID SOMETHING SHOULD HAPPEN, IT GENERALLY GOT DONE. NOW, WHY SHOULDN'T WE DO THAT AGAIN?

Thompson: WELL, YOU KNOW, IT'S A CHECK AND BALANCE. POSSE COMITATUS ACT WAS CREATED TO ENSURE THAT THE MILITARY COULDN'T COME IN AND JUST TAKE CONTROL OF GOVERNMENT. AND I THINK THAT'S A GOOD THING. NORMALLY HOW WE WOULD RESPOND IN A SITUATION LIKE THAT IS YOU GO TO THE LOCAL LEADERSHIP THAT MAY BE LACKING IN THEIR ABILITY BECAUSE, I MEAN, A LOT OF TIMES PEOPLE ARE ELECTED NOT BASED UPON THEIR LEADERSHIP SKILLS BUT UPON THEIR ABILITY TO COORDINATE COMMUNITIES AND THINGS. SO WHAT WE HAVE TRADITIONALLY DONE IS GO INTO A MAYOR, AS AN EXAMPLE, AND SAY, ALL RIGHT, LOOK, WE CAN PROVIDE SOME MILITARY ADVISORS TO YOU THAT WILL HELP YOU ENABLE YOU TO MAKE DECISIONS AROUND THIS AREA THAT YOU MAY NOT BE TOTALLY FAMILIAR WITH. THEY'RE USUALLY VERY, VERY QUICK TO SAY, YES, WE'LL TAKE THAT HELP. AND THEN WE PUT A GOOD LEADER RIGHT IN THERE BESIDE THE MAYOR, AND THEN THEY CAN COORDINATE -- HELP COACH THAT MAYOR DOWN THE ROAD TO THE RIGHT DECISIONS.

Glover: DR. QUINLISK, WE'VE TALKED A LOT ABOUT WHAT GOVERNMENT OUGHT TO DO WHEN WE RESPOND TO THESE TYPES OF EMERGENCIES. WE'VE GOT A LOT OF PEOPLE WATCHING THIS SHOW. WHAT CAN PEOPLE DO, FOR EXAMPLE, TO PREPARE FOR THE OUTBREAK OF THIS FLU? WHAT SHOULD MY FAMILY, YOUR FAMILY DO TO GET READY?

Quinlisk: WELL, ACTUALLY THERE'S A LOT OF THINGS THAT PEOPLE CAN DO. THERE'S SOME OF THE BASIC THINGS THAT I THINK OUR EMERGENCY MANAGEMENT PEOPLE ALWAYS TALK ABOUT, AND PRIMARILY FOR THINGS LIKE TORNADOES, WHICH IS HAVING WATER IN YOUR HOUSE, HAVING AN EMERGENCY PLAN SO YOUR CHILDREN KNOW WHAT TO DO IF THEY'RE AT SCHOOL AND SOMETHING HAPPENS. SO THERE'S SOME OF THAT BASIC STUFF FOR ALL EMERGENCIES PEOPLE CAN DO. BUT FOR THINGS LIKE PANDEMIC FLU, THERE'S ACTUALLY SOME OTHER THINGS THEY CAN DO. AND THESE ARE OFTEN VERY SIMILAR TO WHAT WE TELL PEOPLE TO DO EVERY FLU SEASON, SUCH AS: IF YOU HAVE THE FLU, DON'T GO TO WORK, DON'T GO TO SCHOOL, DON'T SPREAD IT AROUND; GO GET VACCINATED SO THAT YOU DON'T HAVE THE FLU, OR AT LEAST LOWER YOUR RISK OF GETTING THE FLU. SO THERE'S A LOT OF THINGS THAT WE DO RIGHT NOW. THEY'RE ESSENTIALLY THE SAME THINGS THAT WE'RE GOING TO BE TELLING PEOPLE TO DO IF A PANDEMIC FLU OCCURS.

Glover: GENERAL THOMPSON, THERE'S ANOTHER ASPECT TO THE RESPONSE TO SOME TYPES OF EMERGENCY, AND THAT IS WHAT'S THE ROLE OF CHARITABLE ORGANIZATIONS, CHURCHES, FAITH-BASED ORGANIZATIONS? WHAT ROLE CAN THEY PLAY, AND HOW DO YOU COORDINATE THEM INTO THIS WHOLE RESPONSE?

Thompson: WELL, IT'S PRETTY EASY IF YOU'RE TALKING ABOUT A HURRICANE LIKE HAPPENED IN KATRINA, WHERE YOU HAVE ALL OF THESE FAMILIES THAT HAVE LOST THEIR HOMES AND THEIR POSSESSIONS. AND THEY CAN STEP IN AND PROVIDE HELP FOR THOSE INDIVIDUALS. AND THEY'VE BEEN CRITICAL AS I'VE WATCHED THIS KATRINA RESPONSE. PANDEMIC FLU MAY BE A LITTLE BIT DIFFERENT TYPE OF A RESPONSE. THERE WE'RE LOOKING ABOUT -- LOOKING AT A LOT OF THINGS LIKE QUARANTINING FAMILIES IF THEY GET THE FLU OUTBREAK IN THEIR FAMILY. SO IT'S GOING TO BE MORE DIFFICULT FOR THOSE AGENCIES TO RESPOND, BUT I THINK THAT SHOWING COMPASSION AND HELPING THEIR PARISHIONERS IS GOING TO BE AN IMPORTANT THING.

Yepsen: DOCTOR, I WANT TO FOLLOW UP ON MIKE'S QUESTION ABOUT WHAT INDIVIDUALS CAN DO. IF I UNDERSTOOD WHAT YOU SAID RIGHT, DOES GETTING A FLU SHOT NOW DO ANYTHING TO PROTECT AN INDIVIDUAL AGAINST GETTING THIS BIRD FLU?

Quinlisk: NOT DIRECTLY BUT THERE'S AN INDIRECT BENEFIT. THE FLU SHOT THAT WE HAVE RIGHT NOW IS FOR THE SEASONAL FLU, SO IT'S GOING TO PROTECT YOU AGAINST THE FLU VIRUSES THAT WE PROBABLY WILL SEE THIS SEASON. BUT AVIAN FLU VIRUS THAT'S OUT THERE RIGHT NOW IS NOT A HUMAN FLU VIRUS. FOR IT TO CAUSE A LOT OF HUMANS TO GET ILL, IT'S GOING TO HAVE TO DO WHAT'S CALLED REASSORTMENT OF MUTATION. AND FOR IT TO REASSORT, BASICALLY A PERSON WOULD HAVE TO GET AVIAN FLU AND HUMAN FLU AT THE SAME TIME AND ALLOW THE VIRUS WITHIN THEIR BODY TO MIX, AND THEN IT CAN BECOME A HUMAN FLU VIRUS. BUT IT WILL HAVE THE AVIAN PIECES THAT MEANS THAT IT'S GOING TO HAVE THE POTENTIAL TO CAUSE A LOT OF PEOPLE TO GET ILL. SO IF YOU GET THE HUMAN FLU VACCINE, WE LOWER THE RISK OF THAT OCCURRING, WHICH THEN HELPS EVERYBODY.

Yepsen: AS WE TALK ABOUT WHAT CAN INDIVIDUALS DO AND WHAT CAN CHARITABLE GROUPS DO, DOCTOR, WHAT'S THE ROLE OF BUSINESS IN FIGHTING PANDEMICS IN PREPARING FOR DISASTERS?

Quinlisk: WELL, ONE THING I WOULD SAY THE BUSINESSES CAN DO IS FIRST OF ALL LOOK AT THEIR EMPLOYMENT AND SAY WHAT CAN I DO TO PROTECT MY EMPLOYEES. AND AGAIN, SOME OF THE THINGS CAN BE OFFERING THEM THE SEASONAL FLU VACCINE OR MAKING IT EASY FOR THEM TO GET IT, BUT ALSO HELPING THEIR EMPLOYEES PLAN FOR SOMETHING. WHAT ARE THEY GOING TO DO IF A PANDEMIC COMES AND 10 PERCENT OF THEIR POPULATION IS ILL OR HAS BEEN ASKED TO STAY HOME? HOW DO THEY RESPOND TO THAT? HOW DO THEY THEN MAYBE HELP THEIR EMPLOYEES STAY HOME? THINGS AS SIMPLE AS IF WE ASK SOMEBODY TO STAY HOME BECAUSE THEY'VE GOT THE FLU, WOULDN'T IT BE NICE IF THE EMPLOYEES THEN SUPPORT THEM AND SAY WE'RE GOING TO CONTINUE TO PAY YOUR SALARY RATHER THAN SAYING THE MINUTE YOU DON'T COME INTO WORK WE'RE GOING TO FIRE YOU.

Yepsen: I WANT A QUESTION FOR BOTH OF YOU. WHAT DO YOU THINK? ARE INDIVIDUAL IOWANS PREPARED? ARE BUSINESSES IN IOWA PREPARED?

Quinlisk: I THINK WE'RE IN THE PROCESS OF TRYING TO GET MORE PREPARED. WE'RE DEALING WITH SOMETHING THAT WE REALLY HAVEN'T THOUGHT ABOUT VERY MUCH. THERE'S THINGS WE CAN DO. THERE'S THINGS THAT WE'VE BEEN DOING. BUT CERTAINLY ONE OF THE THINGS WE NEED TO DO IS REACH OUT TO PARTNERS IN THE BUSINESS COMMUNITY, IN THE EDUCATIONAL COMMUNITY, AND START WORKING WITH THEM AND SAYING HERE ARE SOME THINGS WE CAN ALL DO TOGETHER TO GET PREPARED AS A SOCIETY.

Yepsen: AND, GENERAL, SAME QUESTION TO YOU. WHAT'S YOUR SENSE OF -- ARE INDIVIDUAL IOWANS PREPARED FOR DISASTERS? ARE BUSINESSES PREPARED FOR DISASTERS? WHAT'S THE STATUS OF THAT PLANNING?

Thompson: MY EXPERIENCE WOULD SAY PROBABLY NOT. OFTENTIMES THEY DO NOT FACE THE POTENTIAL OF A DISASTER UNTIL THE DISASTER IS ON THEIR DOORSTEP. AND I THINK THAT THE VERY FACT THAT THIS VIRUS HAS NOT MUTATED YET AND BECOMES A HUMAN TO HUMAN, THAT THEY'VE REALLY SAT DOWN AND ADDRESSED WHAT ARE THEY GOING TO DO IF THE OUTBREAK IS SO SEVERE AS TO CAUSE THE GOVERNMENTS TO SAY THAT WE'VE GOT TO REDUCE THE PHYSICAL PERSON-TO-PERSON CONTACT, THAT'S THE PART THAT I DON'T KNOW THAT THEY'VE PREPARED FOR OR THOUGHT ABOUT MUCH?

Glover: DR. QUINLISK, YOU MENTIONED THIS EARLIER IN PASSING. THERE'S THE NOTION OF COMPILING SOME VACCINES OR SOME SHOTS TO DEAL WITH THE FLU ONCE IT BREAKS OUT. WE DON'T HAVE ENOUGH TO VACCINATE OR IMMUNIZE EVERYONE, AND YOU HAVE TO DECIDE WHO GETS IT. WHO DECIDES THAT AND HOW -- WHO GETS IT I GUESS IS THE QUESTION.

Quinlisk: WELL, IN OUR PLAN WE DEAL WITH THIS EXACTLY BECAUSE THAT IS ONE OF THE BIGGEST QUESTIONS, AND IT'S NOT JUST VACCINES BUT ANTI-VIRAL MEDICATIONS. WHAT WE'VE DONE HERE IN IOWA IS WE'LL TAKE OBVIOUSLY WHAT THE NATIONAL GOVERNMENT IS SAYING, WHAT THE CENTERS FOR DISEASE CONTROL IS RECOMMENDING. WE'VE ALSO PUT TOGETHER AN ADVISORY PANEL HERE IN IOWA WITH LOTS OF EXPERTS ACROSS THE STATE OF IOWA SAYING BASICALLY: WHAT ARE YOUR IDEAS; HOW DO WE GO ABOUT THE PROCESS OF DECIDING WHO SHOULD GET A VACCINE AND WHO SHOULD NOT, ESPECIALLY IF WE DON'T HAVE MUCH; WHAT IS THE BEST BENEFIT TO SOCIETY OF THE USE OF THAT VACCINE? ONE OF THE THINGS I'LL SAY IS ONE OF THE THINGS WE'VE DONE HERE IN IOWA IS WE'VE DONE SOME MOCK EXERCISES OF HOW TO GET VACCINES OUT TO COMMUNITIES VERY, VERY QUICKLY AND HOW TO SET UP IMMUNIZATION CLINICS OUT IN THE COMMUNITY SO THAT WE CAN VACCINATE PEOPLE VERY, VERY FAST. AND WE'VE ACTUALLY PRACTICED THAT AND WE CAN DO IT QUITE QUICKLY.

Glover: SO IN A QUICK SOUND BITE, WHO GETS IT?

Quinlisk: WE WON'T KNOW UNTIL YOU TELL ME HOW HAS THE VIRUS MUTATED, WHO IS GETTING IT RIGHT NOW, WHO IS AT MOST RISK OF DYING FROM IT AND ALL THAT. WE WON'T KNOW THAT UNTIL THE VIRUS ACTUALLY MUTATES, BUT WE'LL SIT DOWN AND FIGURE THAT OUT BEFORE IT GETS HERE.

Glover: GENERAL THOMPSON, WHO OUGHT TO MAKE THAT DECISION? WHO PLAYS GOD?

Thompson: THAT'S A TOUGH QUESTION. IF YOU'RE -- AS I UNDERSTAND THE POTENTIAL OF THIS VIRUS, IT DOESN'T JUST ATTACK THE OLD AND THE YOUNG. IT ATTACKS EVERYONE VIRTUALLY ON AN EQUAL BASIS BECAUSE THEY HAVE NO IMMUNITY IN THEIR SYSTEM FOR THAT VIRUS AT THIS POINT. SO IT'S GOING TO BE A TOUGH DECISION ON -- I'M SURE THE HEALTH PROFESSIONALS ARE GOING TO MAKE THAT DECISION.

Glover: DO YOU DECIDE BASED ON THE OCCUPATION, CRITICAL OCCUPATIONS? DO YOU BASE IT ON VULNERABILITY, LIKELIHOOD OF GETTING THE DISEASE? WHAT FACTORS GO INTO MAKING THAT DECISION?

Thompson: IT WILL BE PROBABLY DIFFERENT. MY REACTION WOULD BE IT WILL PROBABLY BE DIFFERENT THAN IT'S EVER BEEN BEFORE BECAUSE OF THE FACT THAT YOU'RE GOING TO HAVE TO WEIGH THE FACT THAT YOUR WORKING POPULATION IS AT HIGH RISK. AND SO THERE MAY VERY WELL BE SOME DECISIONS ABOUT THOSE VERY FACTORS THAT YOU'RE TALKING ABOUT.

Borg: DR. QUINLISK IS SHAKING HER HEAD. I WANT HER TO WEIGH IN ON THIS.

Quinlisk: WELL, ONE OF THE THINGS -- YOU HAVE TO SAY, THEN, HOW DOES IT COME INTO IOWA. LET'S SAY WE HAVE ONE TRAVELER FROM ASIA, COMES IN, LANDS AT THE AIRPORT, AND THEN WE FIND OUT THAT THEY HAVE ASIAN FLU. ONE OF THE THINGS WE MIGHT DO IS VACCINATE ALL OF THE PEOPLE WHO WERE AROUND THAT PERSON REGARDLESS OF THEIR AGE OR THEIR SEX OR THEIR BUSINESS, BECAUSE THAT WOULD BE A WAY OF TRYING TO CONTAIN IT THAT WAY. IF IT COMES IN WHERE WE HAVE 500 PEOPLE ALL GETTING SICK AT THE SAME TIME, THEN THAT'S GOING TO CHANGE HOW WE USE THE VACCINE BECAUSE THEN WE WOULD NOT BE ABLE TO ENCIRCLE THAT. SO I THINK A LOT OF IT JUST DEPENDS ON WHAT NATURE THROWS AT US.

Borg: SO YOU'LL HAVE SEVERAL SCENARIOS PROBABLY AS TO WHO'S GOING TO GET THE VACCINE.

Quinlisk: RIGHT. WE HAVE LOTS OF SCENARIOS. AND LIKE I SAID, ONE OF THE THINGS IN THE 1918-1919 PANDEMIC WAS YOUNG ADULTS WERE HIT THE HARDEST. NOW IN OUR TRADITIONAL SEASONAL FLU, IT'S THE ELDERLY AND THE VERY, VERY YOUNG. AND ONE OF THE THINGS WE DON'T KNOW RIGHT NOW IS IF THIS VIRUS MUTATES, WHO'S GOING TO BE HURT THE WORST. AND WE HAVE TO TAKE THAT INTO ACCOUNT, AS WELL AS SOCIETAL BENEFIT WHEN WE DECIDE WHO GETS THE VACCINE.

Thompson: I WOULD MAKE ONE COMMENT. I THINK THE FEDERAL GOVERNMENT HAS BEEN VERY RESPONSIVE TO THIS IN APPROPRIATING THE MONEY THAT THEY HAVE AND WORKING IMMEDIATELY ON THE DEVELOPMENT OF IMMUNIZATIONS. AND THEY'RE WORKING IN A DUAL FOCUS OF DEVELOPING IMMUNIZATIONS. ONE IS AROUND THE EGG PROCESS THAT IS -- YOU CAN'T -- IT'S VERY SLOW AND YOU DON'T GET A LOT OF DOSAGES OUT OF IT.

Borg: USING THE EGG AS A MEDIUM FOR --

Thompson: BUT THEN THEY HAVE THE SYNTHETIC PROCESSES THAT ARE CURRENTLY BEING DEVELOPED THAT CAN BE VERY HIGH VOLUME TYPE DEVELOPMENTS, AND THEY CAN BE VERY RESPONSIVE. SO MY HOPE WOULD BE THAT OUT OF ALL OF THIS THAT THE FEDERAL GOVERNMENT'S DEVELOPMENT OF THE VACCINE THAT PREVENTS THIS IS GOING TO BE AHEAD OF THE ACTUAL MUTATION OF THE VIRUS.

Yepsen: DOCTOR, ARE WE OVERREACTING? I MEAN THIS BIRD FLU HAS KILLED ONLY 75 PEOPLE. WE HAVE A $7-BILLION RESPONSE TO IT. IT HAS NOT MUTATED AMONG HUMANS YET. YOU KNOW, OUR CRITICS -- PEOPLE WHO CRITICIZE THE MEDIA TEND TO ACCUSE US OF OVERREACTING TO THINGS. ARE WE OVERREACTING HERE?

Quinlisk: WELL, I GUESS YES AND NO. SOME OF THE STORIES I'VE HEARD MAKE IT SOUND LIKE IT'S GOING TO COME TOMORROW AND BILLIONS OF PEOPLE ARE GOING TO DIE AND THERE'S NOTHING WE CAN DO. AND I THINK THAT'S PROBABLY, YOU KNOW, A LITTLE BIT OF -- YOU KNOW, HYPING THE SITUATION. BUT ON THE OTHER HAND, WE KNOW FROM THINGS LIKE SARS AND MONKEYPOX AND WEST NILE IS THAT HUMAN BEINGS ARE GOING TO FACE THESE DISEASES COMING INTO OUR SOCIETY AND CAUSING GREAT PROBLEMS. SO BY GETTING READY FOR PANDEMIC FLU, WHETHER OR NOT IT ACTUALLY COMES IN THE NEXT TEN YEARS, WE'RE GOING TO ALSO BE GETTING READY FOR ALL OF THESE OTHER THINGS AND EVEN GETTING READY FOR NATURAL DISASTERS. FOR EXAMPLE, SURGE CAPACITY IN OUR HOSPITALS IS ONE OF THE THINGS WE'RE DEALING WITH RIGHT NOW. WELL, IF WE GET READY FOR SURGE CAPACITY AND HAVE THAT SORT OF FIGURED OUT AND HAVE A PLAN, IT WON'T REALLY MATTER TO THAT PLAN WHETHER PEOPLE ARE GETTING SICK WITH PANDEMIC FLU OR SARS OR AN EARTHQUAKE. WE'LL HAVE A PLAN READY FOR HOW TO DEAL WITH LOTS OF PEOPLE GETTING SICK AND NEEDING MEDICAL CARE ALL AT THE SAME TIME. AND THAT'S GOING TO BE GOOD NO MATTER WHAT HAPPENS.

Glover: GENERAL THOMPSON, THE LEGISLATURE WILL BE CONVENING IN JUST OVER A MONTH FROM NOW. YOU ARE FAMILIAR WITH THE STATE'S EMERGENCY PLANNING SYSTEM. YOU'RE FAMILIAR WITH WHAT HAS TO HAPPEN TO RESPOND TO THESE SORTS OF THING. WHAT WOULD YOU ASK THIS NEXT LEGISLATURE AND GOVERNOR TO DO? IS IT MORE MONEY? IS IT BETTER PROGRAMS? IS IT NEW PEOPLE? OR IS THERE ANYTHING THAT THE STATE CAN DO?

Thompson: WELL, I -- YES, I THINK THERE'S ONE THING THAT AT THIS POINT NEEDS TO BE DONE. AND NORMALLY WHEN YOU -- WHEN YOU START FACING A POTENTIAL DISASTER LIKE THIS, YOU BRING TOGETHER A TASK FORCE. YOU PROVIDE THEM WITH THE NECESSARY RESOURCES THAT THEY NEED IN ORDER TO BRING ALL OF THE AGENCIES THAT ARE GOING TO BE RESPONDERS TOGETHER AND DEVELOP THIS PLAN FOR THE STATE. AND MANY TIMES THERE IS SOME FINANCIAL NEED THAT COMES WITH THAT THAT THE LEGISLATURE SHOULD BE LOOKING AT PROVIDING THIS YEAR AND PUTTING TOGETHER, WITH THE GOVERNOR, THE TASK FORCE ORGANIZATION FOR THIS AND ENSURE THAT AN ADEQUATE STATEWIDE PLAN IS THERE THAT INVOLVES ALL OF THE RESPONDING AGENCIES. OBVIOUSLY THE DEPARTMENT OF HEALTH IS GOING TO BE A KEY LEADER ON THIS ONE, BUT THERE'S MORE AGENCIES INVOLVED THAT CAN -- THAT SHOULD BE PUT TOGETHER IN THIS.

Glover: DR. QUINLISK, YOUR AGENCY WILL HAVE THINGS YOU'RE GOING TO TAKE TO THE LEGISLATURE. WHAT ARE YOU GOING TO ASK THIS LEGISLATURE TO DO?

Quinlisk: WELL, THERE'S A VARIETY OF THINGS. AND GOING BACK TO ONE OF THE THINGS I SAID BEFORE WAS -- ONE OF THE THINGS WE'RE GOING TO ASK IS THAT IF WE ASK SOMEBODY TO ISOLATE THEMSELVES AT HOME OR QUARANTINE THEMSELVES AT HOME, WE'D LIKE TO THEN HAVE SOME ASSURANCE TO THEM THAT THEY'RE NOT GOING TO LOSE THEIR JOB. WE FOUND OUT FROM THE SARS EPIDEMIC AND WHAT HAPPENED IN CANADA WAS THE NUMBER ONE REASON WHY PEOPLE DID NOT COMPLY WITH ISOLATION AND QUARANTINE RECOMMENDATIONS WAS THEY WERE AFRAID THAT THEY WERE GOING TO LOSE THEIR JOB. WE NEED TO TAKE THAT CONCERN AWAY FROM PEOPLE SO THAT WHEN WE ASK PEOPLE TO STAY HOME, THEY WILL FEEL CONFIDENT THAT THEY CAN DO THAT.

Borg: STATE LAW GUARANTY FOR JOB PROTECTION?

Quinlisk: RIGHT.

Borg: THANK YOU VERY MUCH. WE'RE OUT OF TIME. IT'S VERY INTERESTING. I HOPE WE DON'T HAVE TO HAVE YOU BACK SAYING HOW ARE WE GOING TO COPE WITH THIS. ON OUR NEXT EDITION OF "IOWA PRESS," OUR FOCUS RETURNS TO THE IOWA STATEHOUSE. THE NEW CHAIR OF THE APPROPRIATIONS COMMITTEE IN THE IOWA HOUSE WILL BE HERE. URBANDALE REPUBLICAN SCOTT RAECKER IS REPLACING REPRESENTATIVE BILL DIX, WHO IS RUNNING FOR CONGRESS. WE'LL BE ASKING REPRESENTATIVE RAECKER ABOUT THE AGENDA FOR THE 2006 LEGISLATIVE SESSION AS FAR AS APPROPRIATIONS GO. REGULAR "IOWA PRESS" AIRTIMES NEXT WEEK: 7:30 FRIDAY AND SUNDAY AT NOON. I'M DEAN BORG. THANKS FOR JOINING US TODAY.

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