Who's in Charge? Leadership during Epidemics, Bioterror Attacks, and Other Public Health Crises

Who's in Charge? Leadership during Epidemics, Bioterror Attacks, and Other Public Health Crises

Who's in Charge? Leadership during Epidemics, Bioterror Attacks, and Other Public Health Crises

Who's in Charge? Leadership during Epidemics, Bioterror Attacks, and Other Public Health Crises

Synopsis

A detailed exploration of leadership problems that can develop during public health crises such as the anthrax attacks, SARS, and Mad Cow disease.

• First-person accounts from leaders involved in the actual crises, as well as leading experts, scientists, and others

• Primary documents including excerpts from official reports and the medical literature

• Chronologies of five recent public health emergencies

• A comprehensive index organized by disease and by individuals involved in emergency response

Excerpt

Leadership is critical for responding to disease crises. Whether an epidemic spreads naturally or through bioterrorism, any crisis can pose difficult challenges for leaders. Novel pathogens, such as the avian influenza or Severe Acute Respiratory Syndrome (SARS) virus, are particularly problematic because of the initial absence of scientific information about them. Leaders might need input from physicians, veterinarians, public health officials, scientists, economists, lawyers, and ethicists to make effective decisions.

Even with such expert advice, officials might not fully anticipate the implications of various response policies. For example, people’s economic interests might lead them to oppose neighborhood quarantines, food bans, or the slaughter of livestock. In some severe cases, policies can have unintended consequences, such as protest demonstrations and suicides. For example, during the 2001 foot-and-mouth disease crisis in the United Kingdom, veterinarians protested the cruel livestock-slaughtering policies, and some farmers committed suicide because they were overwhelmed by the loss of their herds.

Officials might not fully understand their own roles and responsibilities if these have not been clearly articulated in public health or disaster response laws, policies, or procedures. In the United States, leadership is decentralized and crisis responses are primarily state and local government responsibilities. States vary considerably in their public health laws, but the . . .

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