The President’s stated intent to employ the military to enforce quarantines in the event of an avian flu outbreak is an unfortunate example of misuse of the military to compensate for a gutted public health system. Over-reliance on military forces to prepare for and respond to biological threats is neither an efficient nor an effective biodefense strategy. As it lacks the proper training and resources to combat biological threats single-handedly, the military needs assistance from other civil service agencies better equipped to meet these challenges. Forging a partnership between the military and the public health sector would enhance the ability of both to utilize their resources to protect the American public=
The planned use of quarantines is a microcosm of the administration’s misplaced emphasis on the military’s role in emergency preparedness and response. Large-scale quarantines are not only ineffective, but also may create more volatile situations than the biological threat itself. Historically, quarantines have alienated and angered the public while failing to contain the further spread of a contagious disease. Resorting to such ineffectual measures demonstrates the President’s limited view of strategic biodefense and his over-reliance on the military. Biological disasters cannot be met with military strength alone; they require a wide-ranging response providing social services, education, and medical care to the public. Using the military as a monolithic defense against biological threats, natural or manmade, is the wrong approach to biodefense.
The military cannot effectively provide the social services critical for biodefense, such as public health education, health care, and emergency preparedness in local health facilities. The public health system, however, can provide these services, compensating for the military’s inability to address these needs. We must confront biological threats on multiple fronts, coordinating the military’s efforts with a stronger, more capable public health system.
Unfortunately, with many medical experts having declared the end of the era of contagious disease in the 1970s, the public health system suffers from over 30 years of neglect. Even the response to the HIV/AIDS epidemic has not restored the system to its former vigor. Without renewed resources, attention, and commitment at the highest levels of our national leadership, the public health infrastructure will find itself ineffectual and unable to assist in recovery and response from future threats.
We need to utilize the expertise and experience of the existing public health infrastructure by involving hospitals, clinics, first responders, medical researchers, and others in the strategizing and execution of biodefense. A viable public health system educates people about how to best protect their health, rapidly responds to outbreaks, treats victims, and understands the most effective means of identifying and containing contagions. In coordination with scientific and national security communities, our public health system is positioned to serve on the front lines of the nation’s biological defense.
We should improve the ability of the public health system to educate people about biological threats and appropriate responses. Shaping the public reaction is crucial to mitigating the damage caused by a biological event; rather than panic and resistance incited by quarantines, public health can encourage orderly and informed reactions that will save lives. The public health system, unlike the military, is a constant presence in the community; an adequately funded and supported public health system is uniquely positioned to prepare the public for a biological disaster and to quickly provide information in the event of a catastrophe.
Advocating a larger role for public health in emergency response and preparedness does not lessen the importance of the military’s contribution to the response efforts. Neither the public health system nor the military can adequately provide emergency response alone. The military (most notably State Guards throughout the nation) fulfills vital roles, providing critical access to transportation, maintaining order in times of chaos, and effectively assisting in setting up shelters and care centers for the public. In addition, the military provides manpower and resources that greatly amplify the capabilities of other civilian agencies. The military is indispensable to emergency response, but its effectiveness is diminished when it is forced to perform duties beyond the scope of its capabilities.
Our nation’s over-reliance on the military for biodefense is both misguided and dangerous. By partnering with the public health community, the military can focus its resources on the tasks for which it is most suited, rather than providing social services that are beyond its capabilities. For such a partnership to work, however, the public health system demands the attention and resources necessary to resurrect it after 30 years of neglect. Instead of asking men and women in uniform to perform the duties of those in lab coats, we should have them work side by side, strengthening the existing public health system in order to protect our nation’s health and safety.