Michael Balboni is director of the Greater New York Health Care Facilities Association. Lawrence C. Levy, a former columnist for Newsday, heads the National Center for Suburban Studies at Hofstra University.
Officials of the federal Centers for Disease Control will star at a conference focusing on homeland security and disaster preparedness at Hofstra and Adelphi universities this week. The array of disquieting topics includes terrorist attacks and hurricanes. But there's another on the list that may seem less frightening to Long Islanders: the flu. Don't be lulled into a false sense of security -- the flu is just as worthy of marquee status, especially in the suburbs.
As early as this fall, scientists and policy-makers tell us, the swine flu might mutate into a deadlier disease than the world saw last season, and with a higher rate of infection. So state and local governments must prepare to deliver H1N1 flu vaccine to millions of Americans, faster and more widely than ever before.
That task is exceptionally challenging in suburbs, where more than half the nation's population lives. Suburbanites who commute to urban centers are especially at risk because of increased opportunities for exposure in the densely populated cities where they work. They then can bring the illness home, spreading it like the viral equivalent of suburban sprawl.
There's no doubt that federal efforts must focus on metropolitan areas -- the cities and suburban towns and counties where infection rates tend to be highest. Local officials -- and not the federal government -- will be in charge of providing the manpower to deliver the vaccines.
Long Island has a well-developed disaster preparedness and response system. But emergency officials know that their counterparts in New York and other cities will have an easier time doing the job. Unlike suburbs, which often are a mishmash of hamlet, village, town and county jurisdictions, cities are centrally controlled: There's one health department, one police force, one city council, one mayor.
Cities have mass transit that can speed citizens to points of distribution (PODs), used when traditional means of getting medicine, such as hospitals, doctors offices or pharmacies, are overwhelmed or unavailable. And cities have heavy concentrations of hospitals, clinics and highly trained physicians, sometimes within walking distance.
These are advantages not shared by suburbs like Long Island, and stopping the spread of infection in just the cities is not enough. That's why our policy-makers must ensure that suburban communities have the resources and plans to do the job, including coordination between various fragmented levels of government.
The emergency medical community also needs to rethink how a POD should work. PODs generally mean long lines of recipients, waiting for hours, possibly in the cold, while a pandemic might be raging around them. Standing in line might be the best option in urban centers, but in suburbia, we should take advantage of something everyone has: an automobile.
For all our pollution and traffic problems, the suburbs remain a drive-through society. Why not create drive-up vaccine distribution centers? Standing in line exposes people to the elements and to each other. The use of cars would cut down on the social interaction inherent in standing in line. Also, flu season hits in the late fall and winter months. If we create a plan for people to stay in their warm cars, they might be more willing to get the vaccine and help stop the spread. This could happen in shopping-mall or school parking lots, or at drugstores with drive-through windows
Using cars to ferry people to vaccines is not a new idea. It was done in the 1950s and 1960s to administer the polio vaccine in the suburbs. Fifty to 60 years later, suburban public health and emergency services agencies should consider the car as the way to distribute vaccines to large populations in an orderly way.
PODs must be adapted to meet the needs and lifestyles of specific places. Instead of letting the fear of how to do this drive us, we should simply drive ourselves.