"Sitting down is a role. But shutting up, that's a responsibility."

I recently posted something about the social and personal value of having a home stockpile of antibiotics in case of an anthrax attack.  It makes a lot of sense, but it doesn't do much for the amour propre of public health professionals, who slow-rolled the idea for years in the Bush Administration.  (More on that in the book.)

I wondered aloud if the Obama Administration had sided with the HHS career staff and decided not to encourage home stockpiles.  Now I've found more evidence that that's exactly where things stand.

In an otherwise unsurprising National Strategy for Countering Biological Threats
released by the White House in early December, there's an inevitable section, beloved of bureaucrats, setting out "Roles and Responsibilities."  Beloved because that's where all the turf wars are fought.

Now, you and your family probably didn't hire anyone to participate in those turf wars on your behalf. 

Believe me, it shows.

Because there's a section on the roles and responsibilities of "Individuals and Families."  Here's the whole thing:

"There is a critical role for families and individuals in reducing the risks from biological threats. Individual contributions to community resilience can undermine motivations for biological threats by reducing their effectiveness. We will encourage individuals and families to undertake the following:

• Following general guidance for disaster preparedness, such as keeping supplies of food and other materials at home—as recommended by authorities—to support essential needs of the household for several days if necessary;
• Being prepared to follow public health guidance that may include limiting their mobility throughout the community for several days or weeks, or utilizing designated evacuation routes; and
• Informing appropriate authorities when they encounter or observe suspicious or unusual activities."

I think the verbs tell the story. (Okay, maybe they're gerunds.).  Anyway, our role as individuals is to --

(1) follow

(2) prepare to follow

(3) inform 

Really, pretty much what you'd expect from any self-governing people.

Do you see any way that those three verbs could possibly lead to approval of home medkits? 

Neither do I.

In fact, I think the document resolves the bureaucratic battle conclusively against DIY preparedness.  It says individuals are supposed to "follow guidance" about keeping food and other materials at home.  But in case you didn't understand the first time that you're only supposed to do what the government tells you, the bit about keeping materials at home gets an added and quite redundant qualifier.  While you're following government guidance about keeping materials at home, remember that you're only to keep materials "as recommended by authorities."

So the bad news would appear to be that the administration isn't going to help you prepare a home medkit.  No standard packaging and labels, no encouragement for doctors to prescribe the kits responsibly, no sober discussion of the risks.

The good news is that I still haven't been threatened with prosecution for promoting off-label use of antibiotics.  So when you're asked why you got a medkit on your own, you can say you're just keeping the material at home "as recommended by an authority" -- Skating on Stilts.