Current experience with the Haiti disaster response has provoked memories of the early days of the 2009 H1N1 pandemic, where unofficial reporting mechanisms preceded official reporting. It is clear the work of the unofficial human "mash-ups" like Crisis Mappers Net, with partners like Ushahidi, InSTEDD, HealthMap, and many others are showing a new, agile mechanism for gathering and reporting crisis information. Right now we are observing tremendous chaos and delays in reporting information from the larger NGOs and official organizations who are on the ground in Haiti- where the bigger and more beaurocratic the organization, the more difficult it is to coordinate information flow in an environment where agility is becomes most important. This is the classic hallmark of a disaster, where the demand for information is tremendous... a demand at odds with the very nature of a cumbersome beaurocratic entity.
Below is a chart of unofficial versus official reporting in the early days of the 2009 H1N1 pandemic. Even inside the United States there were tremendous time differences between unofficial reporting of suspected cases and official reporting by CDC, which was reflective of lack of available test kits for pH1N1, the hierarchical nature of reporting at the local, state, and national levels, and the methodical process of forensic epidemiological investigation. When considering the interface of national level reporting to WHO, the same kinds of time delays were also observed.
The numbers in the left and right-hand columns represent the difference in days between first report of suspect cases of H1N1 and first report of laboratory confirmation.
It has been said here we are witnessing the birth of a new professional discipline in the realm of operational biosurveillance... a discipline that places a higher premium on unofficial reporting because the output of this community is timely, relevant warning of biological threats to society.
As we are observing right now in Haiti, the phenomenon of time delays between unofficial and official reporting is certainly not unique to operational biosurveillance.
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