There's the old saying that all politics is local. It turns out that global health crises are, too.
If you're ill, it really doesn't matter what the World Health Organization threat level is. Or whether the Centers for Disease Control has a genetic test for what's making you sick.
What matters is, how do you get medicine if Walgreens is shut down and Target has run out?
"One of the things we're working on is a postal exercise, about distributing medications via your mailman," said Rob Fulton, head of the public health department for St. Paul and Ramsey County.
"We don't have a vaccine. We would be feeling much better if we had tons of vaccines and could start setting up clinics."
Fulton is one of hundreds of public health officials who have shifted their work into worst-case-scenario mode.
"The issue of concern is that we don't have a vaccine. We don't have a lot of infectious diseases that don't have vaccines," said Fulton. "We would be feeling much better if we had tons of vaccines and could start setting up clinics. We are geared to do that."
But it will be months, possibly as late as November, before a vaccine is likely to be available.
So public health officials are stocking up and doing what they can anyway, even if the threat isn't imminent.
Just about every public health department has a thick binder of plans and phone numbers, put together during the bird flu scare four years ago.
Recently, they've added a chapter on H1N1 flu, as well as more pages of other plans and information.
In a recent test in St. Paul, they even put M&M's candies to a new use for public health. Fulton says they lined up several classes at Humboldt High School and doled out bags of the candy as a dry run for handing out Tamiflu or other antiviral medications.
"What we were trying to see was how many people we could run through our clinic in a couple of hours, to get some idea of how fast we would be able to dispense meds," said Fulton. "We had like 100-some kids, and we were trying to push 300 or 400 people through in an hour."
Public health officails are also stepping up surveillance where they can. If you get arrested in Ramsey County these days, you're probably going to have your temperature taken and a look-over for signs of illness as soon as you get to the jail.
Across the river, Minneapolis has prepared restaurant inspectors to help track down people who have may have been exposed to a virulent flu, so they can help follow the trail of an epidemic.
"We want to make sure that the fire and the police and all the essential services are still provided to the citizens," said Gretchen Musicant, Minneapolis' public health director. "So we have acquired masks, and hand wipes, and hand sanitizers and protective goggles and so on, in the event that there is an infectious disease that we need to protect people from as they perform their activities."
Public health officials are also translating health warnings into about a dozen different languages.
They're scouting out secret locations where they can stash flu drugs to keep them from being hijacked by desperate flu patients.
And they're even figuring out how to deliver groceries to people stranded in their homes because they've been quarantined.
They hope it never comes to that, but they expect to be on alert, and ready, well into winter.
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