How well do you think the federal government performed in handling the 2009-2010 pandemic H1N1 influenza outbreak? Here’s the view of the physician who oversaw the effort at the U.S. Department of Health and Human Services (HHS), Dr. Nicole Lurie: “Looking back, I just feel very proud of what we accomplished as a nation.”
Dr. Lurie spoke last week at a meeting sponsored by the Infectious Diseases Society of America, in which participants reviewed the response to the pandemic flu in terms of what worked and what didn’t, and brainstormed to devise a list of priorities for future approaches to both pandemic and seasonal influenza.
The IDSA will incorporate those discussions into a revision of its January 2007 document, “Pandemic and Seasonal Influenza Principles for U.S. Action.” Back then, public health officials were concerned about the H5N1 “bird flu” virus as a possible pandemic strain.
“We were planning for a ‘different’ pandemic. But planning let us ‘pivot.’ Prior investments paid off in terms of vaccine manufacturing capacity and a strengthened public health system,” noted Dr. Lurie, who became the HHS Assistant Secretary for Preparedness and Response in June 2009, 2 months after the first case of pandemic H1N1 influenza was detected. Prior to that, she directed public health and preparedness work at the RAND Corporation.
Among the government’s major accomplishments, she noted, were the initial identification and sequencing of the virus, provision of test kits for states and for other countries, and delivery of the vaccine “in record time” to more than 70,000 sites, over 116,000 providers, and 10,000 retail pharmacy stores. As a result of the combined efforts of several different agencies within HHS, more than 80 million people were vaccinated.
“All-hazards public health preparedness paid off . … Unprecedented, cross-government, whole of community response is indeed possible,” Dr. Lurie said.
But, of course, there were gaps and opportunities for improvement. Response time needs to be faster for making vaccine and implementing other medical countermeasures, and for obtaining funding. Indeed, there was a time lag of about 6 months for Congressional budget appropriations to reach the federal, then state and local levels to the actual shot in a person’s arm. “We have to be more nimble about moving money.”
Communication with the public could also be improved. “Addressing public concerns is key. The health care system handled this one well, but would be challenged in a more severe pandemic. You can never communicate enough,” she noted.
HHS is addressing these and other concerns, including building stronger day-to-day systems within those already in place, incorporating surveillance and scientific endeavors along with clinical care. The ultimate goal, as informed by the 2009 H1N1 influenza pandemic: “Ensure that we are prepared for something we have never seen.”
-Miriam E. Tucker (@MiriamETucker on Twitter)