When public health alarms started ringing over an influenza outbreak, the scenario was supposed to involve the avian flu, not the swine variety. Regardless, as the confirmed flu cases started mounting quickly last weekalong with the death tollthe worlds public health guardians seemed on top of their game. Credit that in large part to a level of readiness resulting from intense workand spendingthese past several years, trying to stay ahead of the pandemic threat from bird flu. But only time will tell if we were as prepared as we truly needed to be and if were ready for other dangers that may lie ahead.
Were we truly prepared?
Time will tell if flu preparedness was adequate, but more still needs to be done
Americas public health agencies, specifically HHS and the Centers for Disease Control and Prevention, as well as the Homeland Security Department kept the nation up-to-date and appeared to be operating in a coordinated fashion. Maybe the lessons of Hurricane Katrina helped here.
The feds truly got this countrys attention with the declaration of a national public health emergency early on as the H1N1 influenza A, commonly known as swine flu, spread with apparent ease. That action opened federal stockpiles of antiviral drugs and supplies and availed state and local agencies other assistance. The World Health Organization reacted in lockstep, rapidly raising its level of perceived pandemic threat.
The agencies deserve credit for their swift response, actionable advice and guidance for the general public and healthcare providers alike as fear spread as fast as the illness itself.
At the same time, however, even before the crisis started dominating headlines, holes in our nations overall level of disaster preparedness were apparent. Even former HHS Secretary Mike Leavitt last week noted the countrys continued vulnerabilities.
Late last month, a study commissioned by HHS and conducted by the Center for Biosecurity of the University of Pittsburgh Medical Center credited Americas hospitals for the progress theyve made in the past five years in disaster readiness (April 27, p. 4). But deeper into the report another alarm was sounded with the conclusion that a more systemic preparation for widespread and prolonged emergencies is still only in its infancy.
According to the report, the U.S. healthcare system is not currently capable of effectively responding to the sudden surge in demand for medical care that would occur during catastrophic events. Such widespread or sustained events would include not only a full-blown influenza pandemic but also bioterrorist attacks, detonation of a nuclear weapon or large-scale natural disasters such as intense storms and large earthquakes.
As weve watched the current flu crisis unfold or look at the calendar and note the approach of another hurricane season, were reminded that these arent low-odds events any longer. Its quite possible any of those catastrophes could visit us in the near future.
Our nations specific vulnerability to a flu pandemicdespite years of supply stockpiling, policymaking and special appropriations for preparednesswas also the central warning in the Modern Healthcare cover story Pandemic peril published just one month ago (April 6, p. 6).
As we reported, after bursts of extra funding earlier in this decadenearly $6 billion was appropriated from 2005 to 2006 alonemoney for preparedness activities has slowed considerably, while at the same time the pandemic flu threat remained as real as ever, public health experts have reminded us time and again. Requested funding was excised from the fiscal 2008 budget and the federal stimulus bill as well.
Have we as a nation been suffering from pandemic fatigue? If so, that needs to be treated immediately, in Washington and across the country. Public health alarms continue to sound.
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