Swine Flu: Testing Our Readiness
(Today's post comes to us from Jeff Levi, Executive Director of Trust for America's Health.)
As the first swine flu cases were diagnosed in Mexico, health officials all over the United States leapt into action. This is the test that they are always preparing for.
As the flu spread, public health professionals have been actively tracking the cases, working to contain the disease by treating areas where the disease is most concentrated, dispensing antiviral medications from the Strategic National Stockpile, and letting the public know how to protect themselves and when to seek treatment.
The Administration has displayed strong, coordinated leadership, with the U.S. Centers for Disease Control, the U.S. Department of Health and Human Services, the U.S. Department of Homeland Security, and the White House all conveying guidance and strategies based on the best expert advice for how to respond. State and local health departments are monitoring and responding to cases as they emerge.
We're lucky. The country has taken many measures to prepare for a potential pandemic flu outbreak. In November 2005, then President Bush issued a National Strategy for Pandemic Influenza that called for a plan that spanned every department of the federal government, every state, and the private sector. Congress provided nearly $7 billion to help prepare. Most of this funding went to stockpile existing antiviral medications and give scientists resources to research and develop vaccines and other pharmaceutical interventions.
Since then, due to the tireless work of public health professionals, the country has made significant strides in preparing for surveillance, coordination, communications, treatment capabilities, and vaccine manufacturing capacity. In addition, all 50 states and the District of Columbia have developed pandemic plans.
Overall, our ability to respond to a pandemic is light-years ahead of where we were just a few short years ago. But, our public health system was under-funded for decades, and there are many existing gaps that still leave us vulnerable, particularly if the swine flu becomes more severe and lethal.
If large numbers of Americans start getting very sick and start flooding into hospitals and health care facilities, our system will really be in for a test. Our health system could be overrun in a very short period of time.
Figuring out how to plan for a massive influx of patients is one of the hardest parts of preparing for health emergencies, and it has yet to be adequately dealt with. "Surge capacity" management is one of our biggest weaknesses, particularly at a time when we have shortages of emergency and public health workers. That problem is getting worse as state and local governments are cutting budgets. An estimated 11,000 public health workers have been laid off in just the past year.
The problem of managing massive numbers of patients is even more complicated under the current health care system, where there is serious concern that people who are uninsured or underinsured may not seek treatment or may have trouble accessing care. There are life-or-death consequences at stake during public health emergencies--if people who are contagious do not seek treatment during the limited time period when antiviral medications might be effective, they are at serious risk--to themselves and to others.
The swine flu outbreak is a very real reminder of why we need a strong and stable public health system in the United States. It's a clear demonstration, also, of why you can't separate public health and health care--we need an overall system that addresses health and health care issues in integrated, rational ways. Public health and health care should not compete with each other as issues in our current health reform debates--we need our leaders to support and build reliable funding streams for both, as our real-life swine flu test case so clearly demonstrates. Unless we do that, we are leaving Americans unnecessarily vulnerable to potential health threats, and our hospitals and health care providers at risk for emergency situations they do not have the capacity to handle.
Kevin Sack’s article in today’s New York Times http://www.nytimes.com/2009/04/30/health/30states.html
illustrates Jeff’s point and looks at how recent budget and staff cuts could strain local and state public health departments’ ability to respond to swine flu if the epidemic escalates.
Posted by: Abbey Cofsky | April 30, 2009 at 09:52 AM
H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. Symptoms of swine flu are similar to those caused by other influenza viruses. Health authorities across the globe are taking steps to try to stem the spread of swine flu after outbreaks in Mexico and the United States. The World Health Organization has called it a "public health emergency of international concern."
Posted by: Sujan Patricia | July 23, 2009 at 02:27 PM