What H1N1 taught us about public health preparedness

Richard Hamburg, deputy director of Trust for America's Health, writes about the H1N1 flu outbreak as a test of the nation's public health system with important lessons for emergency preparedness and health reform.

The H1N1 flu outbreak has been a real-world test of the nation’s public health system, and the results are mixed at best.  The good news is that earlier investments in emergency preparedness created a larger stockpile of antiviral medications. But the outbreak also revealed serious, underlying gaps, including a lack of real-time disease surveillance and laboratory testing, outdated vaccine production capabilities, limited hospital surge capacity and a shrinking public health workforce.

The seventh annual edition of  Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism  shows that a band-aid approach to public health is inadequate.  The report found that 20 states scored six or less out of 10 key indicators of public health preparedness. Montana had the lowest score of all with three out of 10.

Variation in preparedness means that where people live can determine how well they are protected from health threats.  In the case of a pandemic or infectious disease outbreak, one weak link in the public health chain – including providers’  reluctance to treat those who are uninsured or underinsured - could result in disaster for everyone.