Topic A -- Is America Prepared for a Swine Flu Pandemic?

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Tuesday, April 28, 2009; 12:00 PM

With news of 149 deaths in Mexico due to the swine flu, The Post asked experts how prepared America is for a flu pandemic. Below are contributions from Jeffrey Levi, Peter M. Sandman and Thomas V. Inglesby.

JEFFREY LEVI

Executive director of the Trust for America's Health; associate professor in the Department of Health Policy at The George Washington University School of Public Health and Health Services

The Obama administration's fast and effective response to the swine flu outbreak is the payoff of preparedness efforts since 2005, when the government issued a strategy to prepare for a potential pandemic flu. There have been significant improvements in surveillance, coordination, communications, treatment capabilities and stockpiles, vaccine manufacturing capacity, and ensuring that every state now has a pandemic plan.

But, so far, the swine flu crisis has not tested the limits of our response system. A number of key areas still need improvement: providing full funding for research so we can rapidly produce a vaccine against a novel virus -- such as the one we are seeing now; creating new drugs that don't develop resistance; building our stockpile of anti-virals so that every state is equally protected (right now not all states have the same level of stockpiling); supplying enough annual resources to support ongoing state and local response capacity; managing mass casualty care if there is a major surge in patients; and bolstering the public health workforce during a time of cutbacks and layoffs. Let's hope this swine flu doesn't become the pandemic we fear -- but still serves as a wake-up call to address these challenges.

PETER M. SANDMAN

Risk communications expert; member of the SARS Scientific Research Advisory Committee at the World Health Organization

Mobilizing the public is an essential part of preparing for potential pandemics -- a job the government hasn't yet taken seriously with regard to swine flu. Three years ago, when "bird flu" appeared to be a looming pandemic threat, Health and Human Services Secretary Michael Leavitt advised Americans to stock up on food, water, prescription medicines and other key supplies. That was the right message. Now, officials are evading journalists' questions about whether that's still good advice. So far, the government has advised hygiene but not preparedness. It has mostly told people to stay home if they're sick, cover their coughs and wash their hands a lot.

The current outbreak could end up devastating, trivial (at least in the U.S.), or anywhere in between. The government must help the public visualize what a really bad swine flu pandemic might be like. People need to feel the knots in their stomachs that everyone on the inside is feeling, then start preparing as Leavitt suggested two years ago -- which will stand us in good stead even if this isn't The Big One. The World Health Organization finally has ratcheted up its alert level from Pandemic Phase 3 to Phase 4. I hope the government will see this as a signal to start sending different signals.

THOMAS V. INGLESBY

Deputy director of the Center for Biosecurity at the University of Pittsburgh Medical Center; co-editor in chief of Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science

We've come a good way on pandemic preparedness since the beginning of the decade: more educated doctors and nurses, hospitals and health agencies better prepared to deal with crises, new federal efforts to make vaccines and drugs. But in the long-term, to deal with serious pandemics or bioterrorist events will take sustained attention by our political leaders, as well as a consistent funding strategy -- not supplemental to supplemental. The one-year budget cycles imposed on most federal agencies make it difficult to coherently plan and effectively execute biodefense and pandemic preparedness programs. We also need more engagement from the private sector, including hospitals and others in the healthcare sector, public-private partnerships, and community planning organizations. This is a marathon, not a sprint, and we have to act and plan that way now.


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