Avian Flu Diary: Personal Preparedness Stressed At Today's HHS Webcast

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During today's HHS PlanFirst webcast Secretary Leavitt stressed, repeatedly, the need for personal preparedness as he and a panel consisting of Dr. William Raub (Science Advisor to Secretary Leavitt), Dr. Michael Osterholm (Director of CIDRAP), and Health and Science editor Maggie Fox of Reuters discussed the nation's pandemic preparedness.

The broadcast began with a speech by Secretary Leavitt, where he discussed the increased scope of responsibility for the HHS since the 9/11 terrorist attacks, with a newfound emphasis on emergency response.

One of the most worrisome events that the HHS is planning for is a pandemic, and while the odds of one starting in any given year may be low, another pandemic Leavitt assured, is inevitable.

Calling the 1918 pandemic `mindboggling', he reminded the audience that in New York City alone, some 21,000 children became orphans due to the Spanish Flu.

Talking about a future pandemic, Leavitt warned, "The world is overdue, and regrettably we're still somewhat under prepared."

Among the advances made over the past 3 years Secretary Leavitt listed the fact that there are now six companies in various stages of preparing to manufacture vaccines here in the United States.

He noted that investments made by the Federal government in cell-based vaccine technology, along with grants to improve conventional manufacturing capacity, would allow us to produce domestically enough vaccine by 2011 to vaccinate all Americans within six months of a pandemic outbreak.

We now have 26 million doses of pre-pandemic vaccine on hand for first responders, and we have 50 million (10 pill) courses of antivirals in the Federal Stockpile, and the States have purchased another 22 million courses.

Leavitt reiterated his well known mantra:

"Any community that fails to prepare with the expectation that somehow the federal government will come to their rescue at the last moment will be tragically disappointed."

Secretary Leavitt listed advances made towards developing rapid tests for detecting the H5N1 virus, along with other influenza strains. He went on to say that the HHS had assisted more than 40 nations in their pandemic planning, as well.

Leavitt listed four pandemic planning priorities he would like to pass on to his successor.

First, that the next HHS Secretary will need to make sure that $600 million in vaccine contracts let this year for the construction of cell-based vaccine plants are fulfilled, and the plants are actually built.

As a second priority, next Secretary should `defend strongly, the virus sample sharing network' and not allow temporary opportunism to allow nations to hold the system hostage.

The third priority is to concentrate on countermeasure distribution. He warned that while the Strategic Stockpile could deliver supplies within 12 hours to nearly any area of the nation, not all states are capable of distributing them.

And the fourth priority is to continually remind states, businesses, and families about their responsibility to be prepared. This is, he said, a `never-ending task'.

He warned that public health is a state and local responsibility, and that states legislatures are failing to adequately fund local public health programs.

Leavitt said he hoped to release a state-by-state evaluation before he leaves his post early next year, showing which states are adequately meeting their funding obligations.

He then stressed:

"For the world to be prepared, every nation, every city, every business, every school, every hospital, every clinic, every church, and every household needs a plan. We need to exercise them and we need to practice them."

Secretary Leavitt then joined the panel of Dr. Raub, Dr. Osterholm, and Maggie Fox where they took questions via email, and discussed them.

Dr. Raub stressed the theme of `shared responsibility'. Federal governments, state governments, local governments, not-for profit organizations, and businesses large and small must all work together to prepare for a pandemic.

Dr. Michael Osterholm was asked about his statement (see I've Hit The Wall):

"I've finally come to the conclusion that, as a nation, we don't have and can't find either the political will or private-sector commitment needed to address our pandemic preparedness challenges of today. To make matters worse, other national governments and their private-sector enterprises are not making meaningful progress in preparing for the next influenza pandemic, either. In the US, we have a national pandemic influenza plan, but it doesn't even begin to address the disastrous implications of a collapsing global just-in-time economy." Michael Osterholm - Sept 11th, 2008

Osterholm gave the example of a recent study that showed that of 19 essential drugs used in this country, that 95% were manufactured offshore, and in a pandemic would likely become in short supply or become unavailable.

He cautioned that the number of people who could die from these sorts of collateral effects might exceed those who succumbed to the virus.

Email questions started off with "What can private citizens do to encourage local officials to discuss pandemic issues?"

Secretary Leavitt immediately stated he encourages people to do their own preparedness; that people should be prepared for any disaster.

He recommended that citizens let their local, state, and national representatives know that they should make preparedness a high priority.

Dr. Raub and Dr. Osterholm both echoed the need for local investment in pandemic preparedness.

When asked what would be the impact if private business failed to prepare for a pandemic, Dr. Osterholm stated he believed many already had failed. That while they have held meetings and discussions, they have not taken it to the `next level'.

What happens when their suppliers are unable to funnel supplies to them? What happens if local utilities are down?

Osterholm stated that `We need to challenge the private sector much more", to step up and take responsibility for pandemic planning. He stated that he was worried that the current financial crisis was causing some companies to take `pandemic planning off the table'.

A question directed to Maggie Fox asked, "What social responsibility does the media have in covering a mass public health disaster?"

Fox replied that, "the responsibility of the media is to report the news, but that these interests coincide in something like a pandemic because there are local news stations and newspapers who are informing their neighborhoods."

Fox then asked the panel what can we do, besides talking a lot, to get people to prepare for a pandemic.

Dr. Osterholm admitted it is hard to describe a pandemic.

That he could talk about why coal supplies might be jeopardized during a pandemic, which means electricity might be jeopardized - but most people would think it was far-fetched.

Still, he insists, the supply chain is razor thin, and a failure of the grid would be a huge public health issue.

Secretary Leavitt then stated we needed to `continue to focus on individual preparedness - that there are constant manifestations of the need for it - every time there is a serious storm that affects peoples lives, it is personal preparedness that ultimately spells the difference'.

Secretary Leavitt went on to say:

`We need to continue to use every opportunity to talk about individual preparedness. Yes the government needs to play a role, at the state, federal and local level . . . but people have a responsibility and it is the aggregate of their actions that will ultimately determine whether we are prepared or not. "

During the 75 minute long presentation the panel addressed such diverse questions as `What measures has the HHS taken to coordinate its current pandemic plans with US embassies to extend protection to U.S. citizens abroad?" and (from Maggie Fox) "What happens if we are successful in stopping the H5N1 virus? How do we keep people willing to stay prepared for the next threat?"

The last question to the panel was what should families do to plan today?

While acknowledging the financial difficulties that families are having in this economy, the need to prepare is real. Even if you can't afford to stockpile food right now, you can at least be making a family plan, advised Dr. Osterholm.

Dr. Osterholm also stressed that citizens need to voice their concerns over the importance of pandemic (and all-hazards) preparations to their local, state, and national elected officials.

Secretary Leavitt finished by saying "There is no replacement for individual preparedness. Having a small stockpile of food is a very good idea . . .for reasons other than pandemic. Having a little water, having a stockpile of medicines, that could last you an extra week or two if you can't go out of your home . . is a very good idea.

This is not just about pandemics, this is wise management and risk management for any family . . . and every family should do it to the extent they find possible. . ."

This latest video presentation will be archive on the HHS Website in 5 to 7 days.

If you've missed any of the earlier editions of the PlanFirst webcast, they are archived as well.