The current WHO phase of pandemic alert for avian influenza A(H5N1), A(H7N9, and MERS-CoV is: ALERT
# 7425
I suspect that most emergency responders can relate to the old joke about a tourist asking a NYC cabby, `What’s the best way to get to Carnegie Hall?” and the cabby replies, “Practice, practice, practice”.
When it comes to dealing with extraordinary situations, nothing beats having had realistic training, and frequent practice sessions.
Which is why fire departments, EMS, police, Emergency departments, and the military put such time and effort into mass casualty drills.
Between 2005 and 2009 – as scientists watched the emerging H5N1 virus with growing concern – the development of federal, state, and local pandemic plans, and the conducting of emergency drills, were given high priority across the nation and around the world.
A few (out of hundreds of) examples include:
Hong Kong : Exercise Redwood - 2009
UK Exercise: PPE Usage In A Pandemic –2008
Singapore: Public Involvement In Financial Sector Pandemic Drill –2008
Florida's Pandemic Simulation – 2008
Idaho BlogEx : July 28th –2008
UK: Lessons Learned From Winter Willow – 2007
Those efforts no doubt paid off in the spring of 2009, when the H1N1 pandemic started, although the response had to be tempered to deal with a less severe outbreak than originally envisioned.
Since the end of the pandemic in 2010, I’ve seen very little mention of pandemic planning, or pandemic specific drills across the nation. Due in part, I suspect, to the economic downturn, and because because many people now believe - `we’ve had our pandemic, and it wasn’t so bad’.
But as any epidemiologist will tell you . . . if you’ve seen one pandemic . . . you’ve seen one pandemic.
No two are alike, and there are no guarantees that the next pandemic will be as `mild’ as 2009 (a relative term, but `mild’ compared to 1918), or that another won’t come again in the very near future.
Unlike 2007-2008, when the world was watching one virus with pandemic potential (only to be blindsided by a swine H1N1 virus out of left field), we find ourselves watching three viral threats (H1N1, H7N9, MERS-CoV) that the World Health Organization believes have pandemic potential.
We are in the ALERT Phase for all three viral threats, and, according to the WHO, the world should be engaged in preparedness and early response.
To their credit, the CDC, ECDC, and World Health Organization have all been cranking out revised pandemic guidance, timely updates, and advice for both the avian flu threat and the novel coronavirus.
A few recent examples include:
WHO Unveils New Pandemic Guidance
CDC: Pandemic Planning Tips For Public Health Officials
H7N9 Preparedness: What The CDC Is Doing
CDC: Updated H7N9 Guidance Docs
Roughly a month ago, the CDC released their Top 10 Influenza Pandemic Response Planning Tips for H7N9 Virus, which called upon state and local jurisdictions to review, and finalize, 10 key areas of their pandemic response.
But one has to wonder: Is anyone really listening?
A visit this morning to Flu.gov’s State Pandemic Plans links page finds some of the links dead, many of the links to `draft’ documents dating back 5 or more years, and few signs of updates or revisions in the wake of the 2009 pandemic.
It is certainly possible that some states and local jurisdictions are working feverishly to update their plans and are holding drills, but if they are, they are doing so with little or no fanfare.
Of concern, many of these existing state and local pandemic plans envisioned their primary response as mounting massive vaccination campaigns either before, or during, a pandemic.
But the prospects of seeing a vaccine in time, or in sufficient quantity, to mitigate these current threats is actually pretty low (see A MERS Vaccine Candidate & JAMA: Challenges Of Producing An Effective & Timely H7N9 Vaccine).
Quite frankly, the success of many state, local, and corporate pandemic plans appear to be based on the fervent hope a severe pandemic never happens.
While no one can predict whether another pandemic is in the offing – with three serious viral contenders – there’s never been a more opportune time for local, state officials to take a hard and realistic look at their old pandemic plans, to conduct drills, and to make any necessary changes.
And the same goes for hospitals, corporations, and others in the private sector (see Revisiting Pandemic Preparedness).
One of the best places for people to learn about pandemic planning options is CIDRAP’s Public Health Practices website.
A few blogs highlighting some of the content at PHP include:
PHP: Dealing With Chronic Illness During A Disaster
While some may decry the time and expense required to update their preparedness plans when the threat has yet to materialize, the simple truth is - by the time we know a pandemic has started - there will be little time left for planning.
NOTE: Pandemic preparedness should be a part of an overall `all hazards’ disaster plan; one that would serve you, your business, organization, or agency well in any emergency.
The most recently published Ready or Not? TFAH Report 2012, released in December, highlighted key areas where gaps in preparedness exist around the nation.You can download the entire 76-page report here.
Each state is ranked based on ten preparedness criteria. A rating of 10 is the highest, although no state exceeded an 8.
In this age of budget cuts, increased threats from many directions, and pandemic warning fatigue, I’m certain it is tempting for agencies, organizations, and businesses to put off making changes to their pandemic or disaster plans until a `better time’.
And maybe we get lucky, and it will be years or decades before the next pandemic.
We can certainly hope.
But hope is not a plan. And being caught unprepared during a severe pandemic, or any other major disaster, is simply a road that we, as a nation, can not afford to go down.
