Dealing With A Lighter Shade Of MERS

Photo Credit- CDC

 

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With the spring surge in MERS cases in the Middle East, and a (thus far) small number of exported cases to countries like Greece, Malaysia, The Netherlands, and the United States, we’ve seen a lot of talk (pro and con) on the pandemic potential of the emerging MERS coronavirus.  

 

It’s an understandable debate, as a pandemic would have a huge global impact - and if one were in the wings -now is the time we should be preparing for it.

 

Although we’ve seen some impressively large clusters in healthcare settings, so far, the illness hasn’t spawned large outbreaks in the community, and its spread outside of the Arabian peninsula has been anemic. So far, the consensus appears to be that the MERS coronavirus is not yet sufficiently transmissible enough to spark a pandemic.

 

Good news.  With the caveat being that viruses have a nasty habit of changing over time.

 

This disease’s future isn’t a binary one, however;  a `pandemic or nothing’ proposition.  Even in its present incarnation, it has the potential to be a long-term, high-impact problem.

 

Already, with just two introductions into the United States, we’ve seen its expensive and disruptive effects; hundreds of people potentially exposed, scores of healthcare workers furloughed to home isolation, extensive contact tracing & testing programs initiated, and scores of lives and jobs interrupted.

And while only impacting two healthcare facilities directly, the ripple effects – implementing better screening, testing, and heightened infection control in anticipation of future cases – extend to all medical facilities. 

 

The irony is, that as long as a pathogen has unrealized `pandemic potential’, public health attempts to contain it in some ways are more extensive and disruptive than efforts to deal with it after it becomes a pandemic.

 

The arduous process of contact tracing and testing of potentially exposed airline passengers makes sense as long as the virus remains rare, but quickly becomes moot once a virus become pervasive in the community. Similarly, the public health value of stringent isolation and quarantine policies diminish as a pandemic progresses.

 

While better than dealing with a pandemic, fighting a `cold war’ against an emerging infectious disease threat can be protracted, expensive, and exhausting proposition –  much like the battle that has been waged these past few years against emerging antibiotic resistant organisms like NDM-1 and CRE (see MMWR Vital Signs: Carbapenem-Resistant Enterobacteriaceae (CRE)).

 

The spread of HAIs (Hospital Acquired Infections) has cost us hundreds of thousands of lives and billions of dollars over the past decade, and despite elaborate measures taken to prevent them, the `bugs’ seem to be winning. 

Even with limited `droplet or airborne’ transmissibility, MERS-CoV adds to the complexity of infection control in medical settings, meaning that even a handful of imported cases each month have the potential to severely impact healthcare facilities, and many lives, across the nation.

 

It doesn’t require a Stephen King-styled pandemic to turn MERS into a major problem.  A small but steady influx of MERS cases could do that as well – particularly when stacked on top of the growing list of other emerging (although not necessarily pandemic) disease threats.

 

A partial list of ongoing or emerging global health threats we’ve discussed includes:

 

• The  importation of West Nile Virus to North America in 1999 (see WNV: The Economic Costs Of An Invasive Arbovirus)
• The more recent arrival of Dengue Fever in Florida and Texas (see  MMWR: Dengue Fever In Key West)
• Last fall’s Chikungunya outbreak in the Caribbean which now threatens North America (see ECDC: Caribbean Chikungunya Update)
• And the growing threat from antibiotic resistant bacteria (see NDM-1: A Matter Of Import)

 

To this short list you can add the continual spread of H7N9 and H5N1 avian flu viruses (see The Expanding Array Of Novel Flu Strains) in Asia and the Middle East, Polio in the Middle East and Africa, contaminated food or drugs, XDR-TB, and of course the one(s) we don’t even know about yet . . .  Virus X.

 

All of which makes the recent cuts in public health spending all the more egregious, dangerous, and foolhardy.

 

A recent report  from TFAH (Trust for America’s Health) finds a steady decline in the resources available to public health across the nation. 

 

Investing in America’s Health: A State-by-state Look at Public Health Funding & Key Health Facts

 

May 2014

Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released Investing in America's Health: A State-by-State Look at Public Health Funding and Key Health Facts. This is the ninth time the report has been released.

In Investing, TFAH and RWJF examine public health funding and key health facts for each state, finding:

• Wide Variation in Health Statistics by State:  There are major differences in disease rates and other health factors in states around the country.  For instance, only 7.0 percent of adults in Alaska have diabetes compared to 13.0 percent in West Virginia, and 28.3 percent of adults in Kentucky are current smokers while only 10.6 percent report smoking in Utah.
• Cuts in State and Local Funding:  At the state and local levels, public health budgets have been cut at drastic rates in recent years.  According to a TFAH analysis, 33 states and Washington, D.C. decreased their public health budgets from FY 2011-12 to FY 2012-13.  Budgets in 20 states decreased for two or more years in a row, and budgets in 16 states decreased for three or more years in a row. 
• In FY 2012-13, the median state funding for public health was $27.49 per person, ranging from a high of $144.99 in Hawaii to a low of $5.86 in Missouri.  From FY 2008 to FY 2013, the median per capita state spending decreased from $33.71 to $27.49.  This represents a cut of more than $1.3 billion (adjusted for inflation).
• Flat Federal Funding:  Federal funding for public health has remained at a relatively flat level for years.  The budget for CDC has decreased from a high of $7.07 billion in 2005 to $5.98 billion in FY 2013 (adjusted for inflation). Spending through CDC averaged to only $18.92 per person in FY 2013.  And the amount of federal funding spent to prevent disease and improve health in communities ranged significantly from state to state, with a per capita low of $13.67 in Indiana to a high of $46.48 in Alaska. 

Overall, the report concludes that the nation must shore up core ongoing funds for public health. In addition, the report recommends ensuring the Prevention and Public Health Fund is used to build upon and expand— not supplant – existing efforts.

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Even as the number of global disease threats continue to rise, we seem blindly intent on gutting our only line of defense  – our state, local, and Federal public health systems.  In this climate of budget cutbacks, when combined with an ever growing list of other public health challenges, even dealing with a lighter shade of MERS may prove a serious challenge.

 

The old adage is true, `When public health works, nothing happens’. 

 

The one thing we really, really don’t want to ever see in this country is what would happen if public health no longer worked.   

TFAH Report Finds Low Uptake Of Flu Shots Among Young Adults

Credit TFAH 

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After a couple of fairly tame influenza seasons that followed the 2009 H1N1 pandemic, last year saw a particularly nasty H3N2 season  - affecting mostly elderly patients - that produced some of the highest hospitalization and P&I mortality rates  that we’d seen in a decade (see CDC Statement On Elevated P&I Mortality Rate). 

 

While the uptake of seasonal flu vaccines have improved in recent years among those over the age of 65, and for children aged 6mos to 17 years, most young adults (aged 18-65) in the United States still elect not to get the vaccine.

 

The irony here is, while most years the flu shot provides a moderate level (50%-60%) of  effectiveness, the age cohorts most likely to enjoy the best protection are those same younger adults who tend to eschew the jab.

 

This year, we are seeing the pH1N1 strain dominate for the first time since 2010, and as it did in 2009, it appears to be hitting those same younger adults harder than usual. Today, TFAH (the Trust for America’s Health) released a report on the uptake of the flu vaccine from the 2012-2013 flu season, that illustrates these trends.

 

Issue Brief: As Flu Season Ramps Up, Adults 18-64 Years Old Least Likely to Get Flu Shots

January 2014

Analysis Finds 32 States Fail to Vaccinate at least 40 Percent of Adults 18-64 Years Old

An analysis  by the Trust for America’s Health (TFAH) found that only 35.7 percent of adults ages 18 to 64 years old got the flu shot last season (the most recent period data with available data).  By comparison, 56.6 percent of children (ages 6 months to 17 years old) and 66.2 percent of seniors (ages 65 and older) were vaccinated.  The U.S. Centers for Disease Control and Prevention (CDC) recommends all American 6 months and older get vaccinated each year.

 

According to the CDC, the flu season in the United States is beginning to “ramp” up and flu is now widespread in 35 states.  Rates are particularly high in 13 Southern and Central/Western states (Alabama, Arkansas, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Oklahoma, Texas and Utah).

 

H1N1 is the most prevalent flu strain this season, which can disproportionately and adversely impact otherwise healthy children and young adults, according to the CDC.

 

 “The trend of low vaccination rates among younger adults is particularly troubling this year, when they are more at risk than usual for the effects of the H1N1 strain of flu that’s circulating,” said Jeffrey Levi, PhD, executive director of TFAH.

 

Today’s analysis finds that overall flu vaccination rates remain low in the United States.  Fewer than half of Americans (45 percent) got a flu shot during the 2012-13 season, which was an increase over 41.8 percent in the previous (2011-12) season.

(Continue . . . )

 

Whether it is due to complacency, a feeling of invulnerability, or a general distrust of vaccines or big Pharma, getting the seasonal flu shot remains a low priority for many young adults.

 

Knowing this, vaccine manufacturers only produce as much vaccine as they think are likely to be sold each year, else millions of shots would go wasted.

 

This year, as we see from the CDC’s Vaccine Distribution chart below, for the United State’s population of over 300 million people only about 140 million shots were ordered.

 

Seasonal Influenza Vaccine & Total Doses Distributed

• This table reflects the cumulative weekly total number of seasonal influenza vaccine doses distributed in the US as reported to CDC by influenza vaccine manufacturers and selected distributors.
• Currently, manufacturers project 138-145 million doses of flu vaccine to be produced this season.

January 9, 2014 2:00 PM ET

Table of 2013-14 Seasonal Influenza Vaccine—Total Doses Distributed

 

In a related story , Helen Branswell wrote last night about the flu shot shortage in Canada – brought on by the recent climb in serious flu infections among young adults.

 

The flu shot shortage: Who’s to blame?

By Helen Branswell Medical reporter, The Canadian Press

Wonder why some Canadians have to scramble to find a flu shot this year? People may be tempted to blame the authorities – their provincial or territorial government – but to do so would be unfair.

If people are looking for a culprit for this year’s flu shot shortage, they should probably stand in front of a mirror.

It’s as simple as this: Canada doesn’t have more vaccine because it hasn’t used more vaccine in the past.

(Continue . . . )

 

 

There is actually another, potentially dangerous,  downside to the low demand for seasonal flu shots.  

Just as vaccine manufacturers can’t afford to produce enough vaccine for everyone in the United States and Canada, knowing that more than half of the doses would be discarded, they also can’t afford to build and maintain enough manufacturing capacity to quickly produce sufficient pandemic vaccine for the global population quickly.

If the demand for yearly vaccines were considerably greater, the industry would build the infrastructure needed to produce it, and as a result their capacity to produce vaccines during an emergency would increase as well.

For now, the ability of vaccine manufacturers to quickly produce and deliver large quantities of pandemic influenza vaccine remains very limited.  Some vaccine would likely be available within 6 months – but not the kind of quantities that would be required to stop a pandemic in its tracks. 

 

The limits of our current vaccine manufacturing technology, and the steps needed to improve them, are many and complicated, and go far beyond the need to increase yearly uptake of vaccines. They were were well addressed back in the 2012 in CIDRAP: The Need For `Game Changing’ Flu Vaccines – a truly impressive 160-page report that emphasizes the need for a revolution in vaccine technology.

The Compelling Need for Game-Changing Influenza Vaccines

An Analysis of the Influenza Vaccine Enterprise and Recommendations for the Future

Michael T. Osterholm, PhD, MPH, Nicholas S. Kelley, PhD, Jill M. Manske, PhD, MPH, Katie S. Ballering, PhD, Tabitha R. Leighton, MPH, Kristine A. Moore, MD, MPH

For those not ready to commit to reading a 160-page report, there is a 12-page Executive summary available.

Pandemic Planning For Business

Credit TFAH It's Not Flu As Usual Brochure

 

 

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Six years ago, before the H1N1 pandemic emerged in 2009, we were carefully monitoring the H5N1 threat while governments, agencies, and businesses actively prepared for a severe pandemic.

 

As States and Federal agencies drilled and prepared, the HHS released guidance to local governments, individuals and businesses on how to prepare for `the next pandemic’.

 

A small sampling includes:

 

Guidance for Employers

• Guidance on Preparing Workplaces for an Influenza Pandemic (Occupational Safety & Health Administration (OSHA))
• Business Pandemic Influenza Planning Checklist (PDF – 151 KB)
  Lista de Preparacion en Empresas para una
• Pandemia de Gripe (PDF – 276 KB)
• Pandemic Preparedness Planning for US Businesses with Overseas Operations (PDF – 3.03 MB)
• Interim Pre-Pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States (PDF – 718 KB) (CDC)
• Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic (PDF – 497 KB)
• Interim Guidance on Environmental Management of Pandemic Influenza Virus
  Learn more about how to clean and protect surfaces from the influenza virus.

 

When the pandemic finally arrived, it turned out to due to a less severe strain of Swine flu; H1N1.   We got `lucky’ in that we ended up with a `Cat 1’ pandemic, not the feared Category 5 event that most plans had envisioned.

 

 

Since the end of 2009 - between the prolonged economic downturn and the belief that we’d seen `our pandemic’, and another would not likely occur for decades – pandemic preparedness for many businesses has been put on the back burner. 

Many of the carefully prepared pandemic plans drafted in 2006 or 2007 are now gathering dust in some desk drawer, and have not been reviewed or updated for years.

 

No one can predict when, how severe, or what virus will spark the next pandemic.  But the risks of seeing a severe pandemic have not diminished. With three legitimate pandemic `worries’ out there (H5N1, H7N9, MERS-CoV) – if anything, they’ve escalated

 

Making this an opportune time to drag out, dust off, and take a hard look at your old pandemic plans (or create a new one if need be).

 

One of the nation’s leaders in pandemic and disaster planning is Public Health - Seattle & King County.  In 2008 they produced a 20 minute film called Business Not As Usual, designed to help introduce businesses to the core concepts of pandemic planning.

 

Frankly, this video should be required viewing for every businesses owner, manager, and employee.

 

You’ll also find a long list of preparedness resources available on this page as well:

General resources:

• Business Not As Usual: Video User Guide
• Go-Kits checklist (available in multiple languages). Go-Kits are emergency kits to pack in advance, you just pick up a kit and GO!
• Planning Checklist
• Stopping the Spread of Germs at Work

Business and government preparedness:

• Business Pandemic Influenza Planning Checklist
• Continuity of government issues that should be addressed by local agencies
• It's Not Flu As Usual Brochure
• Guidance on Preparing Workplaces for an Influenza Pandemic
• Preventing the Spread of Influenza
• Guidance for employers on returning to work after influenza illness

Community Based Organization (CBO) preparedness:

• 9 Small Steps that Reap HUGE Rewards
• Business Continuity Template
• CARD Agency Emergency Plan
• It's Not Flu As Usual Brochure
• Pandemic Influenza Emergency Response Manual
• Preventing the Spread of Influenza
• Guidance for employers on returning to work after influenza illness

Personal preparedness:

• Family Health Information Sheet
• How to care for someone with influenza
• Pandemic Flu Planning Checklist for Individuals and Families
• Your Personal Go-Kit

 

While another pandemic may not come for years, if you and your business are well prepared to deal with a Cat 4 or 5 pandemic, you are pretty much ready to deal with any disaster.

 

And as bitter experience has shown, earthquakes, floods, tornadoes, hurricanes, industrial accidents, and even terrorist attacks can, and do happen with some frequency.

 

Often, the difference between a business surviving a disaster – or going bankrupt - boils down to how well their emergency and recovery plans were designed and implemented.

 

For more on  disaster preparedness, I would invite you to visit Ready.gov, FEMA,  or revisit these blogs:

 

In An Emergency, Who Has Your Back?

When 72 Hours Isn’t Enough

The Gift of Preparedness 2012

Ready or Not? TFAH Report 2012

Download Link

 

 

# 6795

 

For the tenth year in a row, the Trust for America’s Health (TFAH), has produced a comprehensive report on the the level of preparedness for all 50 states and the District of Columbia.

 

You can find, and compare progress, from my coverage of earlier editions of this report:

 

TFAH: 2011 Ready or Not Report

TFAH Ready Or Not Report: 2010

TFAH: Ready Or Not 2009

From today’s Press Release:

 

Ready or Not?

Protecting the Public from Diseases, Disasters, and Bioterrorism

December 2012

In the 10th annual Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism report, 35 states and Washington, D.C. scored a six or lower on 10 key indicators of public health preparedness.

The report found that while there has been significant progress toward improving public health preparedness over the past 10 years, particularly in core capabilities, there continue to be persistent gaps in the country's ability to respond to health emergencies, ranging from bioterrorist threats to serious disease outbreaks to extreme weather events.

In the report, Kansas and Montana scored lowest - three out of 10 - and Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored highest - eight out of 10.

"In the past decade, there have been a series of significant health emergencies, including extreme weather events, a flu pandemic and foodborne outbreaks," said Jeffrey Levi, PhD, executive director of TFAH. "But, for some reason, as a country, we haven't learned that we need to bolster and maintain a consistent level of health emergency preparedness. Investments made after September 11th, the anthrax attacks and Hurricane Katrina led to dramatic improvements, but now budget cuts and complacency are the biggest threats we face."

(Continue . . . )

 

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. 

 

The report, which is worth reading in its entirety, contains these key findings:

 

 

You’ll find an interactive map, with links to each individual state’s report at :

 

http://healthyamericans.org/report/101/

TFAH: 2011 Ready or Not Report

 

 

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TFAH, or the Trust For America’s Health, is a non-profit organization that audits and reports on public health issues in the United States. 

 

Yesterday, in the middle of an unusually busy health news cycle, they released their annual report on the readiness of the United States to deal with disease, disasters, and bioterrorism.

 

This year’s big concern is that the gains of the past few years in preparedness may be eroded due to budgetary constraints.

 

First an excerpt from the press release, then a link to the study and the conference call, followed by a link to a report by Lisa Schnirring at CIDRAP news.

 

Press Release

For Immediate Release: December 20, 2011

Report Finds Preparedness for Bioterror and Health Emergencies Eroding in States Across the Country

Cuts to Key Programs Could Hurt Ability to Detect and Respond to Crises

Washington, DC, December 20, 2011 -The Trust for America's Health (TFAH) and Robert Wood Johnson Foundation (RWJF) released the ninth annual Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism today, which finds key programs that detect and respond to bioterrorism, new disease outbreaks and natural or accidental disasters are at risk due to federal and state budget cuts.

Some key programs at risk due to continued cuts to federal public health emergency preparedness funds include:

• 51 of the 72 cities in the Cities Readiness Initiative are at risk for elimination; the Initiative supports the ability to rapidly distribute and administer vaccines and medications during emergencies;
• All 10 state labs with "Level 1" chemical testing status are at risk for losing top level capabilities, which could leave the U.S. Centers for Disease Control and Prevention (CDC) with the only public health lab in the country with full ability to test for chemical terrorism and accidents;
• 24 states are at risk for losing the support of Career Epidemiology Field Officers - CDC experts who supplement state and local gaps to rapidly prevent and respond to outbreaks and disasters, such as during the H1N1 flu pandemic and responding to the health impact of the Gulf Oil Spill in 2010; and
• The ability for CDC to mount a comprehensive response to nuclear, radiologic and chemical threats as well as natural disasters is at risk due to potential cuts to the National Center for Environmental Health. All 50 states and Washington, D.C. would lose the support CDC provides during these emergencies.

"We're seeing a decade's worth of progress eroding in front of our eyes," said Jeff Levi, PhD, Executive Director of TFAH.  "Preparedness had been on an upward trajectory, but now some of the most elementary capabilities - including the ability to identify and contain outbreaks, provide vaccines and medications during emergencies, and treat people during mass traumas - are experiencing cuts in every state across the country."

(Continue . . .)

Download the full report

Download a recording of the News Conference Call

 

 

And for good measure, Lisa at CIDRAP filed this report last night. Follow the link to read it in its entirety.

 

Preparedness report card spells out programs at risk for cuts

Lisa Schnirring Staff Writer

Dec 20, 2011 (CIDRAP News) – Public health programs that detect and respond to bioterror events and disease outbreaks are at risk from federal and state budget cuts, a threat that could worsen over the next year if automatic across-the-board cuts kick in, according to an annual preparedness report card released today.

The big-picture preparedness view and warning come from Trust for America's Health (TFAH), a nonprofit health advocacy group, and the Robert Wood Johnson Foundation.

(Continue . . . )

TFAH Ready Or Not Report: 2010

 

 

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TFAH, or the Trust For America’s Health, is a non-profit organization that audits and reports on public health issues in the United States.   I’ve highlighted a number of their previous reports in the past 12 months, including here, here, and here.

 

Today they’ve released their 8th Annual Report on the readiness of the United States to deal with disease, disasters, and bioterrorism.

 

While many gains in preparedness have been recorded, according to TFAH the recession and recent budget cuts threaten this hard earned progress.

 

I’ve links to the full report, a press release, and the audio file of today’s telephone conference about the report’s release.

 

Complete Report (1.7MB pdf)

 

A recording of the National Press Briefing

 

Press Release: Report Finds States Achieve Highest Ever Scores for Public Health Preparedness, But Progress Threatened by Budget Cuts (December 13 2010)

 

 

How the states ranked.

 

 

Press Release

For Immediate Release: December 14, 2010

Ready or Not?

2010 Finds States Achieve Highest Ever Scores for Health Emergency Preparedness, But Progress Threatened by Budget Cuts

Washington, D.C., December 14, 2010 - In the eighth annual Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism report, 14 states scored nine or higher on 10 key indicators of public health preparedness.  Three states (Arkansas, North Dakota, and Washington State) scored 10 out of 10.  Another 25 states and Washington, D.C. scored in the 7 to 8 range.  No state scored lower than a five.

 

The scores reflect nearly ten years of progress to improve how the nation prevents, identifies, and contains new disease outbreaks and bioterrorism threats and responds to the aftermath of natural disasters in the wake of the September 11, 2001 and anthrax tragedies.  In addition, the real-world experience responding to the H1N1 flu pandemic - supported by emergency supplemental funding - also helped bring preparedness to the next level.

 

However, the Ready or Not? report, released today by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation, notes that the almost decade of gains is in real jeopardy due to severe budget cuts by federal, state, and local governments.  The economic recession has led to cuts in public health staffing and eroded the basic capabilities of state and local health departments, which are needed to successfully respond to crises.  Thirty-three states and Washington, D.C. cut public health funding from fiscal years (FY) 2008-09 to 2009-10, with 18 of these states cutting funding for the second year in a row.  The report also notes that just eight states raised funding for two or more consecutive years.  The Center on Budget and Policy Priorities has found that states have experienced overall budgetary shortfalls of $425 billion since FY 2009.

 

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TFAH: Fighting Flu Fatigue

 

# 5044

 

 

 

TFAH (Trust for America’s Health) has released a new report called Fighting Flu Fatigue, that finds (among things) – that hospitalization rates were higher during the 2009 pandemic, but vaccination rates were lower – for African-Americans, Hispanics, and American Indian/Alaska Natives.

 

Jeffrey Levi, PhD, Executive Director of TFAH, urges in the press release that we not return to a national complacency about influenza, but that we build on the momentum of the pandemic response efforts.

 

This report makes a number of recommendations, including the creation of a major campaign that provides:

 

• Education about the need for flu shots, focused on why everyone should get immunized and the safety of the shots;
• Special, concerted outreach to minority groups. It is particularly important to use targeted, culturally-appropriate messages and messengers that encourage vaccinations and address negative beliefs and misinformation;
• Increased easy access to flu shots, even to people who are uninsured or do not receive regular medical care; and
• Incentives for health care workers to be vaccinated. Last season, only 62 percent of health care workers were vaccinated against the seasonal flu and only 37 percent received an H1N1 flu shot by January 2010.

 

 

There is a lot more to read here, as well, so be sure to read the full report.

 

First some excerpts from the press release for this report, followed by a link to the report itself.

 

 

Press Release

For Immediate Release: November 10, 2010

New Report Finds H1N1 Hospitalization Rates Higher But Vaccination Rates Lower for Minorities

Washington, D.C., November 10, 2010 - H1N1 flu hospitalization rates for African-Americans, Hispanics, and American Indian/Alaska Natives were nearly two to one higher than rates for Whites during the 2009-2010 flu season, according to a new report, Fighting Flu Fatigue, from the Trust for America's Health (TFAH). At the same time, both H1N1 and seasonal flu vaccination rates were lower for African Americans and Hispanics than for Whites.

During the 2009-2010 flu season:

• African American hospitalization rates were 29.7 per 100,000 people compared to White hospitalization rates of 16.3 per 100,000 people. Hispanic hospitalization rates were 30.7 percent per 100,000 people;
• H1N1 vaccination rates were 9.8 percent lower for African-American adults and 4.2 percent lower for African-American children than for Whites;
• Seasonal flu vaccination rates were 16.5 percent lower for African-American adults and 5.6 percent lower for African-American children than for Whites;
• H1N1 vaccination rates were 11.5 percent lower for Hispanic adults than for Whites, although rates were 5.5 percent higher for Hispanic children; and
• Seasonal flu vaccination rates were 21.7 percent lower for Hispanic adults and 2.6 percent lower for Hispanic children than for Whites.

The flu is preventable with a vaccine - yet, each year, between 3,000 and 49,000 Americans die from flu-related illnesses (based on a review of deaths from 1976 to 2007) and the flu contributes to more than $10 billion in lost productivity and direct medical expenses and $16 billion in lost potential earnings each year in the United States. Fighting Flu Fatigue examines lessons from the H1N1 pandemic to inform future flu policies and prevention in the United States.

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Click Image or this link for report

 

 

My thanks to Tetano on FluTrackers for posting this link.

TFAH: Ready Or Not 2009

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TFAH, or the Trust For America’s Health, is a non-profit organization that audits and reports on public health issues in the United States.   I’ve highlighted a number of their previous reports in the past (see TFAH Report: H1N1 Challenges Ahead).

 

Today they’ve released their 7th annual report on the readiness of the United States to deal with disease, disasters, and bioterrorism.  In it they find that the H1N1 pandemic outbreak of 2009 has revealed a number of shortcomings in our national public health preparedness plans.

 

A hat tip to Jimmy Jazz at the Break Glass Blog for calling this report to my attention.

 

Here is an excerpt from the press release, and a link to the actual report follows.

 

 

Press Release

For Immediate Release: December 15, 2009

New Report: H1N1 Reveals Gaps in Nation’s Emergency Health Preparedness Efforts; Twenty States Score Six or Less Out of Ten Key Indicators

WASHINGTON, DC - The seventh annual Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism report, released today by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), found that the H1N1 flu outbreak has exposed serious underlying gaps in the nation's ability to respond to public health emergencies and that the economic crisis is straining an already fragile public health system.

 

The report found that 20 states scored six or less out of 10 key indicators of public health emergency preparedness.  Nearly two-thirds of states scored seven or less.  Eight states tied for the highest score of nine out of 10: Arkansas, Delaware, New York, North Carolina, North Dakota, Oklahoma, Texas, and Vermont.  Montana had the lowest score at three out of 10.  The preparedness indicators are developed in consultation with leading public health experts based on data from publicly available sources or information provided by public officials.

 

"The H1N1 outbreak has vividly revealed existing gaps in public health emergency preparedness," said Richard Hamburg, Deputy Director of TFAH.  "The Ready or Not? report shows that a band-aid approach to public health is inadequate.  As the second wave of H1N1 starts to dissipate, it doesn't mean we can let down our defenses.  In fact, it's time to double down and provide a sustained investment in the underlying infrastructure, so we will be prepared for the next emergency and the one after that."

(Continue . . .)

 

Complete Report (1.7MB pdf)

Press Release: New Report: H1N1 Reveals Gaps in Nation's Emergency Health Preparedness Efforts; Twenty States Score Six or Less Out of Ten Key Indicators (December 15, 2009)

 

Using the TFAH criteria, a many states have dropped in ranking since last year.  In 2008, 5 states scored a 10, while this year no state scored higher than 9.  

 

2009  Rankings.

 

2008  Rankings

 

TFAH Report: H1N1 Challenges Ahead

 

 

#3790

 

TFAH, or the Trust For America’s Health, is a non-profit organization that audits and reports on public health issues in the United States.   I’ve highlighted a number of their previous reports, including:

 

 

June 2009

Pandemic Flu: Lessons From the Frontlines

 

March 2009
Shortchanging America's Health 2009
A State-By-State Look at How Federal Public Health Dollars are Spent

December 2008
Ready or Not? 2008
Protecting the Public's Health from Disease, Disasters, and Bioterrorism

October 2008
Germs Go Global
Why Emerging Infectious Diseases Are a Threat to America

October 2008
Blueprint for a Healthier America
Modernizing the Federal Public Health System to Focus on Prevention and Preparedness

 

 

Today TFAH releases a new report that warns of the potential shortage of hospital beds during the coming months, assuming this virus remains no more virulent than the 1968 pandemic.

 

What follows is a small excerpt.  Follow the link to read (and download) the entire report.

 

 

H1N1 Challenges Ahead

 

October 2009

Trust for America’s Health (TFAH) released a new report that finds 15 states could run out of available hospital beds during the peak of the outbreak, if 35 percent of Americans were to get sick from the H1N1 flu virus. Twelve additional states could reach or exceed 75 percent of their hospital bed capacity, based on estimates from the FluSurge model developed by the U.S. Centers for Disease Control and Prevention (CDC). The report, H1N1 Challenges Ahead, estimates that the number of people hospitalized could range from a high of 168,025 in California to a low of 2,485 in Wyoming, and many states may face shortages of beds or may need to reduce the number of non-flu related discretionary hospitalizations due to limited hospital bed availability. The numbers of people who get sick could range from a high of 12.9 million in California to a low of 186,434 in Wyoming, if 35 percent of Americans were to get H1N1.

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Hospital Bed Capacity at Five Weeks into a Pandemic

These estimates are for the peak of an outbreak, based on CDC''s FluSurge, using expert predictions that H1N1 is a relatively mild strain of the flu, similar to the 1968 pandemic flu, and that up to 35 percent of Americans could potentially become sick with H1N1:

• 15 states would be at or exceed hospital bed capacity: Arizona (117%); California (125%); Connecticut (148%); Delaware (203%); Hawaii (143%); Maryland (143%); Massachusetts (110%); Nevada (137%); New Jersey (101%); New York (108%); Oregon (107%); Rhode Island (143%); Vermont (108%); Virginia (100%); and Washington (107%).
• 12 states would be at 75 to 99 percent of their hospital bed capacity: Colorado (88%); Florida (80%); Georgia (78%); Maine (83%); Michigan (79%); New Hampshire (84%); New Mexico (93%); North Carolina (95%); Pennsylvania (77%); South Carolina (93%); Utah (83%); and Wisconsin (75%).

 

(Continue . . . )

 

 

H1N1 Challenges Ahead (0.38MB .pdf)

Press Release