The Department of Health and Human Services’ Office of Inspector General has released two reports assessing just how prepared Americans are for a flu pandemic. Their findings? Communities are on the right track when it comes to preparing for a surge in patient numbers, but they’re not as ready as they could be. Likewise, there’s still more to be done before local organizations will be ready to distribute vaccines and antiviral drugs.
A surge of flu victims
In the Southern Hemisphere, where the flu season has already struck, the biggest systemic issue was lack of space in intensive care units overwhelmed by H1N1 victims. Are American communities doomed to more of the same? After reviewing the coordination, volunteer recruitment/organization, medical equipment, alternate care and triage and admission guidelines of 10 localities as of late summer 2008, the OIG’s answer is a resounding “not quite.” (Get the full 37-page report here.)
The OIG’s to-do list for the assistant secretary for preparedness and response?
- Keep emphasizing those five areas that we evaluated
- Make sure that, when states and localities do medical surge preparedness exercises, they then document and address the lessons they learned from those activities.
- Those lessons everyone just documented? Make sure they share them with everyone else too. Preferably through the CDC. Then the feds can work to address specific local issues.
- Consider working with states (or even the federal government) to “develop appropriate legal protections for medical professionals and volunteers who respond to public health emergencies and who may need to alter standards of care.”
Getting vaccines/antivirals to the right place, at the right time
According to HHS, “even a mild pandemic could cause between 2 million and 7.4 million deaths worldwide” and H1N1 looks to be a “moderate” one. Vaccination is a key component of the prevention plan, which is why the OIG evaluated the pandemic flu plans of 10 communities in the categories of “Receiving & Staging, Dispensing, Tracking, Vulnerable Populations, Priority Groups, Security, Storage, and Transportation.” In general, they found that the communities need to practice more, plan for all eight categories and make those plans “actionable.” In general, folks were best at planning for receiving/staging and dispensing and worst at planning for security, storage and transportation.(Read the whole 57-page report here.)
Based on those findings, the OIG recommended that the CDC:
- Work with states to figure out why folks are still in the “early stages” of planning and help them make some progress
- Prioritize which of the eight areas states should focus on in order to improve local readiness as quickly as possible.
- Emphasize “actionable” plans that “identify the organizations or individuals responsible for carrying out specific actions and the sources that would be necessary to staff distribution and dispensing positions” that are “supported by valid, detailed formal agreements with partnering agencies.”
- Again, make sure locals keep track of what they’ve learned in preparedness exercises and that they make plans to correct any deficiencies. Also, make sure they share plans and “emerging promising practices.”