Presidential panel calls for planning czar, faster vaccine

Jim Wappes

Aug 24, 2009 (CIDRAP News) A White House expert advisory group today released a report calling for the Obama Administration to accelerate novel H1N1 vaccination preparation for high-risk Americans and appoint a White House pandemic preparedness point person, among other recommendations.

The group said the federal government's preparations for a likely fall wave of novel H1N1 influenza have been well organized and scientifically grounded, according to the report by the President's Council of Advisors on Science and Technology (PCAST).

But some preparedness steps, the report said, should be improved or accelerated.

In a press release today, PCAST listed these primary recommendations:

Accelerate preparation of flu vaccine for distribution to high-risk individuals
Clarify guidelines for the use of antiviral medicines
Upgrade the current system for tracking the pandemic's progress and making decisions about allocating resources
Accelerate development of communication strategiesincluding electronic social networking toolsto broadcast public health messages to help mitigate the pandemic's impact
Identify a White House point person with primary authority to coordinate key decisions across the government as the pandemic evolves

The actual wording in the report is that President Obama should "designate a senior member of the White House staff, preferably the President's Homeland Security Advisor, to be responsible for coordination of all major decision-making about the 2009-H1N1 pandemic."

Today's report also emphasizes individuals' pandemic-mitigating behavior, such as frequent hand-washing and staying home from school or work when sick. The report recommends extensive public education campaigns to reinforce those behaviors.

It also calls for policies that would assist education efforts, such as more flexible workplace rules on absenteeism so that employees don't feel pressured to come to work when sick.

The advisory panel, comprising scientists, academicians, and engineers, cited a "plausible scenario" of the H1N1 pandemic to produce symptoms in 20% to 40% of the population, leading to as many as 1.8 million hospitalizations and 30,000 to 90,000 deaths, potentially filling up intensive care units.

The panel was careful to acknowledge, however, that the precise impact of novel H1N1 flu is impossible to predict. It did say the virus "poses a serious health threat" to the nation.

"As this PCAST report notes, it is not possible to predict how the 2009-H1N1 influenza virus or the upcoming influenza season will play out, but it is best that we plan and prepare for a resurgence of H1N1 flu," said Homeland Security Secretary Janet Napolitano in the news release.

"HIN1 influenza has the potential to affect virtually every aspect of our lives, from our economy and national security to our education system. It may not be possible to stop influenza, but we can reduce the number of people who become severely ill by preparing well and acting effectively," she added.

In listing caveats about the report, the advisory panel in its executive summary states that the group performed its mission rapidly and said that some information it gathered "must be viewed as provisional and subject to change."

"In particular," it says, "the report does not rigorously address the measures that might need to be taken in the unlikely event that the pandemic proves to be much more severe than we currently envision."

In lauding the Obama Administration's preparedness efforts, PCAST co-chair Eric Lander, president and director of the Broad Institute of Harvard and MIT, said in today's press release, "The federal government's response has been truly impressive, and we've all been pleased to see the high level of cooperation among the many departments and agencies that are gearing up for the expected fall resurgence of H1N1 flu."

Administration officials in charge of pandemic preparedness welcomed the PCAST report.

"The PCAST H1N1 subcommittee report recommendations will enhance national preparedness and response to 2009-H1N1 flu, and be valuable for longer term, systematic pandemic policy coordination and planning. The President discussed this report at length with PCAST members and expressed sincere thanks for their expert contributions," said John Brennan, White House homeland security advisor.