US must improve pandemic preparedness, group warns

Jun 28, 2005 (CIDRAP News) – Pandemic influenza could kill 540,000 Americans and sicken up to 66.9 million, according to a recent report by the nonprofit organization Trust for America's Health (TFAH).

Projecting that 2.3 million people would need hospital beds in a pandemic, TFAH warns that the nation isn't ready for pandemic flu and should prepare quickly. The United States lags behind the United Kingdom and Canada in pandemic planning, TFAH said, adding that the country hasn't planned for the economic or social disruption that a pandemic would foster.

The report visualizes a pandemic midway in severity between that of 1918-19, which killed an estimated 500,000 Americans, and the relatively mild pandemic of 1968-69, which killed about 40,000 people.

By comparison, the typical seasonal flu bugs kill an average of 36,000 Americans a year, with 200,000 flu victims needing hospital care, according to estimates from the Centers for Disease Control and Prevention (CDC) in Atlanta.

Recent estimates of deaths and illness cases in a pandemic have varied widely. The CDC estimates deaths at 89,000 to 207,000, hospitalizations at 314,000 to 733,000, and outpatient clinic visits at 18 million to 42 million.

In contrast, infectious disease expert Michael T. Osterholm, PhD, MPH, has published estimates that a virus as virulent as the 1918 one could kill 1.7 million Americans today, half of them young adults. Osterholm is director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of this Web site.

The TFAH report emphasizes steps the United States needs to take to prepare for pandemic flu, including boosting federal leadership, expanding national and state pandemic plans into more useful blueprints, obtaining sufficient antiviral medication for treating flu, and developing a process to hasten federal approval of a pandemic vaccine.

The group recommends three kinds of steps for US leaders and policy makers, geared to different time horizons:

  • To minimize loss from an outbreak in the near term, the country should immediately move to improve outbreak tracking, stockpile drugs and medical gear, and create or enhance communications plans.
  • Mid-range steps based on the possibility of a pandemic in the next several years include stockpiling antiviral drugs, such as oseltamivir, that may prevent or minimize flu illnesses and developing surge capacity plans for hospitals and other providers.
  • Longer-term steps, assuming the nation has several years to prepare for a pandemic, include boosting the production and development of new technologies for vaccines.

Other recommended steps include defining needed roles and responsibilities of different levels of government, developing mass vaccination and treatment systems, determining who should receive the limited supply of antivirals and vaccines, and planning to create a backup workforce of healthcare workers and even pandemic survivors.

A mild pandemic could cost the United States between $71.3 billion and $166.5 billion from death and lost productivity, TFAH estimates. Further, the report states, "The US would be impacted by the global implications as soon as a pandemic outbreak occurred in any part of the world due to the interdependence of economies. Sectors, such as hospitals and the health care system, which rely on supplies manufactured in other parts of the world, including Asia, would feel immediate repercussions and supply shortages.

"Travel restrictions, possible limitations on public gatherings and events, and other measures taken to limit the spread of disease would also have rapid and far-reaching repercussions. Since a pandemic could likely result in political and economic destabilization, particularly in developing countries, it poses serious national security concerns for the US."

See also:

TFAH news release

TFAH report

CIDRAP pandemic flu overview

CDC's flu site

Department of Health and Human Services pandemic plan


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