HHS Secretary Kathleen Sebelius
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Yesterday, at the 2010 Public Health Preparedness Summit, Health and Human Services Secretary Kathleen Sebelius assessed the federal response to H1N1. (The summit was spearheaded by National Association of County and City Health Officials.)
Sebelius’s overall tone was positive. She felt the government’s preparation for “all hazards” allowed it to “hit the ground running.”
One of the first steps we took after identifying the flu was to release 11 million antiviral doses, 13.5 million surgical masks, and more than 25 million respirators from our Strategic National Stockpile. Having these countermeasures on hand allowed us to ensure that commercial shortages didn’t slow our response.
She also cited the effectiveness of the Hospital Preparedness Program, which she said guided hospitals “when their emergency rooms and ICU beds started filling up.”
Sebelius highlighted, too, HHS’s “unprecedented multimedia communications campaign,” which “taught an entire generation of kids how to sneeze” and rebuilt flu.gov.
Sebelius pointed to “partnership with state, local, tribal and territorial public health officials” as another critical pillar of the federal response.
But what were the lessons learned? HHS, Sebelius said, is currently conducting a full review. One of the obvious lessons that has already emerged: partnerships outside the public-health community are vital (e.g., with schools, which provided vaccine clinics for many children).
The other standout lesson is that vaccine production needs to be improved. Sebelius praised the speed with which vaccine development began but conceded that “outdated” manufacturing processes caused frustrating delays. As she put it, “there was nothing we could do to make the vaccine grow faster in eggs.” The US needs to make “long-term investments,” she said, in “faster and more reliabl[e]” vaccine technology.
Finally, Sebelius recognized the fragility of the budget-strapped state and local public-health infrastructure.
Ultimately, Sebelius said, HHS needs to aim for this:
[A] modernized countermeasure production process where we have more promising discoveries, more advanced development, more robust manufacturing, better stockpiling, and more advanced distribution practices.
Some local public-health officials — like those in Seattle and King County in Washington — are starting assessments of their own. And some appear less upbeat than Sebelius. The chief of communicable-disease control for King County, for example, feels “‘we need to be much more prepared. [...] This should be a wake-up call.’”
How are your state and local public-health departments evaluating their H1N1 response? And do residents and health-care workers in your town or state see the same successes and failures?