Re: Report: US Not Ready for Pan Flu
USA: Getting Beyond Getting Ready for Pandemic Influenza [Excerpts]
Getting Beyond Getting Ready for Pandemic Influenza
[Original PDF Document at
LINK. EDITED.]
EXECUTIVE SUMMARY
OVERVIEW
Pandemic influenza is not a new phenomenon. Historically, there have been other influenza pandemics,1 enough so that we now believe the planet is well overdue.2 We watch avian influenza move across the world,3 worry about how more than 60% of those people that contract the disease die from it,4 and realize that further mutations in currently circulating strains could cause them to easily infect human beings.5
If that happens, with an already high death rate,6 we expect that hundreds of thousands if not millions would die,7 that every country would be affected,8 and that society would function poorly at best.9
Expressions of culture and government ? scenarios, exercises, movies, fiction, and nonfiction ? have articulated our fears of an infectious disease for which we have no immediately available cure. Work is clearly underway to prepare for such a biological event.10 However, despite the fact that we are overdue for an influenza pandemic11 and that we fear the consequences of such a disease spreading unchecked12 ? we are not prepared13 as a Nation to fully withstand the impact of such a devastating widespread biological event.
Pandemic influenza would destroy the security of our Nation and homeland.14 It is for this reason that the House Committee on Homeland Security has made oversight of pandemic preparedness a priority, and why this study was undertaken.
When Peter Ginaitt, Director for Emergency Preparedness for the Lifespan Hospital Network in Rhode Island, was explaining to staff of the House Committee on Homeland Security the challenges the hospitals in his State were facing ? how he was having to scrounge for extra supplies to stockpile in or near the hospitals, how he was having to fight for the small amounts of funding that could be spared for preparedness efforts, and how regional meetings were resulting in little more than checking the box for the Department of Homeland Security (DHS) and the rest of the Federal government ? he was very clear that, ?we need to get beyond getting ready.?15
Representative Jim Langevin, Chairman of the Subcommittee on Emerging Threats, Cybersecurity, and Science and Technology for the House Committee on Homeland Security agreed and said that, we have to get beyond getting ready and, ??actually be ready.?16 This is not about semantics ? getting ready versus being ready.
Representative Bennie G. Thompson, Chairman of the House Committee on Homeland Security believes that this is about ensuring that the Nation is ready to address such a biological event from a position of strength.17
CHARGE TO THE STAFF
Recognizing the devastating impact an influenza pandemic would have on our Homeland18 and National Security,19 and the need to be ready to handle the pandemic when it occurs, Chairman Thompson and Subcommittee Chairman Langevin directed the Majority Staff to:
- Conduct oversight regarding the pandemic influenza preparedness activities of DHS and other members of the Executive Branch;
- Gather information through hearings, briefings, and meetings to determine the status of National efforts to prepare for pandemic influenza;
- Identify weaknesses in our National preparedness for pandemic influenza; and
- Determine what specific actions could strengthen such efforts and help the Nation achieve readiness for pandemic influenza.
APPROACH
Hearings were held during the 110th Congress on September 26, 2007 in Washington, DC (Beyond the Checklist: Addressing Shortfalls in National Pandemic Influenza Preparedness)20 and July 22, 2008 in Providence, RI (Emerging Biological Threats and Public Health Preparedness: Getting Beyond Getting Ready).21 A member briefing was held on September 23, 2008 in Washington, DC.22 Members and staff met with a number of public and private sector entities from May 2007 through October 2008. The National Strategy for Pandemic Influenza23 and its Implementation Plan24 were examined in their entirety. Information systems, such as Pandemicflu.gov25 and the Lessons Learned Information Sharing system (LLIS.gov)26 were utilized to the extent they were kept updated.
WEAKNESSES TO BE STRENGTHENED
To date, a large number of actions to prepare for pandemic influenza have been undertaken and completed.27 Accomplishments are listed in other places, including Pandemicflu.gov.28 Yet, many organizations either lack the sense of urgency and/or funds29 to continue preparing, or they are stuck endlessly preparing and are not yet ready.30 Majority staff identified the following weaknesses in the current approach to get ready for pandemic influenza:
- Early Warning And Detection Inadequate
o Information used to inform US decisions not uniformly collected or derived;
o Biosurveillance early warning unsatisfactory; and
o Biosurveillance integration insufficient.
- Execution Of Key Planning Activities Incomplete
o Key stakeholders not consulted during strategy development;
o Synergy with other National strategies not identified;
o Planning guidance to the States and Territories inadequate;
o Evidence of pandemic influenza planning for the Federal Departments and agencies scant; and
o Private sector continuity of operations plans lacking.
- Challenges Posed By Key Medical Response Requirements Partially Addressed
o Difficult issues left unaddressed by the Bush Administration;
o Hospital resource and priority management problematic;
o Pharmaceutical interventions limited; and
o Recommendations for non-pharmaceutical interventions lacking.
- Levels Of Preparedness For Pandemic Influenza Unclear
o Measurement of and reporting by the Executive Branch unsuitable;
o Reporting under the Bush Administration inconsistent;
o Federal priority on pandemic influenza preparedness lowered; and
o Example set by Executive Branch Departments and agencies working together poor.
WHAT SHOULD BE DONE
The change in Presidential leadership presents a new opportunity to establish National readiness for pandemic influenza.31 Below are key recommendations to become ready:
- Establish Effective Management And Coordination
o Restore White House leadership of National efforts to get ready for pandemic influenza;
o Report on a consistent basis; and
o Set better example at the Federal level for public health, safety, and security coordination.
- Address And Meet Key Medical Requirements
o Discuss the most difficult topics regarding life and death medical decisions and their consequences;
o Reorient approach to health care delivery in the case of very limited resources; and
o Identify and activate fast and dependable domestic capacity to produce needed pharmaceuticals.
- Evaluate And Update Plans
o Update and modify the National Strategy for Pandemic Influenza32 and its Implementation Plan;33
o Identify and include necessary stakeholders in the evaluation and updating of the Implementation Plan;34
o Analyze and comprehend how the National Strategies interact;
o Understand how a pandemic could be taken advantage of by terrorists and plan accordingly;
o Fill the gap in Federal planning;
o Generate more than grant guidance for the non-Federal government; and
o Require continuity of operations plans to qualify for Federal funds.
- Improve Early Warning And Detection
o Implement an effective public awareness campaign to help citizens; and
o Implement a uniform global biological surveillance program to provide biological warning of incidents and suspicious events.
CONCLUSION
It is possible that the next influenza pandemic will result in hundreds of thousands to millions of deaths even here in the US.35 Clearly, there is cause for concern. Leaders throughout the public and private sectors share the responsibility36 for addressing this threat without delay.37 Indications have been received that the Obama Administration will make this a priority.38 The House Committee on Homeland Security looks forward to working with them to achieve readiness for an influenza pandemic.
We are not incapable. As a Nation we are resourceful and creative. Culturally, we are willing and able to take a step back, assess the state of our affairs, admit mistakes and failures, and redirect our efforts. Doing so will require renewed commitment and greater confidence in our ability to deal with what we think we cannot. We must get beyond getting ready.39 We can get beyond getting ready. The will to meet and overcome this disease is as great a mission as any on the global battlefield.40 Our success depends on keeping up the fight41 until pandemic influenza is overcome.
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