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USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

Giuseppe

Emeritus
USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

THE WHITE HOUSEOffice of the Press Secretary

For Immediate Release

August 24, 2009


President?s Council of Advisors on Science and Technology (PCAST) releases report assessing H1N1 preparations

Administration?s H1N1 efforts to date praised
Additional recommendations made to improve monitoring and strengthen medical response

WASHINGTON


A Presidential advisory group of the nation?s leading scientists and engineers today released a new report assessing the Obama Administration?s preparations for this fall?s expected resurgence of 2009-H1N1 flu and outlining key steps officials can take in the coming weeks and months to minimize the disease?s impact on the nation.

The Federal Government?s preparations for 2009-H1N1 flu have been well-organized and are scientifically grounded, according to the report by the President?s Council of Advisors on Science and Technology (PCAST), which assembled a subcommittee of experts on influenza and public health for the purpose. (PCAST is an independent group of leading scientists from academia and industry administered by the Office of Science and Technology Policy in the Executive Office of the President.) But some aspects of those preparations could and should be improved or accelerated, the group concluded.

"As the nation prepares for what could be a challenging fall, it is crucial that our public health decisions are informed by the very best scientific and technological information," said John P. Holdren, Assistant to the President for Science and Technology and a co-chair of PCAST.

The report concludes that the 2009-H1N1 flu is unlikely to resemble the deadly flu pandemic of 1918-19. But in contrast to the benign version of swine flu that emerged in 1976, the report says the current strain "poses a serious health threat" to the nation. The issue is not that the virus is more deadly than other flu strains, but rather that it is likely to infect more people than usual because it is a new strain against which few people have immunity. This could mean that doctors? offices and hospitals may get filled to capacity.

Among the group?s prime recommendations: accelerate the 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 resource allocation decisions; accelerate the development of communication strategies?including Web-based social networking tools?to broadcast public health messages that can help mitigate the pandemic?s impact; and identify a White House point person with primary authority to coordinate key decisions across the government as the pandemic evolves.

An overarching message of the new report is that through their behavior, individuals can have a potentially big impact on the flu season?s severity.

Frequent hand-washing and staying home from school or work when sick will be crucial.

The report recommends intensive public education campaigns to reinforce those key behaviors, and also calls for policy adjustments that can reduce economic and other incentives that might encourage people to risk infecting others. For example, workplaces could liberalize rules for absenteeism so employees don?t feel pressured to come to work when sick and school districts could arrange alternative means of distributing lunches to children who are sick but who normally depend on school meals for adequate nourishment.

Overall, the PCAST subcommittee concluded that it was "deeply impressed" by the H1N1-related efforts underway across the Federal Government, including the breadth of issues being anticipated and addressed, the depth of thinking, the overall level of energy being devoted, and the awareness of potential pitfalls.

"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," said Harold Varmus, a PCAST co-chair and President of Memorial Sloan-Kettering Cancer Center.

"This virus has pulled us all together in common cause," said PCAST co-chair Eric Lander, who is also President and Director of the Broad Institute of Harvard and MIT. "The preparations are the best ever for an influenza pandemic."

"As the Council of Advisors on Science and Technology notes, influenza brings many challenges and agencies across the government will need to make many key decisions in the face of uncertainty about when and how the virus will play out. As we did in the spring, we can hope for the best, but we must prepare for the worst."

Administration officials leading the flu response efforts praised the report and welcomed the recommendations from the PCAST subcommittee.

"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.

"The President has been clear from day one that he wants our H1N1 flu response to be guided by science. He also has made it clear that he believes that responding to the flu is a shared responsibility, one that requires the efforts of every American and cooperation between the private and public sectors," said Health and Human Services Secretary Kathleen Sebelius. "The Department of Health and Human Services, including the Centers for Disease Control and Prevention, National Institutes of Health, and Food and Drug Administration, has already made some important progress on the recommendations found in the PCAST subcommittee report and we plan to adopt others to ensure we are doing everything we can to keep Americans healthy and safe."

"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. "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."

"Schools, child care facilities and institutions of higher learning will not only play a key role in helping to mitigate the transmission of the flu this fall but will also play a significant role in promoting critical public health information," said Secretary of Education Arne Duncan. "I am happy to report that we are well on our way to implementing many of the recommendations for schools found in this comprehensive report and have joined with our partners across government to roll out guidance for K-12 and Institutions of Higher Learning over the past two weeks."

"The President?s Council of Advisors on Science and Technology did an excellent job, working on a short timeline, of summarizing and assessing the U.S. preparations for 2009-H1N1 influenza," said CDC Director Tom Frieden. "Their subcommittee, which included individuals from across the public and private sectors, has provided valuable insights and recommendations, including strategies for strengthening our nation's ability to monitor the presence and impact of 2009-H1N1 influenza and strengthen our medical and non-medical response."

To see the PCAST Recommendations and Administration Progress, click here (pdf).

To see the full report, click here (pdf).

For more about PCAST, visit: http://www.ostp.gov/cs/pcast.​
<cite cite="http://www.whitehouse.gov/the_press_office/Presidents-Council-of-Advisors-on-Science-and-Technology-PCAST-releases-report-assessing-H1N1-preparations/">The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations</cite>
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

USA. REPORT TO THE PRESIDENT ON U. S . PREPARATIONS FOR 2009 -H1N1 INFLUENZA (PCAST, excerpts, edited)

[Original Full Document: LINK. EDITED.]

REPORT TO THE PRESIDENT ON U. S . PREPARATIONS FOR 2 0 0 9 -H1N1 INFLUENZA

Executive Office of the President President?s Council of Advisors on Science and Technology
August 7, 2009


About the President?s Council of Advisors on Science and Technology

The President?s Council of Advisors on Science and Technology (PCAST) is an advisory group of the nation?s leading scientists and engineers, appointed by the President to augment the science and technology advice available to him from inside the White House and from cabinet departments and other Federal agencies. PCAST is consulted about and often makes policy recommendations concerning the full range of issues where understandings from the domains of science, technology, and innovation bear potentially on the policy choices before the President. PCAST is administered by the White House Office of Science and Technology Policy (OSTP).

For more information about PCAST, see www.ostp.gov/cs/pcast.


EXECUTIVE OFFICE OF THE PRESIDENT - PRESIDENT?S COUNCIL OF ADVISORS ON SCIENCE AND TECHNOLOGY
WASHINGTON, D.C. 20502
August 7, 2009
President Barack Obama
The White House
Washington, DC 20502


Dear Mr. President:

We are pleased to transmit to you the report, U.S. Preparations For 2009-H1N1 Influenza, prepared by your Council of Advisors on Science and Technology (PCAST). This report examines the strategic issues raised by the likely resurgence this fall of the novel influenza virus called 2009-H1N1.

The report reviews the full range of response options for minimizing negative impacts from a fall 2009-H1N1 epidemic and provides an integrated set of recommendations about how to think about hard issues and key policy decisions regarding the epidemic. The nation?s response to the threat of a fall epidemic involves decisions by government on a wide range of issues --- medical, scientific, social, and financial. We have tried to assess these, keeping in mind your interest in having the best available scientific insights and perspectives to inform your thinking about the nation?s response to the continued spread of this new virus.

To provide a solid scientific basis for our recommendations, the Council assembled a PCAST Working Group of non-governmental experts, including one other member of PCAST, from a number of relevant fields (virology, public health, pediatrics, medicine, epidemiology, immunology, and others). On July 16-17, the Working Group met with government officials and others to discuss various aspects of the 2009-H1N1 pandemic, and then developed an in-depth report based on its own knowledge, the information provided during the meeting, and additional consultations with government, academic, and industry experts. The results of that report were presented to PCAST at its meeting on August 6-7, and the Council then approved an Executive Report of findings and recommendations for transmittal to you along with the in-depth Working Group report to PCAST.

The Working Group report discusses the complexities posed by influenza epidemics, and the uncertainties inherent in an epidemic that is still in progress. The report identifies the key decisions and actions to be taken, while recognizing that many decisions (for example, relating to use of vaccines and to school closures) cannot be resolved now but will need to be made rapidly as the epidemic unfolds. In these instances, the Working Group report instead offers guidance about how decisions should be made over the coming weeks and months.

PCAST hopes that its Executive Report and the full Working Group report help lay a foundation for the medical, scientific, social, and financial decisions you and others in the Federal Government must make this fall. We are grateful for the opportunity to serve you and the country in this way.

Sincerely,

John P. Holdren
Co-Chair

Eric Lander
Co-Chair

Harold Varmus
Co-Chair


The President?s Council of Advisors on Science and Technology Executive Report - U.S. Preparations for the 2009-H1N1 Influenza

In April 2009, a novel influenza A (H1N1) virus (2009-H1N1) appeared in Mexico, causing pneumonias and 59 deaths in Mexico City alone. The virus soon spread to the United States and to other continents. Within two months, the World Health organization (WHO) declared that the viral outbreak met the criteria of a level 6 pandemic. Although initial concerns of an extremely high fatality rate have receded, the expected resurgence of 2009-H1N1 in the Fall poses a serious health threat to the United States.

Since the initial report of the outbreak, the Federal Government, through various departments, agencies, and offices, has been actively studying the course of events, responding to them, and planning for a resurgence of the pandemic this fall. In late June, President Obama requested that his Council of Advisors on Science and Technology (PCAST) undertake an evaluation of the 2009-H1N1epidemic and the nation?s response to a probable recurrence.

In this Executive Report, PCAST assesses the emerging Federal response to a second wave, identifies critical questions and gaps in this response, and suggests additional opportunities for mitigation. PCAST?s observations, conclusions, and recommendations presented here are based on the analysis of its 2009-H1N1 Working Group, consisting of 3 PCAST members and a further 11 non-governmental experts in virology, public health, pediatrics, medicine, epidemiology, immunology, and other relevant scientific fields. The Working Group?s deliberations were informed by discussions with government officials and others on various aspects of the 2009-H1N1 pandemic.


2009-H1N1 in Historical Context

Based on the history of influenza pandemics over the past hundred years, PCAST places the current outbreak somewhere between the two extremes that have informed public opinion about influenza. On the one hand, the 2009-H1N1 virus does not thus far seem to show the virulence associated with the devastating pandemic of 1918-19; moreover, medical science now has many potent tools at our disposal to mitigate an influenza pandemic in ways that were not possible ninety years ago. On the other hand, the 2009-H1N1 virus is a serious threat to our nation and the world, unlike the ?swine flu? episode in 1976 that led to the vaccination of over 40 million Americans in the absence of any spread of the virus beyond an initial four cases at a single Army base.
(...)
-
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Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

(continue from the post above)

(...)

The Current Situation and a Plausible Scenario

Indeed, the 2009-H1N1 influenza is already responsible for significant morbidity and mortality world-wide ? from its appearance in the spring, its continued circulation in the U.S. this summer, and its spread through many countries in the Southern Hemisphere during their winter season.

While the precise impact of the fall resurgence of 2009-H1N1 influenza is impossible to predict, a plausible scenario is that the epidemic could:

- produce infection of 30?50% of the U.S. population this fall and winter, with symptoms in approximately 20?40% of the population (60?120 million people), more than half of whom would seek medical attention.
- lead to as many as 1.8 million U.S. hospital admissions during the epidemic, with up to 300,000 patients requiring care in intensive care units (ICUs). Importantly, these very ill patients could occupy 50?100 percent of all ICU beds in affected regions of the country at the peak of the epidemic and could place enormous stress on ICU units, which normally operate close to capacity.
- cause between 30,000 and 90,000 deaths in the United States, concentrated among children and young adults. In contrast, the 30,000?40,000 annual deaths typically associated with seasonal flu in the United States occur mainly among people over 65. As a result, 2009-H1N1 would lead to many more years of life lost.
- pose especially high risks for individuals with certain pre-existing conditions, including pregnant women and patients with neurological disorders or respiratory impairment, diabetes, or severe obesity and possibly for certain populations, such as Native Americans.

There is an important issue with respect to timing:
- The fall resurgence may well occur as early as September, with the beginning of the school term, and the peak infection may occur in mid-October.

- But significant availability of the 2009-H1N1 vaccine is currently projected to begin only in mid-October, with several additional weeks required until vaccinated individuals develop protective immunity.

This potential mismatch in timing could significantly diminish the usefulness of vaccination for mitigating the epidemic and could place many at risk of serious disease.

PCAST emphasizes that this is a planning scenario, not a prediction. But the scenario illustrates that an H1N1 resurgence could cause serious disruption of social and medical capacities in our country in the coming months.

The circumstances underscore the importance of:
- ensuring that the nation?s complex and distributed healthcare systems are prepared to deal with the potential surge in demand, especially with respect to critical care.
- ensuring that all feasible steps are taking to protect the most vulnerable populations.

(...)
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

Resistance to these agents, especially oseltamivir, as a result of viral mutation or genetic recombination, can be a major factor limiting antiviral effectiveness
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

full report here: (86 pages, .pdf)
http://www.whitehouse.gov/assets/documents/PCAST_H1N1_Report.pdf
table of contents at page xvii
chapter summaries from pages 1,7,13,21,31,47,53,59 in text-form are here:
http://www.setbb.com/fluwiki2/viewtopic.php?p=1839&mforum=fluwiki2#1839

30%-50% (of the US-population) infected in fall or winter ,
20%-40% symptomatically infected (in fall or winter)
> more than 10%-20% will seek medical attention
> 1.8M hospital admissions
> up to 300000 ICU admissions
> 30000-90000 deaths
> start in early September,peak in mid October

assuming the clinical severeness will be the same in the fall as it was in the spring

PCAST H1N1-group members involve Palese,Webster,Fineberg,Lipsich (page xvi)
they call it "a plausible scenario (page viii), a planning scenario not a prediction"
However in the introduction they call it "estimates".
They don't provide their definition of these terms

I can't find (keyword search only, I didn't read the full report) any explanation why it should be
worse than e.g. Australia (population=20M)
who already have a full wave which seams to have peaked now.
With their numbers I calculate for USA 4000 deaths,100000 hospitalizations, 20000 ICU admissions,
Or with the NZ-numbers I get 1200 deaths


I think they should try to estimate the total number of seasonal excess deaths in Australia,
Argentina,New Zealand,Brasil,South Africa,Hongkong,... to get a picture of indirect deaths
connected with MF - as the seasonal flu deaths in USA are estimated to be 36000 yearly,
but most indirect and not officially attributed to flu.
This number should be smaller for MF since mostly younger people are affected.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

I hope everyone has read this; but in case they haven't, I'm going to pick out some the points I have a problem with. The first is this comment:
PCAST is impressed by the efforts underway across our government
Well, maybe they see big improvements since this administration took over but most of the issues the Working Group and PCAST have suggestions for have been known since 2005 when the pandemic plan was formed.

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.
Why not!!?? They tell us on a regular basis they can't predict what this influenza will do and yet they don't provide for a pandemic that might turn more severe?

Moreover, as much as 50 to 100 percent of ICU capacity in the United States could be required solely to treat 2009-H1N1 patients at the peak caseload, in hospital units that typically run at 80 percent of capacity. Such stress on ICUs and emergency departments would cause severe disruption of hospital function, necessitating marked curtailment of all but the most urgent admissions and surgeries.
What can I say about this that hasn't been said so many times already. This is such and important and long-standing issue; but they have just put out a request for information. How long would it take to receive an order of 5000 vents?

HHS had put out a solicitation for next generation portable vents last fall but I can't find the update on it. Here are a couple of the requirements:
# The Offeror must be able to ramp up production in an emergency to supply at least 1700 fully kitted ventilators in one month to meet a capability goal of at least 10,000 fully kitted units within 6 months.
# flexibility to accommodate a wide patient population from neonate to adult
# intuitive user interface for ease of use in a clinical setting so that inexperienced health care providers with no respiratory support training could safely and easily use the device

There is also a solicitation for 3rd party testing for vents.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

we had these questions for H5N1 ...

it's unfortunate and embarrassing to even discuss the details of
a severe pandemic.
It gives the readers a bad,depressed feeling.
And they were "required" to spend more money, which
they don't want to.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

I haven't included all the comments in these catagories. After reading this, I'm reminded of: "You're doing a great job, Brownie".

PCAST is impressed by the efforts underway across our government

While the data collected about 2009-H1N1 thus far have been extremely valuable, they have a number of limitations. The key shortcomings of existing data streams are:

* Some key data are not updated continuously
Since individual-level case reporting ended in early May, there has been no systematic way to update national data on high-risk groups (i.e., according to age and predisposing conditions) for confirmed infection and severe outcome at the national level. Some of these data exist locally but are not being aggregated into a national picture now that reporting to CDC is not at the individual level.

* Current systems are geographically limited
Many of the most detailed data feeds, such as the influenza-confirmed cases at hospitalization monitoring sites funded by CDC through the Emerging Infections Program (EIP), are geographically limited. By chance, during the spring none of these EIP sites was in an area with a heavy burden of 2009-H1N1 disease.

* Current systems do not provide reliable estimates of influenza morbidity and mortality.
For many purposes it is critical to know, for example, approximately how many people are infected or hospitalized, measured as total numbers of people or numbers per 100,000 population. Most of these systems do not answer that question,...

* No systematic approach yet exists to monitor the capacity of the health care system to respond.
Such a system, called “HAvbed,” is planned by DHHS but has not yet been implemented.

* Laboratory capacity to confirm diagnosis and isolate viruses for further characterization is limited.
Most public health laboratories now restrict virus testing to patients with severe disease and many laboratories will be unable to maintain even this practice if the number of cases grows much higher in the fall.

* Current systems cannot monitor the burden of mild illness that does not come to medical attention.
Reliable estimates of this burden are needed to understand the severity of illness...At present we do not know this number

* Current systems for reporting and analyzing adverse events associated with vaccination may not be well suited to challenges likely to arise during a vaccination campaign for2009-H1N1.
Existing systems may not be able to rigorously evaluate elevated rates of such common events in high-risk groups, e.g., spontaneous abortions (miscarriages) in pregnant women or various complications in neurologically impaired patients.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

we had these questions for H5N1 ...

it's unfortunate and embarrassing to even discuss the details of
a severe pandemic.
It gives the readers a bad,depressed feeling.
And they were "required" to spend more money, which
they don't want to.
Yes, you're right.

It gives me an even worse bad, depressed feeling to be told it could get more severe and they haven't made any plans for that.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

you just list the negatives
What did we expect ?



more sequences from USA than from any other country.
Good sureillance as compared with other countries.
USA-flu-discussion forums like this - more then
in other countries
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

I hAVE TO LAND HERE

We have been used to believe that the cavalry is always coming at the last minute.

Altough I do not believe it certainly will come, I cannot excluded (Why would I).

But since I know the cavalry is still far away and that I do not see the dust made by it from far away, better turn inside and take it from here.

What can I do to not catch it, what can I do if one of the family catch it, what can I do in my sourrounding, what can I coordinnate with outside my districts.

After doing all that at least if there is no cavalry I will have done all I could.

And if there is a lot of community that becomes more independent it will be less a burden for the cavalry and who knowns if all our work has failed, the cavalry will have the freedom to move an give a hand.

Snowy
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

Here's something I missed seeing before: Apparently a bottleneck in the vax production has to do with govt regulations regarding bottling the vax.

Since it's urged that this decision be made almost immediately, and this report is dated Aug 7, we should have heard by now if DHHS has decided to proceed with the early fill and finish.
--------------------------------------------------------------

Currently, vaccine availability is gated by results of clinical studies concerning safety and optimal dose (expected in mid-September), after which manufacturers can “fill and finish” the vaccines at the appropriate doses (which requires another 3–4 weeks).

We thus recommend a “hedged” strategy in which an initial amount of product is packaged “on risk,” assuming a 15 microgram dosage, and the remainder is packaged when dosing and safety information
becomes available in mid-September following the first results of clinical trials conducted by the NIH and industry. The risks of this course of action appear to be relatively low: some vaccine product could be wasted by filling vials at sub-optimal doses.

If a somewhat larger dose is required, however, physicians can administer additional vaccine (e.g., a second dose of 15 micrograms to achieve 30 micrograms). The optimal amount of vaccine will need to be determined from immunological responses in clinical tests and an appropriate decision analysis.

However, it seems clear that filling and finishing up to 40 million doses could have a substantial effect on the incidence of disease and death in these vulnerable populations.

The Working Group recognizes that there are important considerations for manufacturers as they contemplate reconfiguring their “fill and finish” operations to meet accelerated deadlines. If DHHS elects to follow this approach, a highly knowledgeable Federal decision-maker would need to work promptly with one or more of the pharmaceutical companies already contracted to produce vaccine to execute this strategy.

We recommend that DHHS accelerate the availability of a portion of the vaccine supply to mid-September by having manufacturers begin to “fill and finish” a subset of the bulk vaccine product at 15 micrograms.

Such a decision would need to be taken almost immediately.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

you just list the negatives
What did we expect ?

more sequences from USA than from any other country.
Good sureillance as compared with other countries.
USA-flu-discussion forums like this - more then
in other countries

I expected better.

I'll end my postings with the positives.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

I'll make this my last little summary of mostly good things.

Here's a good thing: Federal Government also has taken an important step to help already overburdened state and local public health organizations respond to the pandemic by providing $350 million from the emergency appropriation, through DHHS, to state and local governments and hospitals. Because rates of hospitalization for 2009-H1N1 are highest in children, hospitals can also anticipate needing more pediatric equipment than is typically available. We have a special fund called the Public Health Emergency Fund. Bad Thing: (We note, however, that this access is currently (missing word from the .pdf) since Congress has not appropriated any public monies to the Fund.)

This is a good thing being recommended is the issue of how the hospitals will survive the additional expenses of things like the uninsured, or insurance companies that will reinburse them at lower rates, added expense of expensive contagion control measures, etc.

Here's another good one regarding a conflict about the usage of N95s: We recommend that CDC work to harmonize its recommendations with those of relevant professional societies prior to their public release. As discussed in Chapter 5, relevant societies include the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and, where recommendations concern children, the American Academy of Pediatrics (AAP).

Here's one final one (maybe they read someone's repeated requests to make a webpage): websites with information about initial self-diagnosis and treatment, up-to-date information about the epidemic, and perhaps even ways to share personal information that could help inform national surveillance;
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

Thanks mixin, for the highlights. I had missed seeing this whole thread ....:eek: [the eek is because I totally missed it.....]
:eek::eek: [that's for the content.....]

Did I expect more from the Government? No. I was hopeful, but I'm not surprised.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

Commonground,
Your welcome.

There was a lot more but someone made me feel guilty about posting all the negatives. ;) :D I guess we should be glad for having as much of a plan as we do have. Some of the underdeveloped countries probably have very little planning completed.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

You know, the US federal government lives and works in a fish bowl. There's not a lot they do that doesn't see the light of day.

It is prudent for all of us to reflect on our level of preparations as we enter what will likely be a really nasty flu season. And the more objective that review is, the better. And that is what this President asked PCAST to do. A very proactive and smart thing in my view.

Having said that, we now have a reaction to their findings, some of which findings were positive, some negative, some quite frankly ambiquous, even contradictory. But the findings in this report will likely assist those agencies who do have the ultimate responsibility for getting this nation prepared. No one has all the answers. This is new ground we plow. We don't have decades of skill set development for the best way to handle influenza pandemics. And I think we are all seeing that in how this is playing out real time and in the open.

What we perhaps need, however, is one voice. Having an incident command structure in place is usually very helpful when dealing with disasters and emergencies. And such structures typically have one name at the top of the list that is responsible for response activities. It can be PCAST, HHS, Homeland Security, CDC or the President himself.

The President will probably delegate this to one of the others, leaving a council of experts, a politician's politician, an attorney/politician, or the doctor/politician as the choice. When all's said and done, it may not really matter which is chosen, because all are likely to work together to come up with the final solutions, directives, and guidance, but having all of these folks offer opinions right now, is not necessarily helpful to the general public. I bet a single strong voice would do wonders to ease some of the concern.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

Mamabird,
They did suggest someone as "the voice" but it's buried somewhere in that pdf.

Did you read the H1N1 COUNTERMEASURES STRATEGY AND DECISION MAKING FORUM, HOSTED BY THE PANDEMIC INFLUENZA WORKING GROUP NATIONAL BIODEFENSE SCIENCE BOARD June 18–19, 2009? I came away from that amazed that so little was known and undecided upon. Otoh, it gave me a degree of reassurance to know that all those experts (the list is impressive, imo) came together to try to make some decisions.

Maybe my expectations are too great? I do think it's plain to see we need to be responsible for what we can do to best help ourselves.
 
Re: USA. The White House - Press Office - President's Council of Advisors on Science and Technology PCAST releases report assessing H1N1 preparations

Mamabird,
They did suggest someone as "the voice" but it's buried somewhere in that pdf.

Yes, PCAST recommended the following (p54):

"CDC clearly is the lead Federal agency for communication with three constituencies: (1) state and local health departments, (2) health care providers, and (3) the general public. The Working Group reviewed CDC?s communications plans in these areas for the anticipated epidemic this fall."

Now, what I think appropriate based on said recommendations is for the politician/politician and the attorney/politician to stop holding news conferences, media briefings and interviews on the subject and let the doctor/politician do his job.

While we might not all agree on the message, at least the message will be clear and consistent.
 
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