The United States is better prepared now to handle a pandemic than in recent years, but challenges remain in the areas of surge capacity, vaccine distribution, and general emergency preparedness, according to a report by the Trust for America's Health.
“This report focuses on the challenges a pandemic poses for our health care system,” Jeffrey Levi, Ph.D., executive director of the Trust for America's Health, said in a telebriefing.
The report's authors based their estimates on two predictions from the scientific community: The pandemic influenza A(H1N1) virus is relatively mild, and up to 35% of Americans could potentially become ill during flu season.
If that percentage were to become ill, hospitals in 15 states could potentially run out of beds, according to the report. States and localities also would have to manage a likely influx of people in doctors' offices and ambulatory care settings, Dr. Levi noted.
Challenges related to vaccination include issues of distribution, reimbursement, and getting the message out to populations that don't often get vaccinated, such as young adults and minority populations, Dr. Levi said.
“State and local governments are struggling to create distribution systems,” especially for priority groups for H1N1 vaccination. The administrative costs of the H1N1 vaccine also could become a burden for state and local health departments, he noted.
Inconsistent resources remain a problem, Dr. Levi added, because emergency departments and public health departments have lost personnel and funding in recent years.
Local health department staffing levels this fall are lower than they were in spring 2009, according to the National Association of County and City Health Officials (NACCHO). That reduction comes just as the demands on these systems are likely to increase with the spread of the pandemic virus. State and local health departments need “renewed and sustained and constant funding to give us the core capacity that people expect,” said NACCHO Executive Director Robert M. Pestronk, during the telebriefing.
The take-home message for clinicians is to stay on top of the H1N1 situation as it evolves, and communicate with their local health departments, Dr. Levi said. H1N1 “is going to pose a challenge for the entire health care system,” he said. “Clinicians are going to be on the front lines to educate patients” about the importance of vaccination and about protective measures such as hand hygiene and covering coughs. “Local physicians should be working closely with their local health departments,” added Mr. Pestronk. Clinicians might also consider stepping outside their practices to help administer vaccinations or volunteering staff members to assist with these efforts, he said.
To view the complete report, including state-specific data on hospital capacity, visit healthyamericans.org