Transcript Document 7127526

U.S. Pandemic Influenza
Preparedness and Response:
Update & Progress Report
“The pandemic influenza clock is ticking.
We just don’t know what time it is.”
“This is the one health threat we’re
preparing for that we know will happen”
When Will the Next Influenza
Pandemic Occur?
2004 – H7N1 Avian virus
2004 – H7N3 Avian virus
2004 – H5N1 Avian virus
2003 – H7N7 Avian virus
2003– H5N1 Avian virus
1999 – H9N2 Quail virus
1997 – H5N1 Avian virus
1995 – H7N7 Duck virus
1993 –Swine/avian recombinant
1988 – H1N1 Swine virus
1986 – H1N1 Swine virus
1976 – H1N1 Swine flu
Timeline of human infection with novel influenza viruses
(since the 1968 pandemic)
Current Pandemic Threats
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H5N1, Asia
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Domestic poultry infections identified in 9 countries
23 deaths and 34 cases documented in humans (most
recent case in March 2004)
Control efforts (culling ~100 million birds) have
reduced the risk but given difficulties with surveillance
it cannot be assumed that poultry is virus free and no
risk to humans remains
H7N3, British Columbia, Canada
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2 cases of conjunctivitis in persons with contact with
infected poultry (most recent case April 2004)
U.S. Pandemic Influenza
Preparedness Activities, 1
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Enhanced surveillance
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CDC request for proposals for surveillance in Asia
HHS support for WHO surveillance activities
Vaccine security and supply
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HHS funding to assure year-round egg availability
and to promote expansion and diversification of U.S.
influenza vaccine production
NIH is obtaining and testing pilot lots of H5N1
vaccine
U.S. Pandemic Influenza
Preparedness Activities, 2
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Antiviral drugs
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Establishment of an oseltamivir stockpile
State/local preparedness
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Continued support for State planning activities
HHS funding for health care system preparedness
Development of software to predict impacts and
tabletop exercises to practice State/local plans
Estimated Impact of an Influenza
Pandemic on Healthcare in Atlanta
Peak-week impacts estimated using Flu-surge software.
Assumes an 8-week period of illness in a community.
Category
Number
% of Total
1915
26%
ICU beds
401
45%
Ventilators
201
29%
Hospitalizations
Note: Hospitals usually run near full capacity; thus, addressing
this burden would require emptying or adding beds
CDC, FluSurge software, 2004
Pandemic Influenza Preparedness
& Response Plan Status
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Plan has been cleared by HHS & HHS agencies
and is being reviewed by other Departments
After clearance, plan will be released for public
comment
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Federal Register and on-line
60-day comment period
Revise and post “final” plan
Key Issues
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Public and private sector vaccine purchase
and distribution
Priority groups for early vaccine and antiviral
chemoprophylaxis and therapy
Approach to indemnification, liability
protection, and compensation
Pandemic Vaccine Purchase Options:
Public/Private Sector Roles
Purchase
All public
Public sector roles & planning needs
 Best opportunity to target priority groups
 Requires planning for mass distribution
Increased
 Public sector focus on target groups and
public
underserved populations
 Requires coordination with private sector
Current (mostly  Public sector focus on limited target
private) system
groups and children via VFC
Vaccine Purchase and Distribution:
Potential for Changes Over Time
Vaccine available
Current
Increased public
All public
First wave
Second wave
Timeline and waves of pandemic disease
Note: This is presented as an illustration
and not to endorse as a preferred option
Priority Groups for Pandemic Vaccine
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Base definition of priority groups on pandemic
response goals
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Reduce health impacts – Maintain quality healthcare
system & protect those at highest risk
Reduce social and economic impacts – Maintain
essential community services
Role of national plan in defining priority groups
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Need for national guidance vs state-by-state decisions
Specific definition of target groups at State/local levels
(e.g., who provides essential community services?)
Potential NVAC Roles in Pandemic
Plan Review Process
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Provide input on key issues
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Highlighted “decision” issues
Other issues where NVAC’s broad stakeholder
perspective or NVPO priorities (e.g., vaccine supply,
financing, safety, etc) are relevant
Provide a forum for public discussion and input
through the Public Participation Working Group
Other?