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Vol. LXI, No. 16
August 7, 2009
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‘Improve the System’
NIH Hosts H1N1 Flu Summit

On the front page...

On July 9, NIH hosted the White House’s H1N1 Influenza Preparedness Summit, jointly led by HHS Secretary Kathleen Sebelius, DHS Secretary Janet Napolitano and Education Secretary Arne Duncan.

“I’m very grateful that all of you are taking this seriously,” President Obama said by telephone link from L’Avila, Italy. “Although we were fortunate not to see a more serious situation in the spring, the potential for a significant outbreak in the fall is looming.”

The meeting assembled about 500 emergency managers, educators, school nurses and public health officials from around the country, including Dr. Nicole Lurie, nominated as assistant secretary for preparedness and response; Dr. Francis Collins, nominated as director of NIH; and Dr. Raynard Kington, acting director of NIH.

Continued...


  HHS Secretary Kathleen Sebelius (l), DHS Secretary Janet Napolitano (c) and Education Secretary Arne Duncan team up at NIH for a summit on flu.  
  HHS Secretary Kathleen Sebelius (l), DHS Secretary Janet Napolitano (c) and Education Secretary Arne Duncan team up at NIH for a summit on flu.  

Joining them were Maryland Governor Martin O’Malley and Rep. Chris Van Hollen, whose congressional district includes Bethesda.

“The most important thing for us to do,” said Obama, “is to make sure that state and local officials prepare now to implement a vaccination program in the fall.”

Sebelius outlined the federal government’s response.

A voluntary fall vaccination program against the 2009 H1N1 flu virus, she said, will depend on the availability of a safe and effective vaccine. Once it becomes available, the first shots likely would be given to school children, health care workers, pregnant women and people with underlying ailments that might increase their risk.
Collins sings and plays guitar at The Directors performance in honor of outgoing NIH director Dr. Elias Zerhouni last Oct. 30. Secretary Sebelius discusses federal government preparations for the fall season, when the flu pandemic is predicted to pick up speed again.
Above left, NIAID director Dr. Anthony Fauci (r) shares a moment with Bill Modzeleski of the Department of Education. During the summit’s early hours, Fauci offered details on NIH’s role in the fight against H1N1. At right, Secretary Sebelius discusses federal government preparations for the fall season, when the flu pandemic is predicted to pick up speed again.

NIH: Part of the Team

NIH research has played a crucial role in responding to the 2009 H1N1 flu virus. The next step is preparing and field-testing the vaccine.

“NIH will use our…clinical trial infrastructure to quickly evaluate pilot lots of vaccine candidates,” said NIAID director Dr. Anthony Fauci. By early August, he said, “We hope to start our first clinical trials of 2009 H1N1 vaccine candidates.”

As testing confirms the vaccine’s safety, effectiveness, appropriate dose and number of dosages, the Centers for Disease Control and Prevention is organizing state, territorial, city and tribal health departments to line up vaccination programs.

With the caveat that no final decision has been made, Sebelius said that the vaccination drive might begin as soon as mid-October.

She also encouraged people to get a regular flu shot to protect them from seasonal flu, which is distinct from the H1N1. Seasonal flu alone kills about 36,000 people in the U.S. annually.

Calling All Public Service Announcements

To help families and communities prepare, HHS Secretary Kathleen Sebelius said HHS is updating its web site, www.flu.gov, with checklists and fact sheets.

And to raise public awareness, “This is our YouTube challenge to everyone,” she said. “We’re inviting the American people to record and submit their own 60-second public service announcement regarding the H1N1 virus.”

The winning PSA will air on national television and receive a $2,500 cash award.

“This H1N1 pandemic is a tremendous challenge that has brought real hardship,” said Sebelius. “But it has also brought a valuable opportunity. The attention being paid to the H1N1 virus is accelerating our work to improve the entire public health system.”

 

‘This flu is not over’

Typically, the influenza virus does not survive well at temperatures above 70 degrees, which helps explain why “flu season” starts in the fall.

Yet the novel (that is, new) H1N1 virus hit the U.S. last spring.

“This flu is not over,” said Dr. Thomas Frieden, newly appointed head of the CDC.

H1N1 has not only continued to spread in S. summer camps, he said, it’s also active in the southern hemisphere, currently in its own flu season.

After appearing in the U.S. in April, H1N1 has spread to all 50 states. Of the estimated 1 million Americans infected, more than 260 had died as of mid-July. Worldwide, some 160 countries have reported cases. Officials are concerned that the outbreak here could worsen when fall arrives and schools open.

There are about 100,000 schools in the U.S. and closures have a significant ripple effect, aggravating parents’ logistical challenges while straining their resources.
A panel on preparedness lessons learned from states and localities includes (from l) Dr. Marcelle Layton of the New York City department of health and mental hygiene, Dr. Damon Arnold of the Illinois department.
A panel on preparedness lessons learned from states and localities includes (from l) Dr. Marcelle Layton of the New York City department of health and mental hygiene, Dr. Damon Arnold of the Illinois department
of public health and the Illinois Army National Guard, and moderator Dr. Stephen Redd of CDC’s influenza coordination unit. Also on that panel is Anslem Roanhorse, Jr., (below) of the Navajo Nation division of health.
Anslem Roanhorse, Jr. of the Navajo Nation division of health.

Get a Plan

Napolitano urged schools and businesses to make contingency plans for increased absenteeism and disruptions in service.

“As a former governor, I can say: Make sure your payroll continues,” she said. “Whoever processes your checks, make sure they have a backup.”

School nurse Mary Pappas was on the front line when the flu hit New York City last spring. The only nurse for 2,700 students at St. Francis Preparatory School, she described how she coped with limited resources, space and staff.

“I had every kid [being sent home sick] pull out their cell phone, because I had only one office line,” she said. “I got security guards to help.”

Schools should designate “ready rooms [isolation areas],” she said, to handle infected students waiting for their parents. And Pappas offered students this tip: “I told them: If it’s wet, and it’s not yours, don’t touch it.”

Who’s Closing? Who’s Funding?

O’Malley moderated a videoconference Q&A with several other state governors. Most had questions about school closures and vaccination program funding.

Education secretary Duncan noted that, at the peak of the outbreak in May, 726 schools closed. This fall, any decisions to close schools will be made on the local level, he said. The Obama administration will offer updated, clear guidelines “on a case-by-case basis.”

Sebelius said that the federal government will provide $260 million in “preparedness grants” to all U.S. states and interests for the vaccination effort and $90 million to hospitals for a projected surge in cases.

“A federally funded vaccination program may recapture payments from insurers, but we don’t anticipate [that states will cover the costs],” Sebelius said. “This will be a public effort funded by the federal government.”

Congress has already appropriated $1 billion to purchase bulk ingredients, and up to $7.5 billion more for vaccine testing, purchase and distribution. NIHRecord Icon

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