Influenza Pandemic Preparedness

Conclusions: Maximizing Resources and Planning Efforts

Conference attendees were well aware of the need to simultaneously plan and prepare for the next influenza pandemic and the next bioterrorist event. However, much work remains to be done. Without agreement regarding the top priority for allocating scarce resources, planning and implementing an optimal response to either pandemic influenza or a bioterrorist event will be difficult, if not impossible. Illustrating potential planning problems was the incongruity between the inability of most attendees to agree on the goal of planning and response measures (Figure 1) while 75% of a subgroup stated that essential workers and physicians should be the first to receive vaccines and antiviral drugs. In a situation with limited resources, usually only one goal can be optimized (either maximized or minimized).^[9] Therefore, before accepting any of the initially limited supplies of vaccine and antiviral drugs, physicians and first responders will have to explain how such an allocation will help achieve the chosen top priority.

Unprecedented resources for enhancing the public health preparedness and response infrastructure have been recently provided to all states by congressional appropriations in the form of bioterrorism cooperative agreements. The request for proposals stated that planning moneys may be used "... to upgrade state and local public health jurisdictions' preparedness for and response to bioterrorism, other outbreaks of infectious disease, and other public health threats and emergencies...".^[10] Using such resources and reflecting upon the lessons learned from previous influenza pandemics and the 2001 terrorist events, public health, medical, and emergency management communities must work together to develop an effective plan to strengthen our national readiness to respond to any catastrophic infectious disease situation.

If our public health planning efforts are too narrowly focused on preparing responses to a few select bioterrorism-related scenarios, a new opportunity for planning responses to a broad spectrum of infectious disease-related catastrophes will be lost. Any plans made for responding to either pandemic influenza or bioterrorism events must include an explicit mechanism for making difficult decisions regarding the prioritization of scarce resources. The conference highlighted the need for all states to continue their discussions and public debates regarding the setting of priorities and methods for allocating scarce resources. Obviously, each state or local government will chose its own specific method for drawing up a plan to deal with catastrophic infectious disease events such as an influenza pandemic. To help aid the planning process, materials such as a planning guide are available from agencies such as CDC and CSTE. Ideally, such planning and prioritization activities should take place well in advance of any catastrophic infectious disease event.

We thank Kakoli Roy and Margaret Coleman for their help in administering and analyzing the questionnaires; Pascale Wortley for valuable comments on an earlier draft of the manuscript; and the Council of State and Territorial Epidemiologists for its support. The following members of the ad-hoc Influenza Pandemic Conference Planning and Steering Committee significantly contributed to organizing the conference in May 2002: Lynnette Brammer, Ron Burger, Nancy Cox, Zygmunt Dembek, Kristine Ehresmann, Keiji Fukuda, John Iskander, Deva Joseph, Donna Lazorik, Ann Moen, Mack Sewell, and Gregory Wallace.

Emerging Infectious Diseases. 2003;9(12) © 2003 Centers for Disease Control and Prevention (CDC)

Cite this: Influenza Pandemic Preparedness - Medscape - Dec 01, 2003.