I thought with flu season ahead of us in the northern half of the hemisphere it might be a good time for people to share what they learned from the 2009 H1N1 pandemic.  Perhaps share what they thought worked well in their plans, and also what they have changed.  Not to constrain discussion but offer some areas to look at below you will find some key topics:

Layered Surveillance Is Critical to an Effective Pandemic Response – I am curious what triggered you to go to a more active surveillance versus passive and at what point did the over-whelming number of cases make it an academic exercise.

Development of Guidance for Clinical Management and Antiviral Drug Use Is an Iterative Process – What triggers did you use and how long did it take for you to begin to aggressively use the antivirals most states were stockpiling?  How could you speed up the process?

Laboratory Services Can Become Overburdened – What triggers did you use to move to a presumptive diagnosis of H1N1 versus laboratory confirmation or did you?

Enhanced Infection Control and Surge Capacity Is Needed for Intensive Care Services – Did you hospital policies change on mandatory influenza vaccinations or use of enhanced PPE with Influenza like Illness (ILI)?

Application and Monitoring of Nonpharmaceutical Interventions Must Be Consistent – What triggers did you use when you implemented social distancing mitigation measures, were they timely and was the benefit (prevent illness in the community as a whole) worth the social and economic disruption?

Availability and Uptake of Pandemic Vaccine Must Be Timely – How did you handle the pandemic strain vaccine and seasonal strain vaccine programs given the predictable delays in obtaining a pandemic vaccine and determination of priority groups?

Risk Communication Requires Active Coordination and Monitoring – Did you find communication messages between the business community to be consistent with emergency management and public health?  What triggers were used?

Needs of Displaced Persons/Migrants Must Be Included in Pandemic Preparedness and Response Plans – Were social services and healthcare systems able to address this population adequately?

External Evaluation of Response Efforts after a Pandemic Peak Is Useful – Did you seek outside assistance when looking for lessons learned to obtain an unbiased view of areas to improve?

 

Don’t feel constrained to the points above, please share where ever you feel we can do better.  I am especially interested in what those in the business community have to say.

One suggestion I have is to rename all the “pandemic” plans as “influenza” plans and implement mitigation strategies every year to decrease morbidity and mortality from this preventable disease.  Saving a pandemic plan for “the big one” is akin to only putting on your seatbelt when you know you’ll be in a big crash.  Exercising a plan against a real world event annually builds muscle memory and helps the public learn simple prevention measures which will work just as well during seasonal influenza as a pandemic strain. I look forward to your comments.