Keep­ing us safe

Ex­tra at­ten­tion to ex­ist­ing and emerg­ing health threats is wel­come news

Modern Healthcare - - Opinions Editorials -

In the weeks since the failed Christ­mas Day air­liner bomb­ing, so much of the de­bate has cen­tered on how well—or just how poorly—the anti-ter­ror­ism “sys­tem” worked. More im­por­tant of course, as Pres­i­dent Barack Obama made clear in his re­cent state­ments ad­dress­ing the short­com­ings lead­ing up to the at­tempted at­tack, is what can be learned from the in­ci­dent.

In­te­gral to on­go­ing eval­u­a­tion and prepa­ra­tion for fu­ture threats will be our na­tion’s pub­lic health lead­er­ship, pub­lic safety and first-re­spon­der corps, and ev­ery sin­gle per­son in­volved in front­line health­care de­liv­ery. Preven­tion and in­ter­dic­tion are the top jobs un­der coun­tert­er­ror­ism, but if the un­think­able oc­curs, it’s those peo­ple who will feel it first.

That was part of the mes­sage from HHS Sec­re­tary Kath­leen Se­be­lius just last week when she an­nounced the release of the first-ever na­tional health se­cu­rity strat­egy. She said im­prov­ing our na­tion’s abil­ity to ad­dress ex­ist­ing and emerg­ing health threats is a re­spon­si­bil­ity to be shared by all of us.

Last month, the weapon of choice for the al-Qaida-linked would-be bomber was once again a U.S. jumbo jet. Luck, and some brave pas­sen­gers and crew mem­bers, in­ter­vened. But what about some other, more omi­nous weapons? Specif­i­cally, what’s the state of our de­fenses against bioter­ror­ism? Here, the news hasn’t been good. Just last Oc­to­ber, an in­terim re­port pub­lished by the bi­par­ti­san Com­mis­sion on the Preven­tion of Weapons of Mass De­struc­tion Pro­lif­er­a­tion and Ter­ror­ism raised plenty of red flags, con­clud­ing that the U.S. is not do­ing enough to ad­dress what the panel deems is the most ur­gent threat: bi­o­log­i­cal pro­lif­er­a­tion and ter­ror­ism.

“The clock is tick­ing,” ac­cord­ing to Bob Gra­ham, the com­mis­sion’s chair­man and a for­mer U.S. se­na­tor. “The United States has taken action, but we have not kept pace with those who would do us, or the world com- mu­nity, harm. The ter­ror­ists are flex­i­ble and in­creas­ingly ca­pa­ble. The ex­ec­u­tive branch, the leg­isla­tive branch, and even the Amer­i­can peo­ple must do more.” While the re­port noted progress to­ward rec­om­men­da­tions made in an ear­lier, equally alarm­ing 2008 re­port, it also cited sev­eral ar­eas of con­cern, in­clud­ing our na­tion’s dis­ease-sur­veil­lance ca­pa­bil­i­ties.

As the re­port states, “The abil­ity for the na­tion to rec­og­nize a dis­ease emer­gency—whether it is de­lib­er­ate or nat­u­rally oc­cur­ring—is the first link in a chain that leads to a ro­bust pub­lic health re­sponse.”

In the same vein, Amer­ica’s re­sponse to the H1N1 flu pan­demic also tells a cau­tion­ary story.

While pub­lic health leaders are to be com­mended for their game plan to ed­u­cate the na­tion on the threat of H1N1 and mit­i­gate its spread, the fight against this virus cer­tainly ex­posed a se­ri­ous vul­ner­a­bil­ity in the dis­ease-fight­ing arse­nal: pro­duc­tion and dis­tri­bu­tion of a vac­cine.

Back in mid-Oc­to­ber, when the cases of the “swine flu” seemed to be ex­plod­ing, and when the Cen­ters for Dis­ease Con­trol and Preven­tion had pre­dicted some 40 mil­lion vac­cine doses would be avail­able, the ac­tual count fell short by about 25%—or 10 mil­lion to 12 mil­lion doses.

The trusted but outdated egg-based pro­duc­tion method used to grow the virus for the vaccines proved un­pre­dictable with H1N1. An­other com­pli­ca­tion came months later when some 800,000 doses of the chil­dren’s vac­cine had to be re­called be­cause of di­min­ished po­tency.

This ex­pe­ri­ence calls into ques­tion the na­tion’s re­ac­tion time to pro­duce and de­liver an ef­fec­tive vac­cine should some man-made pathogen prove to be much more vir­u­lent than H1N1. The hu­man toll from such de­lays in the ac­cess to a vac­cine could be hor­rific, so it’s vi­tal that this na­tion speed up the move to new pro­cesses and tech­nolo­gies.

HHS’ new health strat­egy is good news, but there’s hard work ahead.

DAVID MAY As­sis­tant Manag­ing


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