One flu over: Lessons of the H1N1 pandemic

A doctor absorbs the Hungarian made Fluval-P, H1N1 vaccine from a vial in Budapest, Hungary.
A doctor absorbs the Hungarian made Fluval-P, H1N1 vaccine from a vial in Budapest, Hungary. — Bela Szandelszky / Associated Press file photo

— Sawyer

The term pandemic has to do with the geographic spread of a disease and not with the severity. So, use of the term was completely appropriate and justified last year and now. Unfortunately, there was (and still is) a lot of misunderstanding as to this term, and it caused a significant degree of worry and concern.

— Alessandro Sette

Director, Center for Infectious Disease, La Jolla Institute for Allergy and Immunology

How would you grade the performance of public health officials and agencies?

The overall response, mostly coordinated through public health agencies, was outstanding. Governmental institutions demonstrated flexibility and quick decision-making, neither of which are typical attributes of governmental responses. Those who question the value of public health agencies need to imagine what this pandemic would have been like without the CDC and local health-department responses. There would have been widespread paranoia and panic. There would not have been a vaccine. We wouldn’t know if the virus responded to antiviral drugs. We wouldn’t have had a test for the virus. Many more people would have died.

— Sawyer

The response was remarkably efficient. Within weeks of the outbreak, global awareness was raised, “Patient Zero” was identified and circulating strains of virus were quickly made available to scientists for characterization and vaccine development.

There was a worldwide pandemic, so the warnings were definitely justified. Viruses are unpredictable, especially when they spread through the population rapidly, and are capable of acquiring mutations. Whenever a pathogen jumps species and shows signs of efficient human to human transmission, we will need to sound the alarm.

However, this event also exposed weakness in our response, particularly around vaccine production and distribution. We will need to invest in approaches to accelerate vaccine production and increase vaccine efficiencies, so less vaccine can be used to immunize more people. Of particular concern is the distribution of vaccine in underdeveloped regions of the world.

— Sumit Chanda

Associate professor, Infectious and Inflammatory Disease Center, Sanford/Burnham Medical Research Institute

All health-care facilities are required to have pandemic influenza planning and the necessary protocols in place. Strategies to prevent transmission of infection, such as source control, respiratory hygiene and cough etiquette, hand hygiene, personal protective equipment and the importance of influenza vaccination, are promoted year-round. As the pandemic unfolded, however, it became evident that although such recommendations are in place, the practical application of such strategies requires consistent reminding.

— Dr. Raymond Chinn

Infectious disease specialist/epidemiologist, Sharp Memorial Hospital

The response was exceptional, though we were probably lucky this time.

When assessing the response of public health authorities, it is important to consider the potential ramifications of a more conservative approach. Rapid decisions of this sort will always have to be made on the basis of incomplete information or data, before we have a sense of just how deadly a virus may be. If we had waited longer before reacting and the virus had been significantly more virulent, the severity of the pandemic and the number of deaths could have been astronomical. This must always be weighed against the risk of causing unnecessary alarm.


