President’s Advisors Predict as many as 90,000 H1N1 Flu Deaths

The President’s Council of Advisors on Science and Technology (PCAST) recently released a report that indicates as many as 90,000 people – mostly children and young adults – could die from the H1N1 flu virus if it re-emerges this fall. While that number seems high, people are being reminded that approximately 40,000 deaths annually are attributed to seasonal flu.

According to the report, the federal government’s preparations for 2009-H1N1 flu have been well-organized and are scientifically grounded. But, according to PCAST, some aspects of those preparations could and should be improved or accelerated.

“As the nation prepares for what could be a challenging fall, it is crucial that our public health decisions are informed by the very best scientific and technological information,” said John P. Holdren, assistant to the president for Science and Technology and a co-chair of PCAST.

The report concludes that the 2009 H1N1 flu is unlikely to resemble the deadly flu pandemic of 1918-19. But in contrast to the benign version of swine flu that emerged in 1976, the report says the current strain "poses a serious health threat" to the nation.

The issue is not that the virus is more deadly than other flu strains, but rather that it is likely to infect more people than usual because it is a new strain against which few people have immunity. This could mean that doctors’ offices and hospitals may get filled to capacity.

Among the group’s prime recommendations: accelerate the preparation of flu vaccine for distribution to high-risk individuals; clarify guidelines for the use of antiviral medicines; upgrade the current system for tracking the pandemic’s progress and making resource allocation decisions; accelerate the development of communication strategies – including Web-based social networking tools – to broadcast public health messages that can help mitigate the pandemic’s impact; and identify a White House point person with primary authority to coordinate key decisions across the government as the pandemic evolves.

An overarching message of the new report is that through their behavior, individuals can have a potentially big impact on the flu season’s severity. Frequent hand-washing and staying home from school or work when sick will be crucial. The report recommends intensive public education campaigns to reinforce those key behaviors, and also calls for policy adjustments that can reduce economic and other incentives that might encourage people to risk infecting others.

For example, workplaces could liberalize rules for absenteeism so employees don’t feel pressured to come to work when sick and school districts could arrange alternative means of distributing lunches to children who are sick but who normally depend on school meals for adequate nourishment.

Overall, the PCAST subcommittee concluded that it was "deeply impressed" by the H1N1-related efforts underway across the Federal Government, including the breadth of issues being anticipated and addressed, the depth of thinking, the overall level of energy being devoted, and the awareness of potential pitfalls.

“The federal government’s response has been truly impressive and we’ve all been pleased to see the high level of cooperation among the many departments and agencies that are gearing up for the expected fall resurgence of H1N1 flu,” said Harold Varmus, a PCAST co-chair and president of Memorial Sloan-Kettering Cancer Center.

“This virus has pulled us all together in common cause,” said PCAST co-chair Eric Lander, who is president and director of the Broad Institute of Harvard and MIT. “The preparations are the best ever for an influenza pandemic … influenza brings many challenges and agencies across the government will need to make many key decisions in the face of uncertainty about when and how the virus will play out. As we did in the spring, we can hope for the best, but we must prepare for the worst.”

Administration officials leading the flu response efforts praised the report and welcomed the recommendations from the PCAST subcommittee.

“The PCAST H1N1 subcommittee report recommendations will enhance national preparedness and response to 2009-H1N1 flu, and be valuable for longer term, systematic pandemic policy coordination and planning,” said John Brennan, White House homeland security advisor.

Read the PCAST Recommendations and Administration Progress (pdf).

The Centers for Disease Control and Prevention (CDC) has released a new guidance designed to help employers prepare now for the impact that seasonal and 2009 H1N1 influenza could have this fall and winter on their employees and operations. View the CDC Guidance for Businesses and Employers.

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