3 Lessons About Outbreak Preparedness From Contagion

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3 Lessons About Outbreak Preparedness From 'Contagion'

By Glassman & Kate McQueston Sep 9 2011

The agencies tasked with handling a public emergency are lacking key capacities,

according to a National Security Council report.

I'm glad the new Hollywood blockbuster Contagion will be scaring moviegoers

around the world this fall. The truth is, we probably should be scared. Pandemic

emergencies are a very real threat in our ever more globalized society.

Unfortunately, both the Obama administration and Congress are set to cut funding

to investigate and track new infectious diseases. They seem to think that sudden

pandemics are works of fiction.

he government's top security experts know otherwise. The National Security

Council (NSC) recently released a low-profile but extraordinarily important

report: Promoting Global Health Security: Guidance and Principles for U.S.

Government Departments and Agencies to Strengthen International Health

Regulation Core Capacities Internationally. While lacking a decent title, this

paper is the first NSC document to acknowledge that the U.S. apparatus

responsible for handling international public health emergencies is split among

many agencies and lacking key capacities. If you want to view the paper, you'll

have to wait: The interagency group that created the document is still deciding

where it will be posted.

Hollywood blockbusters are not normally a recommended form of educational

material, but Contagion and the NSC report make similar points:

1. We are badly prepared for inevitable future outbreaks. Dramatic soundtracks

aside, there are good scientific and security reasons to fear novel viruses like

H5N1 and an uncoordinated, fragmented and ineffectual response. A 2010 study

examining the initial response of health care institutions to H1N1 found that

more than half of hospitals neglected important infection prevention measures.

The New England Journal of Medicine reports that one month after the release of

the H1N1 vaccine only seven percent of high-priority adults had been vaccinated.

According to the same study, nine months following the pandemic, 54 percent of

survey respondents said that the federal government was doing a poor or very

poor job of providing the country with adequate vaccine supplies. Our health

systems don't have a great track record for responding to public health crises,

and with the rise of drug resistance in many disease strains, the lack of proper

containment and response efforts could pose a significant security threat.

2. Better coordination is urgently needed: Improving coordination among the many

agencies responsible for responding to a pandemic emergency will be crucial for

the effective response. For example, even seemingly straightforward goals such

as maintaining one trained field epidemiologist for every 200,000 people is

vastly complicated by the fact that this responsibility is spread across six

different programs in three different U.S. agencies. Nothing tests coordination

capacity like a health security scare; let's make sure we pass next time.

3. Cutting funding could cost lives: The NSC report has excellent suggestions

for improving coordination. But guess what? They can't do it with less funding.

The already extremely cheap Centers for Disease Control program to investigate

and track novel disease outbreaks (just $37.8 million in 2010) was cut (PDF) by

almost $10 million in the Administration's pre-debt crisis 2012 budget proposal.

Currently just $1 million per year is budgeted for the program's crucial

Operations Center, which sends experts to investigate novel diseases -- the kind

that translate so well to the silver screen. By comparison, Contagion cost $60

million.

It remains to be seen if the popular interest in pandemics stirred up by

Contagion will have a lasting impact on public health preparedness. In the

meantime don't forget to wash your hands.

http://www.theatlantic.com/life/archive/2011/09/3-lessons-about-outbreak-prepare\

dness-from-contagion/244786/