A pandemic's dry run

June 21, 2009

ALTHOUGH Massachusetts recorded its first swine-flu death this month, the effect of the disease has not been as dire as many feared. As a result, public health officials have been able to view the health system’s response to the pandemic as a test case for an even more dangerous outbreak of flu. Among the lessons learned is the need for better coordination between the public-health sector and the private suppliers of the tools needed to contend with flu: face masks, swabs, and antiviral medicines such as Tamiflu.

Doctors, clinics, and hospitals need better, up-to-date information about the availability of commercial medicine stockpiles. Inevitably, an illness like flu that strikes patients with varying intensity will be treated in settings ranging from the home to hospital critical-care units. This increases the need for public officials to have a better fix on how quickly supplies of medicines, in particular, are being depleted and how best to blend public and private stockpiles. Officials should consider mandated reporting by commercial suppliers if necessary.

This month also saw the first swine-flu death outside the Western Hemisphere - in Scotland. So far, the disease has claimed fewer than 200 lives globally, far below the 250,000 to 500,000 who die annually around the world during a regular flu season. Still, the World Health Organization declared swine flu a pandemic June 11 because the virus is now undergoing communitywide transmission in both North America and Australia.

Health officials are only too aware that swine flu could return in the fall, the normal flu season, in a deadlier form. Partly for that reason, vaccine makers, who have already manufactured their vaccines against regular flu strains, have begun work on swine flu vaccines as well.

Infectious disease experts say that the swine flu H1N1 virus would not have to mutate into a form as lethal as the infamous 1918 flu to take more lives. It could increase its toll simply by becoming resistant to Tamiflu, a much more likely development. In that case, doctors would likely turn to another antiviral, Relenza. But this drug comes as a powder and is taken with an inhaler, which makes it more expensive and less convenient. State officials say they have supplies of Relenza in government stockpiles.

One positive sign in this spring’s swine-flu outbreak, according to state Public Health Commissioner John Auerbach, was effective communication, both with the public in many different languages, and through a series of teleconferences with clinicians, local health officials, and school officials. Such communication - with all those groups and commercial medical suppliers - will be all the more needed if swine flu returns in a more virulent form.

http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2009/06/21/a_pandemics_dry_run/