The H1N1 Pandemic Analysis

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The 2009 Novel Influenza A (H1N1) pandemic brought to the forefront the critical issues of disaster preparedness and planning. Influenza pandemics often portend a political, humanitarian, social, and economic crisis if managed poorly. The essence of this assertion is that an influenza outbreak is an unpredictable and recurrent event (Jhung et al., 2013). As such, Nelson et al. (2007) have argued that advanced preparedness and adequate planning are essential to mitigate the impacts of influenza pandemics. Nonetheless, these efforts require the input of everyone in the community. Both national and international guidelines have provided the framework for addressing these issues adequately (McCormick et al., 2009). The state of Tennessee’s response to the H1N1 pandemic has provided valuable lessons for future practice.

The health and disaster management agencies should form collaborative linkages to respond to pandemics efficiently (Barrios et al., 2012). No single organization can respond to a pandemic independently considering the practical issues involved in disaster management. In addition, an effective reaction to emergencies requires the mobilization of massive resources (Nelson et al., 2007). Interagency collaboration is essential to build sufficient capacity. Emergency response mechanisms achieve their intended goals when agencies utilize their resources and knowledge base collectively (Barrios et al., 2012). The health administrators in Tennessee understood the value of cooperation by deploying the services of the Tennessee Emergency Management Agency (TEMA).

Each of the agencies involved in the multidisciplinary team should have explicit roles to avoid a conflict of interest. The best strategy to achieve this goal entails the delegation of duties depending on the resources and specialty of each organization (McCormick et al., 2009). For instance, the Department of Health (DOH) and TEMA assumed the leading role during the H1N1 pandemic in Tennessee. On the one hand, DOH had the resources, expertise, and contacts to address public health issues because of its background in health matters. On the other hand, TEMA would have addressed the security and logistic concerns since it had developed expertise in these areas over the years.

The agencies involved in emergency response should ramp-up resources in a progressive manner depending on the magnitude of the situation (McCormick et al., 2009). According to Barrios et al. (2012), the deployment of resources should follow a rational plan to prevent the incidences of overutilization. An influenza pandemic often expands in scope and magnitude as the virus spreads. It is illogical to deploy all the resources at once during the initial stages of outbreak. Such an action may constrain the capacity to respond to a fully blown situation in the future (McCormick et al., 2009). The authorities at Tennessee abdicated TEMA’s lead role to DOH after realizing that the pandemic would not increase in severity based on the initial assessment.

The development of efficient communication channels is essential to coordinate interagency efforts during a pandemic (Nelson et al., 2007). Interagency collaboration mechanisms are often complicated because the organizations involved have conflicting interests. These agencies may move in different directions without a clear chain of command (McCormick et al., 2009). The state of Tennessee ensured efficient communication by within the team through the establishment of the State Health Operations Center (SHOC). The principal function of SHOC was to act as a conduit for coordinating and disseminating information between the state authorities and their partners. This was an integral task because Tennessee has a hybrid public health system.

A two-way communication and collaboration between authorities and the public is an elemental strategy to dispel fear. The deleterious social and health effects of pandemics usually cause anxiety among community members (McCormick et al., 2009). The residents look to their local leaders to provide timely and accurate information. In the same vein, the contagious nature of pandemics requires the delivery of risk planning and reduction information (Nelson et al., 2007). Nelson and his colleagues have identified risk communication as one of the essential aspects that keep the local communities apprised of the risks and prevention measures. The Tennessee health authorities worked closely community leaders to prevent an explosive spread of the virus. For instance, these authorities engaged with school administrators on the issue of school closures.

Health authorities and their partners should work closely with the media during a pandemic. Media channels play a significant role in reducing the risk of cross-transmission. The media serves as the primary source of information for the masses (Nelson et al., 2007). Conversely, speculative and sensationalized reporting can increase anxiety and fear. As such, the disaster management team should keep the media informed to avoid these challenges (McCormick et al., 2009). The senior public health officials in Tennessee held conferences and briefs with representatives of media organizations. The authorities also participated in talk shows on both the radio and television to respond to the concerns of the public. These correspondences facilitated the dissemination of crucial information.

The emergency response team should use the established guidelines and protocols to minimize the spread of pandemics. National and international protocols provide best practices based on scientific evidence (Barrios et al., 2012). According to McCormick et al. (2009), these standards should inform the development of strategies that are necessary to counter the emergency. For example, Tennessee relied on policy updates from the CDC to determine the closure of schools. Conversely, some of these provisions may not address unique circumstances considering the unpredictability of emergencies. Health authorities should instead revise these guidelines based on the situation on the ground (Barrios et al., 2012). Tennessee adopted this strategy when one school reported a positive diagnosis after the CDC had relaxed its school closure policy.

The implementation of the pandemic response should consider legal and ethical issues relating to the distribution of scarce resources. Health agencies face the challenge of prioritizing the distribution of the vaccines, medications, and beds in intensive care units (Thomas, Dasgupta, & Martinot, 2007). Tennessee experienced a shortage of vaccines because of delays in production and distribution. In addition, the state recorded a surge of patients at the Le Bonheur Children’s Hospital due a severe outbreak among children. These challenges require the emergency response team to develop both implicit and explicit measures to rationalize the distribution of vaccines and antiviral drugs (Coleman, 2009).

First, Influenza pandemic has the potential to overwhelm the medical system. Jhung et al. (2013) have asserted that the overutilization of the emergency department imposes an immense stress on hospital resources. Consequently, Barrios et al. (2012) have demonstrated that patients who need urgent care desperately may leave the hospital without receiving any medical attention. Health facilities and departments should develop rational patient care pathways to ensure that only deserving patients utilize the emergency services. Le Bonheur Children’s Hospital addressed the surge at the surge at the facility by redirecting patients to hospitals with low capacity. This plan would not have succeeded without efficient triaging and communication.

The development and implementation of public health education and promotion is essential to minimize the spread of pathogens. Although vaccines and antiviral offer protection, they do not provide a cure (Thomas, Dasgupta, & Martinot, 2007). The execution of public health countermeasures reduces the risk of exacerbation significantly. The emergency response team should work with the local authorities, the media, and other partners to educate the public about the modes of influenza transmission (Coleman, 2009). For example, the interdisciplinary team should distribute information fliers and pamphlets, as well as establish a call centre where people can get accurate information (Nelson et al., 2007). One of the major challenges of vaccinations is the low rates of compliance because of religious or philosophical reasons. Health education can benefit defaulters and minimize the risk of exposure (Thomas, Dasgupta, & Martinot, 2007).

Secondly, the contagious nature of pandemics may necessitate the use of restrictive measures (quarantine, travel restrictions, and social distancing). Nonetheless, these strategies raise fundamental questions regarding human rights and liberties (Barrios et al., 2012). Health authorities should communicate effectively to justify the use of quarantine and other containment strategies instead of making unilateral decisions. Thomas, Dasgupta, and Martinot (2007) have indicated that health authorities carry the legal mandate of ensuring that disease containment measures do not stigmatize or harm the affected individuals. The health authorities should ensure that the affected individuals have full access to essential goods and services to prevent human suffering (Barrios et al., 2012).

References

Barrios, L. C., Koonin, L. M., Kohl, K. S., & Cetron, M. (2012). Selecting nonpharmaceutical strategies to minimize influenza spread: The 2009 influenza A (H1N1) pandemic and beyond. Public Health Reports, 127, 565–571.

Coleman, C. H. (2009). Allocating vaccines and antiviral medications during an influenza pandemic. Seton Hall Law Review, 39(4), 1111-1123.

Jhung, M. A., Epperson, S., Biggerstaff, M., Allen, D., Balish, A., Barnes, N., … Finelli, L. (2013). Outbreak of variant influenza A (H3N2v) virus in the United States. Clinical Infectious Diseases, 57, 1703–1712.

McCormick, L. C, Yeager, V. A., Rucks, A. C., Ginter, P. M., Hansen, S., Kazzi, Z. N., & Menachemi, N. (2009). Pandemic influenza preparedness: Bridging public health academic and practice. Public Health Representative, 124, 344–349.

Nelson, C., Lurie, N., Wasserman, J., & Zakowski, S. (2007). Conceptualizing and defining public health emergency preparedness. American Journal of Public Health, 97(1), S9-S11.

Thomas, J. C., Dasgupta, N., & Martinot, A. (2007). Ethics in a pandemic: A survey of the state pandemic influenza plans. American Journal of Public Health, 97(1), S26-S31.

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The H1N1 Pandemic Analysis

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