October 1, 2009

Communication, Vaccine Campaign Top H1N1 Challenges

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Rear Admiral Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, on the challenges of the H1N1 pandemic.

Dr. Anne Schuchat:

This is the first pandemic in 41 years and it's fortunate for us that we've had several years now of strengthening our preparedness, of trying to be ready for something like this. It's fortunate that this virus doesn't seem to be as bad as the 1918 virus or the H5N1 bird flu strain.

But we have a delicate public health system and a delicate health system and a challenging communication environment and my hope is that people can make good decisions for the health of themselves and their family, that they have access to interventions that can be life saving, that those who can really benefit and need the vaccine have access and available vaccine that they can get and that we can reduce the illness and severe toll that this virus has as far as possible -- we're trying to do that in a way that balances the disruption to society.

Shutting down society might slow spread a little bit, but the cost might be too great in terms of all those other things that would suffer. So, it's not really just about money. It's about that whole balance of our complex community.

You know I think we have several challenges. In the spring of course we had this challenge with a new virus and understanding what kind of disease it was causing, making a vaccine, testing it, planning the distribution and delivery site, certainly going forward now -- it's a major challenge to make sure that vaccine is where it needs to be and when it needs to be and that the people who really need and can benefit most from it are motivated to seek it out and that it's available to them when they want it and you know when it's out there in the system.

But there are other big challenges. I think information is one of the major challenges in this. We want to have credible accurate, timely information and we know that we're competing with a lot of other sources, some of whom don't have that same mission that we have of really sharing public health information accurately.

So, I think we're working hard to be accurate, but also quick and to really quash out myths as quickly as we can, because they can take on a life of their own.

Even for treatment there are a lot of changes. You know at this point we're recommending treatment for people who have underlying conditions that make it likely they would have a complication from flu, but we're not recommending the use of anti-virals for absolutely everyone who has a flu like symptom.

And the reason is we want the medicines to work when they really need to work and we are worried about the resistance problem. But we also want everyone with a severe illness to be treated with anti-virals and we want that to be prompt treatment.

It's a huge challenge because we're telling people stay home, you don't need to see a doctor. If you're not in a risk group and you don't have warning signs, stay home, chicken soup, that should be fine.

But for these other groups as quick as possible get in touch with your medical care provider or see a physician and try to see whether you do need treatment promptly because prompt treatment can be life saving. A very complex message.

And you know we may not be right 100 percent of the time and there tragedies that occur and we also have issues with spot shortages of some of the supplies, you know, how do we stretch the supplies to the right place and the people who really need them. It's again a -- you know an issue of coordination and planning and balancing some difficult choices.