Steven Helgerson, MD, MPH

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Presentation transcript:

Reflecting on Decision Making During an Influenza (H1N1 – Unusual) Epidemic Steven Helgerson, MD, MPH Montana Dept of Public Health and Human Services

What Went According to Plan & Was Helpful? HAN system: distributed (much) information, frequently State health department was the lead agency: mostly Stockpile distribution: SNS to state; state to local Laboratory surveillance: enhanced, intense

What Could Have Been More Helpful? News releases: what is the message? Self-fulfilling prophecies Information for public: what is the message? Choice of terminology

Influenza Types Reported to MTDPHHS 4/25 to 6/01/09* Total Number Seasonal 114 Novel A/H1N1 19

The physician must…have two special objects in view with regard to disease, namely, to do good or to do no harm. —Hippocrates, Epidemics, Book 1, Sect 5 Is “primum non nocere” applicable for public health?

Issues to Consider for Updating the Plan Realistic plans Less time escalating worst case scenarios More time refining strategies to control the effect Messaging Practice formulating a message (what is the objective?) Consider ways to disseminate the message Anticipate two outbreaks Influenza Anxiety How not to stimulate the latter while trying to control the former?

Issues to Consider for Updating the Plan Distribution and use of whichever influenza antiviral medication(s) is pertinent at the time of an outbreak Available when indicated Not unnecessarily used or hoarded Research issues HAN messages get to whom? Are interpreted how? Public messages get to whom? Are interpreted how? To what extent could public health use “anxiety outbreak” to emphasize a variety of messages?