Presentation:   Lessons Learned from Pandemic Planning and the 2009 H1N1 Influenza Pandemic-New Mexico Department of Health’s Self Assessment

 

Speaker:          David Selvage, MHS, PA-C

 

 

The New Mexico Department of Health (NMDOH) was challenged by the 2009 novel H1N1 pandemic despite years of planning.  Fortunately, the 2009 novel H1N1 pandemic was mild by historical standards.  How NMDOH would have faired during a more severe pandemic is uncertain.

 

 

Background: State and local health departments have been preparing for pandemic influenza for years utilizing Centers for Disease Control and Prevention (CDC) and Health and Human Services (HHS) planning tools. In April 2009, a novel H1N1 pandemic influenza strain was recognized which quickly spread worldwide. This presentation reviews lessons learned by the New Mexico Department of Health (NMDOH) comparing pandemic planning and emergency preparations with the reality of the H1N1 pandemic.

 

Methods: Strengths and weaknesses in the state’s response were reviewed in the following areas: surveillance (influenza-like illness {ILI}, hospitalizations and death); laboratory capacity; distribution and tracking of SNS assets (antiviral agents, personal protective equipment {PPE}); vaccine distribution and doses administered; coordination between federal and state agencies; public and provider communication; and policy development. 

 

Results: The pandemic challenged key aspects of NMDOH pandemic response plans.  ILI and death surveillance were adequate. Implementation and operation of statewide hospital surveillance was time intensive and disrupted surveillance for other public health conditions. Laboratory testing capacity was initially inadequate. Stockpile antiviral agents were received and delivered but with difficulty. Assessing appropriate use of antivirals was challenging.  Vaccine distribution was complicated by demand far-exceeding supply initially; and the need to repackage vaccine for distribution to providers had not been anticipated.    Messages disseminated by CDC (e.g., promoting large public clinics) caused public complaints since NM had inadequate vaccine supplies to support such efforts.  Public and provider communication within the state was effective.  Policies regarding school closure were confusing. PPE policy development was difficult with NMDOH ultimately following the World Health Organization recommendations.  NMDOH established a small workgroup of senior leaders to make key decisions during the response and this approach worked well.

 

Conclusions: Surveillance for disease was complicated by the lack of laboratory testing for 2009 H1N1 influenza and the resources required for statewide hospitalization surveillance. Rapid distribution of antiviral agents was difficult given New Mexico’s size and rural nature. Inventory tracking of vaccines and antiviral agents was labor intensive and inaccurate. The aspects of the response (e.g., risk communication and ILI and death surveillance) that were judged adequate are functions routinely performed by the agency.

 

 

Learning Objectives

Please complete the following with regard to the learning objectives of your presentation.

At the end of this session, attendees will be able to:

 

1.       Attendees will be able to describe the challenges faced by NMDOH and other state health departments in responding to the 2009 novel H1N1 pandemic.

2.       Attendees will be able to describe how NMDOH has begun to evaluate its performance during the pandemic.

3.       Attendees will be able to describe the results of NMDOH’s evaluation efforts