H1N1 Challenges Ahead

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Country Faces Challenges in Hospital Care, Vaccinations, Antivirals, and At-Risk Community Preparedness

Media Contact: Laura Segal (202) 223-9870 x 27 or [email protected].

(October 1, 2009, Washington, DC) — Trust for America’s Health (TFAH) released a new report today that «estimates_or_finds», if 35 percent of Americans get sick from the H1N1 virus. «this_or_that», based on estimates from the FluSurge model developed by the U.S. Centers for Disease Control and Prevention (CDC).

According to the new report, H1N1 Challenges Ahead, «here_or_there»

In addition, «Cases_at_35_attack_rate» people in «state» could get sick if 35 percent of Americans get H1N1.

“Health departments and communities around the country are racing against the clock as the pandemic unfolds,” said Jeff Levi, PhD, Executive Director of TFAH. “The country’s much more prepared than we were a few short years ago for a pandemic, but there are some long-term underlying problems which complicate response efforts, like surge capacity and the need to modernize core public health areas like communications and surveillance capabilities.”

The report examines other H1N1 outbreak concerns the country faces this fall related to vaccines, antiviral medication, health care, and the special needs of at-risk communities. Additional key findings from the report include:

  • Last year, only «Vaccination_rate_for_all_adults» percent of adults in «state» were vaccinated against the seasonal flu. This means that there will need to be a major upsurge in vaccinations in order to vaccinate the entire population for H1N1, compared to what states and communities have managed in the past.
  • «Vaccination_Rates_for_65» percent of seniors (over the age of 65) in «state» are vaccinated for the flu annually, but only «Vaccination_Rates_for_1849» percent of younger adults in «state» receive vaccinations (ages 18 to 49). Seasonal flu vaccination efforts have concentrated on immunizing seniors, but H1N1 is considered to be more dangerous for young adults and children, which means outreach for vaccinations must be very different.
  • Budget cuts and layoffs in states and communities are hampering preparedness efforts. Local health departments eliminated 8,000 staff positions in the first half of 2009, which adds to the 7,000 local public health jobs lost in 2008. In addition, federal public health preparedness funding was cut by 25 percent from fiscal year 2005 to 2009.
  • Nearly half of private sector workers do not have any paid sick leave benefits, which means millions of Americans will face losing their jobs if they are sick, or they attend work and risk contaminating others.
  • While the federal government pays for the purchase and distribution of vaccines, payment for the administration of vaccines will be the responsibility of insurance providers, state and local health officials, or, in some cases, it could be an out-of-pocket cost for individuals.
  • There are 47 million Americans without health coverage. If 35 percent of the public becomes infected with H1N1, some 15 million uninsured Americans could become sick and either go without care or seek care in already crowded emergency rooms.
  • African-Americans and Hispanics are more likely to have severe cases of H1N1 because they suffer from more underlying chronic conditions, like asthma and diabetes. At the same time, many significant gaps remain in systems for reaching minority communities. For instance, emergency preparedness information is often disseminated on the Internet, which many people do not have access to, and there is limited availability of non-English information.

The report includes short-term recommendations to address some immediate concerns for the upcoming H1N1 season and long-term recommendations for improving the nation’s overall capacity for preparing for health emergencies. Some of the short-term recommendations include:

  • Refine plans for rapid distribution and administration of vaccines for the first mass vaccination effort to be conducted in such a short time in U.S. history;
  • Risk communications must be a top priority. Special efforts must be made to reach out to young adults, minorities, and other at-risk groups to get vaccinated. This should include communications in many languages;
  • Vaccination campaigns must continue past the fall to prepare for a potential third wave outbreak;
  • An emergency health benefit should be established to care for the uninsured and under-insured during the H1N1 outbreak;
  • An emergency sick leave benefit should be made available to Americans without sick leave benefits;
  • The emergency supplemental funding for H1N1 preparedness has been very important, but it is one-time funding and is insufficient to fill chronic public health infrastructure gaps, including the need to modernize surveillance systems and upgrade other technologies;
  • All public and private health insurers should waive co-payment requirements for H1N1 vaccines and out-of-network care for H1N1-related illness and allow providers to bulk bill for the administration of vaccines instead of requiring cumbersome paperwork for every individual;
  • The U.S. Department of Labor should communicate with the private health benefit plans governed by the Employee Retirement Income Security Act (ERISA) to encourage them to waive co-pay requirements for vaccines and out-of-network restrictions and to provide information to state and local health departments to help with their vaccination campaigns in communities; and
  • Health providers should follow the guidance from the U.S. Department of Health and Human Services and the Occupational Safety and Health Administration on the best way to protect health care personnel; and
  • Health providers and health departments should develop and disseminate strong public messages about ways to practice good hygiene and understand symptoms and remedies.

Hospital Bed Capacity at Five Weeks into a Pandemic

These estimates are for the peak of an outbreak, based on CDC’s FluSurge, using expert predictions that H1N1 is a relatively mild strain of the flu, similar to the 1968 pandemic flu, and that up to 35 percent of Americans could potentially become sick with H1N1:

  • 15 states would be at or exceed hospital bed capacity: Arizona (117%); California (125%); Connecticut (148%); Delaware (203%); Hawaii (143%); Maryland (143%); Massachusetts (110%); Nevada (137%); New Jersey (101%); New York (108%); Oregon (107%); Rhode Island (143%); Vermont (108%); Virginia (100%); and Washington (107%).
  • 12 states would be at 75 to 99 percent of their hospital bed capacity: Colorado (88%); Florida (80%); Georgia (78%); Maine (83%); Michigan (79%); New Hampshire (84%); New Mexico (93%); North Carolina (95%); Pennsylvania (77%); South Carolina (93%); Utah (83%); and Wisconsin (75%).

The full report, including a chart with state-by-state information on illnesses, hospitalizations, and flu vaccination rates, is available on TFAH’s web site www.healthyamericans.org. The report was supported by a grant from the Robert Wood Johnson Foundation.

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Trust for America’s Health Releases Blueprint for Modernizing Public Health for the Presidential Transition and Next Congress

October 21, 2008

Washington, D.C. – Trust for America’s Health (TFAH) today released a Blueprint for a Healthier America: Modernizing the Federal Public Health System to Focus on Prevention and Preparedness with recommendations for the next Administration and Congress on ways to improve the health of Americans. More than 150 experts and organizations helped identify gaps and fixes for federal public health agencies and programs through a year-long consensus-building process.

“America’s public health system is broken. Serious gaps exist in the nation’s ability to safeguard health, putting our families, communities, states, and the country at risk,” said Jeff Levi, PhD, Executive Director of TFAH. “This Blueprint reflects ideas from the best and the brightest minds in public health for ways to prevent disease, prepare for disasters, and bring down health care costs.”

Even though the United States spends more than $2 trillion annually on health care, tens of millions of Americans suffer from preventable diseases and major vulnerabilities exist in the nation’s preparedness to respond to health emergencies.

Some highlighted recommendations in the Blueprint include:

  • Setting new, realistic short and long-term health goals for the country;
  • Investing in disease prevention as a cornerstone of health care reform;
  • Ensuring a stable and reliable funding stream for core public health functions and preventive services, such as immunizations and screening, public health emergency preparedness, and promoting physical activity, good nutrition, and smoking prevention.
  • Creating an independent, science-driven National Public Health Board;
  • Implementing a National Health and Prevention Strategy focused on lowering disease rates, including a strategy to combat obesity;
  • Increasing accountability by tying tax-payer investments to improving the health of Americans and improving federal, state, and local coordination;
  • Addressing the public health workforce crisis with stepped-up recruitment efforts;
  • Clearly defining public health emergency preparedness and response roles and responsibilities;
  • Establishing an emergency health benefit for use by uninsured and underinsured Americans during major disasters and disease outbreaks; and
  • Fixing the food safety system.

The Blueprint contains an analysis showing a shortfall of $20 billion annually — across state, local, and federal government — in funding for critical public health programs in the U.S., based on research conducted by The New York Academy of Medicine and a panel of leading experts. Approximately $1 billion of this shortfall is due to cuts to the U.S. Centers for Disease Control and Prevention (CDC) budget from fiscal year 2005 levels.

The Blueprint calls for establishing a stable, reliable funding stream for public health and provides options for funding mechanisms to make up the $20 billion shortfall by increasing federal spending by $12 billion and state and local spending by $8 billion annually over the next four to five years. TFAH recently issued a report that found that an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within five years.

The Blueprint was supported by a grant from the Robert Wood Johnson Foundation.

View the complete document

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. Helping Americans lead healthier lives and get the care they need–the Foundation expects to make a difference in our lifetime. For more information, visit www.rwjf.org.

Contact

Liz Richardson
202-223-9870 x21
[email protected]

Laura Segal
202-223-9870 x27
[email protected]