PARIS — Len Pagano, president of The Safe America Foundation kicked off the first of a two-day conference on pandemic influenza preparedness saying, "This is a global problem that needs a global answer." Comments from many of the 32 attendees meeting at the French Ministry of Health headquarters, echo the notion of this being a "global" problem that has a strong chance of materializing. This pandemic could be akin to or worse than the flu pandemic of 1917-18.
But will containing it and surviving mean finding a "global answer?" As the day-long discussions drew to a close, a strong sentiment emerged that the flu will be managed at a community level.
With more knowledge, technology and massive resources committed by French and U.S. governments, the discussions by some of the most knowledgeable people on the topic lead to the notion of a local solution.
The French preparedness initiative, led by Dr. Didier Houssin, director general of health for the national government, is a plan now in its thrid update and a multi-part action plan. The French government has purchased a large supply of anitviral drugs, acquired one billion surgical masks that will be distributed by druggists, and vaccines aimed at the current strain of the H5N1 avian flu virus.
The United States has devoted an unprecedented commitment of $7 billion for pandemic preparedness, with most of it earmarked for reserarch and development, Dr. Jeffrey Levi told the group. Levi, executive director of Trust for America’s Health, presented an outline of Pandemic Flu and the Potential for U.S. Economic Recession: A State-by-State Analysis.
As one participant observed, "The United States doesn’t have a consistent [pandemic flu] health policy. Where you live will determine who gets what" when it comes to antiviral drugs, vaccines and treatment. Some states, Dr. Levi said, are better equipped than others. When the pandemic hits, California is the best place to be, Nevada is the worst.
The United States clearly contrasts with the centralized model of France, with a strong national government that has prefictures in regions throughout the country, who help bring national support to cities and towns. America’s public health is guided by thousands of local and state health departments with no two being like any other.
Organization aside, what leapt forth to me, is the idea that this pandemic challenge will be met locally, in communities. Employees of global giants may have well-developed information and kits to protect and prevent, but these employees will be going home to their families and their pets.
Much of the discussion at Safe America’s conferences in Chicago, New York, Philadelphia and Los Angeles has been about social distancing. But dealing with a pandemic will require far more than closing schools, cancelling gatherings and working at home.
It would be like having a Hurricane Katrina situation in every state. Would families be able to sustain weeks of "snow days?" How will the food supply chain function? There are many more questions, and the answers are now being developed. But what is clear is that the front line will be in the community.
