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Report to the President on U.S. Preparations for 2009-H1N1 Influenza

Click "source" to view the full "Report to the President on U.S. Preparations for 2009-H1N1 Influenza" from the President’s Council of Advisors on Science and Technology.

Here is the Council's "planning scenario":

Indeed, the 2009-H1N1 influenza is already responsible for significant morbidity and mortality world-wide — from its appearance in the spring, its continued circulation in the U.S. this summer, and its spread through many countries in the Southern Hemisphere during their winter season. While the precise impact of the fall resurgence of 2009-H1N1 influenza is impossible to predict, a plausible scenario is that the epidemic could:

• produce infection of 30–50% of the U.S. population this fall and winter, with symptoms in approximately 20–40% of the population (60–120 million people), more than half of whom would seek medical attention.

• lead to as many as 1.8 million U.S. hospital admissions during the epidemic, with up to 300,000 patients requiring care in intensive care units (ICUs). Importantly, these very ill patients could occupy 50–100 percent of all ICU beds in affected regions of the country at the peak of the epidemic and could place enormous stress on ICU units, which normally operate close to capacity.

• cause between 30,000 and 90,000 deaths in the United States, concentrated among children
and young adults. In contrast, the 30,000–40,000 annual deaths typically associated with seasonal flu in the United States occur mainly among people over 65. As a result, 2009-H1N1 would lead to many more years of life lost.

• pose especially high risks for individuals with certain pre-existing conditions, including pregnant women and patients with neurological disorders or respiratory impairment, diabetes, or severe obesity and possibly for certain populations, such as Native Americans.

There is an important issue with respect to timing:

• The fall resurgence may well occur as early as September, with the beginning of the school term, and the peak infection may occur in mid-October.

• But significant availability of the 2009-H1N1 vaccine is currently projected to begin only in mid-October, with several additional weeks required until vaccinated individuals develop protective immunity.

This potential mismatch in timing could significantly diminish the usefulness of vaccination for mitigating
the epidemic and could place many at risk of serious disease.

PCAST emphasizes that this is a planning scenario, not a prediction. But the scenario illustrates that an H1N1 resurgence could cause serious disruption of social and medical capacities in our country in the coming months.
 
 

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