U.S. Response to Swine Flu Called Good

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Effective communication was another widely acknowledged strength of the response, largely because it helped alleviate public anxiety, the report stated.

"This was clearly the top priority in managing and controlling this outbreak -- I give them [public health officials] high marks," said Dr. Scott Lillibridge, assistant dean for the Texas A&M Health Science Center School of Rural Public Health in Houston, and executive director of the National Center for Emergency Medical Preparedness and Response, who was not at the conference but was geographically at the frontlines of the epidemic.

But communication wasn't perfect, Fleming said, with the national picture often lagging one to two weeks behind local happenings. Local health officials had a clearer picture of what was actually occurring: who was being infected, how severely, how the virus was being transmitted, and how resources were handling the strain.

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Another shortcoming, according to the report: Public health departments are strapped in terms of resources -- including personnel -- and need to be replenished.

One expert who was not involved with the report agreed.

"Health departments and labs in hospitals were really marginally staffed. New technologies helped but the people were just not available," said Dr. Kenneth Bromberg, chairman of pediatrics and pediatric infectious diseases at the Brooklyn Hospital Center in New York City. "We don't have enough respirators in the U.S. for the worst-case scenario of a flu epidemic."

The report also said authorities need to think more carefully about the effects of school closings on parents, students and employers, as well as the reality that about half of all working Americans don't have sick leave.

The report made several recommendations, all based on the stated vulnerabilities. They include:

• Making sure that the national stockpile of antiviral medications, vaccinations and equipment is maintained.
• Improving coordination among federal, state and local governments and the private sector, including taking into account how the nature of flu threats change over time.
• Enhancing the nation's biomedical research and development abilities to rapidly develop and produce a vaccine.
• Making sure all Americans are vaccinated. Currently, more than 50 percent of Americans do not get their annual flu shots.

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