Government Agencies Are Not Ready for Predicted H1N1 Outbreak

These deficiencies remain among the 10 highlighted recommendations:

• As the U.S. saw so tragically with the Katrina disaster, federal coordination is key. But "it is not clear how (existing agencies) would work in practice," the report said. Relationships and roles of the Departments of Health and Human Services, Homeland Security, the Homeland Security Council, the Federal Emergency Management Agency, and principal federal official for influenza pandemic are "unclear," the report said. While several exercises had been conducted since 2007, "it is unclear whether these exercises rigorously tested federal leadership roles in a pandemic." Roles of federal versus state officials also remain unclear, especially as they relate to border closures and vaccine distribution.
• Better coordination and collaboration between federal and state governments and the private sector are needed to assure adequate supplies of energy, food and agriculture, telecommunications, transportation, and water.
• Crucial documents, such as the National Pandemic Strategy and National Pandemic Implementation Plan, do not address five of six crucial characteristics of an effective strategy, and contain "no discussion of what it will cost, where resources will be targeted to achieve the maximum benefits and how it will balance benefits, risks and costs. Moreover the documents do not provide a picture of priorities or how adjustments might be made in view of resource constraints."
• Several agencies are "still in the early stage of developing their . . . measures to protect their workforce."
• While the federal government has provided some guidance and funding to help states plan for additional capacity, "some states' officials reported, however, that they had not begun work on altered standards of care guidelines, that is, for providing care while allocating scarce equipment, supplies, and personnel in a way that saves the largest number of lives in mass casualty event."

Or, they "had not completed drafting guidelines, because of the difficult of addressing the medical, ethical and legal issues involved." The GAO recommended that HHS serve as a clearinghouse for sharing such standards, but "HHS did not comment on the recommendation, and it has not indicated if it plans to implement it."