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As reported in the Washington Post ... HHS Secretary Kathleen Sebelius has ordered a major evaluation of the government's response and preparedness strategy against health threats such as pandemics and bioterrorism. The review will be led by Nicole Lurie, assistant secretary for preparedness and response, and will be complete by "early next year," was ordered in part because the H1N1 vaccine shortage has highlighted U.S. dependence on antiquated technology...

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What I hope will happen in this review are as follows:
a. That the Asst Secretary will look at Steve Musseys incredibly funny but regrettably truthful you tube blog. The CDC has lost some trust ground with its handling of the H1 vaccine issues and must reclaim trust as a critical component of future success.
b. That the NIMS/ICS command and control structure is not optimal for biodefense. The DOD is learning a valuable lesson in Iraq about empowering the boots on the ground. Management and influence with instilled local resilience is a far better approach.
c. When did innovation and risk taking die in this country. In the UK tamiflu was dispensed via a 1-800 NHS number, in France you got your H1 vaccine with a syringe and needle and gave it to yourself. Yes I know the lawyers fear drug users suddenly awash with needles. But what is the greater risk that drug users wont get needles or that standing for hours in a vaccine line with people some of which will have it, which violates social distancing will actually contribute to the spread of the disease. For that matter where I see an outreach by DHS, the World Bank and others to actually explore new tools such as voxiva, ushahidi , epi surveyor and collaboration hubs, I am not sure if ASPR is as innovative (note I have the deepest respect for ASPR leadership so I am just asking not pontificating on this point).
d. Before we put all of our faith in vaccines please listen to Thomas Jeffersons report on seasonal vaccines via the Cochrane library. Moreover what we currently know is the vaccine came out late and as the H1 bug morphs may not be effective during wave three. I make this point not to suggest eliminating an emphasis on vaccines but rather to suggest we also need to spend far more time on non pharmaceutical interventions.
e. We need to be more thoughtful about collecting data and deciding what works and what doesnt work. And we need to recognize that data isnt going to come via HavA Bed or any of the 300 biosurveillance tools we have, but from a disparate list of sources including payors, social media sites and others.
I have a series of other points but this is a blog not a book so I will simply wish the Asst Secretary God Speed in her endeavour


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