An Ounce of Prevention

We were lucky. At press time, the threat of the H1N1 flu in the United States was dwindling as quickly as it had become front-page news.

Our government rolled out an extraordinary response to the new flu, deploying medicines and supplies to all states. People who were sick were urged to stay home from work or school. President Obama asked for $1.5 billion to fight the disease, and manufacturers began development of a vaccine against the novel virus.

On the job for only a day, HHS Secretary Kathleen Sebelius ordered 13 million drug doses to replace those shipped out of the national stockpile. More than 700 schools were closed. Health departments across the country began calling hospitals to see how many patients could be discharged early in order to accommodate flu victims.

The CDC added 50 staff members to its information line and set up daily press briefings. (At the height of the scare, the agency Web site was getting a record 8 million hits a day.)

Did we need all that? Thank goodness, no, and some critics are already wondering if the government’s aggressive actions were too much.

I wonder instead what would have happened if this flu had turned out to be as infectious or deadly as first feared. A report from the Los Angeles Times points out HHS’ “moderate” pandemic flu model envisions 90 million Americans getting sick and 865,000 hospitalizations. Those projections only hint at how bad things could get. There are 36,000 deaths here each year just from seasonal flu.

As this episode runs it course, we’ll hear more about what went right or wrong. So while we won’t need the flu preparations for this go-round, the exercise will be informative. For one thing, we’ve already found out there weren’t even close to enough protective masks on hand. (Experts say we’ll need hundreds of millions.) The Times noted critical equipment such as ventilators could have been taxed if the outbreak had been worse. We know now the public isn’t educated about the flu; 12,000 people logged onto a CDC Webcast in the middle of the workday April 30 to ask questions.

The scare was also a strong reminder for those outside this industry that home care personnel will play a huge role in caring for patients in a flu pandemic, which health officials say remains a question of “when,” not “if.”

According to an AAHomecare survey taken April 30-May 1, 53 percent of the nation’s HME providers had a formal plan for responding to a pandemic flu, and another 18 percent said they would have one in place within the week. Two-thirds of the participating providers, who collectively serve more than 2.5 million patients in all 50 states, said they were coordinating/communicating with other organizations in their communities for a pandemic. Twenty-three percent said they had stockpiled N95 masks or other supplies that would be needed, and I’ll bet the other 77 percent have since put in their orders.

“Home-based care is a centerpiece of the national pandemic flu response,” affirmed AAHomecare President Tyler Wilson, “and in a pandemic situation, home medical equipment personnel will be on the front lines.”

As you’re talking with members of Congress about the industry’s issues during the upcoming health reform debate, or about how the oxygen cap or competitive bidding could put you out of business, remind them that the country’s network of HME providers is one we simply can’t do without in a pandemic — or at any time.