TY - JOUR
T1 - Public health management of antiviral drugs during the 2009 H1N1 influenza pandemic
T2 - A survey of local health departments in California
AU - Hunter, Jennifer C.
AU - Rodríguez, Daniela C.
AU - Aragón, Tomás J.
N1 - Funding Information:
This article was developed with funding support awarded to Cal PREPARE, University of California at Berkeley Center for Infectious Diseases and Emergency Readiness under cooperative agreements with the US Centers for Disease Control and Prevention (CDC) grant number 5P01TP000295 (Preparedness and Emergency Response Research Center). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or other partner organizations. The authors would like to acknowledge all of those individuals who participated in this research, especially the LHD representatives, the members of the Pandemic Influenza Vaccine and Antiviral Advisory (PIVA) Advisory Group. We would also like to acknowledge the following individuals for reviewing survey materials and providing editorial support: Dr. Deborah Miller, Dr. Harvey Kayman, Mark Hunter, Donata Nilsen, Adam Crawley, and Jane Yang. Finally, we would like to thank Dr. Gwendolyn Hammer, Lisa Goldberg, and the California Department of Public Health for establishing the Pandemic Influenza Vaccine and Antiviral Advisory (PIVA) Advisory Group and developing the related decision-making methodology.
PY - 2012
Y1 - 2012
N2 - Background: The large-scale deployment of antiviral drugs from the Strategic National Stockpile during the 2009 H1N1 influenza response provides a unique opportunity to study local public health implementation of the medical countermeasure dispensing capability in a prolonged event of national significance. This study aims to describe the range of methods used by local health departments (LHDs) in California to manage antiviral activities and to gain a better understanding of the related challenges experienced by health departments and their community partners. Methods. This research employed a mixed-methods approach. First, a multi-disciplinary focus group of pandemic influenza planners from key stakeholder groups in California was convened in order to generate ideas and identify critical themes related to the local implementation of antiviral activities during the H1N1 influenza response. These qualitative data informed the development of a web-based survey, which was distributed to all 61 LHDs in California for the purpose of assessing the experiences of a representative sample of local health agencies in a large region. Results: Forty-four LHDs participated in this study, representing 72% of the local public health agencies in California. While most communities dispensed a modest number of publicly purchased antivirals, LHDs nevertheless drew on their previous work and engaged in a number of antiviral activities, including: acquiring, allocating, distributing, dispensing, tracking, developing guidance, and communicating to the public and clinical community. LHDs also identified specific antiviral challenges presented by the H1N1 pandemic, including: reconciling multiple sources and versions of antiviral guidance, determining appropriate uses and recipients of publicly purchased antivirals, and staffing shortages. Conclusions: The 2009 H1N1 influenza pandemic presented an unusual opportunity to learn about the role of local public health in the management of antiviral response activities during a real public health emergency. Results of this study offer an important descriptive account of LHD management of publicly purchased antivirals, and provide practitioners, policy makers, and academics with a practice-based assessment of these events. The issues raised and the challenges faced by LHDs should be leveraged to inform public health planning for future pandemics and other emergency events that require medical countermeasure dispensing activities.
AB - Background: The large-scale deployment of antiviral drugs from the Strategic National Stockpile during the 2009 H1N1 influenza response provides a unique opportunity to study local public health implementation of the medical countermeasure dispensing capability in a prolonged event of national significance. This study aims to describe the range of methods used by local health departments (LHDs) in California to manage antiviral activities and to gain a better understanding of the related challenges experienced by health departments and their community partners. Methods. This research employed a mixed-methods approach. First, a multi-disciplinary focus group of pandemic influenza planners from key stakeholder groups in California was convened in order to generate ideas and identify critical themes related to the local implementation of antiviral activities during the H1N1 influenza response. These qualitative data informed the development of a web-based survey, which was distributed to all 61 LHDs in California for the purpose of assessing the experiences of a representative sample of local health agencies in a large region. Results: Forty-four LHDs participated in this study, representing 72% of the local public health agencies in California. While most communities dispensed a modest number of publicly purchased antivirals, LHDs nevertheless drew on their previous work and engaged in a number of antiviral activities, including: acquiring, allocating, distributing, dispensing, tracking, developing guidance, and communicating to the public and clinical community. LHDs also identified specific antiviral challenges presented by the H1N1 pandemic, including: reconciling multiple sources and versions of antiviral guidance, determining appropriate uses and recipients of publicly purchased antivirals, and staffing shortages. Conclusions: The 2009 H1N1 influenza pandemic presented an unusual opportunity to learn about the role of local public health in the management of antiviral response activities during a real public health emergency. Results of this study offer an important descriptive account of LHD management of publicly purchased antivirals, and provide practitioners, policy makers, and academics with a practice-based assessment of these events. The issues raised and the challenges faced by LHDs should be leveraged to inform public health planning for future pandemics and other emergency events that require medical countermeasure dispensing activities.
KW - Influenza
KW - Public health preparedness and response
KW - Public health systems research
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U2 - 10.1186/1471-2458-12-82
DO - 10.1186/1471-2458-12-82
M3 - Article
C2 - 22276659
AN - SCOPUS:84856113721
SN - 1471-2458
VL - 12
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 82
ER -