By Glenda Fauntleroy
April 23, 2007
The RAND Corporation last week sounded the alarm for refocusing the
nation's attention on a potential pandemic outbreak, warning that the
country is underprepared for a disaster that could claim as many as 2
million U.S. lives.
We are overdue for a pandemic outbreak, said Nicole Lurie, M.D.,
co-director of RAND Center for Domestic and International Health
Security, at a briefing Friday. Lurie said a pandemic might kill 2
million U.S. residents and 50 million worldwide. And when it strikes, it
would take at least 6 months to develop a vaccine for protection.
The federal government has invested more than $5 billion since the
terrorist attacks of Sept. 11, 2001, to upgrade the countrys ability to
prevent and respond to large-scale public health emergencies, she said.
In contrast, public health has not been well funded for the past 25
years. It took 9/11 to wake people up to see our public health system
was a mess. She said the system is still recovering.
The amount of $5 billion may look like a lot of money, but its really
just a drop in the bucket to whats really needed to reshape the public
health system, she said.
Lurie said progress has been made in using technology to improve
communications and pandemic surveillance but that more investment was
needed. Theres been lots of payoff in investing in technology, she said.
Those investments have allowed public health agencies to make gains in
two critical areas communications and surveillance.
Despite these advances, Lurie said, there are still huge gaps in
preparedness. She said one hindrance to answering the question, Are we
prepared? has been that there is no clear understanding of what being
As a step toward establishing methods to measure whether a community is
ready for a large-scale health emergency, RAND recently convened an
expert panel to come to a clear definition of public health
The panel issued 16 recommended actions for communities around the
country to better deal with emergencies, including having a clear
command structure, strong public communications, an adequate number of
public health workers and volunteers, and a continuous process of
testing and maintaining systems.
Lurie said that after adopting the panels recommendations, the next step
is to ensure public health has a reliable funding stream to continue
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