States Make Progress But Still Unprepared for Pandemic, Says U.S.

In the first report of its kind, U.S. health officials said the nation’s states and cities made a strong effort to prepare for a flu pandemic, bioterrorism or other emergency health crises, but big challenges remain.

“I think in terms of effort and progress, an ‘A,”‘ said Dr. Richard Besser of the Centers for Disease Control and Prevention, when asked to assign a letter grade.

“In terms of amount of work to be done, I would say that’s absolutely enormous,” he added.

It was the government’s first assessment of the payoff from its investment of more than $5 billion since the terrorist attacks of 2001 to make the country better prepared for a variety of public health emergencies.

The report looked at the staffing, laboratory capability and other resources of state, local and territorial health departments for handling bioterrorism or other disasters.

The number of state and local health departments able to detect biological agents grew to 110 in 2007, up from 83 in 2002. Labs able to detect chemical agents increased to 47, from zero in 2001, the CDC found.

All states are now doing year-round flu surveillance — an important measure if the bird flu virus in Asia mutates into a more dangerous form easily spread among people, unleashing a worldwide epidemic.

Information sharing between labs and public health professionals has grown tremendously. And the count of illness-investigating epidemiologists assigned to emergency response rose to 232 in 2006, from 115 in 2001.

“Clearly we are better able to handle most public health events in this country today than we were in 2001, and that’s very good news,” said Michael Osterholm, a University Of Minnesota infectious disease expert.

Some of the bad news: Many states still do not have enough epidemiologists, and 31 states said they’re having trouble attracting qualified lab scientists. Laws need to be updated, and disease surveillance data exchange appears to be inadequate in at least 16 states.

Other public health experts said federal funding is also a problem. The CDC’s funding to state and local health departments for emergency preparedness dropped from $991 million in fiscal year 2006 to $897 million in fiscal 2007, according to the CDC report.

The agency did not release more recent figures. But some public health experts noted budget request figures that show a steady drop, including a proposed $609 million for fiscal 2009.

“You can’t expect states to be doing better if the federal government keeps cutting funding,” said Jeff Levi, executive director of Trust for America’s Health, a Washington-based public health research organization.

CDC officials said this is the first of what will be an annual series of reports on state and local emergency preparedness.

Trust for America’s Health has evaluated state preparedness five times in annual reports. Among the findings in the last report, released in December: Seven states had yet to participate in a federal program to buy antivirals for a potential flu pandemic and 13 did not have adequate plans to distribute vaccines and medical supplies from the Strategic National Stockpile.

That organization’s report is a bit more sweeping, and is a complement to the CDC report, said Besser, director of the CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response.

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