Thank you, Tom. I also want to thank NACCHO for hosting this important
conference and for inviting me to speak here today. Public health is a
top priority for this administration. So is strengthening our
partnerships across government. So I’m glad I could come talk with you
about how we can work together to keep Americans healthy and safe.
Before I get to our H1N1 response and some of the lessons we’ve learned,
I want to acknowledge a couple members of our terrific public health
team who are here today. Many of you knew Tom Frieden from his
trailblazing work as New York City Health Commissioner. Since then, many
of you have gotten to know him as one of the key leaders of our H1N1
response. We’re very fortunate to have him as our CDC director.
You’re also going to hear later today from Dr. Nicki Lurie, our terrific
Assistant Secretary for Preparedness and Response. Like Tom, she plays a
key role in almost all our public health activities. And over the last
year, those efforts have greatly benefited from her extraordinary
experience, not just in the federal government, but in the private
sector, academia, and state government. So we’re very lucky to have her,
too.
And last, I want to mention one member of our team who isn’t here today.
A few weeks ago, we lost one of our own, Diane Caves, in the Haiti
earthquake. Diane joined CDC’s Office of Public Health Preparedness and
Response in 2007, and I’m told she immediately impressed her colleagues
with her deep caring and adventurous spirit. So no one was surprised
when she volunteered to go to Haiti to strengthen our HIV/AIDS programs
there. She was working on those programs when the earthquake hit. Our
thoughts and prayers are with Diane’s family and with all families who
have lost loved ones in the earthquake.
Like so many of you here today, Diane’s passion was building safer,
healthier communities. And that job has never been more challenging than
it is today. We face a wider range of public health threats than ever
before in our history. It could be a dirty bomb set off in a subway car,
or a contaminated food outbreak that originates outside our borders. Or
we could face a new strain of flu that targets our children, like the
novel H1N1 virus. America’s families are counting on us to prepare for
all of these threats – and to be as prepared as possible even when we
face a new threat that we haven’t seen before.
Because you’re on the front lines of response, you know better than
anyone that these health emergencies can test our entire public health
system. How well we respond depends on the strength and numbers of our
health workforce. It depends on the effectiveness and reliability of our
countermeasures. Our response depends on how diligently we plan and
practice in local communities, and on whether we have enough hospital
beds and working emergency rooms. Can we execute a national response
strategy on the local level and inform the national strategy with the
best local data? And we know that no response can work unless we’re also
able to reach the public to educate them about the threat – and how to
prevent it.
The 2009-10 H1N1 flu was one of those crises that put every aspect of
our public health system to the test. I was sworn in as Secretary just
as we were recognizing the first wave of the disease. Less than an hour
after I became Secretary, I was taken to the White House Situation Room
to get briefed.
I’ve been involved in the H1N1 response from my first day on the job.
And what’s been striking about this flu is that like so many public
health crises, it hasn’t evolved the way we planned. We had planned for
a pandemic that was more deadly and emerged far away from our shores.
The flu that presented was less lethal – thank heavens – and already
present in several states. This confirmed the wisdom of our flexible,
“all hazards” approach to public health preparation. The most dangerous
public health threat is often the one you’re least prepared for, so we
tried to be prepared for everything.
When the H1N1 flu hit in April, these preparations paid off. One of the
first steps we took after identifying the flu was to release 11 million
antiviral doses, 13.5 million surgical masks, and more than 25 million
respirators from our Strategic National Stockpile. Having these
countermeasures on hand allowed us to ensure that commercial shortages
didn’t slow our response.
Another example of preparation paying off is our Hospital Preparedness
Program. Since 2002, we’ve sent more than $3 billion to state, local,
and territorial public health departments, which have been invested in
strengthening our medical surge capacity. Because of this investment,
many of our hospitals had actually conducted pandemic flu exercises
before H1N1 hit, so they knew what to do when their emergency rooms and
ICU beds started filling up.
Steps like these allowed our public health response to hit the ground
running. Working with partners in government, industry, and around the
world, we rapidly characterized the virus, developed a candidate
vaccine, made sure it was safe, and began production. By acting quickly,
we made the first doses of the vaccine available in October, less than
six months after the flu was identified.
At the same time, we launched an unprecedented multimedia communications
campaign, first to educate Americans about how to recognize the flu and
how to prevent it from spreading and then to encourage them to get
vaccinated. We taught an entire generation of kids how to sneeze and
built an incredibly powerful one-stop web site called flu.gov that
served as a resource for millions of people.
All these successes had one thing in common: they were made possible by
our unified public health response. In some cases, that meant
partnerships between agencies within our own department, for example
when the CDC, NIH, FDA and others worked to develop a safe vaccine. In
other cases, it meant partnership with other departments in the federal
government, like when we worked with the Education Department to develop
a school closing plan that balanced health risks with the value of time
in the classroom.
Most often, it meant partnership with state, local, tribal and
territorial public health officials like all of you. In any public
health emergency, you are both our eyes and ears on the ground and our
first line of defense. That was certainly true with the H1N1 flu. And
what we also saw with H1N1 was that these partnerships pay off. When we
spoke with one voice, our message was clearer. When we responded
together, our efforts were more effective. One good example was our
vaccine locator tool on flu.gov, which used information you collected
about clinics in your neighborhoods to make it incredibly easy for any
family to find the nearest vaccine site.
Another example were the ASTHO and NACCHO liaisons we embedded in our
CDC Emergency Operations Center. Having these liaisons made it
incredibly easy to share information and ideas. It helped us get
feedback on whether the flu was stressing local health departments and
allowed us to identify innovative approaches in local communities that
we could then spread throughout the country. We also got invaluable
input from our vaccine implementation steering committee, which brought
state, local, territorial, and community organizations together to
assist our CDC vaccine task force. Being able to incorporate these field
perspectives was a huge advantage.
This combination of preparation and partnership has allowed us to have a
successful response to the H1N1 flu so far. Today, we have filled,
finished, and released more than 155 million doses of the H1N1 vaccine
and more than 70 million Americans have been vaccinated.
But I want to stress that the H1N1 flu is still circulating and is still
a dangerous disease. The one thing we know for certain about the flu is
that it’s unpredictable. The level of H1N1 disease has declined over the
past couple of months, but there’s no guarantee that trend will
continue. So we need to continue to watch for an uptick in disease. And
we need to continue to encourage Americans to get vaccinated, especially
health care workers and those who are at high risk of complications.
Like the cross country racers competing in Vancouver, we need to lean
into the finish line and make sure we finish the job.
We’ll continue to work with you to keep Americans safe this flu season.
But as we monitor this dangerous disease and the seasonal flu, we must
also always look ahead to the next public health crisis. And that means
taking a hard look at our H1N1 flu response for lessons that will allow
us to do our jobs better next time, when the threat could be more
dangerous or unexpected, and when we may have even less time to respond.
Our department is currently conducting a rigorous review of our flu
response to identify lessons that can be applied to future threats. But
we already have a few insights that I can share this afternoon. For
example, we’ve learned about the importance of partnerships outside the
public health community. There was a very interesting survey recently of
parents who had gotten their children vaccinated against H1N1. Almost
one out of every three parents said that at least one of their children
had gotten vaccinated at school. So one of the things we’re going to
change is we’re going to look for new ways to work with outside partners
to further public health goals, whether it’s with our public school
system or universities or businesses.