Preparedness for pandemics: does variation among states affect the nation as a whole?

TitlePreparedness for pandemics: does variation among states affect the nation as a whole?
Publication TypeJournal Article
Year of Publication2012
AuthorsPotter MA, Brown ST, Lee BY, Grefenstette J, Keane CR, Lin CJ, Quinn SC, Stebbins S, Sweeney PM, Burke DS
JournalJ Public Health Manag Pract
Volume18
Issue3
Pagination233-40
Date Published2012 May-Jun
ISSN1550-5022
KeywordsCivil Defense, Computer Simulation, Humans, Influenza Vaccines, Influenza, Human, Pandemics, State Government, United States
Abstract

OBJECTIVE: Since states' public health systems differ as to pandemic preparedness, this study explored whether such heterogeneity among states could affect the nation's overall influenza rate.DESIGN: The Centers for Disease Control and Prevention produced a uniform set of scores on a 100-point scale from its 2008 national evaluation of state preparedness to distribute materiel from the Strategic National Stockpile (SNS). This study used these SNS scores to represent each state's relative preparedness to distribute influenza vaccine in a timely manner and assumed that "optimal" vaccine distribution would reach at least 35% of the state's population within 4 weeks. The scores were used to determine the timing of vaccine distribution for each state: each 10-point decrement of score below 90 added an additional delay increment to the distribution time.SETTING AND PARTICIPANTS: A large-scale agent-based computational model simulated an influenza pandemic in the US population. In this synthetic population each individual or agent had an assigned household, age, workplace or school destination, daily commute, and domestic intercity air travel patterns.MAIN OUTCOME MEASURES: Simulations compared influenza case rates both nationally and at the state level under 3 scenarios: no vaccine distribution (baseline), optimal vaccine distribution in all states, and vaccine distribution time modified according to state-specific SNS score.RESULTS: Between optimal and SNS-modified scenarios, attack rates rose not only in low-scoring states but also in high-scoring states, demonstrating an interstate spread of infections. Influenza rates were sensitive to variation of the SNS-modified scenario (delay increments of 1 day versus 5 days), but the interstate effect remained.CONCLUSIONS: The effectiveness of a response activity such as vaccine distribution could benefit from national standards and preparedness funding allocated in part to minimize interstate disparities.

DOI10.1097/PHH.0b013e3182295138
Alternate JournalJ Public Health Manag Pract
PubMed ID22473116
PubMed Central IDPMC3758226
Grant List1P01TP000304 / TP / OPHPR CDC HHS / United States
1U54GM088491-01 / GM / NIGMS NIH HHS / United States
P20 MD006737 / MD / NIMHD NIH HHS / United States
U54 GM088491 / GM / NIGMS NIH HHS / United States
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