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

Potter, MA and Brown, ST and Lee, BY and Grefenstette, J and Keane, CR and Lin, CJ and Quinn, SC and Stebbins, S and Sweeney, PM and Burke, DS (2012) Preparedness for pandemics: Does variation among states affect the nation as a whole? Journal of Public Health Management and Practice, 18 (3). 233 - 240. ISSN 1078-4659

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Objective: Since states public health systems differ as to pandemic preparedness, this study explored whether such heterogeneity among states could affect the nations 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 states relative preparedness to distribute influenza vaccine in a timely manner and assumed that "optimal" vaccine distribution would reach at least 35% of the states 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. Copyright © 2012 Lippincott Williams & Wilkins.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Brown, ST
Lee, BYbyl1@pitt.eduBYL1
Grefenstette, Jgref@pitt.eduGREF
Keane, CRcrkcity@pitt.eduCRKCITY
Lin, CJ
Quinn, SC
Stebbins, S
Sweeney, PM
Burke, DSdonburke@pitt.eduDONBURKE
Centers: Other Centers, Institutes, Offices, or Units > Center for Vaccine Research
Date: 1 May 2012
Date Type: Publication
Journal or Publication Title: Journal of Public Health Management and Practice
Volume: 18
Number: 3
Page Range: 233 - 240
DOI or Unique Handle: 10.1097/phh.0b013e3182295138
Schools and Programs: Graduate School of Public Health > Epidemiology
School of Medicine > Medicine
Refereed: Yes
ISSN: 1078-4659
Date Deposited: 05 May 2015 16:59
Last Modified: 02 Feb 2019 16:57


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