Anne Gershon, MD, president of the Infectious Diseases Society of America (IDSA), made the following statement today: “In week two of the current H1N1 or 'swine flu' epidemic, we are hearing some Monday-morning quarterbacking about whether it was right to raise alarms, close schools, and gear into pandemic mode. But the Infectious Diseases Society of America thinks the Centers for Disease Control and Prevention (CDC) has been correct in ramping up the nation’s response—and it’s equally appropriate that CDC is re-evaluating some of the guidance as we learn more about the current behavior of this novel virus. Whenever a new influenza virus emerges, a red flag goes up for virologists, influenza experts, and public health authorities because influenza is notoriously unpredictable. When you are facing a possible pandemic, you cannot set the course from day one -- you have to revise and reassess your strategy at every turn, just as CDC has done. Given the notorious history of influenza, the initial response has to be appropriate for what could be a worst case. We have learned so much in the last few days. As it has become evident that the pattern of transmission and clinical course of the new H1N1 is similar to that of seasonal influenza viruses, CDC has been reassessing its guidance on infection control, use of antivirals, school closures and other “community mitigation”—and that is just as it should be. Recommendations are being guided by science, with CDC consulting appropriately with clinicians and public health authorities at the local level. Officials also are evaluating practical matters such as supplies of masks, drugs, and other equipment, as well as the disruptive impact of closing schools and canceling community events. Officials are appropriately weighing the benefits and costs. Right now, the virus is spreading easily but appears to be causing mostly mild or less severe disease. That could change. We must be prepared. We have to watch carefully how this virus behaves as it moves into the southern hemisphere, where the traditional influenza season is imminent. We also need to be prepared for what happens in the U.S. in the fall. Even in a normal year, influenza is serious, contributing to about 36,000 deaths in the U.S. every year. We expect that CDC’s recommendations will continue to evolve as scientists and public health experts learn more. Revisions in recommendations are an indication that as we learn more about the behavior of the virus and its evolutionary changes, we are successfully coping with it. Changes in our approach are unavoidable, necessary, and should be expected when we use science to drive our response. Very clearly, the investments that we have made in pandemic preparedness and in the scientific understanding of the influenza virus have paid off. We’ve made huge improvements in surveillance, coordination, control and treatment. But we can’t back off now—we need a sustained commitment. The House Appropriations Committee has asked for $2 billion to help replenish antiviral stockpiles, develop vaccines, support global detection and surveillance, and aid state and local preparedness. IDSA thinks that’s a good starting point. In the meantime, there are simple steps all of us can take: wash your hands, cover your cough or sneeze, stay home if you are sick, get your influenza vaccine every year, and be prepared.”
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