Prof. suggests changes to current H1N1 strategy
By Paulina Karpis
Published on Friday, October 2, 2009
The federal government should work to better centralize oversight of its response to pandemics and consider more aggressive measures beyond vaccination to control transmission of harmful contagions, according to a paper written by Dartmouth Medical School professor Joseph Rosen, along with a team of students and DMS professor James Geiling.
The paper, which is currently in draft form and was provided to The Dartmouth by Rosen’s research assistant, Lindsay Katona, explores what strategies could be used to fight the pandemic if it gets to the level of the 1918 influenza, when 2 percent of the U.S. population died as a result of infection. In addition, the paper urges the government to provide funding and logistical support to stay ahead of what could be an evolving disaster.
“Pandemics connect together private health, public health and international health, and these combine to become a major issue for national security,” Rosen, who has a background in strategic threats, said in an interview with The Dartmouth.
The draft paper proposes establishing the vice president — working with the National Security Council and the Department of Defense — as the high-level individual responsible for responding to a pandemic. It also recommends that the United States immediately implement a comprehensive plan that includes isolation and quarantine in addition to vaccination efforts.
The team of Dartmouth researchers is currently tracking the pandemic’s progression. Rosen said he is particularly concerned about H1N1 because it has a high transmission rate, and individuals shed the virus before they show any symptoms.
“This fall, the U.S. might encounter a scenario where there are thousands of fatalities within a few short weeks, cities are strained to feed their populations, and civil authority begins to break down,” the draft paper says.
Katona said she was also concerned that the public does not fully grasp the potential severity of the virus.
“We are really not prepared locally at Dartmouth, in New Hampshire or globally to deal with the size of the threat of swine flu,” she said.
The researchers plan to release the paper in December or January, since they predict that the second phase of the pandemic will end by then, Rosen said. Katona added that she believes the pandemic may be severe enough by that time that the public will “actually pay attention to what we are saying,” and leaders will still have time to take action.
The students who contributed to the paper all took Rosen’s Engineering 87 class this summer. The course, which focused on improving responses to disasters, covered the H1N1 pandemic, along with Hurricane Katrina and the SARS outbreak.
Rosen said he and the students in the class were inspired by Colorado College professor Andrew Price-Smith’s book, “Contagion and Chaos,” which argues that epidemic disease fosters instability among and within nations.
Price-Smith, in an interview with The Dartmouth, said he is skeptical of strategies for fighting H1N1 based solely on vaccination.
He advocates that the government urge citizens to act more responsibly and cancel events that draw large crowds.
Thomas Richardson ’11, who worked on the paper, said he is optimistic about the United States’ ability to fight the pandemic.
“[I] know that even if the U.S. response plan needs a small change here and there, that there are more people like my group who can and will draw attention to areas of opportunity to make the U.S. response stronger and more effective,” Richardson said in an e-mail to The Dartmouth.