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H1N1 Influenza:A Harbinger of Things to Come
Michael T. Osterholm, PhD, MPHDirector, Center for Infectious Disease
Research & PolicyDirector, Minnesota Center of Excellence for Influenza
Research and SurveillanceProfessor, Division of Environmental Health Sciences,
School of Public HealthAdjunct Professor, Medical School
University of Minnesota
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Human Influenza Pandemics
• Human influenza pandemics are a part of our history● 11 in the past 300 years
• Novel influenza virus subtype emerges in humans with:● little or no human immunity● transmission of the virus to humans by
humans● moderate to severe disease occurrence
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Novel Influenza A (H1N1) Virus Outbreak
• Caused by a novel influenza A virus that likely made the “animal to human jump” in Mexico in the late winter/early spring of 2009
• Human-to-human transmission is well established (worldwide distribution)
• Severity of illness spectrum varies by age and risk factor
• The virus is largely sensitive to Tamiflu and Relenza
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WHO Phases Of Pandemic Alert
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The Critical Concepts for Pandemic Preparedness That Are Largely Absent
in Our Current Planning Efforts
• The global just-in-time economy• Critical products and services
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Global Just-in-time Economy
• Globalization of the world’s economy results from the movement of manufacturing and services to developing world countries due to reduced costs for labor and natural resources and less government regulation
• Just-in-time (JIT) is an inventory strategy implemented to improve the return on investment of a business by reducing in-process inventory and its associated carrying costs. Quick communication of the consumption of old stock which triggers new stock to be ordered is key to JIT and inventory reduction. This saves warehouse space and costs. However, because stock levels are determined by historical demand, if any sudden demand rises above the historical average demand, the firm will deplete inventory faster than usual and cause customer service issues.
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Critical Products and Services
• Products and services on which we depend for our immediate health and safety – Water– Food– Basic prescription drugs– Safety– Protection against the elements (heat or cold)
• These products and services are often taken for granted and it is assumed they will “always be available”
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50 Largest Container Ports and Major Sea Lanes, 2004
Dubai
Tacoma
Santos
Jeddah
Durban
Seattle
Salalah
Oakland
Colombo
Melbourne
Long Beach
Charleston
Nhava Sheva
Los Angeles
New York/New Jersey
Kobe
TokyoOsaka
BusanNingbo
Nagoya
Manila
Dalian
Yanti an
Tianjin
Keelung
Yokohama
ShenzhenShanghai
Quingdao
Singapore
KaohsiungHong Kong
GuangzhouPort Kalang
Laem Chabang
Tanjung Priok
Tanjung Pelepas
LeHavre
Hamburg
Antwerp
Valencia
Rotterdam
Barcel ona
Algeciras
Felixstowe
Gioia Tauro
Bremen/BremerhafenPacific Asia Europe
Traffic 2004 (TEU)
Less than 2 million
2 to 4 million
4 to 7 million
7 to 10 million
More than 10 million
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Weather-Watch Ships at Sea: Tuesday, February 12, 2008, 1:00 PM
(ships participating in a voluntary global weather watch system,of 40,000 ships at sea today)
World container ship traffic has doubled since 1997
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The Integrated Freight Transportation Network
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• Little planning has been done on how we will maintain critical international, national, regional or local transportation
• One million highly skilled workers on 50,000 maritime freighters that move the global supply chain: they are not on any country’s priority plan for pandemic vaccine or antivirals
• No plans for how to prioritize fuel for critical transportation needs
Transportation and SupplyChain Integrity During the Next Pandemic
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A Modern World View of Pandemic Influenza
Chicken Little “We’re All Going to Die”
The Truth
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“Plans are useless, but planning is invaluable.”
Sir Winston Churchill
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