Homeland Security Hearing- 10.21.09

[Readymom]

Here are my notes: (very fast notes!)
Liberman:
Poses greater risks for children
Moved with alarming speed. Taken an exceptionally large toll.
Spread to all parts of the country w/ all states reporting outbreaks.
(shows chart with past peaks and current spread)
43 pediatric deaths tallies so far 11 in the past weeks. Stats are already equal to what we see annually for children. Shows no signs of waning.
28 pregnancy deaths. CDC concerned.
Panel has been made very publicly accessible.
Libermans is concerned that the flu is spreading so rapidly and in some instances so intensely that it may be getting ahead of ability to respond.
Schedule of vaccine has slipped. 28-30 mil doses is 25% below initial projections of 40mil avail by end of October.
Unsetting reports of vac shortages leading a lot of people asking will we get it in time.
He said one reporter referred it to ?quiet desperation?.
Lieb. Concerned about:
1. that hospitals, etc. don?t have the capacity to meet hospital surge.
2. 27 states could exceed or come close to bed space if 35% get infected.
3. Avail. Of intravenous antiviral meds for seriously ill
It?s estimated that between 150-300 thousand hospitalizations could be so serious that they will need ICU treatment. They will not be able to be treated with the Tam & Rel.

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Senator Susan Collins (R-ME)
We must continually assess the feds response
Strikes preg. Women, children & young people
Bates college: # of flu cases jumped from 6 to 160 in less than 1 week. As of yesterday there are 245 infected.
CDC says 46% of admitted were healthy when infected.
It is clear much work and preparation has gone into preparation from health care, non profits, etc that have prepared pans. Schools have plans. Katrina was point of experience.
Strong foundations has been laid.
Significant concerns remain.
Despite reassurance from feds, millions of Americans remain worried about safety of vac.
CDC in Main reports many calls about safety.
In the next 8 weeks Main will only receive 340,000 doses, falling short needed to vac everyone in the PRIORITY groups! She is very concerned about reports of inadequate supply of vac. CDC has been saying that fed. Gove purchased enough and now there appears that production delay will result in 25% reduction. Early peak in the flu causes concern
? Pediatric formulations is needed. Reports of phony tamiflu out there. Concerns about surge of sick to emergency rooms (Sebuluius & Napolitano Are chatting head to head!)
(Sorry missed some, fox broke away and I h ad to pull it up on my laptop)

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Janet Napolitano:
There was a lag time assume between flu spiking and availability of vac.
Simple actions (wash hands, etc. can help slow spread of virus)
Since April: preparations have been made, workforce protections steps have been clarified, fed. Continuity has been planned; fema has been coordinating continuity plans for fed. Agencies for govt.
Surge in what we are seeing is beyond what we have anticipated.
International response with Canada and the UK-being coordinated.
We will work our way through this over the next several months.
Regarding surge in health care: there has been at least 3 billion dollars for surge planning given to hospitals. Many have plans, if necessary to handle patients OUTSIDE of the hospitals. Examples: tent triage, old cancer center,.
Thanks the works of the committee.

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Sebulius:
Point out to the committee members that there is a folder w/ important info. They should be guided by the science.
Updates are now being done twice a week by the CDC.
Flu.gov is now getting 5 million hits a week.
Good News: (about this flu EPIDEMIC) it?s getting a robust response. A couple of cases that seem to be outliars: antivirals are working against the flu
Flu season officially began on Oct. 4th. 41 states: widespread activity. Remaining states are at elevated levels.
Concern about young attacked. 86 pediatric deaths. Equal to annual flu deaths. Half hospitalizations under age 25. Different from seasonal. 90% of deaths under 65 y/o. grim facts. Thanks to committee, they are better prepared than ever before in history.
Greatly enhances surveillance system, than in the past.
Greatly enhanced testing.
Provided specific recommendations working hand in hand for schools, businesses, community & faith based organizations. Making sure info is shared.
Vac program is underway. Production is slower than they would have hoped. Put in Context: Virus first reported in April, vac is available. Five producers. Capacity for vac has been built. As of Mondaly 11 million doses are available and they are being shipped.
150 thousand sites where the vac is automatically delivered.
Anticipated 2 dose regiment. Everyone over age of 10 will only need one dose. Immune response in 8-10 day period.
Vac early delays due to:
1. Antigen production was yielding lower results than originally estimated.
2. New production lines that were put into place by producers that encountered glitches. Have been corrected. Number should now grow.
By early Nov. Vac will be widely available for EVERY American.
Still using egg-based technology. Working on cell based technology.
Vac safety is essential. CDC monitors safety. There are still lingering questions: where is the vac and have you taken enough time for clinical trials. Yes. More than 100 mill people a year receive seasonal vac and they anticipate same good results w/ safety.
Intravenous antiviral: they have encouraging results on this. BARTA began process. They are encouraged by results. Antivial will soon be on the market.
Simple steps:
Socialization
Stay home
Wash hand
Cough in arm (kids ARE listening to ELMO!)
Communication effort in traditional media, Ses.Street, Sid the Science Kid, twitter, facebook,, UTube, etc.

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Hon. Sec. Duncan (Dept. of Education)
Guidance for educational facilities been prepared. Can be used as a model for other scenarios.
Keep students, faculty safe during pandemic. Keep them Safe Keep them learning.
Look back to see where they were in the spring . They have made significant progress.
Spring closures were revised by CDC. More than 1,050 schools closed in the spring. 5/5/09 was day of greatest school closure. Lesson learned: schools follow CDC advice. There are consequences if the schools close: loss of millions of school meals, loss of parent wages who have to stya home, loss of supervision for older kids who stay home.
Need to improve:
Accurate on time date for school dismissal./
Need to develop materials for school educators.
Need to get message out, make it right, make it quick
Offer schools balanced clear guidance
(1) Schools can remain open, if clear measures are taken:
(2) Social distancing
(3) Cough etiquette
(4) Cleaning
(5) As of yesterday only 88 schools were dismissed. The reductions of the number of schools closed are due to amt. of outreach and communication.
Guide for parents was collaborated on, including alternate language documents. HHS, CDC had phone call conference on alternate care centers.
Made resources available for alternate education : internet, etc. Continuity guidance has been developed.
He and his wife will get their kids vaccinated. Best way to keep spread down.
Sample letter by CDC is available for schools to send home for student vaccination@ schools.
School based clinics in various formats: during school, weekends, with help of other agencies

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Lieberman: pointing to chart- what should we expect? Is it still going to go up?
S: You used the appropriate term in unpredictably. We are not seeing significant surge in communities where we saw surge in spring. We are still seeing ?hot spot? activity. We anticipate that line will continue to rise until we can make a significant dent w/ the vaccine. Getting people vac is the key.
L: Vacs are working?
S: yes. Immunity is 8-10 days.
L: 25% LESS of vac. Due to production? (Wanted clarification)
S: Yes. Has been corrected. We anticipate a much more robust production line, now. Daily contact w/ manufacturers
L: Clarificiation: We will get enough, but right NOW we do NOT have enough?
S: Yes. As soon as it?s out, it?s sent out. States order daily. Pushed to states overnighted.
L: out of 5 produces only ONE is in the US. We have lost that edge. More urgent question: concerned about the intravenous vac. for more serious cases. W/ extraordinary predictions of over 150 thousand needing ICU he expresses concern. Ata defense science board meeting they talked about a tested, emergency use intraven. Use vac. How soon will these patients get this vac?
S: It is among the highest priorities. It has been id?d early on as a need. I would say that we are very close to having a couple of the candidates being tested in the early stages. It is imminent. We hope that is the case (within a few days, as asked by Lieberman).
L: it will be available even w/out the full clinical trials completed?
S: Yes. Pediatric Suspension: there is a shortage. 75% of the stockpiles was pushed out. Guidelines were published for compounding pills + syrup for kids. Production has been ramped up.
Sen. Collins: Vac is effective and as safe as seasonal. Still an issue of getting to people too late. There will be enough, but a study that was pulished by perdu states the vac will arrive too late. The greatest number of infectins will occur THIS WEEK. Are you concerned that although we have been very successful that it will arrive too late?
S: I would suggest that we are at the very beginning of seasonal flu. As people get seasonal flu and it mixes with H1N1, it will continue to rise. We anticipate that there are still of 100s of millins of Americans that will be protected by the vaccine. Even if people experience the flu earlier/spring, they should still get the vaccine.
SC: our country has lost the capability of vac production. We have to go to other countries. Her understanding we have lost that capabilityis due to liability.
S: the congress invested in an entity (BARTA). This vac development was a collaborative event from the outlet. Reduced the growth time. No safety steps were cut. Re liability: legal protections have been in place for the past 5-6 years.
SC: in Maine many schools have stepped up and have school based vaccinatins. Many schools cd. Potentially be held libel if there is a vac reaction. Is this an issue that you are hearing about from schools?
Duncan: Schools will NOT be held libel. They will be protected from claims.
SC: Note passed on to Sen Collins by RE: Campus outbreak she mentioned earlier: They want a Main Medical Response System unit to be dispensed to the campus for help in responding, due to increase in student illness, as of this morning.

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Sen McCain:
Sen:Questioned increase in chart spike.
S: hope that as people get vac. Spread will be stemmed.
Sen. Questions the fact that millions of people may NOT be vaccinedatd.
S: stammered, sputtered (and sen. Got the answer he was looking for, lol!)
Observation: Sen: questions confidence that this will work . Cut her short when she tried to squelch his concerns. He continued to pound on the point that there is NOT enough vac out there in time. Short and quick w/ his interrogation!
S: Egg bases techonolgoy is producting lower yields. They are now getting higher production. Hopefully by early Nov. they will be bavk on track.
Sen: How long do you expect a state like Arizon get on track. He pressed for an answere for ALL states.
S: has to get back to him on that. She can?t answer: ?We can get you that number Senator?
Sen: He presses for WHEN.
S: We will get you that information
Observation: WHEW!
Sen: It is already here
Napolitano: what we are doing is the most that can be expected and anything else would not have an impact on the American people.
Sen: Re schools closing.What?s the answer?
Duncan: We are doing everything we can to keep schools open. Disruption to free meals, families routies, etc. Critically important to keep schools open.

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Sen. Kirk
Sen: Immunity from seasonal vac (in a long-winded round about question, lol)
S: Good news that folks are getting seasonal vac but they need to follow up with H1N1 vac.
Sen: Concerned over seasonal vac supply right now.
S: early run on seasonal vac. Production is backfilling that. It will be more widely available.
Sen: Re colleges/universities- vac. Determined by population. Has there been consideration of the inclusion of out of state student population? Is that considered?
S: leaders are very mindful of getting vac there.
Sen: delay of vac and oncoming of Thanksgiving, etc. If kids go home and are ill, are the colleges encouraged to use their facilities as clinics for surge.
Ducan: yes. We are encouraging this to be done.
Sen: why aren?t we helping ourselves and ourselves by production of vac. He understands we have glitches, and strain has to be considered. Aren?t? there things that HHS, HLS, etc. shouldn?t be considering to bering the production bak to the USA? Shouldn?t the departments be considering this together?
S: I think this is a very wise suggestion. We are going to be having a lot of ?lessons learned? from this. There are 5 manufacturers at this point. Up from 2. We are now in a situation where much of the world relies on our capacity. Helping other nations build facilities is important. We also need to get more here.
Sen. Lieberman: there have been news reports (Canadian?) they are under pressure to fill the Canadian needs before ours. It puts an exclamation point on the need for home-based production.
_________________

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Sen. Burse (Sp?)
Sen: certain minorities are at high risk due to health,etc. How are you reachibg out to these populations?
S: we identified early on how to get to high risk populations. Asked our partners to think about how to reach high risk populations. Faith based can reach these populations to get the word out and also get vaccinated.
Sen: Reaching schools, how are we doing with that? (in regards to minorities)
Duncan: Hugely important. They know the families and the communities. Extraordinarily impressed with their ability to reach those folks. Info needs to not only be available, but to be taken advantage of when it is available.
Sen: Questioned the surge capacity
Napol: It?s not like we will see tents all over the place. It will be how do you deal with mild and worried well.
(Observation: They keep saying ?EPIDEMIC? and not PANDEMIC)
Sen: will they come in to the actual hospital. He?s concerned with the medical personal being able to handle the long hours. Can the staffing handle this?
Nap: that is part of the planning process that has been under way. Situation will vary from place to place.
Sen (same quest to Seb)
S: bed capacity and provider capacity both considered.
S: tent situations: those facilities have verywisley decided to triage to keep ill separated from everyday concerns.

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Sen. Tester
Sen: is the outbreak greater or about the same in Canda, Europe, etc.
S: It is spreading about the same
Sen: Is Canada or mexico doing the same thing we are?
S: very coordinated effort occurring. Sharing survellience teams,e tc.
Sen: Why should be be more entitled to that vac than other countries in the world?
S: the balance is difficult. Safety & security . We are a global partner.
Sen: 1 production here 4 outside our country
S: (sorry .. they lost me here)
Sen: Cell based vs egg based-research being done here?
S: being done world wide and here.
Sen: Vac = 100% you won?t get the flu
S: 85-95 response.
Sen: Get it once, get it again?
S: get the vaccine (Missed her first couple of words)
Sen: schools: are there concerns that kids out of schools getting proper nutrition at home vs schools, if they close
Duncan: Absolutely it?s a concern. One day 900 schools closed, last spring. Yesterday 80+. One of our concerns. How do we feed at the school? FDA is partnering on this.
Sen: School nurses on this?
Duncan: leading the way.
Sen: school nurses staffing: do we have enough
Deuncan: we are under resourced in nurses in both urban and rural situations.

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Sen McCaskill
Want to understand we have a problem with reporting both ways. Report shows due to flu-like symptoms. So reporting is skewed (my words)
S: we are no longer testing all cases. These are not confirmed tested H1n1 cases.
Sen: So this is good news on this chart. They are NOT all H1n1 cases.
S: I think that is fair.
Sen: What are the confirmed deaths to H1n1 this year, from past years.
S: I know we have 86 confirmed ped. Deaths, that is as high as regular flu season. Kids don?t die from seasonal flu.
Sen: what is the number of others? (Observation, if I am correct in the very quick back & forth banter here) She is pressing that the numbers we are seeing are way lower, compared to seasonal.
S: that is absolutely correct.
(Observation: this Senator is very colorful in her participation)
Sen: thousands of Missourians raising hogs. Can we state for the record that no one can contract from eating portk.
S: NO ONE CAN CONTRACT FROM EATING PORK. (she actually said that it may protect you! :O )

[Readymom]

Re: Homeland Security Hearing- 10.21.09

Sen. Carper
Sen: Passed cudos on to the committee. Yadda yadda yadda. Then talked about personal observations of folks around him (woman using tissues to push elevator button).
Then talked about his son being sick and home from school. Son had it mild and then ran a marathon. Kids are resilient.
?? in addition to first responders, we also have technical arsenal to fight this. We must continue to invest in technical ways to fight future outbreaks.
Committee went on to talk about this ? I had to stop notes for a bit ? home duty called

[Chuck]

Re: Homeland Security Hearing- 10.21.09

http://www.foxnews.com/story/0,2933,568838,00.html

H1N1 Running Rampant Amid Shortage of Vaccine

Wednesday, October 21, 2009
By Marrecca Fiore

FC1
ADVERTISEMENT

H1N1 flu is running rampant throughout the U.S., and the country will have received only 25 percent of the vaccine that was expected by the end of October, Sen. Joe Lieberman told a Senate committee hearing Wednesday.

The grim news was the focus of a special hearing of the Senate Homeland Security and Governmental Affairs Committee, at which three Cabinet secretaries were called to address the panel: Health and Human Services Secretary Kathleen Sebelius, Homeland Security Secretary Janet Napolitano and Education Secretary Arne Duncan.

As of last week, there were more than 5,000 cases of flu reported, compared to 7 cases in October of last year. More than 800 people have died from H1N1, including 86 children, according to the latest reports from the U.S. Centers for Disease Control and Prevention.

?It?s moved with alarming speed and took an exceptionally high toll at a time of year when we don?t encounter a high number of flu cases,? said Lieberman, I-Conn, who leads the Senate's homeland security committee. ?Flu spikes typically occur in January. We?re in October ? and the number of cases is higher than what we usually see at the flu?s peak in January.?

Full Coverage H1N1: Click here

LiveShots Blog: H1N1

CDC officials say there should be widespread availability of the vaccine by mid-November.

Sebelius blamed the vaccine shortage on lower than predicted yields from vaccine manufacturers and on some manufacturing "glitches" that have occurred since May. She said the yields are now more in line with original predictions and that any glitches have been corrected.

"We anticipate a robust production line moving forward," she said.

She said the vaccine that has been received by the U.S. is safe and "right on target" as far as matching the H1N1 strain that is circulating and that most people will require just one vaccination rather than the two originally predicted. Two vaccinations are recommended for children under the age of 10.

Napolitano said federal officials had assumed there would be a lag in vaccine availability and a spike in the flu, so officials are not surprised that H1N1 has spiked at a time when there is not enough vaccine available.

Sebelius said the country is working with five manufacturers to get the vaccine out to the states as quickly as possible and that within another month there should be enough vaccines available for whomever wants to get one. She said so far states have requested 11 millions doses of H1N1 vaccine and the government is shipping it out to states as it becomes available.

Updated guidance has been offered to schools, governments and the private sector on how to handle outbreaks, Napolitano said.

"We could have a surge before everyone is vaccinated and we need to keep the country moving,? she said.

The words came offered little comfort to senators.

Sen. Susan Collins, R-Maine, said she is concerned about the lack of vaccine ? her state is only set to receive another 340,000 doses next week. She?s also concerned that there?s not enough pediatric Tamiflu available. Collins said this is of particular worry because children are at high-risk for complications and death from the H1N1 flu virus.

In fact, Sebelius said half of flu hospitalizations this year have involved people under the age of 25, and 90 percent of deaths have occurred in people under the age of 65. This is the opposite of what usually happens in a typical flu season when most hospitalizations and deaths typically involve people over the age of 65.

Lieberman said he is concerned that hospitals are not equipped to handle widespread outbreaks of the virus. He said some health officials predicted as many 300,000 flu patients could require ICU treatment in hospitals this year. Typically, about 200,000 people are hospitalized with influenza each flu season, and less than half require ICU treatment.

?I?m worried the virus is getting ahead of the public health system's ability to control it,? Lieberman said.

A study released Tuesday from Purdue University said it may be too late for the H1N1 vaccine to be of any benefit to Americans, as they may contract the virus before the vaccine takes effect. The study said most people would be infected during the month of October at a time when the vaccine is not available to most Americans.

Click here read more about that study.

Sebelius disagreed and said government health officials anticipate a spike in both seasonal and H1N1 cases going forward, not a drop off ? meaning that the vaccine will not reach the majority of Americans too late. She added that even those infected with H1N1 in the spring should consider getting the vaccine once widespread availabilty is made.

[Chuck]

Re: Homeland Security Hearing- 10.21.09

http://www.google.com/hostednews/afp/article/ALeqM5geFsZ0d2FzstSATLckNurGzYyhSw

US faces swine flu vaccine shortage

(AFP) ? 31 minutes ago

WASHINGTON ? US health authorities on Wednesday acknowledged a swine flu vaccine shortage in the United States and, that manufacturers would likely not catch up until December.

US Health and Human Services Secretary Kathleen Sebelius told the Senate Homeland Security Committee that currently there is not enough H1N1 vaccine made to inoculate every American who wants to receive the shot.

"Right now we are at a point where the demand is ahead of the yield," Sebelius told lawmakers worried about the spread of the sometimes deadly disease and closely watching the US government's response.

Independent Senator Joseph Lieberman, the committee's chairman, noted that experts had previously forecast there would be 40 million doses available by late October but that expectations now were for roughly 30 million.

"There are now very unsettling reports of growing vaccine shortages," said Lieberman. "We're asking ourselves if enough vaccine will be produced in time for all who will need it as we continue to experience the spread of H1N1 flu."

At least 4,735 people have died from swine flu infections since April, when an outbreak of H1N1 flu was first reported in Mexico, the World Health Organization has said.

Earlier, US Homeland Security Secretary Janet Napolitano told CNN television that vaccine makers "will be caught up somewhere around December."

"This is a delay. It's not a shortage. There, ultimately, is going to be vaccine for everyone who wants to be vaccinated," said Napolitano, who urged Americans to take "common-sense" precautions.

"It's keeping your child home from school if he or she is sick, staying home from work yourself if you're sick. It's coughing properly into your arm, not into your hand. It's frequent hand washing.

"You know, those may sound kind of low-tech, which they are, but they're remarkably effective things when it comes to slowing the transmission of the virus," she said.

[hawkeye]

Re: Homeland Security Hearing- 10.21.09

Thanks ReadyMom
nothing like some good ole' fashion politics for good measure.

Sen: thousands of Missourians raising hogs. Can we state for the record that no one can contract from eating portk.
S: NO ONE CAN CONTRACT FROM EATING PORK. (she actually said that it may protect you! :O )