Wednesday, May 6, 2009

Testified before House Committee on Foreign Affairs, Subcommittee on Africa and Global Health with Anne Schuchat and a USAID person. May 6 – 16, 2009 – It is apparent that the epidemic is “stabilizing’ in that it is looking like a typical seasonal flu, only out of season in the Northern Hemisphere. Only exception is Mexico, where the apparent severity is not explained compared to the rest of the world. It still could be an issue of the “denominator, i.e. there may be very many undetected mild cases in Mexico and so we are only seeing the severe cases and are assuming that the disease is more sever in Mexico. As of May 15, there have been 4714 confirmed and probable case in the USA in 46 states with 173 hospitalizations and 5 deaths. Internationally, there have been 7520 confirmed cases in 34 countries. Clearly this is different from the “swine flu” situation in 1976 where the virus infected 230 soldiers in Fort Dix, NJ with one death, but the infection never spread outside of Fort Dix. This has important implications in the intense planning that is going on in HHS regarding the production and administration of a vaccine. I am part of the “vaccine team” at HHS made up of Bruce Gellin, Robin Robinson of HHS’s BARDA, me, Jesse Goodman and Josh Scharfstein of FDA with input from CDC (Rich Besser et al.). We are being very careful to uncouple the decisions about going ahead to produce the vaccine for administration next Fall and Winter from the decision to actually administer the vaccine next Fall and Winter. We will have to observe what the virus does this summer here and in the Southern Hemisphere (their winter flu season). This drama is eerily unfolding like the situation in 1976. Thomas Frieden, Commissioner of NYC Dept. of Health, announced as Obama choice for CDC Director. Interesting in that many people thought that the choice would be Rich Besser because of the amazing public exposure he was getting, and the very nice job he did, during the flu crisis (every major network every day). Just goes to show you – sic transit glory or welcome to Washington!