A Pandemic by Definition

Commissioner’s Commentary
June 18, 2009

By David L. Lakey, M.D.
Commissioner, Texas Department of State Health Services

The declaration by the World Health Organization earlier this month (June 11) of a pandemic alert phase 6, its highest level, came as no surprise to Texas public health officials. This designation defines a worldwide outbreak of H1N1 flu, certainly evident as more than 75 countries are now reporting cases.

The WHO pandemic designation is neither cause for alarm nor a signal that Texans are more at risk for serious illness today than they were a week ago. It does not change what the Texas Department of State Health Services and local public health departments currently are doing in response to H1N1 flu. This pandemic definition reflects geographic spread, not the severity of illnesses.

Although the WHO has acknowledged phase 6, Texas and the United States initiated our pandemic response plans weeks ago.

Texas has been on the front lines since the H1N1 flu virus was identified in the United States in late April, reporting some of the first cases and unfortunately the first deaths in the country. The public health response here and in the United States has been quick and aggressive.

It had to be.

H1N1 was a new virus, unpredictable, and spreading widely to people who had little or no immunity. There was no public health track record to label who was at risk, how severe the outbreak would be or how lethal the virus could be.

DSHS and local health departments searched diligently for flu cases. State and local public health laboratories quickly geared up for testing thousands of flu samples. DSHS and local health departments worked with health care providers and hospitals, providing guidance and support. Within a week of the first cases, Gov. Rick Perry requested 850,000 courses of antivirals from the federal Strategic National Stockpile that DSHS distributed to more than 200 Texas sites. The State Operations Center held daily conference calls with up to 2,500 local leaders to coordinate response efforts.

All these actions were appropriate to protect Texans from an unknown virus.

We have learned a lot in the last few months. H1N1 is not going away. The virus continues to circulate in Texas, in the United States and in countries from Iceland to New Zealand. Case counts change daily; and while H1N1 flu illnesses in general have been mild to moderate in the United States, unfortunately the death toll also has been rising.

Public health continues to respond. DSHS is working with local and regional partners to prevent and detect respiratory outbreaks this summer in places such as camps, long-term care facility and child care centers. And we all need to continue good health practices such as staying home if sick, covering coughs and sneezes and washing our hands frequently and thoroughly.

There remain, however, many unknowns about this novel virus. We now have a window of opportunity over the summer to fill in many knowledge gaps and plan for the likely resurgence of H1N1 in the fall. We also are watching the Southern Hemisphere as that part of the world enters its winter flu season, tracking how far reaching and how serious the illnesses become there.

Planning is taking place now around such issues as epidemiology and surveillance, laboratory testing, antiviral and vaccine distributions, needs of special populations and actions that communities can take to reduce the spread of flu. Infection control in hospitals and other healthcare facilities is a critical issue together with their capacity to care for any increasing numbers of  patients.

I strongly urge everyone – schools, businesses, communities, individuals and families – to prepare as well. As with any natural disaster, we must be ready for the worst situation. Stay informed about H1N1 online at www.TexasFlu.org. Get help building family emergency plans and emergency supply kits at www.TexasPrepares.org. This summer is not a time to relax our vigilance.


( News Media Contact: Emily Palmer, DSHS Assistant Press Officer, 512-458-7400.

Downloadable photo of Dr. Lakey available.

Last updated January 18, 2011