Response to the H1N1 outbreak will be a marathon and health-care officials may have difficulty keeping up with a barrage of patients and maintaining supplies. That was one of the messages delivered to an audience of health-care workers at the statewide disaster planning for hospitals conference called From Readiness to Recovery on Sept. 15 in Sacramento, Calif.

Gilberto Chavez, state epidemiologist and chief of the Center for Infectious Diseases for the California Department of Public Health, said most of the cases of flu in California have been H1N1 and that 1,806 people have been hospitalized and 152 have died. Chavez said there’s a temporary reprieve from the virus, but that will change this fall.

Officials found this summer that though there may have been a good supply of anti-virals, masks and ventilators, they weren’t always easily accessible. One of the lessons learned from this summer is to develop better communication between government agencies and the private sector and among government agencies and jurisdictions.

“We were told there were good supplies, but had trouble getting those from the private sector,” Chavez said. He also said the supply chain needs strengthening and policy changes rapidly requiring effective communication among agencies and jurisdictions.

Chavez said Australia was forced to deploy its surge capabilities and that will likely have to occur in the United States as well. He said there’s a high probability of mutation of the virus, that it won’t end anytime soon and that there will be little capacity for mutual aid because everyone will be affected. 

California thought it was well prepared for an outbreak of flu, having invested $172 million over the last five years to prepare. But officials were surprised when the H1N1 virus was found in multiple locations in April 2009. The prevailing thought was that an outbreak of H5N1 avian flu would strike, not the so-called swine flu.

“When the first case was discovered we thought it was unusual but not something we couldn’t handle,” Chavez said. “The second case was highly unusual.” He said the case was a combination of swine, avian and human flu never before seen. “We knew it had potential for a pandemic and could be as severe as the 1918 pandemic.”