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H1N1 Lessons Learned
Emergency response to flu outbreak shapes future strategies.


Jim Scheulen and Gabe Kelen
Jim Scheulen and Gabe Kelen expect the unexpected.

On the afternoon of Saturday, April 24, a telephone call to Jim Scheulen sparked what became Hopkins Medicine’s comprehensive, round-the-clock response to the H1N1 (swine) flu crisis.

Telephoning Scheulen was physician Nelson Tang, who heads special operations for Emergency Medicine, with reports of an H1N1 flu outbreak south of the border.

The stories were worrisome enough to prompt Scheulen and Gabor Kelen, head of Emergency Medicine and director of Hopkins’ Office of Critical Event Preparedness and Response (CEPAR), to launch a plan they’d been practicing for years—Hopkins’ Pandemic Influenza Preparedness, Response and Recovery Plan.

“The flu season was over,” says Scheulen, executive director of CEPAR. “For this to be starting now in Mexico told us that this clearly was not seasonal flu. It was a potential pandemic, and we should begin to respond.

“I’d hate to think where we’d be if we hadn’t thought about and put on paper a pandemic plan,” continues Scheulen. “In some ways, the plan is very specific and in other ways it’s still an outline of things we know we need to think about, such as exactly how we’re going to advise and respond to employees who have the flu. We had an idea, but now it became time for the rubber to meet the road.”

Now that the current crisis has passed, a key assumption on which the plan is based may need to be revised: that the flu it is designed to deal with would be a rapidly spreading, deadly contagion affecting large segments of the population. So far, for the most part the H1N1 flu has been “milder than any regular seasonal flu,” says Kelen. “Yet when you look at the numbers of people infected and where it is, the plans call for some fairly major measures.

“We got caught up—appropriately so—in the fact that this is an influenza variety that no one has seen before,” continues Kelen, “and since we haven’t seen it, we’re thinking, danger, danger, danger. When we re-tweak the plans, we’ll have to put in some concept of calibrating the response based on the virulence of what we’re actually dealing with.” 

“We’ve learned more about how things will really work than we ever could have simulated in any way,” Scheulen says. “This is a great example of how with every event that occurs you get better at responding to the next one.”

–Neil A. Grauer

Info: http://www.insidehopkins



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