Northern Illinois H1N1 After-Action Report: A Case for Enhanced Regionalization

Issues: The 2009 H1N1 pandemic severely challenged the response capacities of several regional health departments, and prompted a formal review of response strategies to document success and challenges in an effort to improve the regional public health response capabilities. Description: An H1N1 work group established to conduct the review identified eleven key issues, including inconsistent guidelines regarding school closure criteria and vaccination eligibility, gaps in the collection of essential data, uncertainty in the use of standing orders, and potentially confusing relationships with the media and public communication across the region. Lessons Learned: H1N1 challenged the region's capacity to sustain an intensive response to a public health emergency while maintaining routine responsibilities, at a time when resources were under severe strain due to an economic recession. Strategies were highly responsive to local needs, but at a greater cost to individual health departments than if a more coordinated regional approach had been taken, which drew more effectively on shared resources and regional capacities. Recommendations: Recommendations include standardizing the collection of data by establishing a minimum set of epidemiological information. A more formal forum for sharing best practices should be developed, as well as a regional media presence that includes the pre-sharing of response strategies. Additional guidance should be requested from state agencies regarding the training and credentialing of supplemental health professionals. A first step is the promotion of a regional health monitoring system that would provide aggregate data profiles and easily identify disease outbreaks to more efficiently mobilize emergency response strategies.