Publication Type: Conference Paper/Unpublished Manuscript
Abstract: Avian influenza continues threaten domestic poultry populations around the world. While the World Health Organization (WHO) and other international health institutions have not confirmed direct human to human transmission of this infectious disease, public health officials are increasingly concerned about the severity of this security threat. Since 2003, avian influenza has swept westward from South East Asia, through Central Asia and Eastern Europe, into parts of Africa, and most recently into Western Europe. Until recently, this disease posed minimal risk to the general human population; with only those in direct contact with foul at increased risk. However, the events in Indonesia, coupled with that fact that this strain of avian influenza shares similar characteristics with the 1918-19 Spanish Flu pandemic which killed between 25 and 40 million people globally serve to highlight the threat to individuals and states alike. Further, the WHO recognizes that the emergence of human pandemic flu, most likely through a mutation of a form of avian influenza, is not a matter of, if, but when. Avian influenza, as well as other naturally occurring infectious diseases, is a security threat that must be incorporated into a state’s security framework. The securitization of this threat, though, does not mean a military solution. Rather, theoretical developments in the field of international relations now view non-military threats, like influenza as important as interstate conflict. Further, states do not tackle these types of threats individually. Rather, it is through international cooperation and engagement, a society, states react to security threats like infectious diseases.

Publication Type: Abstract
Abstract: Objective: To interactively and transparently develop an evidence-based, practical, and ethical hospital preparedness plan using an innovative project management website, and to create a tabletop exercise to demonstrate and evaluate the plan for regional stakeholders.
Methods: Students will be divided into eight groups of 2-4 students to develop a specific aspect of a hospital preparedness plan using recent regional health-system plans and national guidelines for inspiration. Sections include education, administration, surveillance, logistics, admissions/triage, occupational antivirals and vaccines, patient antivirals and vaccines, and surge capacity. Students will be evaluated based on group participation, clinical decision making, designing the plan based on predetermined hospital characteristics, and anonymous peer-review. Innovative components of this plan include the use of web-based project management software in which students can conduct all work and continuously monitor project progress, post and update files, and communicate to all members of their group and/or class.
Results: Each group will justify the essential health care tasks and resources required in both pre-pandemic and pandemic situations. At the end of the semester, each groups’ section will be compiled into a hospital-wide plan that will be tested in a mock pandemic tabletop exercise written and evaluated by the students as a whole.
Implications: This project will increase the students’ knowledge of public health pharmacy through interactive, applied, service-oriented learning using technology optimal for pandemic planners. This project will also prepare these future health professionals for service in before and during influenza pandemic in command, planning, operational, and logistical roles.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: The article reviews different historically and culturally conditioned role positions available to actors under pandemic dramas. Although it concentrates on the contemporary scene of Avian Influenza, the aim is to examine the precursor epidemic scares suc

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: This article reports the results of a case study on crisis management at a county health department following the 2004 flu vaccine shortage. The study compares the department’s approach to established crisis communication principles, which emphasize image restoration following organizational wrongdoing. The results show that the department relied on strategic partnerships to navigate the crisis. Accepted crisis communication theories provide limited explanation of this community-based crisis. The implications of two emerging crisis frameworks are discussed.

Publication Type: Abstract
Abstract: This study examines the determinants of influenza vaccine demand among the elderly U.S. population and it’s effect on the cost and usage of care. The analysis is done using data from the Medicare Current Beneficiary Survey (MCBS). In contrast to other studies that use a non-representative sample and are cross-sectional in nature, MCBS data is a panel and a representative sample of the Medicare population. Influenza or complications arising from it are responsible for a large number of hospitalizations and deaths among the elderly and as such, vaccinations have large potential benefits. I examine the following determinants of demand: the price of the vaccine to the individual which depends on insurance coverage, demographics such as age, race, gender, education and income, family composition such as whether the person lives alone or not, health conditions including chronic ones (e.g, asthma) that may be complicated by influenza. I also examine the effect of an individual’s expectation about the risk of infection. These individual expectations depend on the prevalence of the disease as well as on the individual’s own past experience with the flu and the vaccine on demand. Heterogeneity in expectations could give rise to differences in demand among individuals who are similar in other aspects. This project also studies the effect of getting a flu shot on hospitalizations and on payments by Medicare. I use the fact that Medicare Part B started covering flu shots in 1993 to identify the price elasticity of demand. This is likely to induce demand among part B beneficiaries but not among those with only part A coverage. While, the induced demand would increase payments by Medicare, vaccination itself might reduce hospitalizations and other medical care use. Vaccinations also affect mortality and in turn the cost of care conditional on survival. Thus, the exact impact on Medicare costs and medical care use is not clear without an empirical analysis.