School of Public Health professor advising feds on H1N1 policy

One thing certain about the flu is uncertainty, according to
Marc
Lipsitch, a professor of epidemiology at the Harvard
School of Public Health and a prominent authority on the spread of
infectious disease.

The rise and rapid spread of H1N1 flu virus, known as swine flu,
has kept Lipsitch busy in recent months. An expert in computer modeling of
disease dynamics, Lipsitch has been part of a team advising federal officials
on swine flu’s likely behavior and the government’s response to it.

In April, shortly after the flu hit the headlines, Lipsitch
was called to Atlanta as an adviser to the U.S. Centers
for Disease Control and Prevention. For a week, he worked intensively with
other advisers and officials there to provide analysis and perspective. He
appreciated, he said, how difficult the job of health policymakers is in the
early stages of a pandemic, when difficult decisions are being made on the
basis of still-sketchy information about how dangerous and contagious a
pathogen is.

“Academics have the ability to spend more time thinking
about these questions than people who provide valuable services,” Lipsitch
said. “I felt frantic the whole time, but not nearly as frantic as the people
who had to [make decisions] each day.”

Lipsitch kept in touch with officials in Atlanta after he
returned to Boston through conference calls, at first daily and now weekly.

Last summer, as a member of the 2009 H1N1 Working Group of
the President’s Council of Advisors on Science and Technology, he helped draft
an assessment of the federal government’s handling of the swine flu outbreak so
far. He gave it high marks, particularly for its flexibility.

Flexibility is key in handling an outbreak’s beginning, he
said. Because officials didn’t know how dangerous H1N1 was, the initial
response included fairly dramatic steps, such as closing schools if a case were
diagnosed there. Those responses were dialed back as officials began to
understand that, while contagious, H1N1 wasn’t as deadly as past pandemic flus
have been — at least so far.

“People took it seriously and then scaled back as the nature
of it was shown,” Lipsitch said. “The response was well-tailored to cover the
range of possibilities at any one time.”

Lipsitch was recently named the head of a new center at the
Harvard School of Public Health designed to provide better information about
disease outbreaks to public health officials and policymakers. The Center for
Communicable Disease Dynamics, which received a $10 million grant from the
National Institutes of Health, will focus on mathematical modeling of seasonal
infectious diseases such as the flu, on drug resistance, and on the best ways
to allocate resources in interventions.

Lipsitch said that more people with such public health
expertise are needed in the United States, so part of the center’s mission will
also be to educate a new generation of students in the discipline.

Lipsitch, who received his doctorate from Oxford University in 1995, has considerable
experience to lend to the effort. Much of his study has focused on the pathogen
that causes pneumonia, childhood ear infections, and meningitis, Streptococcus
pneumoniae. He has evaluated how it
spreads, how it is affected by interventions, and what the patterns of drug
resistance are. He also worked on the 2003 outbreak of severe acute respiratory
syndrome, or SARS, and has worked to better understand the 1918 Spanish flu
that killed millions around the world.

With the Northern Hemisphere flu season looming with the
pending of winter, Lipsitch said uncertainty remains about the nature of the
flu’s coming second round. Though H1N1 is so far not as severe as past flu
epidemics, it is clear that some will die from the ailment, Lipsitch said.
Vaccines, which are being rushed through development and distribution, will be
available in October, but it takes time to administer the dose and more time
for the body to develop immunity.