We aren't quite done with this particular flu outbreak. The 2009 H1N1 pandemic (aka swine flu) is declining in most places in the US (not in New England yet, but that will come) and we have no idea whether there will be a third wave in spring (maybe), or whether lower amounts of H1N1 illness will hang out like it did all summer (probably.) Vaccine can help to mitigate that, so get your shot when it becomes available (use google maps to find one near you). There's room on line for everyone, but the head of the line belongs to pregnant women and children, followed by older children as well as 25-64 year olds with underlying conditions. And even as flu declines, we already know that we can learn some lessons from what has already occurred in the spring and fall.
1. Expect the unexpected
No one saw an H1N1 pandemic coming. Moat of the planning was for a more severe H5N1. This had implications, because a less severe pandemic needed more flexibility in planning. Schools didn't close, so school buildings could not be used for mass dispensing areas for vaccine and tamiflu or alternate care clinics (and school personnel were busy with their day jobs aqnd not available to help.) HHS and DHS figured out how to get tamiflu to hospitals but not to private pharmacies (how to you give pre-purchased free-to-the-public medicine to retail stores?) While tamiflu shortages didn't materialize in the fall (spot shortages in children's preparations were addressed with instructions to pharmacists to compound adult capsules into syrup), they were a problem in the spring. Flexible responses helped to the point where most of these issues were invisible to the public.
2. Don't over-promise
The response from the Feds and the states, for the most part has been good. The one major error was HHS' over-optimistic prediction of plenty of vaccine by September. Had they simply said "it takes six months (April identification, October production) and it won't all come at once" back on April, they'd not have raised expectations.
3. Don't underestimate the American public (and lose the word "panic" from your vocabulary)
The public only panics when the government tells them not to panic. There's been a relatively orderly approach to vaccine, for example, along with much frustration and angst (see point #2) but given the size of the country and the magnitude of the task, it's a manageable problem. Americans can cope, but only with open and transparent information. See vaccine to Wall Street for what happens when perception is that something unfair is happening.
4. Don't underestimate anti-vaccine sentiment
While a small number of nutters (vaccine is a government plot to implant thought control chips, vaccines are evil) make a large amount of noise, a very big segment of the public has legitimate concerns about vaccine safety and necessity, especially for their children. They need to be treated with respect and their issues patiently addressed (but don't waste time on the nutters.)
5. Public health is under-funded at state and local level
The interface with health reform (get your shot from your doctor) is obvious but nuanced (your doctor may not routinely give shots, you may not have a doctor, you may not be able to afford or find a pharmacy offering shots.) We may be able to (barely) administer 90 million seasonal vaccines each year, but that doesn't mean we can give out 250 million with the same infrastructure. While the feds are in a position to give advice, the locals are not always in a position to carry it out. We've heard from many commenters here about inadequate local vaccine programs, and it is not at all clear that if 250 million vaccines appeared tomorrow, we'd have a way to get it into people's arms. That's the main reason vaccine went to Wall Street (intended for the high risk people only.) Some local public health systems functioned admirably, others simply had no plans for identifying high risk populations and getting vaccine to them. A few that had plans (and most that didn't) were not prepared for the communication piece that is needed to run smoothly. You can't just turn public health infrastructure on with a switch if it is not there.
6. A segment of the public will deny that the sun is coming up
Sometimes it's politics (expect the President's opponents to try and politicize this, a really bad idea when it comes to public health, and one that should be strongly resisted.) And sometimes it's the human tendency to deny (40% of the public in surveys simply doesn't like to think about tomorrow, or bad things.) Taken to extremes (positive thinking prevents illness, and other natural disasters), we get Bill Maher.
While we are losing "panic" form our vocabulary, we should also lose "fear-mongering", the definition of which seems to be "you are telling me facts I don't want to hear." The most ironic example, of course, is the internist who writes books about fear and not panicking, whose own kid was exposed in camp to H1N1 — and, of course, panicked (and had to be reprimanded by CDC.)
7. We need novel vaccine production to come on board
Had this been an H5N1 outbreak with its greater virulence, we'd have been screwed. We are almost there. Newer cell-based and recombinant methods will brew up vaccine in vats (without eggs!) but we are a few years away from that coming on line. Those investments of public dollars need to be continued, and we need progress reports from HHS as to where we are at. See this excellent review for details).
There'll be more lessons to learn, but every institution need to be planning for the next pandemic. Maybe it'll be needed in the spring when a third wave hits, and maybe it won't be needed for a few years to come. But pandemics happen. And when they do, they mean shortages (staff, space and stuff.) Internalize that, be prepared, and expect to be flexible in your response. If you do, and with some cooperation from the virus, you just might mitigate the effects.