When the surgical mask industry moved overseas, hospitals didn't consider the effects relying on those suppliers would have if a pandemic hit, says Bowen.

"The first thing you need to ask yourself is, in a global emergency do you want the mask supply in the U.S., controlled by U.S. health officers, or in China?" Bowen says. "Are they going to send masks to us when people [over there] are dying?"


In an effort to help hospital clients, Prestige Ameritech opened the Global Pandemic Preparedness and Response Center last March - a stockpile of masks made available to customers during shortages at no extra cost. Development began about five years ago when American mask manufacturers moved south to Mexico or overseas.

"We're going to build this company on the pandemic story and the national story," says Bowen.

Protection: Cost of an arm

The development of the H1N1 vaccine during the midst of the pandemic was hotly debated, as tends to be the case for new vaccines: was it safe? The CDC reported a similar safety profile between H1N1 and the seasonal flu vaccine. But even with some skeptics skipping out on the vaccine, there was still a shortage. This fall's seasonal vaccine will include the 2009 H1N1 strain, according to Dr. Michael Shaw of the CDC.

The vaccine uptake wasn't as high as some health care officials had hoped, says ASPR's Knebel.

"We're trying to understand why health care providers did not accept the vaccine in as large numbers as we would have thought," she says. "If it had been a more severe pandemic...[not getting the vaccine] really could have hurt us in terms of being able to staff the health care system."

"Vaccination is still highly underutilized for whatever reason," says the Joint Commission's Fugate.

According to a CDC survey, 37 percent of health care workers polled said they received the H1N1 vaccine versus 62 percent for the seasonal flu vaccine.

Mount Sinai's Chason says vaccination was one of the biggest countermeasures against the H1N1 pandemic. But that important measure was difficult to carry out in his facility, which had a hard time getting enough of the vaccine and putting together a system that would vaccinate staff quickly.

While New York state requires vaccination for its health care workers, the law was temporarily suspended due to supply issues, says Chason.

"Ultimately, there were enough vaccines available, but early on, distribution allotments were not sufficient to vaccinate every health care worker and patient," he says. "We had to provide vaccines to our highest-risk patients and staff and then to everyone else."

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