Antiviral Drugs and the 2009 H1N1 Influenza Pandemic
Antiviral Drugs and the 2009 H1N1 Influenza Pandemic
There are several limitations to this study. First, we chose to permit only one response per LHD and allowed anyone within the LHD to respond. Thus, we received responses from SNS coordinators, health officers and other LHD personnel. It is possible that SNS coordinators and other health department staff, especially health officers, experienced the 2009 H1N1 influenza pandemic differently given their different roles. To account for this, we gave LHDs the flexibility of choosing the person who was most familiar with their antiviral response. Given that ninety eight percent of respondents stated that they knew "a lot" about their agency's antiviral response activities, we consider their perspectives to be a valid representation of the LHDs' experience.
A second limitation is the number of LHDs represented in the study. While this sample includes health departments that represent nearly three-quarters of the 40 million residents in California - our unit of analysis is the health department, resulting in a small absolute number of cases. Furthermore, the communities served by these LHDs differ dramatically with respect to organizational and demographic factors. For example, the smallest health department in California represents 1,200 individuals and the largest serves over 8 million. Because of these differences, we present some of our results stratified by the size of the population served by the LHD. However, once the data are divided by population size (or any other community characteristics of interest), the number of health departments represented in each stratum is very small, recommending caution in making strong inferences about any of the observed differences.
Lastly, because this research focused on LHDs in California, it is possible that the findings are unique to this state. However, given concurrence of our research findings with previous qualitative work with a wider geographic scope, we believe these results are more broadly applicable beyond California. To improve our understanding of the role of LHDs in the management of antivirals, this work should be replicated in a state with a different organizational, political, or authority structure is in place, which might be expected to contribute to different experiences at the local level (e.g. a large state with a centralized public health authority). Additional studies from other nations that also used publicly purchased antivirals during the H1N1 influenza response, particularly those with different policies on antiviral drug use, would cast important light on this issue.
Limitations
There are several limitations to this study. First, we chose to permit only one response per LHD and allowed anyone within the LHD to respond. Thus, we received responses from SNS coordinators, health officers and other LHD personnel. It is possible that SNS coordinators and other health department staff, especially health officers, experienced the 2009 H1N1 influenza pandemic differently given their different roles. To account for this, we gave LHDs the flexibility of choosing the person who was most familiar with their antiviral response. Given that ninety eight percent of respondents stated that they knew "a lot" about their agency's antiviral response activities, we consider their perspectives to be a valid representation of the LHDs' experience.
A second limitation is the number of LHDs represented in the study. While this sample includes health departments that represent nearly three-quarters of the 40 million residents in California - our unit of analysis is the health department, resulting in a small absolute number of cases. Furthermore, the communities served by these LHDs differ dramatically with respect to organizational and demographic factors. For example, the smallest health department in California represents 1,200 individuals and the largest serves over 8 million. Because of these differences, we present some of our results stratified by the size of the population served by the LHD. However, once the data are divided by population size (or any other community characteristics of interest), the number of health departments represented in each stratum is very small, recommending caution in making strong inferences about any of the observed differences.
Lastly, because this research focused on LHDs in California, it is possible that the findings are unique to this state. However, given concurrence of our research findings with previous qualitative work with a wider geographic scope, we believe these results are more broadly applicable beyond California. To improve our understanding of the role of LHDs in the management of antivirals, this work should be replicated in a state with a different organizational, political, or authority structure is in place, which might be expected to contribute to different experiences at the local level (e.g. a large state with a centralized public health authority). Additional studies from other nations that also used publicly purchased antivirals during the H1N1 influenza response, particularly those with different policies on antiviral drug use, would cast important light on this issue.
Source...