H1N1 is declared a national emergency

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By Sean Lengell

The White House has declared the 2009 H1N1 "swine flu" pandemic a national emergency, a designation that will make it easier for medical facilities to handle a surge of patients infected with the potentially deadly virus.

The president's action on Saturday is intended to remove bureaucratic roadblocks and make it easier for the sick to seek treatment and medical providers to provide it immediately. It also will allow medical facilities to waive certain standard requirements for Medicare, Medicaid and other federal health insurance programs on a case-by-case basis.

"The foundation of our national approach to the H1N1 flu has been preparedness at all levels - personal, business and government - and this proclamation helps that effort by advancing our overall response capability," said President Obama in a statement released by the White House.

Mr. Obama signed the proclamation designating the flu a national emergency late Friday and formally notified Congress on Saturday.

The Centers for Disease Control and Prevention (CDC) said on Friday that the H1N1 flu has become widespread in 46 states, a level comparable to the peak of ordinary flu seasons, but occurring far earlier and with more waves of infection expected.

Health and Human Services Secretary Kathleen Sebelius initially declared the flu strain a "public health emergency" in April, renewing the declaration in July and again on Oct. 1.

But Mr. Obama said "given that the rapid increase in illness across the nation may overburden health care resources," raising the level of the virus to national emergency status was warranted.

The new declaration clears the way for medical providers to bypass federal requirements that, for example, could prevent hospitals from establishing off-site, alternate care facilities that could help them deal with emergency department demands.

Because of delays in producing the swine flu vaccine, the government has backed off initial, optimistic estimates that as many as 120 million vaccine doses would be available by mid-October. As of Wednesday, only 11 million doses had been shipped to health departments, doctors' offices and other providers across the country, the CDC said.

The government now hopes to have about 50 million doses of swine flu vaccine out by mid-November and 150 million in December.

Hospitals and state health officials nationwide have asked healthy adults to step aside and allow children, pregnant women and people with underlying health problems to have the first crack at H1N1 influenza vaccinations.

Virginia Health Commissioner Dr. Karen Remley said Friday that the CDC had allocated fewer than 400,000 doses of vaccine to the state so far because of manufacturing delays. No vaccination sites have yet received all of what they had originally anticipated, she said.

Federal health officials say that the swine flu is more widespread now than it ever has been, resulting in more than 1,000 deaths so far in the United States. About 100 pediatric swine flu deaths have been reported.

The only states without widespread flu are Connecticut, Hawaii, New Jersey and South Carolina, the agency said.

Swine flu has hit young adults and children the hardest, while seasonal flu normally is more dangerous to people older than 65. Seasonal flu normally peaks sometime between late November and early March.

"As a nation, we have prepared at all levels of government, and as individuals and communities, taking unprecedented steps to counter the emerging pandemic," Mr. Obama said. "Nevertheless, the 2009 H1N1 pandemic continues to evolve."

The H1N1 flu isn't confined within U.S. borders. The World Health Organization on Friday reported more than 414,000 laboratory-confirmed cases of H1N1 worldwide, with nearly 5,000 deaths.

While many drug manufacturers and national governments around the globe initially said that a single dose of the vaccine was sufficient for most adults, some health officials are beginning to question that strategy. Europe's drugs watchdog, the European Medicines Agency, said Friday that giving two doses of the vaccine was preferable.

Swine flu vaccine supplies in the U.S. are being hindered by production delays at two unidentified drugmakers, as well as by GlaxoSmithKline PLC's failure to gain regulatory approval for its product, a government official said Friday.

The U.S. won't get the 195 million doses it had planned for by the end of the year because of the delays, said Nicole Lurie, Health and Human Services' assistant secretary for preparedness and response.