On August 24, 2009, the President's Council of Advisors on Science and Technology (PCAST) released its "Report to the President on U.S. Preparations for 2009-H1N1 Influenza," predicting, among other things, that the H1N1 (aka "swine flu") pandemic would resurge in North America in September, peaking by mid-October, causing infection and illness to up to half the U.S. population before the end of 2009. The PCAST assessment also suggested that H1N1 vaccines would not be available for the general public until well after the mid-October peak, and the epidemic would surge so rapidly that it could overwhelm hospitals, medical supplies, and intensive care units, leading to as many as 90,000 deaths in the U.S. The predicted surge held special significance for schools, parents, and employers, as sick-outs and school closures could impact productivity. Despite months of preparation, supplies of vaccines, medicines, and protective gear were expected to be inadequate, and global competition for essential tools for pandemic control and treatment would be fierce. One billion doses of H1N1 vaccine were ordered from several pharmaceutical companies, and the bulk of that supply was prioritized for ten wealthy nations, particularly the U.S. Little, if any, vaccine, medicine, or protective gear was expected to be ready, affordable, and distributed for the bottom four billion poorest people on Earth.
The CFR meeting was convened at the predicted peak of the North American pandemic. Will the PCAST model have proven correct? Looking forward, what can be scientifically forecast regarding shifts in the virology and epidemiology of the H1N1 pandemic? What are the economic and financial impacts of the outbreak? What have been, and can be predicted to be, the foreign policy implications of the pandemic and related competition for medical and public health tools?