To: Duke University & Duke University Health System Faculty and Staff

From: Victor J. Dzau, M.D., Chancellor for Health Affairs and CEO, DUHS

RE: Update on H1N1

As we approach this weekend's annual commencement activities at Duke, I wanted to provide you with an update regarding planning, preparation, and educational activities that have been implemented throughout the University and the Health System.

Let me start by just saying that our infectious disease experts in the Health System, as well as many other leading national and global experts, are reassured by available information about this novel virus. The collective understanding is that this strain behaves more like a typical seasonal flu. This assessment, of course, does not lessen the significance of seasonal flu as one of the country's most important annual health care challenges, nor should it suggest that this novel H1N1 virus will not result in severe or fatal outcome for some affected persons. Our medical experts will continue their heightened vigilance and surveillance of this ongoing situation, and it is generally considered a good idea for all of us to continue to practice prudent prevention behaviors such as frequent hand washing.

An institution-wide committee was formed immediately following the first news reports of the H1N1 outbreak in Mexico and has met nearly every day since to coordinate Duke's efforts and ensure a common understanding of newly available information. In addition to immediately providing direction to all employees in regard to proper preventive behaviors and actions, clinical guidance was provided by the Health System to all faculty physicians and caregivers. Other actions that have been taken over the last 10 days include the procurement of thousands of treatment courses of antiviral medications and supplies from the national stockpile and commercial vendors, development of the ability to perform specialized testing (PCR) here at Duke to aid in local diagnostic capabilities, a 24-hour-a-day flu pager for clinicians to easily reach our infectious disease expects, daily surveillance of lab test ordering and prescription writing for antiviral agents, as well as contingency planning in many areas ranging from business continuity to commencement activities. All of our activities have been closely coordinated with local, state, and federal public health authorities.

This outbreak is ongoing, but our understanding of the illness continues to improve and we will monitor the situation closely. At the appropriate time, we will also ask our team to reflect on the lessons learned over the course of the last few days so that we can be even better prepared for future events.