Posted on 10/16/2005 6:13:36 PM PDT by mdittmar
WASHINGTON - The Bush administration is scrambling to prepare the nation for a possible global rampage by a new flu germ that it fears could kill nearly 2 million Americans, sicken tens of millions more and shatter the economy.
The key question is how much preparation can be done before a calamity strikes that, in a worst-case scenario, could make the health system collapse; overwhelm morgues; close schools, airports and harbors; end public gatherings; require strict quarantines; and cripple businesses and vital public services by mass absenteeism.
"You're looking at a nation-busting event," warned Tara O'Toole, director of the Center for Biosecurity at the University of Pittsburgh Medical Center.
To be sure, it may not happen. But scientists warn that it's frighteningly possible and that governments at all levels must prepare for the worst.
Whether such a catastrophe occurs depends upon whether the H5N1 influenza virus now slaughtering birds across Asia and parts of Europe mutates into a form that retains lethal virulence and passes easily among humans. So far it hasn't, and the virus has been around since 1997. But viruses mutate constantly, and most experts agree that the world is statistically overdue for a pandemic.
"We must plan for a worst-case scenario," said Michael Osterholm, a public health expert and former adviser to the Department of Health and Human Services, which is leading U.S. preparations.
The federal government could take steps to mitigate the impact of a pandemic, experts agree. They include:
-Working with state and local officials to bolster the ability of hospitals and other health care providers to cope with floods of infected patients requiring isolation;
-Ordering enough Tamiflu, an expensive antiviral drug made by only one firm that alleviates flu symptoms and may even prevent infection, to cover at least 25 percent of the U.S. population;
-Creating a crash program to rapidly mass-produce and distribute a vaccine as soon as a pandemic-causing germ is isolated and its genetic properties analyzed so that a vaccine can be designed.
HHS is expected to release a long-awaited pandemic preparedness plan as early as this week outlining such measures.
Osterholm, who's familiar with the plan's latest draft, said it projects a worst-case scenario that kills as many as 1.9 million Americans and sickens half the population of 294 million.
The plan acknowledges that state and local officials would have to manage much of the response, such as ensuring food supplies, he said. Other aspects would take time and an estimated $6 billion to $10 billion to implement.
HHS Secretary Michael Leavitt conceded earlier this month that the United States remains unprepared for a pandemic ignited by any new germ that the human immune system isn't programmed to fight.
"We could be battling 5,000 different fronts at the same moment," Leavitt told an Oct. 6-7 international conference called by the United States to boost international cooperation on early pandemic detection and containment.
A number of other countries are ahead of the United States in preparedness. Britain finalized its plan in March, has created a Cabinet-level coordinating office, ordered enough Tamiflu for 25 percent of its population and put in place a system for rapidly producing and distributing a vaccine once one is developed.
Critics complain that the Bush administration has ordered only enough Tamiflu to cover less than 2 percent of the U.S. population, despite a 2000 recommendation by the U.N. World Health Organization that governments cover at least 25 percent.
Swiss-based Hoffmann-LaRoche, the sole maker of Tamiflu, says that with 25 other countries ahead of it, the United States must wait until the end of 2007 to buy enough of the drug to cover 25 percent of its population.
The Infectious Diseases Society of America says even that isn't enough; it wants HHS to stockpile enough Tamiflu to treat 50 percent of the U.S. public.
The Senate voted Sept. 29 to provide $3.9 billion for the purchase of more Tamiflu and other items for the Strategic National Stockpile, a federal reserve of medicines and materials that would be distributed during a major health emergency when local supplies are exhausted.
Experts say immediate preparations also must be taken to bolster hospitals' abilities to cope with massive numbers of patients suffering respiratory problems and other life-threatening symptoms. Many parts of the United States have serious shortages of doctors, nurses and equipment; many are stretched thin even by annual bouts of ordinary influenza.
In a pandemic, even the best-staffed facilities would lack personnel, machines such as ventilators, beds and space to isolate patients.
Since the Sept. 11, 2001, terrorist attacks, more than $2 billion in federal funds have been spent improving hospitals' capacity to deal with mass casualties caused by terrorists using biological weapons, such as anthrax.
But experts say preparations for such attacks, which would be limited to a few locations, are insufficient for a pandemic that would hit many cities and states nearly simultaneously.
An additional complication: Seeking hospital care would be a double-edged option, as they would be the places where it would be easiest to contract influenza. So public-education programs will be needed to ensure that only the very sickest are brought to hospitals, experts said.
Washington must also work with state and local officials on other ways to contain a pandemic, such as guidelines for closing schools and banning public gatherings.
Another recommendation: Federal, state and local governments should encourage employers to help stricken employees stay home, such as developing ways to compensate them if they miss work.
"We have people ... who are living paycheck to paycheck and they don't want to report that they have a communicable disease," said Archer of the Kansas City Health Department. "Parents can't get off work to watch their kid, so they take them to a day care center ... and the disease spreads."
Some in Congress are calling for appointment of a Cabinet-level coordinator to work with HHS and an alphabet soup of federal agencies in partnership with state and local governments.
The federal government also should order a crash program to develop, mass-produce, license and distribute an influenza vaccine, which can be designed only when a lethal virus is isolated, experts said. But only three companies produce conventional influenza vaccines for sale in the United States and only 50 million to 60 million doses per year.
"This is probably the biggest gaping hole in all of this," said Kim Elliott, deputy director of Trust for America's Health, a nonprofit health policy organization. She said it would probably require 600 million doses - two for every American - to protect the population against avian flu.
The federal government, she said, should provide incentives such as tax breaks and the guaranteed purchase of a set amount of vaccine to encourage drug companies to expand their manufacturing capacity.
The Bush administration also should push legislation to protect vaccine producers and health care workers from liability lawsuits in case a rapidly produced and tested vaccine causes adverse reactions in people, experts said.
During the months between detecting a pandemic and production of a vaccine, health authorities will have to rely on other measures to limit the impact, including using Tamiflu and other antivirals to prevent infections.
The government will have to decide who should get priority in receiving the limited amounts of antivirals and initial batches of vaccine, experts said, warning that panic over unavailable supplies could ignite riots.
"It's never happened and I doubt it ever will."
Ever considered reading some history? 1918, for instance?
Actually, I think it would be smart and profitable to convince people that this "bird flu" will probably mutate into a computer "virus". Then I could get some geeks-for-hire to go around the country installing some super-duper "Windows Wiper" software designed to wipe the bird crap off computer monitor screens at startup.
I could get as rich as a generator salesman before Y2K.
Farrakahn is going to accuse the Administration of using the vaccine as cover to give the bird flu to black children.
What's the shelf life for Tamiflu? (Nothing worse than paying for a drug that expires before you need it.)
Good question..ok exp date 2008
In that case, purchasing Tamiflu seems like a prudent idea. I think I'll disuss this with my doctor. Unless your hubby is available to e-mail me a prescription. LOL (only kidding)
LOL I dont think he would..he does write for family but does exams and keeps a record!! Just in case!
Now if we just had some alcohol,opium and cocaine we could beat this thing!
Oh yea,smoke alot,that kills the germs;)
Yes, they are starting to. It has taken them months (years?) but they are finally recognizing it may be a serious threat. That's some sort of progress, I suppose?
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