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Walgreens, CVS shifting flu battle from seasonal to H1N1

October 16, 2009
http://www.suntimes.com/lifestyles/health/1828421,CST-NWS-flu16.article

Walgreen Co. and CVS Caremark Corp., the two largest drugstore chains, will stop providing seasonal flu vaccines at many locations to shift their focus to swine flu immunization.

Walgreens will not restock the seasonal flu vaccine after it runs out. Some Walgreens already are out. CVS said it will halt its seasonal flu clinics Oct. 22. Depending on how available the vaccine is, it will continue to offer shots at its 500 clinics throughout the flu season.

Fear of pandemic swine flu, H1N1, has heightened public awareness of seasonal influenza, causing vaccine shortages at doctors’ offices, clinics and retail drugstores. Manufacturers are behind in delivering supplies because they’re using factories to make both vaccines.

The inability to deal with an epidemic, or any “surge need” of sophisticated medical care has been known for several years now.

And the fundamental problem remains: there just is not, nor can there be enough of the sophisticated technology and trained personnel available. Which leaves only a few alternatives.

The first of these are to use common, publicly available OTC means to stop the problem from developing in the first place, and second, to innovate much less complex and inexpensive technologies that can be mass produced and used with far less expertise.

The first option is of course preferred, at the first sign of infection to issue a cocktail of both viral inhibition chemicals, antivirals, and drugs to stave off secondary effects, like ARDS, which must be continued for the duration of the infection. The mission is not to cure the disease, but to mitigate it into a less lethal form. This has to be done by the public with the advice of the medical community once they can determine the optimal cocktail formula.

It will not stop all acute problem, but hopefully will reduce the numbers of those that need sophisticated medical equipment and supervision.

The second option, of creating large numbers of much less sophisticated hardware, that can be monitored by an intelligent layman, is a desperation play, but might be the only alternative left to abandonment and death.

Such systems amount to a “blood bypass”, in which blood is removed from the patient, oxygenated and purged of CO2, and returned safely to their body. Typically, however, this would require a high volume of blood to be effective, but there might be another way.

Perfluorocarbon-based “oxygen therapeutics” are far more efficient than blood hemoglobin in carrying oxygen. In past, these blood substitutes were considered for high volume use as blood replacements, and are undergoing Phase III trials right now. One or more has already been approved for use in other countries.

However, if only small amounts are used, the volume of blood that would need to be oxygenated would be significantly reduced. Thus the external blood oxygen machine could be simpler.

While each device would likely still be expensive, they might be able to be mass produced, unlike the $120,000 system mentioned in the report. Instead of a trained expert monitoring the system, an ordinary computer with software would do most of the work, allowing the expert to respond only when there was a problem, so that many more systems could be in operation at the same time, perhaps watched by family members.

Certainly not optimal, but again, a desperate means to save the lives of people that would otherwise be forfeit.