Saturday, August 18, 2007

August 18 Flu Update

5,400 poultry culled in Bali.

Togo is also fighting bird flu.

Revere blogs about the problems we could have vaccinating immigrants and the homebound. He notes that, first, the vaccine is the center part of our pandemic plan, and second, that even immigrants are contagious, even if they don't show up for their shots.

ProMed comments on yesterday's Promed post on migratory birds.


At 7:14 PM, Blogger Wulfgang said...


Ah, Revere hit a home run out of the ball park today with his article today on the controversial subject of why we should make provisions for vaccinating “Hard to Reach” (HTR) individuals for influenza.

So, so true. Most people who are the “haves” I’ve noticed in my life, have a tendency to forget about the poor, immigrants, homeless, group homes and the down-trodden. People in general seem to forget the following fundamental fact though: diseases do not discriminate against anyone – EVERYONE is vulnerable, especially to influenza. Epidemics and pandemics strike without warning, killing and incapacitating people indiscriminately. The larger numbers of people we vaccinate, the quicker we can achieve “herd immunity”.

Most unfortunately, the federal government we have in office now, has not made provisions for the HTR’s. Fortunately, the private clinics, pharmacies, larger retailers (Walmart), and most large employers (both government agencies and industry), all have provisions to offer seasonal influenza shots to the general population. They have for years and are quite good at it.

The really bad news is as Revere describes it: who get’s the extremely limited pre-pandemic vaccinations, and worse still, who would the priorities be for to receive the actual pandemic inoculation – 6-12 months down the road ? Currently, the method that the federal government plans to follow during an emerging pandemic is to: (1) release the anti-viral stockpile at some point to the states, for general distribution, and, (2) proceed to inoculate the highest priority individuals in descending order – military, government, HCW’s, first responders, old, and young – if I’ve done my research correctly, and the pre-pandemic vaccine is gone. Then we all wait out the production and delivery of the matched pandemic vaccine 6-12 months down the road.

The trouble with this ill-thought-out pandemic approach, is clearly what Australia is currently facing with their terrible current seasonal influenza epidemic: stockpiles of Tamiflu have not been distributed for access, and large numbers of people have failed to be vaccinated. This is a disaster waiting to happen when the actual pandemic occurs, where much high transmission and fatality rates will be occurring. Most of us will never get the anti-viral to meet the 48 hour exposure requirement. Most of us will be pretty screwed. To think otherwise, is dreaming or in the realm of Bigfoot and UFO’s.

Too little. Too late. Crisis management by consensus is the government will operate. This really means absence of real leadership. FEMA at it best.

This is why I have great sympathy for the HCW’s and physicians during a pandemic – they will be in a no-win situation. When large numbers or segments of the population feel they have been shut out from the Tamiflu and the vaccines, violence and social disorder will occur, in my view.

Like Revere says, and I absolutely believe it: better to stand down on the Iraq debacle for a week, save 2-3 billion dollars and provide assurance to the entire population of the US that Tamiflu and vaccine will be available when needed. If not, then the government better be prepared for some of worst civil violence it has ever seen – people know where these drugs and vaccines are stored in every state and they will take it. It is estimated that there are over 300 million guns in the US – what does anyone thing is going to happen when people get really really angry about their family members dying needlessly ?

It’s just that simple Orange.



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