Friday, October 14, 2005
We are woefully unprepared (again) --this time for the flu
Please visit the Flu Wiki and use their resources to blog about bird flu. The more accurate information people have, the better off we'll be.
So, you're probably wondering what the U.S. government has in the way of a plan for dealing with a possible flu pandemic. Here's some quick history:
August 2004: The Department of Health and Human Services released a "Pandemic Influenza Response and Preparedness Plan". It was actually a draft plan.
May 2005: The DHHS draft plan was still in draft form when it was assessed by the GAO (pdf).
The GAO report commented that the plan did not define the role of the federal goverment in vaccine and antiviral drug purchase, distribution, and administration, among other things.
Other noteable dates: Click here for a timeline through May 2005, of steps taken by the U.S. government to prepare for a possible pandemic. Note that these steps are important, but obviously, an actual plan is still missing (source, pdf).
Until now... well, not really. The draft plan is a little more detailed, but it's still a draft. It was leaked to the New York Times:
A plan developed by the Bush administration to deal with any possible outbreak of pandemic flu shows that the United States is woefully unprepared for what could become the worst disaster in the nation's history. A draft of the final plan, which has been years in the making and is expected to be released later this month, says a large outbreak that began in Asia would be likely, because of modern travel patterns, to reach the United States within "a few months or even weeks." If such an outbreak occurred, hospitals would become overwhelmed, riots would engulf vaccination clinics, and even power and food would be in short supply, according to the plan, which was obtained by The New York Times. The 381-page plan calls for quarantine and travel restrictions but concedes that such measures "are unlikely to delay introduction of pandemic disease into the U.S. by more than a month or two." The plan's 10 supplements suggest specific ways that local and state governments should prepare now for an eventual pandemic by, for instance, drafting legal documents that would justify quarantines. Written by health officials, the plan does [not] yet address responses by the military or other governmental departments.
So this plan has been "years in the making," yet it still doesn't define the role of the federal government in the response to a flu pandemic? At least the roles of local and state governments have been defined, but what the heck is the problem with saying "this is our advice to Executive Branch, and various federal agencies..."?
The role of the DHHS has actually been laid out in the plan. But who's going to be in charge?
While the administration's flu plan, officially called the Pandemic Influenza Strategic Plan, closely outlines how the Health and Human Services Department may react during a pandemic, it skirts many essential decisions, like how the military may be deployed.
"The real shortcoming of the plan is that it doesn't say who's in charge," said a top health official who provided the plan to The Times. "We don't want to have a FEMA-like response, where it's not clear who's running what." The same official says that the plan is "a major milestone." Well, yes, it is, compared to the one that came out two years ago.
Other issues in the leaked document:
Who gets vaccines and essential medicines first? This is a major point of contention in the plan. The military wasn't included in the discussion, but pharmaceutical plant workers are at the top of the list, as well as medical workers. These are followed by the elderly and severely ill, pregnant women, immunocompromised individuals, parents of infants, and police, firefighters, and government leaders.
A stockpile of 133 million courses of antiviral medication (the Bush administration has bought 4.3 million).
The responsibility of health officials is laid out (planning and surveillance, as well as coordination with the DoD).
Finally, the NYT article says that the plan includes some elements of drama. It has a fictional scenario: "In April of the current year, an outbreak of severe respiratory illness is identified in a small village. Twenty patients have required hospitalization at the local provincial hospital, five of whom have died from pneumonia and respiratory failure," the plan states.
The flu spreads and begins to make headlines around the world. Top health officials swing into action and isolate the new viral strain in laboratories. The scientists discover that "the vaccine developed previously for the avian strain will only provide partial protection," the plan states.
In June, federal health officials find airline passengers infected with the virus "arriving in four major U.S. cities," the plan states. By July, small outbreaks are being reported around the nation. It spreads. As the outbreak peaks, about a quarter of workers stay home because they are sick or afraid of becoming sick. Hospitals are overwhelmed. "Social unrest occurs," the plan states. "Public anxiety heightens mistrust of government, diminishing compliance with public health advisories." Mortuaries and funeral homes are overwhelmed.
Heightened mistrust of government because...? Just go back to the first paragraph of the article. Would you trust a government that was "woefully unprepared"? After Katrina, it's hard to trust the government in the event of any disaster.
So, you're probably wondering what the U.S. government has in the way of a plan for dealing with a possible flu pandemic. Here's some quick history:
August 2004: The Department of Health and Human Services released a "Pandemic Influenza Response and Preparedness Plan". It was actually a draft plan.
May 2005: The DHHS draft plan was still in draft form when it was assessed by the GAO (pdf).
The GAO report commented that the plan did not define the role of the federal goverment in vaccine and antiviral drug purchase, distribution, and administration, among other things.
Other noteable dates: Click here for a timeline through May 2005, of steps taken by the U.S. government to prepare for a possible pandemic. Note that these steps are important, but obviously, an actual plan is still missing (source, pdf).
Until now... well, not really. The draft plan is a little more detailed, but it's still a draft. It was leaked to the New York Times:
A plan developed by the Bush administration to deal with any possible outbreak of pandemic flu shows that the United States is woefully unprepared for what could become the worst disaster in the nation's history. A draft of the final plan, which has been years in the making and is expected to be released later this month, says a large outbreak that began in Asia would be likely, because of modern travel patterns, to reach the United States within "a few months or even weeks." If such an outbreak occurred, hospitals would become overwhelmed, riots would engulf vaccination clinics, and even power and food would be in short supply, according to the plan, which was obtained by The New York Times. The 381-page plan calls for quarantine and travel restrictions but concedes that such measures "are unlikely to delay introduction of pandemic disease into the U.S. by more than a month or two." The plan's 10 supplements suggest specific ways that local and state governments should prepare now for an eventual pandemic by, for instance, drafting legal documents that would justify quarantines. Written by health officials, the plan does [not] yet address responses by the military or other governmental departments.
So this plan has been "years in the making," yet it still doesn't define the role of the federal government in the response to a flu pandemic? At least the roles of local and state governments have been defined, but what the heck is the problem with saying "this is our advice to Executive Branch, and various federal agencies..."?
The role of the DHHS has actually been laid out in the plan. But who's going to be in charge?
While the administration's flu plan, officially called the Pandemic Influenza Strategic Plan, closely outlines how the Health and Human Services Department may react during a pandemic, it skirts many essential decisions, like how the military may be deployed.
"The real shortcoming of the plan is that it doesn't say who's in charge," said a top health official who provided the plan to The Times. "We don't want to have a FEMA-like response, where it's not clear who's running what." The same official says that the plan is "a major milestone." Well, yes, it is, compared to the one that came out two years ago.
Other issues in the leaked document:
Who gets vaccines and essential medicines first? This is a major point of contention in the plan. The military wasn't included in the discussion, but pharmaceutical plant workers are at the top of the list, as well as medical workers. These are followed by the elderly and severely ill, pregnant women, immunocompromised individuals, parents of infants, and police, firefighters, and government leaders.
A stockpile of 133 million courses of antiviral medication (the Bush administration has bought 4.3 million).
The responsibility of health officials is laid out (planning and surveillance, as well as coordination with the DoD).
Finally, the NYT article says that the plan includes some elements of drama. It has a fictional scenario: "In April of the current year, an outbreak of severe respiratory illness is identified in a small village. Twenty patients have required hospitalization at the local provincial hospital, five of whom have died from pneumonia and respiratory failure," the plan states.
The flu spreads and begins to make headlines around the world. Top health officials swing into action and isolate the new viral strain in laboratories. The scientists discover that "the vaccine developed previously for the avian strain will only provide partial protection," the plan states.
In June, federal health officials find airline passengers infected with the virus "arriving in four major U.S. cities," the plan states. By July, small outbreaks are being reported around the nation. It spreads. As the outbreak peaks, about a quarter of workers stay home because they are sick or afraid of becoming sick. Hospitals are overwhelmed. "Social unrest occurs," the plan states. "Public anxiety heightens mistrust of government, diminishing compliance with public health advisories." Mortuaries and funeral homes are overwhelmed.
Heightened mistrust of government because...? Just go back to the first paragraph of the article. Would you trust a government that was "woefully unprepared"? After Katrina, it's hard to trust the government in the event of any disaster.
