AT ISSUE: Antivirals not necessary to prepare for pandemic
Dr. Ned Calonge, Colorado Department of Public Health and Environment
Published March 19, 2008 at 5:01 p.m.
Randy Atkinson and Catherine Benavidez got it wrong on March 10 when their Speakout accused state officials of "being slow to react" in planning for a pandemic ("Is Colorado ready for a flu pandemic?"). The Centers for Disease Control and Prevention recently rated Colorado as one of the nation's best-prepared states. The writers' real objection is with the state's decision not to make a $7 million purchase to add to the state's current 670,000 dose antiviral supply in the federal Strategic National Stockpile (SNS).
Part of every state's planning for pandemic involves preparations to care for those most vulnerable in the event a pandemic occurs. Based on CDC's most extreme projections of illness for an anticipated pandemic, Colorado's SNS allotment would be sufficient to treat all hospitalized flu patents; all high-risk patients with the flu who would seek care; all essential service workers (first responders, medical care providers, law enforcement, etc.) with the flu who would seek care; and enough to provide at least eight weeks of continuous protection for all health-care workers taking care of flu patients.
The federal purchase program also limits use of the antivirals to a pandemic and the medication needs to be discarded after seven years. With no ability to predict when the next pandemic will occur, the state's investment in antivirals could be wasted. Moreover, we do not know whether these medications will effectively treat flu in the event of a pandemic.
The department's decision was endorsed by the Governor's Expert Emergency Epidemic Response Committee and supported by the Colorado Medical Society, the Public Health Directors of Colorado and the Colorado Association of Public Health Officials. These true medical and public health experts all concur with the state's approach.
Dr. Ned Calonge is chief medical officer at the Colorado Department of Public Health and Environment.
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March 20, 2008
12:04 a.m.
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WalterMD writes:
I would very much like to disagree with Dr Calonge. For one thing Avian flu in its current form has a 62% mortality rate. There are only two drugs known to treat it. Tamiflu and Relenza. Currently Tamiflu is 92% effective. If I or any of my family members had Tamiflu having a 92% chance of living is better than a 62% chance of dying. I don't know how public health official can say that the only thing we need to do is hide from it (social distancing its called). I don't know how they can say this but I know why. The why is because Health and Human Service bought $3 Billion dollars of Tamiflu and and have not been able to figure out a way to distribute it. So apparently the plan is to let the medication expire in the Strategic National Stockpile without an effort to rotate the stock.
Also plans were proferred to public health that would efficiently distribute the Tamiflu and at the same time recoup 50% of the cost of the Tamiflu. The idea was rejected 2 years ago when HHS still were intending to distribute the Tamiflu and a world wide shortage existed. Maybe they might want to revisit the idea.
March 20, 2008
12:23 a.m.
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windbourne writes:
I am amazed that this is even an issue. In particular, the anti-viral being discussed is Tamiflu. GWB has been stockpiling it, and removed it from the US market to keep ppl from using it. Why? Because flu builds up a resistance to it over a period of time. So it makes sense that we not use it. Problem is, that Roche wanted to make money at it. So, they have been selling it to south east asia for sometime, in particular Indonesia and China. And it is sold CHEAP. How cheap? The locals are using it to inject their chickens. So, what is the issue? Well, first off, the flu in that region is now showing resistance to it. Keep in mind, that this will almost certainly be the area that will convert avian flu to being airborne. So, when it happens, it will most likely be with a resistant virus. The real question should be why are these ppl doing this? Because roche sells it there for a penny. When it was available on the market, it was costing us $20. Down there, it is a fraction of the cost here.
The best thing that can happen is for us not to waste our money this. We would be better off pushing for isolating ppl. In particular, WHEN avian flu breaks out (and it will), then we should be separate from ppl. That means getting everybody to have some form of networking in their home, since the computer and telephone will almost certainly be the main link to the world.
March 20, 2008
5:17 p.m.
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WalterMD writes:
The evidence for social distancing is not very persuasive. Some of the leading historians of the 1918 Spanish Influenza have criticized the very statistics that are being used to bolster this argument. Secondly, if the studies show anything about social distancing is that they can slow the spread but no studies show that it will decrease the percentage of people who will eventually get the flu.
No one is even talking about what will happen if everyone shuts down and goes into hiding for weeks. What will happen is that those that have stockpiled food and supplies will have it "redistributed" either voluntarily or involuntarily. I think I can hide from the flu for a week or two but I am not sure I can hide from people without food who are going to infect me with influenza and take my food. Anybody who was in New Orleans and holed up for a week or more feel free to comment as to how effective "social distancing" was.
March 22, 2008
10:34 p.m.
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asdfjkl writes:
Could Dr. Calonge provide a website or other source that provides the evidence to back up his statement?
"Based on CDC's most extreme projections of illness for an anticipated pandemic, Colorado's SNS allotment would be sufficient to treat all hospitalized flu patents; all high-risk patients with the flu who would seek care; all essential service workers (first responders, medical care providers, law enforcement, etc.) with the flu who would seek care; and enough to provide at least eight weeks of continuous protection for all health-care workers taking care of flu patients."