Pandemics: ". . . and Federal coordination goes to -- drum roll -- Homeland Security"
Saturday, November 05, 2005
From Effect Measure, the progressive health blog, a scenario that reads like black comedy: Homeland Security in charge of pandemic?
DHHS has lead on the medical response, Agriculture on the veterinary response, State on international activities, and the overall domestic incident management and Federal coordination goes to -- drum roll -- Homeland Security.
Don't you feel better, now? The folks who brought us color coding, Katrina, Michael Brown and so many other museum pieces of incompetence will be coordinating a public health emergency.
The same blog has a subsequent post on the Federal plan for pandemics. The post concludes:
So that's what the planners were planning for. Straightforward. Correct. None of it news. It says, in essence, what many have known for years. If a pandemic strikes, we're screwed.
A 1918-like influenza pandemic would tax the resources of the best prepared nation. It is an overwhelming natural catastrophe. But like other natural catastrophes (e.g., hurricane Katrina), adequately preparation makes a world of difference in mitigating the consequences. And we are not a best-prepared nation. Our government hasn't gotten us ready, and in fact, has pursued policies that severely weakened us. The Iraq mistake was an ideologically based experiment that failed in spectacular and tragic fashion, its failure affecting almost everything else. As we generate anti-American feeling abroad, we spend more at home to cope with the anticipated effects. This diverts existing resources to topics like "biodefense" which have severely distorted and weakened our public health system. The gigantic $200 billion war cost has run up an even larger deficit (caused by give-to-the-rich tax cuts) which in turn prompts budget cuts which further weaken public health.
We hear daily about "the war on terror," a war we are losing and whose vague outlines are often contrived or worse. Until now we heard almost nothing from our "leaders" about the pandemic threat public health scientists knew was ever-present. Even our preparation for terrorism was a botched job, so with the expenditure of countless billions, we are left worse off than before.
Hence the stark reality of the Pandemic Flu Plan, which has no real plans in it except to say to the states and localities, "Watch Out. Here it comes. Good night and good luck."
MEANWHILE, Declan Butler writes in Nature about how a drug cocktail could extend supplies of Tamiflu. Wartime tactic doubles power of scarce bird-flu drug: Use of common drug could stretch world stocks of Tamiflu.
Doctors think they have hit on a way to effectively double supplies of a drug that fights bird flu. Administering Tamiflu alongside a second drug that stops it being excreted in urine means that only half doses of the treatment would be needed.
Tamiflu (oseltamivir phosphate) is the main antiflu medicine recommended by the World Health Organization (WHO). The WHO suggests that, in anticipation of a flu pandemic, countries should stockpile enough for at least a quarter of their population. But although Swiss drugmaker Roche, the sole supplier, has quadrupled its production capacity over the past two years, the current supply is thought to cover just 2% of the world population.
Last week, Joe Howton, medical director at the Adventist Medical Center in Portland, Oregon, suggested a way to double supplies, after browsing basic safety data from Roche for a talk on avian flu.
The technique was invented during the Second World War to extend precious penicillin supplies. Scientists found that a simple benzoic acid derivative called probenecid stops many drugs, including antibiotics, being removed from the blood by the kidneys. Probenecid is readily available and is still widely used alongside antibiotics to treat gonorrhoea and syphilis, and in emergency rooms, where doctors need their patients to have high, sustained levels of antibiotics in their blood.
. . . [And the article closes:]
Like many scientists, Fedson is stumped by the apparent lack of interest from Roche, and the relevant authorities. "It's stupefying," he says.