Friday, October 30, 2009

Only an Emergency

Don’t Panic. It’s only a National Emergency. President Obama has declared the H1N1 (Swine) flu threat a National Emergency. However, according to the U.S. Department of Health and Human Services, the National Emergency designation just allows hospitals to cut through the red tape, set up triage centers, determine levels of care, and treat the sickest patients first, as well as establish alternate care facilities for swine flu victims in schools, nursing homes, and elsewhere off-site, without jeopardizing reimbursements from Medicare and Medicaid.

Statistics of the Centers for Disease Control and Prevention estimate about 36,000 in the U.S. die annually of flu. So far in 2009, swine flu deaths in 46 states have reached 1,000.

OK. So I tried to get a swine flu shot. My neighborhood mini-mall, walk-in healthcare provider had swine flu vaccine Friday two weeks ago, but they ran out by the time the weekend was over. Calls to the DeKalb County health department reported no vaccine, call back tomorrow, and tomorrow, and tomorrow, until finally they quit answering their phone. My regular family doctor has not ordered any swine flu vaccine, and even my pulmonary specialist does not want to fool with it. Not enough incentive in vaccines at $25 an injection.

Take a tip from the telecommunications industry: bundled services, cable tv, internet, cell phone and unlimited long distance all for one package price, a savings over the total of the individual features. Doctors who cannot be troubled with even ordering swine flu vaccine might be attracted by bundling swine flu vaccine with higher profit items like MRI and CT-Scans, which they do not seem to mind scheduling at the drop of a hat, no matter the complaint. MRI and CT-scan tests vary from $1,000 to over $8,000, according to one hospital billing clerk. If the doctors threw in a $25 swine flu vaccine, they could still offer the package at the same price as an MRI or CT-scan.

The U.S. government has purchased 250 million doses of 2009 H1N1 vaccine, so anyone who wants to get the vaccine will have the opportunity to do so, the CDC says. The CDC website publishes figures about the number of doses of swine flu vaccine that have been ordered, delivered, and are scheduled to be manufactured. If you can make sense of it, let me know. Meanwhile, CDC says as soon as vaccine is available, school children, pregnant women, and people under 65 years of age should take it.

I am not under 65 years of age. The CDC says the “best way to prevent seasonal flu is by getting a seasonal flu vaccination each year.” Yeah. Right. How about swine flu? “When the 2009 H1N1 vaccine becomes available for people 65 years and older, you should get that vaccine also,” CDC advises.

Meanwhile, wash your hands. You might even ask other people to wash their hands before shaking your hand or preparing your food or giving you change at the store.

Older people are at greater risk of serious complications from the flu compared to young, healthy adults. An estimated 90 percent of seasonal flu deaths and more than 60 percent of seasonal flu hospitalizations in the U.S. each year are those 65 and older.

Small consolation: CDC guidance prioritizes the over-65 population to get antiviral drugs if they become sick with the flu. A WHO medical health officer said his biggest concern is that the H1N1 virus could mutate and become resistant to Tamiflu, the antiviral drug.

Flu symptoms, including 2009 H1N1: cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue, with or without fever, sometimes vomiting and diarrhea.

(Copyright 2009 by William C. Cotter)


Carl said...

"Meanwhile, wash your hands. You might even ask other people to wash their hands before shaking your hand or preparing your food or giving you change at the store."

Maybe "Monk" will become our poster child. Pass the hand wipe.

Professor Staff said...

This hasn't been reported widely, but when I was spending my year in the State Dept last year, I worked on "biological security" and knew quite well the folks at Health and Human Services involved in emergency preparedness and response, including the people that issue contracts for vaccine production and stockpiling.

I have a vague (faulty?) memory from last June/July that the target date for the vaccine to be widely distributed was December, with some optimistic public statements that some vaccine would be distributed as early as October. The key here is delivery would START (i.e. first vaccines off the production line) in October and continue throughout the fall.

The way the press reports this, you would think it is all made on one large batch. The whole country wants their dose now.

My memory might be faulty, but if it is not, I wonder if this entire "shortage" is nothing more than mismananged expectations by the press and politicians?

- Rob B.

Paw Paw Bill said...

Your memory is probably correct, and I believe the press, politicians, and the Center for Dease Information Control can always be counted on to mismanage.

tina said...

I called my doc's office and talked to his nurse about it. She said she personally was not going to take the shot and that the doctors would not decide until mid-December whether or not they would recommend the shot. I called the health department and they said they might have some vaccine in two weeks and they did not know yet how the shots would be prioritized. Meanwhile I'm not going to the mall and I use the sanitizer wipes on the grocery cart when I go shopping. At stores where they do not have the free wipes, I get a cart that has been out in the sunshine a while.


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