On July 14, the World Health Organization reported 56 laboratory-confirmed cases of highly virulent avian flu in humans so far this year, up from just three in 2003. The Pan American Health Organization has just warned that the disease — which has spread to 30 countries in Asia, Europe, Africa and the Middle East in just the last six months — could reach the Americas any day. “We should take this interval to get prepared,” David Nabarro, senior United Nations system coordinator for avian and human influenza, told international health experts attending a recent two-day meeting in Washington.
It doesn’t appear that Washington region officials are heeding Nabarro. Here’s the background: The Centers for Disease Control says the H5N1 strain of the virus reported in humans in Vietnam and Thailand last year was resistant to amantadine and rimantadine, two antivirals commonly used to treat influenza. That leaves just two others — oseltamivir and zanamivir — that epidemiologists think might be effective against bird flu. Only the former (found in medications such as Tamiflu) is FDA-approved as a preventive if taken within 48 hours of exposure. There is still no vaccine, although one may be available next year.
The incubation period for the avian flu virus is one to four days, but up to six months are required to ramp up mass production of antiviral medication. By that time, a typical six- to eight-week outbreak will be long over. As the federal government’s massive 396-page manual on pandemics points out, “Huge and uncoordinated demand for antivirals early in a pandemic could rapidly deplete national and local supplies … .”
What local supplies? The federal government clearly recommends that state and local governments procure and maintain their own stockpiles for distribution during a pandemic in addition to what’s stashed away in eight secret Strategic National Stockpile warehouses. But local officials have been spending their share of $644 million in federal grant money on “outreach” — not medicine.
Fairfax County’s “self-care” guide, translated into multiple languages, reminds residents to stick a thermometer in their mouths. Instead of taking steps to protect residents, Loudoun health officials are holding seminars on what people can do to protect themselves. A Montgomery County spokeswoman told The Examiner most local jurisdictions plan to rely on the Strategic National Stockpile because “nobody has enough storage space or money to stockpile at the local level.” The SNS can theoretically deliver supplies to an impacted area within 12 hours; people from New Orleans would likely beg to differ.
Since as many as 180 million Americans do not fall into any federal priority categories for distribution of medications needed to deal with an avian flu outbreak, it’s only prudent for local health departments to keep enough antivirals on hand to create a disease firewall. Tamiflu has a five-year shelf life, according to a Roche Laboratories spokesman, so even if a deadly version of bird flu never materializes, it can always be used during the next regular flu season.
What government officials are not telling the public is that during a real pandemic, they’re essentially on their own. When the cavalry does come, it will be to enforce an executive order on mandatory quarantines.
Meanwhile, the ostriches among us are spending federal funds on DVDs, PowerPoint presentations, and guides that tell people to wash their hands and take their temperatures, wasting not only money, but valuable time.
