Monday, March 10, 2008

The coming pandemic and antivirals (again)

The anti-viral controversy has raised its head yet again.

Today, the Rocky Mountain News published an opinion piece from two members of an organization called the Colorado Coalition for Pandemic Preparedness. Read it for yourself at http://www.rockymountainnews.com/news/2008/mar/10/speakout-is-colorado-prepared-for-a-flu-pandemic/.

The writers think that Colorado has "been slow to react to the Health and Human Services request to secure our own antiviral stockpile that we can immediately access in a flu pandemic."

While I appreciate the efforts to bring pandemic flu and public health preparedness back to our consciousness, on this point, they are just plain wrong.

As soon as the feds made their "generous" offer to the states to pay one-quarter of the cost of a state stockpile of Tamiflu, the Colorado Department of Public Health and Environment gathered its resident experts to consider the options. Then, as now, there were two possibilities:

1. Colorado could buy extra antivirals at a cost of about $7 million. We also would have to figure out how to store them properly, an additional ongoing cost for refrigerated storage. It would mean eliminating staff and several programs devoted to public health preparedness for all-hazards situations -- whether flu, blizzard, tornado, plane crash, bioterrorism or explosion. And it would mean a reduction in funding to local public health departments all over the state. And, since the feds won't extend the shelf life for the state stockpiles (only their own), we'd have to throw it out and buy more in five years.

2. Colorado could focus its efforts on the "other tools in our toolbox" to combat a pandemic, since we have no idea whether a pandemic virus would respond to Tamiflu or other available antivirals.

When we last visited this topic (see December 19, at http://breadybhealthybinformed.blogspot.com/2007/12/to-tamiflu-or-not-to-tamiflu.html), I posted 10 reasons for Colorado to abstain from purchasing extra antiviral medication. And I still stand by those 10 reasons... and we could keep adding to the list.

No one can just dismiss the writers' concerns for themselves and other first responders and medical professionals. They are our heroes time and time again.

But Colorado is providing for the people on the front lines of pandemic flu. In fact, the Governor's Expert Emergency Epidemic Response Committee heard from a medical ethics expert before taking pen to paper (or fingers to keyboards) and creating a list of priorities for medication and vaccinations in an epidemic. And with our allocation from the Department of Health and Human Services, Colorado would have plenty of meds for firefighters and nurses called to those front lines.

So, what do you think? Have you changed your mind as a result of this opinion column? Do you think Colorado is on the right track for public health preparedness?

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