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| New York Prepares For The Arrival Of Avian Flu H5N1 |
| 2005-05-22 |
| Convinced it's only a matter of time before a new flu strain capable of killing millions reaches New York, city health officials have started drawing up a crisis plan, the Daily News has learned. Infectious-disease experts at the Health Department have been meeting every two weeks to prepare a strategy for protecting the city against diseases such as the Asian bird flu, or H5N1, which many scientists believe is just one crucial mutation away from turning into a monster malady. The written blueprint, which officials expect to complete before the next flu season starts in late fall, spells out how the agency will tackle potentially controversial measures. The issues addressed include how to handle quarantines, test virus samples for new strains, cope with overcrowded hospitals and ration lifesaving vaccines and other treatments. "It's very high on our priority list," said Dr. Isaac Weisfuse, the city's deputy commissioner of disease control who is spearheading New York's pandemic plan. "This is clearly an issue that we're concerned about." Officials are honing the plan as more and more evidence suggests H5N1 is evolving rapidly since it reappeared in Asia with a vengeance in late 2003. The World Health Organization unveiled an alarming report Wednesday indicating the virus is becoming more contagious - from birds to people and possibly even among people. But critics say the city's plan may not go far enough, particularly if it counts on a share of the meager federal stockpile of Tamiflu, the antiviral drug that is the only known treatment against bird flu, also known as avian influenza. "It's irresponsible that we are not stockpiling more of the antivirals," said Rep. Nita Lowey (D-N.Y.), a member of the congressional committee that overseas federal health agencies. "We could really fail to adequately respond if there is a pandemic." Federal authorities have purchased 2.3 million doses of Tamiflu - barely enough to treat 1% of Americans. Antivirals can reduce the severity of an illness and lower the infectiousness of people with the flu. Britain, France and New Zealand have ordered enough Tamiflu to cover up to 20% of their populations, with Canada covering about 17%, according to Roche, the Swiss-based maker. Roche plans to open more plants in the United States by this fall and has fulfilled all orders, company spokesman Terence Hurley said. Even before Britain placed its order, London officials independently bought about 100,000 doses of Tamiflu for its police, fire and transit workers after WHO issued a sobering warning about the growing threat of a pandemic. New York officials said the city has not decided whether to stockpile Tamiflu, and cited major obstacles to stockpiling. Because a pandemic can last up to two years, "we would have to buy a tremendous amount of Tamiflu because you would have to continually give it," Weisfuse said. "You're looking at a fairly major investment." It costs about $2 million for 100,000 doses. Also, there is no consensus among public health officials on how to use antivirals during a pandemic and who should get priority when supplies are limited, Weisfuse said. But independent experts said city officials may be walking a fine line - trying not to upstage federal counterparts, whom they have to lean on in times of crisis. Dr. Martin Blaser, president-elect of the Infectious Diseases Society of America, an association of physicians, agreed that details on how and when to use Tamiflu must be resolved. "But the bottom line is that it is a good idea to stockpile it in some reasonable amount," he said. "Should New York City have its own supply? Probably so." Lowey put it more bluntly: "You can't play nice-nice when it comes to people's health and their lives. States and cities have to take the initiative to protect their own populations." A pilot bird-flu vaccine is in clinical trials at the National Institutes of Health. But large-scale production of any new vaccine would take at least six months once an epidemic breaks out... |
| Posted by: Anonymoose |
| #5 Regardless when (if) a flu pandemic occurs, this kind of planning is good for any kind of mass infection, including terrorist-caused. One question I haven't seen addressed in posting here, and admittedly I've been lazy and haven't searched out the information, is how long the tamiflu antiviral can be stored without losing its effectiveness. Lots of meds have a one- two- or three-year effectiveness period under ideal storage conditions. And, NYC has an awful lot of running expenses, and very little spare money to throw away if the epidemic doesn't occur. I guess what I'm asking is, compared to all the other high priority burgeoning emergencies, what is the real risk of a flu pandemic, as compared to risks of something really ugly landing in a shipping container in New York Harbor, or a bomb being set off in the subway? |
| Posted by: trailing wife 2005-05-22 22:59 |
| #4 The Southern Hemispheres flu season is just starting. Anyway once a pandemic gets going the season will be immaterial. |
| Posted by: phil_b 2005-05-22 17:49 |
| #3 Gleling Greatle9407: Don't jump the gun. They've as much as come out and said it won't be this flu season. They plan to change the method of vaccination when it does hit from the standard "old people, infirm and infants" to "school aged children (the biggest communicators), and blanket vaccinations for outbreak areas"; which is actually the *old* way of doing things, statistically better in an epidemic. However, the US's lead time from Asia for the flu to hit has been radically reduced, so we could get the full-blown epidemic of highly-lethal avian strain almost as soon as it breaks out into the Asian population. As far as "crying wolf", there have been concerns about the next "killer flu" since the 1980s, after the false start with the "swine flu" in the Ford Adminstration, which *didn't* kill around 500,000 Americans *only* because it mutated to a less harmful strain just before it hit the US. |
| Posted by: Anonymoose 2005-05-22 16:26 |
| #2 Its a balance of probabilities as to when a pandemic occurs, although probably not if. Every new strain of this type (3 of them) we know about has gone pandemic. In my view it has already started. A couple of things. Tamiflu resistance has already occured in Vietnam and the Tamiflu stockpiles may prove to be useless. H5N1 was present in India in 2001/2002 and was carried by migrating birds to East Asia. |
| Posted by: phil_b 2005-05-22 15:35 |
| #1 Crying wolf? This business with Avian Flu H5N1 is starting to smell.....a bit too hyped. If it turns out to be a dud, then what will happen next year if a real problem appears. but wtf do i know. |
| Posted by: Gleling Greatle9407 2005-05-22 15:19 |