Agencies and health departments prepare for swine flu

Governments and drug companies are struggling with efforts to prepare for a possible resurgence of swine flu in the fall as well as questioning who should receive swine flu vaccines as they ramp up production.

The Boston Globe reports on low stockpiles as disease trackers prepare for the fall to see how the swine strain develops. The paper reports: "The arrival of swine flu in the United States exposed gaps in the supply chain that delivers medication, masks, and even testing swabs to hospitals and doctors' offices - shortcomings that could prove vastly more worrisome if a deadlier strain returns in the fall, officials say. In Massachusetts, where the state health agency had to tap its emergency cache of flu-relief pills to supplement dwindling private supplies, the administration of Governor Deval Patrick is asking the Legislature to spend $1 million more to bolster the state stockpile, a request that is pending." The paper also notes: "The experience with swine flu has underscored how the agencies responsible for corralling dangerous germs often have no way of assuring whether pharmaceutical and medical supply companies have stocks sufficient to satisfy demand."

Later this month, five dozen health officers will convene in Massachusetts to analyze the handling of swine flu. Massachusetts health authorities have noted that supply shortages tended to be localized and that nation's health system didn't experience major upheaval. The Boston Globe also notes: "Disease specialists fear that the appearance of twin flu strains could sorely tax the nation's healthcare system, which faced episodic supply shortages since the first cases of swine flu were diagnosed. In the early days of the epidemic, Massachusetts doctors reported that some patients had trouble getting prescriptions filled for Tamiflu - the main medication used to treat the novel virus - as drug-store reserves ran low. As a result, the state Department of Public Health distributed enough antiviral medication from its stockpile to treat the flu or prevent it in 53,000 patients. Some hospitals said shelves usually brimming with surgical masks, used to slow the virus' transmission, turned barren - and suppliers proved unable to replenish supplies in the standard 24-hour timeframe. Hospitals sometimes found themselves in competition with each other for supply reinforcements, and there were instances when departments within the same medical center raced to get their orders in first" (Smith, 6/15).

The Wall Street Journal reports that "the world's biggest drug companies have started producing vaccines against the H1N1 virus and expect the first doses to be available by the fall. Many Western countries have ordered millions of doses, at a cost of more than $1 billion. But they have yet to figure out who should be first in line to get the shots, or to what extent they are even needed, given that the virus has so far proved less deadly than feared." The paper reports on the dilemma of dealing with a high-risk health care challenge like swine flu: "If they move to produce too much vaccine, they could find themselves wasting taxpayer money and using up scarce capacity that could be producing other life-saving vaccines. But not getting enough vaccine -- or not vaccinating the right people -- could expose them to trouble if the pandemic worsens. The World Health Organization, which formally declared swine flu a pandemic Thursday, has yet to offer guidelines on how many people should be vaccinated and who should be first. But some governments are moving ahead with their own plans." Meanwhile, "U.S. officials are gathering more information on the virus and waiting to see the results of clinical trials on the safety and efficacy of the shots before making any decisions" (Whalen, 6/15).

The Associated Press reports that Health Secretary Kathleen Sebelius says production of a swine flue vaccine is being set up and production could start as early as late summer and be ready in fall. Meanwhile, the government is working with governors and health and schools officials in case a major vaccination program is needed. The AP also noted: "Nearly 18,000 cases of swine flu have been reported across the United States, with 45 confirmed deaths" (6/15).

In a separate article, the Boston Globe reports on training for other emergency and public health scares through an examination of Boston's DelValle Institute for Emergency Preparedness, which was set up in 2003 by the city's Emergency Medical Service and the Public Health Commission. The institute "has won praise from national antiterrorism specialists" with nearly 13,000 nurses, doctors, police officers, ambulance teams and other emergency personnel having received training there. The Globe reports that experts from countries targeted by recent mass-casualty terror attacks will meet at DelValle this week to connect with their local and national counterparts (Smith, 6/15).