by DemFromCT
From the LA Times today:
State Not Ready for a Flu Crisis
A pandemic would quickly overwhelm the healthcare system, which lacks sufficient beds, medical staff and equipment, officials say.
Los Angeles County and the rest of California have nowhere near the capacity to treat the hundreds of thousands of people who might need medical care should a pandemic flu strike, according to health officials and experts across the state.
Officials are only beginning to work out how they would find the extra hospital beds, health workers and equipment needed in such a crisis. County and state authorities could not say, for instance, how many ventilators might be on hand to keep severely ill people breathing.
"No one, and I repeat no one, is prepared for a pandemic that starts tomorrow," said Dr. Howard Backer, an official with the California Department of Health Services.
And this is why we write about it.
I note on the [Daily Kos] FP story I wrote over the weekend several comments about 'one-sided' story-telling impying this is all fear and hype.
In fact, it's impossible to objectively assess the current preparedness situation and come to any different conclusion than Dr. Backer comes to.
The only way we will prepare is to prepare. Arguing about the relative odds of H5N1 causing as problem is a useless waste of time and bandwidth. Many authoritiess see the current situation as alarming, but not inevitably pandemic-producing. There's a wonderful summary by top-notch reporter Helen Branswell here.
Influenza expert Dr. Peter Palese is one who believes some factor science doesn't yet recognize may be blocking this virus from becoming a flu strain easily sneezed from one human nose to the next.
"I am convinced that pandemics will occur in the future," says Palese, chair of the department of microbiology at Mt. Sinai School of Medicine in New York.
"I'm just not sure it will be H5."
Dr. Jeffery Taubenberger isn't either. But while Palese is betting against H5N1, Taubenberger believes nothing can be precluded at this point with this virus.
"I think that the best answer is that we do not understand the rules under which influenza pandemics form," says Taubenberger, the American scientist who led the team that found and sequenced the 1918 Spanish flu virus.
"And therefore we don't actually know if there are biological constraints limiting particular strains and particular subtypes, that they either can or cannot adapt to humans and cause pandemics," Taubenberger, chief of molecular pathology at the U.S. Armed Forces Institute of Pathology, explains in an interview.
"So I think the jury remains out as to whether H5 has that ability."
Dr. Ruben Donis of the U.S. Centers for Disease Control's influenza branch doesn't believe the passage of time indicates anything about H5N1's ability - or lack thereof - to become a pandemic strain.
Donis, who heads the branch's molecular genetics section, points out that a flu virus called H3N8 circulated in horses in North America for nearly 40 years before jumping into dog populations and triggering the canine flu that grabbed headlines last fall.
"That's the reality. We don't know. It doesn't exclude anything," Donis says.
What seems clear is that it isn't easy for an avian flu virus to adapt to the point where it can spread efficiently from person to person. If it were, pandemics would happen with greater frequency.
"It is fair to say that if it was a simple thing for the virus to change and to become pandemic . . . that probably would have happened by now," says Dr. Malik Peiris, an influenza expert at the University of Hong Kong whose laboratory has been studying H5N1 viruses for years.
"That I think is a fact. (But) this applies to all the avian influenza viruses out there."
But while he describes pandemics as rare and "low probability events," Peiris notes that a pandemic with this flu subtype could be severe, with enormous public health consequences.
"It would be extremely irresponsible if one did not take this threat seriously," he says.
We are not irresponsible. Neither are Drs. Palese (100% in favor of prepping), or the other experts quotd here. Drs. Fauci and Gerberding may try to protect the poultry industry by downplaying risks of H5N1 and maybe they're right. But as responsible adults, we plan on pushing preparedness. It's the only responsible thing to do.
See Flu Wiki and www.pandemicflu.gov for more.
"There will never be enough surge capacity in our existing hospitals," Dr. Jonathan Fielding, Los Angeles County public health director, said at the summit last month. "Even if there were enough beds -- which there won't be -- there won't be enough people. We have trouble getting enough nurses now."
It's the health system that needs revamping, and until and unless the will is there, we'll be sounding the alarms for the foreseeable future. Get used to it.
crossposted at The Daily Kos
I don't know about other states, but our former State Commissioner of health (now at the University) Dr. Michael Osterholm keeps making sure that the current legislature reconfirms the right of Health Commissioners to take over any Hotel or Motel in the state in a time of epidemic, and he keeps reviewing plans for making the necessary conversions, adding equiptment, staffing, etc, etc. In contrast with 1918, for instance, he found that no hospital, motel, hotel -- does its own laundry these days -- thus he also believes states need the power to commendere all linens in a state in department stores, wallmats, trargets and the like. Studies of providing flu appropriate food, for instance, would exhaust the state's supply in about ten days, which is far too short for an epidemic that might last four months at least. Getting the state to stockpile the basics -- chicken soup base, canned chicken, noodles and rice -- and some sort of crackers apparently is something no one wants to contemplate. But at least we have someone publicly trusted who is regularly on TV and Radio talking about the specifics in a way suggesting the outlines of a plan are in place. And no -- he still has not resolved the resperator matter. But it is important to have someone putting pressure on the State Legislature for resources and the constant confirmation of Public Health Powers.
Posted by: Sara | April 17, 2006 at 19:58
If some D needs a campaign issue, spending the dough to rebuild the public health system would be one thing to consider.
Posted by: Paul Lyon | April 18, 2006 at 00:56
Paul Lyon, that is certainly so. Health care trumps immigration, Iraq trumps them all.
Posted by: DemFromCT | April 18, 2006 at 09:20