Poor Public Health Policy in Play

It appears I must abandon my pledge not to blog on swine flu issues - while I can't offer any medical points of view, I certainly can talk to the policy aspects. As our self-induced drama over the swine flu continues, administration officials are already starting to move into action - because any semblance of action is better than, you know, actually developing an effective plan based on risk management principles. From NPR this morning:

Normally it takes six months to make a regular flu vaccine. An effective vaccine protects most people from getting the flu. It would be the primary weapon against a flu pandemic — if it can be made, distributed and gotten into people's arms in time.

Bruce Gellin, the nation's top vaccine official, says the plan is to make enough swine flu vaccine for all 304 million Americans by September — only five months from now. Gellin is deputy assistant secretary for Health and Human Services for vaccinations, immunizations and infectious diseases.

Gellin says the first decision points on whether to go ahead will be in early June. That's when manufacturers would be told to switch over from making regular seasonal flu vaccine to a special swine flu vaccine. Fortunately, he says, the nation's flu vaccine makers will be finished by then with making all the components for next season's regular flu vaccine.

Now there are all sorts of things wrong with this decision, and the article does a fairly good job of discussing the issues. My major point is this: the influenza flu causes on average about 40,000 deaths within the United States, about three orders of magnitude over swine flu (so far). So we're going to tell all the flu vaccine producers to drop everything to switch to this new fear. Have we forgotten the swine flu case of 1976 so quickly?

Experts are haunted by what happened with the nation's last campaign to vaccinate against swine flu back in 1976. It was halted after 45 million Americans got flu shots, because several hundred people came down with Guillain-Barre syndrome, a rare paralyzing disease. Some of them died.

And in the end, the threatened swine flu pandemic never materialized.

History repeats itself? Well, maybe the administration can bill the swine flu production as part of the economic stimulus. That might be more beneficial than actually planning to use it. Policy makers ought to be cautiously examining the overall public health needs and priorities. We've had years to develop plans for a pandemic flu outbreak - it's hard to believe that these points have not been discussed and that we're going to let blind panic of a few outbreaks drive our public policy.

UPDATE: And of course, the most hilarious thing would be to defend the policy of not planning for a pandemic flu outbreak after years of discussion on this topic.

Comments

[NVH]

Give me a break on your update J. The guys right, buying more antivirals wasn't going to stimulate the economy, the same amount of people employed then would be employed now, just making more. ANything that references Huffington by the way one should never look at anyway.

[NVH]

ANd not without a refence, an equally useless right wing blog
http://www.redstate.com/moe_lane/2009/04/27/schumer-video-bragging-about-cutting-pandemic-fund-surfaces/

[J.]

Yep, NVH, you're right, paying a US company to produce medical countermeasures shouldn't be confused with creating jobs... much.

As for Schumer, he's a tool. I'll laugh at his absurd policy statements each and every day.

[NVH]

you do realize there is only one place in PA where they make this vaccine right? It's just like that horse they had for the anthrax vaccine.
Oh, and you're being vague, they won't hire new people or expand, they'll just make more of the shit with the stuff they have now, because they know in a year when the hype is gone and / or we're all dead and living with Will Smith in Manhattan with M4 carbines, driving mustangs, hunting deer and lions, that the money will dry up and the company will disappear if they expand...just ask schumer....ah, anyway

[Sam]

My two questions: why and who cares? This is the sort of thing that makes me wonder whether scientific approaches to policy are actually any more insightful than faith-based approaches to policy. No scientist in the world should automatically jump to the conclusion that a single virus is responsible for a 1:13 mortality rate on one side of the Rio Grande but a 1:109 mortality rate on the other side of the Rio Grande.

So all the people tested had swine flu antibodies. Okay. I bet you can find chickenpox antibodies in all of them, too, but that's not what killed them.