Flu In The Cuckoo's Nest

It seems that at every opportunity, President Bush is pushing forward the military for response to disaster. Now it is this plan of choice for the possibility of an Avian Flu epidemic. Why do visions of the 1995 movie "Outbreak" come to mind? As I recall the story line, Dustin Hoffman works for the military versions of the CDC, and his separated wife works for the CDC. There is an epidemic of a Marburg type virus (which Hoffman later learns was created by the government). Eventually, some California hamlet ends up quarantined with order to blast the little town and all of its citizens to dust. Hoffman and his team come up with a last minute vaccine, and take off to fly into stop the bombing of the hamlet.

The draft of the US Influenza Pandemic Plan has been out there - apparently for a year - with no action by the administration. Now the administration is "taking action." That "action obviously proposes changing the posse comitatus law to allow U.S. military to be deployed inside the United States, andchanging the laws for vaccine producers. Ah well, this crowd never saw a disaster they couldn't bleed the silver lining from. Now "vaccine producers" I presume are pharmaceutical companies (big supporters of Bush). What kind of "protections" might these companies get when it comes to "protection?" Perhaps "protection" from law suits?

The other big splash is that the U.S. is rushing out to move on acquiring "anti-virals" and vaccines. This may look like "action," but may be all for show. According to a Reuters's article, Drugs (Are) No Answer to Bird Flu. Well we could of guessed that vaccines wouldn't be effective since the virus is mutating. But the article also notes that a vaccine might be exceptionally difficult to make since most vaccines are incubated in eggs. This is the "bird" flu after all, so the usual practice might not work well. But what about "tamiflu," or "relenza?" According the experts interviewed by Reuters, these drugs would only be somewhat effective if a person was taking it at the time of infection. "I think that potentially neuraminidase inhibitors may work if you are already on them as prophylaxis (prevention)," Osterholm said. That would mean taking them daily for days or weeks."

Well, that might not be a good idea, and there is certainly not an adequate supply of these drugs to prophylacticly prescribe them for entire populations.

Prevention of an outbreak would seem to be the better idea. Prevention would require good early warning systems, and rapid response. Both of which are public health issues, and in the U.S. public health has been gutted. It also means taking the political and economic heat to shut down an epidemic before it starts. That may mean closing schools, malls, and businesses. It may mean requiring exposed individuals to quarantine themselves at home until they either get sick or don't. We have seen the limited quarantine play out in Canada with SARS. Somehow they got on the ball early, and never even came close to calling in the troops.

Despite the political play with a possible outbreak, the threat of a bird flu pandemic is high according to the Department of Health.

"It's a very real threat," Dr. Sue Bailey, the former Asst. Secretary of Defense, Health Affairs, told Hensel. "We think the mutations are going to occur that set us up for a pandemic."

The movie "Outbreak" was a worst case scenario with a "happy" ending, but somehow, the movie haunts me. I have little faith that there are many on-the-spot vaccines for any epidemic. I doubt that any Hoffman-like character would appear to save that town (or multiple towns) from destruction. I don't doubt that the military might be ordered to destroy a town or city to "save" the country. The U.S. is living under an administration that "lacks creativity" according to reports. Certainly, that lack of creativity is in part tied to its limited focus. With the threat of a global pandemic high, I just don't gain much comfort from either the talk of rushing to prepare, nor in our disabled health care systems being capable of an adequate response.