State ignores federal flu help
By TOM MARSHALL
Published March 20, 2007
If state and federal officials are right, the next influenza pandemic could kill 128,000 people in Florida and send 640,000 to hospitals.
Despite that, Florida is the only state in the country considering taking a pass on federal help to get ready.
Last week the federal government sent a letter to Florida's Office of Public Health Emergency Preparedness, warning it faced a Friday deadline to purchase $36.7-million worth of discounted antiviral drugs to develop a state stockpile.
Gov. Charlie Crist has put that money in his Department of Health budget request and considers it essential, said Health Department spokeswoman Wendy Riemann.
But the chairman of the House committee in charge of that budget said the five-year shelf life of the drugs leaves him skeptical. "It just doesn't rank as one of my priorities," Rep. Aaron Bean, R-Fernandina Beach said last week.
For one national expert on pandemics, the delay is unconscionable.
"Pandemics are like earthquakes, hurricanes and tsunamis," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "They occur. You can't say that's scare mongering, you can't say that's hype."
He said the mortality patterns of the H5N1 strain of avian influenza - which has so far killed 162 people worldwide, including at least two from human-to-human transmissions - are similar to that of the 1918 strain that killed 500,000 Americans and tens of millions worldwide.
Like the 1918 strain, H5N1 produces an immune response that rapidly compromises victims' respiratory systems.
"We do not know if that could become the next pandemic strain, but it could do so tomorrow," Osterholm said. "Many of the victims would be young, healthy adults."
Based on extrapolations from the 1918 outbreak, an avian flu pandemic could send as many as 640,000 Floridians to hospitals. That would require about 65,000 more hospital beds than the state now possesses, and may force officials to use gyms and community centers as emergency shelters.
It's not at all clear whether antiviral medicines like Tamiflu or Relenza would be effective in minimizing the symptoms of a new, vigorous influenza strain, said William Tynan, director of the state Office of Public Health Preparedness. But he said it's the state's best shot to protect itself.
"If the medicine is provided to patients who are suffering from influenza within 24 to 48 hours after they begin to show symptoms, it has the potential to greatly decrease how sick someone would get," he said. "It would also decrease the amount of time they would be sick."
In an outbreak, there would be no vaccines for at least four to six months, until scientists had time to design and manufacture them. And the world capacity for manufacturing vaccine is only about 350-million doses a year, Osterholm said.
Other measures like quarantine might not be effective, particularly in metropolitan areas where people can move whether officials want them to or not.
"We can't stop Pinellas from coming to Pasco and Hillsborough," said Steve Huard, a spokesman for the Hillsborough County Health Department.
More effective measures might include canceling public events and encouraging people to stay at home if they're ill, he and others said.
Tynan said the five-day treatment course of Tamiflu costs $110 retail in pharmacies, but less than $15 at the discounted federal rate.
If Florida opted not to take that price break, it could wind up paying $130-million more to treat the estimated 25 percent of the population that might need it, he said.
Put in those terms, the program looks like a bargain, said the vice chairman of Rep. Bean's committee.
"If we were to get hit, $34-million would be a small price to pay," said Rep. Juan C. Zapata, R-Miami.
He said there was a clear need for more public awareness of state plans for a flu pandemic, as well as a state stockpile.
Information from the Associated Press was used in this report. Tom Marshall can be reached at firstname.lastname@example.org or 352 584-5537.