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Experts see bird flu challenge to U.S. health system
2007-01-15
A bird flu pandemic remains a threat that the U.S. health care system must take seriously despite less frequent media coverage and the absence so far of human cases in the United States, experts warned. John Bartlett, an infectious disease expert at John Hopkins University, said the decentralized U.S. health system will make it more difficult to get ready for a possible human pandemic of H5N1 avian virus -- or anything else. He denied the threat from bird flu has been overstated by the media. "The number of cases in 2006 was more than it was in 2005, which is more than it was in 2004 ... so it continues to go up in people," he said in an interview. "And it continues to be just as lethal as it was in the beginning," Bartlett told Reuters at a conference aimed at helping U.S. hospital administrators prepare for a pandemic. The virus mainly affects birds but the deaths of two Indonesian women last week brought the worldwide death toll among people from the virus to 159, out of a total of 256 infected since 2003. "It's there to stay in birds which means it is just waiting for the opportunity to make the mutation," Bartlett said. The H5N1 virus is steadily changing and could at any time acquire the changes it needs to be easily transmitted from human to human. It would then spark a pandemic that could kill millions within months. Bird flu as an issue in the United States suffered from "press fatigue" in the absence of new things to say about the health threat, he said. DRUG SCARCITY, ETHICAL CONCERNS Bartlett was echoed by David Nabarro, bird flu coordinator for the United Nations, who said fewer headlines were a result of increased familiarity with the disease rather than a diminished threat. "It is incredibly infectious virus and it has not gone away. It is very much there, lurking at all times ready to strike," Nabarro told Reuters. At last week's conference at Johns Hopkins School of Medicine in Baltimore, Bartlett and other experts debated how U.S. hospitals would struggle with expected shortfalls of medicine, hospital beds, respirators and health-care workers. "What we learn about flu ... (can) prepare you for natural disasters, bio-terrorism or another pandemic," Bartlett said. Thomas Inglesby of the Center for Biosecurity at the University of Pittsburgh told the panel "the time line has already begun to slip a little bit" on the U.S. goal for 2011 of having enough vaccine for the entire population within six months of the identification of a pandemic influenza virus. Hospitals "have to plan that there'll be no vaccine," he said, urging administrators to start "speaking collectively about the need for a much more ambitious and aggressive vaccine strategy." With no federal guidance on who will receive pandemic vaccine once it is developed and manufactured, Inglesby said, state and local health authorities will have trouble making and enforcing decisions. Bartlett and Inglesby said the absence of clear guidelines on an avian flu pandemic would pose ethical challenges when it came to choosing who would receive scarce treatments. (Additional reporting by Lesley Wroughton in Washington)
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