Letter to Florida lawmakers Re antiviral stockpile

This is a letter I am sending to Representatives in the Florida House & Senate about the Florida antiviral stockpile purchase. If anyone wants to use anything from this - feel free.

As the budget negotiations draw to a close, here is a proposal for our lawmakers that cannot find room in their budget for a Florida antiviral stockpile to fight a potential pandemic: Assess a one-time only $10 pandemic preparation fee on everyone’s utility bill. Since there are approx 18 million Floridians, this should completely cover Governor Crist’s recommended $36.5 million for an antiviral purchase and leave enough money to stockpile N95 masks as well. Why an assessment on our utility bill? Because without a vaccine to prevent the virus (which currently has a 50% - 75% death rate of those infected) and without any treatment options available, a huge number of people are simply not going to come to work as they begin to see their coworkers dropping dead. Without enough utility workers, water and electrical service will begin to fail. Without water and electricity, our cities will quickly fall apart and descend into anarchy, making the deaths from the actual virus seem insignificant.

Compared to what we are paying for health insurance, homeowner’s insurance, and auto insurance, $10/family is an awfully good deal for insurance that our society will not collapse because people are afraid to go to work and risk infection. $10 is also a good investment to ensure that if our children get sick, we won’t have to watch them die for lack of a treatment. Our government already made the mistake of deciding not to worry about maintaining the levies around New Orleans. Not preparing for a pandemic could easily make the Katrina disaster pale by comparison. Currently, Florida is the only state not participating in the federally subsidized program, according to the U.S. Department of Health and Human Services. Please fund the full antiviral purchase. This is one disaster we cannot afford to ignore.

Why is it so important with all the other issues facing Florida? Statistically, we are already overdue for another pandemic. The H1N1 1918 Spanish flu pandemic killed about 100 million people worldwide. This is more than all the casualties from World War I. The death rate was approximately 2% of those it infected. Currently, the H5N1 bird flu virus has a much greater death rate of 50% - 75% of those who are infected, depending on the strain.   Like the 1918 pandemic, death occurs approximately one week after the first symptoms appear. Unlike the seasonal flu, which usually only kills the elderly and infirm, the highest mortality rates from bird flu occur in children and young adults.

How likely is a pandemic? The bird flu has already spread to 58 countries. It is already infecting humans in Azerbaijan, Cambodia, China, Djibouti, Egypt, India, Indonesia, Iraq, Laos, Nigeria, Thailand, Turkey, and Vietnam. Limited human-to-human transmission has already been documented by the World Health Organization. In addition to birds and people, the bird flu virus has also already adapted to other mammals including cats, dogs, pigs, mice, bats, and ferrets. It has also recently been found in flies and mosquitoes. Once a pandemic starts it will spread very quickly, first to cities around the world with airports and harbors and outward from there.

The federal government is taking the possibility of a pandemic quite seriously. Michael Osterholm, PhD Director of the Center for Infectious Disease Research and Policy (CIDRAP) and associate director of Homeland Security’s National Center for Food Protection and Defense has said “It’s going to happen. It’s not a matter of if - it’s a matter of when, where it starts, and how bad it’s going to be.”

U.S. Health and Human Services Secretary Michael Leavitt has repeatedly warned that "Any community that fails to prepare, with the expectation that the federal government will at the last moment be able to come to the rescue, will be tragically wrong."

The best solution would be a preventative vaccine, but this is not a viable option in the near future. A pandemic vaccine cannot be made until the pandemic begins and the exact strain is known. It then takes 6 – 9 months to produce with the current technology. Worse, there are no longer any American owned injectable flu vaccine manufacturing companies. There are 2 foreign owned flu vaccine plants in America. Our government does not “do” health care. Since 2005, the US has had to buy all of our seasonal flu vaccines from the French owned Sanofi Pasteur and the Swiss owned Novartis Vaccines. When a pandemic starts, the US will be lining up with the rest of the world to try to buy vaccines after they are produced. (The government stockpiled vaccine you hear about – for 1% of our population - is for 2 of the dozens of current bird flu virus strains which are constantly mutating. It is unknown if the vaccines stockpiled in advance will have any protective value at all against the strain that evolves to spread easily among humans and starts the pandemic).

Currently, the only effective treatment option for a potential pandemic is the antiviral Tamiflu. The cost of the federally subsidized Tamiflu is $14/person. Without the federal subsidy, the cost is more than $100/person. Florida cannot afford to wait and buy it later after the subsidy offer has expired.

The federal government has been warning employers to plan for 40% absenteeism in a pandemic due to illness, the need to care for sick family members, and the fear of infection. And this recommendation assumes the states have stockpiled some hope of a cure.   What our lawmakers need to consider is once the pandemic is underway and the virus is spreading more easily between people, will our doctors and nurses be willing to go to work and risk exposure to a virus that kills 50% to 75% of its victims with no vaccine to prevent the disease and no treatment to cure it?   Is there even any point to them taking such a huge risk if they have little or no treatment to offer? How many of our pharmacists, police, firefighters, water and electrical utility workers, and other essential personnel will choose to risk exposure of themselves (and their families) if no treatment exists? Will truck drivers bringing food and gas supplies agree to make deliveries to Florida if we are the only state in our country that cannot provide treatment if they get sick while they are here?


Recommended resources if you’d like to know more:
*******
www.avianflutalk.com
www.******
www.thefluclinic.com
http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/index.html
http://*************



Thank you for reading the above letter. In case you are “on-the-fence” about the importance of an antiviral stockpile, please read the following bulletin sent out by the US Dept. of Defense to US embassies overseas November 3, 2006 – about the same time the study was published in Nature Magazine about the newest bird flu mutation that improved the virus’s ability to attach to human lung cell receptors. The Dept. of Defense obviously has considered the probability of social breakdowns in a pandemic for quite some time now.

Thanks,
Jim & Teri Ervin


http://hongkong.usconsulate.gov/ci_avian_2006110301.html

Avian Flu
American Citizens Services Newsletter
Pandemic Influenza -- Preparing for Possible Shelter-In-Place
U.S. Consulate General for Hong Kong and Macau
November 3, 2006
The U.S. Department of State recently sent a cable to all diplomatic and consular posts entitled "Pandemic Influenza: Preparing for Possible Shelter-In-Place". The cable's main intent was to provide guidance to all staff regarding "shelter-in-place". That is, in the event of severe pandemic influenza with high morbidity, the public may be advised to self-quarantine. Therefore, current guidance notes that families should be prepared to "shelter-in-place" for up to twelve weeks, and maintain sufficient food and water supplies to accommodate that entire period.
Just as in the United States, U.S. government employees and their families overseas have primary responsibility for maintaining adequate supplies of food to shelter-in-place. This also applies to private U.S. citizens. For the long term, families are advised to store foods that are non-perishable, do not require refrigeration, or preparation (including the use of water), or cooking. The cable also advises that families should store one gallon of water per person per day.
Potable Water
Please note that at this time, Hong Kong's water supply is potable. In the event of complete infrastructure breakdown, water supply that is currently potable in some areas or countries may not remain so. However, water can be purified in several ways. Boiling is a reliable method for killing microbes and parasites. Bring water to a rolling boil and continue boiling for at least ten minutes. Also, regular Clorox Bleach isn't just a laundry-aid, it's a lifesaver (use only regular Clorox bleach, not Fresh Scent or Lemon Fresh). In an emergency, one gallon of Regular Clorox Bleach purifies 3,800 gallons of drinking water. First, let water stand until particles settle. Filter the particles if necessary with layers of cloth, coffee filters, or fine paper towels. Pour the clear water into an uncontaminated container and add Regular Clorox Bleach per the below indicated ratio, mix well, and wait 30 minutes. Water should have a slight bleach odor.
Ratio of Clorox Bleach to Water for Purification:
2 drops of Regular Clorox Bleach per quart of water
8 drops of Regular Clorox Bleach per gallon of water
1/2 teaspoon Regular Clorox Bleach per five gallons of water If water is cloudy, double the recommended dosages of Clorox Bleach.
To insure that Clorox Bleach is at its full strength, rotate or replace your storage bottle every three months. Also, don't forget to sanitize the water storage containers. To sanitize containers and utensils, mix one tablespoon of Regular Clorox Bleach with one gallon of water, creating a Sanitizing Solution. Always wash and rinse the items first, then let each item soak in Clorox Bleach Sanitizing Solution for two minutes. Drain and air dry.
Please remember that water in dehumidifiers is also potable, but be sure to sanitize the dehumidifier water container.
Emergency Supply List
The U.S. Government's "one-stop" web site on avian influenza, www.PandemicFlu.gov, provides a sample list of foodstuffs and other emergency supplies for stocking:
Examples of food and non-perishables:
Ready-to-eat canned meats, fish, fruits, vegetables, beans and soups Protein or fruit bars Dry cereal or granola Peanut butter or nuts Dried fruit Crackers Canned juices Bottled water Canned or jarred baby food and formula Pet food
Examples of medical, health and emergency supplies:
Prescribed medical supplies such as glucose and blood-pressure monitoring equipment Soap and/or alcohol-based (60% - 95%) hand wash Medicines for fever, such as acetaminophen or ibuprofen Thermometer Anti-diarrhea medication Vitamins Fluids with electrolytes Cleansing agents Flashlight Batteries Portable radio Manual can opener Garbage bags Tissues, toilet paper
To better help plan for "shelter-in-place", all U.S. citizens are encouraged to refer to the www.PandemicFlu.gov website, as well as the World Health Organization website (www.who.int/en/). Please also visit the U.S. Consulate General website for further information: Avian Flu.
We will continue to distribute and share pertinent information on Influenza Pandemic Preparedness as we receive it.

Impressive!