Skip to comments.Bush Outlines $7.1B Flu-Fighting Strategy
Posted on 11/01/2005 8:58:42 AM PST by Solson
By LAURAN NEERGAARD, AP Medical Writer 32 minutes ago
President Bush outlined a $7.1 billion strategy Tuesday to prepare for the danger of a pandemic influenza outbreak, saying he wanted to stockpile enough vaccine to protect 20 million Americans against the current strain of bird flu.
The president also said the United States must approve liability protection for the makers of lifesaving vaccines. He said the number of American vaccine manufacturers has plummeted because the industry has been hit with a flood of lawsuits.
Bush said no one knows when or where a deadly strain of flu will strike but "at some point we are likely to face another pandemic."
The president, in a speech at the National Institutes of Health, said the United States must be prepared to detect outbreaks anywhere in the world, stockpile vaccines and anti-viral drugs and be ready to respond at the federal, state and local levels in the event a pandemic reaches the United States.
Bush outlined a strategy that would cost $7.1 billion including:
_$1.2 billion for the government to buy enough doses of the vaccine against the current strain of bird flu to protect 20 million Americans; the administration wants to have sufficient vaccine for front-line emergency personnel and at-risk populations, including military personnel;
_$1 billion to stockpile more anti-viral drugs that lessen the severity of the flu symptoms;
_$2.8 billion to speed the development of vaccines as new strains emerge, a process that now takes months;
_$583 million for states and local governments to prepare emergency plans to respond to an outbreak.
Bush said a pandemic flu would be far more serious than the seasonal flu that makes hundreds of thousands of people sick ever year and sends people to their doctors for a flu shot. "I had mine," Bush said. Unlike seasonal flu, pandemic flu can kill people who are young and healthy as well as those who are frail and sick, he said.
In asking Congress for money to buy vaccine, Bush said the vaccine "would not be a perfect match to the pandemic flu because the pandemic strain would probably differ somewhat from the avian flu virus it grew from. But a vaccine against the current avian flu virus would likely offer some protection against a pandemic strain and possibly save many lives in the first critical months of an outbreak."
He also said the United States was increasing stockpiles of antiviral drugs, such as Tamiflu and Relenza. Such drugs cannot prevent people from catching the flu, but they can reduce the severity of the illness when taken within 48 hours of getting sick, he said.
"At this moment there is no pandemic influenza in the United States or the world, but if history is our guide there's reason to be concerned," Bush said. "In the last century, our country and the world have been hit by three influenza pandemics, and viruses from birds contributed to all of them."
He pointed out that the 1918 pandemic killed over a half million Americans and more than 20 million people across the globe. "One-third of the U.S. population was infected, and life expectancy in our country was reduced by 13 years.
"The 1918 pandemic was followed by pandemics in 1957 and 1968, which killed tens of thousands of Americans and millions across the world," Bush said.
Bird flu has been documented in Asia and has spread to Europe but has not reached the United States, the president said. "Our country has been given fair warning of this danger to our homeland and time to prepare," he said.
Bush said the cornerstone of his strategy was to develop new technologies to produce new vaccines quickly. "If a pandemic strikes, our country must have a surge capacity in place that will allow us to bring a new vaccine online quickly and manufacture enough to immunize every American against the pandemic strain," Bush said.
The principal goal of Bush's plan, Health and Human Services Secretary Michael Leavitt said, "is the capacity for every American to have a vaccine in the case of a pandemic, no matter what the virus is." "There is no reason to believe that in the next day or two or week or month that that's going to occur," Leavitt said on CBS's "The Early Show." But he added that "we do need to be ready in case it begins to mutate into a human transmissable disease."
Pandemics strike when the easy-to-mutate influenza virus shifts to a strain that people have never experienced before, something that has happened three times in the last century. While it is impossible to say when the next super-flu will strike, concern is growing that the bird flu strain known as H5N1 could trigger one if it mutates to start spreading easily among people. Since 2003, at least 62 people in Southeast Asia have died from H5N1; most regularly handled poultry.
The nation's strategy starts with attempting to spot an outbreak abroad early and working to contain it before it reaches the United States.
Today, most of the world's vaccine against regular winter flu, including much of that used by Americans each flu season, is manufactured in factories in Britain and Europe.
The government already has ordered $162.5 million worth of vaccine to be made and stockpiled against the Asian bird flu, more than half to be made in a U.S. factory.
But the administration plan, to be released in more detail on Wednesday, calls for more than stockpiling shots. It will stress a new method of manufacturing flu vaccines growing the virus to make them in easy-to-handle cell cultures instead of today's cumbersome process that uses millions of chicken eggs as well as incentives for new U.S.-based vaccine factories to open.
Such steps will take several years to implement, but the hope is that eventually they could allow production of enough vaccine to go around within six months of a pandemic's start.
Associated Press Writer Nedra Pickler contributed to this report.
From what I understand it could be very serious.
But from what I understand there's no vaccine that would help if the breakout does occur.
I've read that perhaps its not so serious...
I'll stick to chicken soup.
When I heard this on the news this morning, I'm thinking to myself, is this really a true threat?
I mean, they reported 60 deaths since 2003 in ASIA. IN ASIA... So what's going on in the US? And why is this so pertenant (sp?) to doing something about it right now?
I love Bush, but sometimes I wonder why he wastes time on this kind of stuff and completely ignores the biggest problem the US has, illegal aliens and protecting our border. Grrr...
A pox on our wallets...
Now that birds with this have been found in Europe and now Canada, it might be the reason.
Something is missing from the article.. I've read all through it but I can't find the spending offsets to pay fo this....
I wonder where they are.
H5N1 weaponized...is not a good time, and though it may not be a "pandemic" yet...sometimes heeding the chicken littles of the world isnt a bad thing?
And, yes, illegal immigration is still a problem...but, it's a big world, you can have more than one "big" problem at a time.
No protection for chickens and turkeys?... It's more likely to wipe out our poultry industry than it is to kill large numbers of people. And people are more likely to get it from chickens and turkeys than they are to get it from each other.
Follow the money...
There is a fear that the H5N1 virus has a high probability of becoming pandemic and run wild. Here is some info from CDC concerning pandemic diseases and their possible impacts:
Pandemic: A Worldwide Outbreak of Influenza
An influenza pandemic is a global outbreak of disease that occurs when a new influenza A virus appears or emerges in the human population, causes serious illness, and then spreads easily from person to person worldwide. Pandemics are different from seasonal outbreaks or epidemics of influenza. Seasonal outbreaks are caused by subtypes of influenza viruses that already circulate among people, whereas pandemic outbreaks are caused by new subtypes, by subtypes that have never circulated among people, or by subtypes that have not circulated among people for a long time. Past influenza pandemics have led to high levels of illness, death, social disruption, and economic loss.
Appearance (Emergence) of Pandemic Influenza Viruses
There are many different subtypes of Influenza or flu viruses. The subtypes differ based upon certain proteins on the surface of the virus (the hemagglutinin or HA protein and the neuraminidase or the NA protein).
Pandemic viruses emerge as a result of a process called "antigenic shift, which causes an abrupt or sudden, major change in influenza A viruses. These changes are caused by new combinations of the HA and/or NA proteins on the surface of the virus. Changes results in a new influenza A virus subtype. The appearance of a new influenza A virus subtype is the first step toward a pandemic; however, to cause a pandemic, the new virus subtype also must have the capacity to spread easily from person to person. Once a new pandemic influenza virus emerges and spreads, it usually becomes established among people and moves around or circulates for many years as seasonal epidemics of influenza. The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have large surveillance programs to monitor and detect influenza activity around the world, including the emergence of possible pandemic strains of influenza virus.
Influenza Pandemics during the 20th Century
During the 20th century, the emergence of several new influenza A virus subtypes caused three pandemics, all of which spread around the world within a year of being detected.
1918-19, "Spanish flu," [A (H1N1)], caused the highest number of known influenza deaths. (However, the actual influenza virus subtype was not detected in the 1918-19 pandemic). More than 500,000 people died in the United States , and up to 50 million people may have died worldwide. Many people died within the first few days after infection, and others died of secondary complications. Nearly half of those who died were young, healthy adults. Influenza A (H1N1) viruses still circulate today after being introduced again into the human population in 1977.
1957-58, "Asian flu," [A (H2N2)], caused about 70,000 deaths in the United States . First identified in China in late February 1957, the Asian flu spread to the United States by June 1957.
1968-69, " Hong Kong flu," [A (H3N2)], caused about 34,000 deaths in the United States . This virus was first detected in Hong Kong in early 1968 and spread to the United States later that year. Influenza A (H3N2) viruses still circulate today.
Both the 1957-58 and 1968-69 pandemics were caused by viruses containing a combination of genes from a human influenza virus and an avian influenza virus. The 1918-19 pandemic virus appears to have an avian origin.
Stages of a Pandemic
WHO has developed a global influenza preparedness plan , which defines the stages of a pandemic, outlines the role of WHO, and makes recommendations for national measures before and during a pandemic. The phases are:
Phase 1 : No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.
Phase 2 : No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.
Pandemic alert period
Phase 3 : Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.
Phase 4 : Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.
Phase 5 : Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans but may not yet be fully transmissible (substantial pandemic risk).
Phase 6 : Pandemic: increased and sustained transmission in general population.
Notes: The distinction between phases 1 and 2 is based on the risk of human infection or disease resulting from circulating strains in animals. The distinction is based on various factors and their relative importance according to current scientific knowledge. Factors may include pathogenicity in animals and humans, occurrence in domesticated animals and livestock or only in wildlife, whether the virus is enzootic or epizootic, geographically localized or widespread, and other scientific parameters.
The distinction among phases 3 , 4, and is based on an assessment of the risk of a pandemic. Various factors and their relative importance according to current scientific knowledge may be considered. Factors may include rate of transmission, geographical location and spread, severity of illness, presence of genes from human strains (if derived from an animal strain), and other scientific parameters.
Vaccines to Protect Against Pandemic Influenza Viruses
A vaccine probably would not be available in the early stages of a pandemic. When a new vaccine against an influenza virus is being developed, scientists around the world work together to select the virus strain that will offer the best protection against that virus. Manufacturers then use the selected strain to develop a vaccine. Once a potential pandemic strain of influenza virus is identified, it takes several months before a vaccine will be widely available. If a pandemic occurs, the U.S. government will work with many partner groups to make recommendations guiding the early use of available vaccine.
Antiviral Medications to Prevent and Treat Pandemic Influenza
Four different influenza antiviral medications (amantadine, rimantadine, oseltamivir, and zanamivir) are approved by the U.S. Food and Drug Administration (FDA) for the treatment and/or prevention of influenza. All four usually work against influenza A viruses. However, the drugs may not always work, because influenza virus strains can become resistant to one or more of these medications. For example, the influenza A (H5N1) viruses identified in human in Asia in 2004 and 2005 have been resistant to amantadine and rimantadine. Monitoring of avian viruses for resistance to influenza antiviral medications continues.
Preparing for the Next Pandemic
Many scientists believe it is only a matter of time until the next influenza pandemic occurs. The severity of the next pandemic cannot be predicted, but modeling studies suggest that the impact of a pandemic on the United States could be substantial. In the absence of any control measures (vaccination or drugs), it has been estimated that in the United States a mediumlevel pandemic could cause 89,000 to 207,000 deaths, 314,000 and 734,000 hospitalizations, 18 to 42 million outpatient visits, and another 20 to 47 million people being sick. Between 15% and 35% of the U.S. population could be affected by an influenza pandemic, and the economic impact could range between $71.3 and $166.5 billion.
Influenza pandemics are different from many of the threats for which public health and health-care systems are currently planning:
A pandemic will last much longer than most public health emergencies and may include waves of influenza activity separated by months (in 20th century pandemics, a second wave of influenza activity occurred 3 to 12 months after the first wave).
The numbers of health-care workers and first responders available to work can be expected to be reduced. They will be at high risk of illness through exposure in the community and in health-care settings, and some may have to miss work to care for ill family members.
Resources in many locations could be limited, depending on the severity and spread of an influenza pandemic.
Because of these differences and the expected size of an influenza pandemic, it is important to plan preparedness activities that will permit a prompt and effective public health response. The U.S. Department of Health and Human Services (HHS) supports pandemic influenza activities in the areas of surveillance (detection), vaccine development and production, strategic stockpiling of antiviral medications, research, and risk communications. In May 2005, the U.S. Secretary of HHS created a multi-agency National Influenza Pandemic Preparedness and Response Task Group. This unified initiative involves CDC and many other agencies (international, national, state, local and private) in planning for a potential pandemic. Its responsibility includes revision of a U.S. National Pandemic Influenza Response and Preparedness Plan.
If this administration were concerned with a disease epidemic as they act like they are, they would do something about the border. There are many diseases coming across. People are being told to be vacinated for diseases being brought in that were long ago gone from the US and now being returned. We used to demand an "immigrant" be free of disease. Google Dr. Madeline Cosman for some information on this.
H5N1 can also be weaponized as a biological terror weapon and being ready to combat it is both prudent and responsible.
I think Bush had to respond because Dusty Harry was making a big deal out of how unprepared we are for this dastardly disease. I don't like Bush playing defense. He'll wear himself out if he responds every time Dusty get's hysterical.
Somebody in the medical profession is bound to turn $500 million profit on this episode. I'm wondering who is holding the magic card. Who has Karl Rove been dining with the past four weeks?
Indeed, pharmaceutical companies hold the cards. Which one is producing the vaccine?
I don't think that as of yet it is spreading from person to person. You get it from dealing with infected birds. However,scientists are concerned that it will in time mutate to a point where you will be able to catch it from an infected person.
It seems to me Bush might be moving towards a tighter border, etc., by way of flu pandemic (it could be an avenue to use to avoid the PC crowd), but nevertheless...there are many problems the administration must deal with right now.
And everyone is screaming about illegal immigration, but while we're all screaming, let's not ignore the fact there are many other "big" issues in the world.
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