USA - Guidance on Allocating & Targeting Pandemic Influenza Vaccine

[AlaskaDenise]

Re: USA - Guidance on Allocating & Targeting Pandemic Influenza Vaccine

IF we have a severe pandemic, I expect the best the government can do is "controlled chaos." Even that won't occur everywhere.

Sharon's right - we must rely on ourselves.

Any government planning MUST include flexibility and common sense. Acting only according to a pre-determined plan can be lethal.

(To repeat, sorry....) I lived downwind of Mt. St. Helens when it blew up. All of eastern Washington owes an enormous debt to one radio station manager who chose to ignore the official planners that refused to warn of a large eruption because all the "official criteria" hadn't been met.

That radio manager simply started calling homes that would be downwind of any eruption - his horse-sense planning system. When they all said there was sand falling from the sky, he cranked up the radio station's power and broadcast the warning to most of eastern Washington. MANY people who were driving long distances were saved when they were warned to stop at the nearest town and prepare for what was coming.

He called in his staff and told them to prepare to stay at the station for days. They broadcast encouraging messages and good advice - they were REAL heroes.

.

[AlaskaDenise]

Re: USA - Guidance on Allocating & Targeting Pandemic Influenza Vaccine

.........* to tell the elderly of their fate..........

Isn't the jury still out on whether "elderly" who are pre-1957 H1N1 & H2N2 survivors have an edge to survive H5N1? Combine that immunity with a subdued cytokine response, and the "elderly" may be survivors.

Parts of this prioritization sound too much like planned genocide.

.

[AlaskaDenise]

Re: USA - Guidance on Allocating & Targeting Pandemic Influenza Vaccine

The elderly and infirm will be allowed to die off in next pandemic

May 5, 2008

Doctors to decide who lives and who dies in coming pandemic
Who should MDs let die in a pandemic? Report offers answers

AP | May 5, 2008
By LINDSEY TANNER

CHICAGO (AP) — Doctors know some patients needing lifesaving care won’t get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn’t be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals “so that everybody will be thinking in the same way” when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

The idea is to try to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way, task force members said.

Their recommendations appear in a report appearing Monday in the May edition of Chest, the medical journal of the American College of Chest Physicians.

“If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing,” the report states.

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won’t get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:

_People older than 85. (this may be the definition of "elderly")

_Those with severe trauma, which could include critical injuries from car crashes and shootings.

_Severely burned patients older than 60.

_Those with severe mental impairment, which could include advanced Alzheimer’s disease.

_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Dr. Kevin Yeskey, director of the preparedness and emergency operations office at the Department of Health and Human Services, was on the task force. He said the report would be among many the agency reviews as part of preparedness efforts.

Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also “a political minefield and a legal minefield.”

The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.

If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said. While health care rationing will be necessary in a mass disaster, “there are some real ethical concerns here.”

James Bentley, a senior vice president at American Hospital Association, said the report will give guidance to hospitals in shaping their own preparedness plans even if they don’t follow all the suggestions.

He said the proposals resemble a battlefield approach in which limited health care resources are reserved for those most likely to survive.

Bentley said it’s not the first time this type of approach has been recommended for a catastrophic pandemic, but that “this is the most detailed one I have seen from a professional group.”

While the notion of rationing health care is unpleasant, the report could help the public understand that it will be necessary, Bentley said.

Devereaux said compiling the list “was emotionally difficult for everyone.”
That’s partly because members believe it’s just a matter of time before such a health care disaster hits, she said.

“You never know,” Devereaux said. “SARS took a lot of folks by surprise. We didn’t even know it existed.”

http://aftermathnews.wordpress.com/2...next-pandemic/
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[Giuseppe]

Re: USA - Guidance on Allocating &amp; Targeting Pandemic Influenza Vaccine

The striking feature of the entire pandemic planning making-of is the complete lack of dissent, different opinions and non-economic aspects, like the human factor, the psychological burden, the hopeless feeling of people.

I hate to say that if 100 billion of US$ are lost in a single bad day at shares markets, nobody care of the resources loss.

More acceptable should be the loss of millions of already diseases people for lack of .... resources....?

Excuse me, again. I cannot accept anyway this policy, this anticipated disaster planning. I strongly oppose to it.

I am too disant culturally from US or UK background, too naif, too illitterate.

But I ask only a thing: all of you, keep a minute and take a measure: 100 US$ billion in a day and no resource for health...

[Giuseppe]

Re: USA - Guidance on Allocating &amp; Targeting Pandemic Influenza Vaccine

''Devereaux said compiling the list ?was emotionally difficult for everyone.?

But it seems too simple: the most frail among the frails, does it need a suffering thinking?

[mixin]

Re: USA - Guidance on Allocating &amp; Targeting Pandemic Influenza Vaccine

Bumping this up for our newbies who might not have ever seen it. Ironorehopper's post #5 includes an attachment with the actual tiers.

Their tier 1 included 24 million people but I've read they are now planning for only 20 million people. Has an updated version of the tier scheme been published?

I know there was supposed to be additonal public input regarding vaxing to keep the grid up; I can't remember if those people are included or not.

[tropical]

Re: USA - Guidance on Allocating &amp; Targeting Pandemic Influenza Vaccine

That will be obviously the worldwide used policy ...

Giving ours surviving rights to a hand of local professionals because of the total systems impreparation and of lenitive decisions on the needed field stocking from few dirigents:
another human made settled theater for mass suferings and worst.

The most painful thing is that all human science and ratio aren't able to make enaugh critical mass numbers to drive an qualitative and quantitative change from the countries rulers/decisors ...