By Sabin Russell
The San Francisco Chronicle
Copyright 2006 The Chronicle Publishing Co.
If an outbreak of deadly pandemic influenza hit the United States tomorrow, there would not be enough antiviral drugs in the federal Strategic National Stockpile to meet the anticipated needs of hospitalized flu victims — the highest-priority group designated to receive rationed supplies.
The federal stockpile is an arsenal of antiviral drugs deemed the nation’s first line of defense in a pandemic. But it will take until December 2008 to fill that stockpile with a planned 81 million treatments. Even then, supplies will be carefully rationed.
Two federal advisory panels, in consultation with medical ethicists, developed the rationing system last year, and in November it was included in the federal Pandemic Influenza Plan — www.hhs.gov/pandemicflu/plan/.
The rationing plan lists, in order of priority, 11 groups who would gain access to drugs from the government supply. It would set aside 7.5 million treatments for the first priority group: hospitalized flu patients in danger of dying. But as of June 29, there were only 6.2 million treatments of the antiviral drug Tamiflu, or oseltamivir, in federal hands.
If production projections hold, it will take until the year’s end to have enough of the drug to treat everyone in the top four priority groups, including hospitalized patients, health care workers who directly treat them, pregnant women, police, fire and prison guards, government decision-makers and the people making antiviral drugs.
The stockpile would still be 11 million treatments short for priority group five: the 22 million children and senior citizens visiting doctors’ offices and deemed at high risk of hospitalization and death.
Not until antiviral supplies top 36 million — possibly late next year — will the sixth priority group become eligible for the drugs. Members of that group include emergency room staffers and ambulance crews.
The plan also appears to place a priority on completing the federal stockpile before private stashes of Tamiflu can be filled: “In advance of an influenza pandemic, (Health and Human Services) ... will acquire sufficient quantities of antiviral drugs to treat 25 percent of the U.S. population and, in so doing, stimulate development of expanded domestic production capacity sufficient to accommodate subsequent needs through normal commercial transactions.”
Personal stockpiling is clearly discouraged in the federal plan.
“It is not recommended that individuals, fearing a pandemic, stockpile oseltamivir in homes or that health-care providers prescribe oseltamivir to individuals for prophylaxis against pandemic influenza. At the present time, quantities are insufficient to address all of the interim pre-determined groups, and thus stockpiling oseltamivir will take away limited resources from those with highest priority,” the plan says.