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10/26/2009
WHY THE SHORTAGE OF SWINE FLU VACCINE?

I took some time this morning to do a little research on this issue, going back to last April when the first hint that Swine Flu would be a problem in the US was dropped.

In the ensuing months, the government conscientiously planned for an epidemic - a “worst case scenario” as laid out by HHS Secretary Kathleen Sebelius back in July. Funds totaling more than $700 million were made available from HHS to purchase vaccines from the 5 remaining vaccine makers (a whole separate story of government interference in the market that reduced the number of vaccine makers by 2/3 over the previous decade), as well as help states and local governments gear up for the crisis. In addition, more than $3 billion in preparedness funds will come from the stim bill, as well as monies redirected from WMD funds.

This was all done months ago and would appear to show the Obama administration out front of the problem.

At a planning meeting in July, the government set a goal of having 120 million doses of the vaccine by mid-October, with 200 million doses by the end of the year.

Then in August, it became apparent that there were snafus in making the antigens that protect us from the Flu. This put the whole process of approval by the FDA back a couple of months.

Hence, large scale manufacture of the vaccine was delayed. And as it has been reported, the government hasn’t even come close to the 120 million doses promised. In fact, there are about 30 million doses that will have been made available by the end of the week. And even if the companies making it are at peak production (they are not quite there yet evidently), the goal of 200 million doses will also prove to be elusive. The companies may very well have been able to manufacture something close to that number, but foreign orders will cut into the number of US doses available anyway.

Federal officials had projected that 40 million doses would be on hand by Oct. 15, but not even 13 million doses had arrived by Tuesday.

“They [federal health officials] made some earlier projections, but it looks like a number of those projections have been overly optimistic,” said Dr. Ciro Sumaya, a professor at the Texas A&M Health Science Center School of Rural Public Health, and a member of the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.

On Tuesday, a top CDC official acknowledged that production of the vaccine was lagging, with a revised goal now of 50 million doses by mid-November and 150 million by year’s end.

So what happened. Whose fault is it?

In 2004, the shortage of Flu vaccine was George Bush’s fault. Just ask any Democrat:

As public health officials scramble to find more flu vaccine and experts debate how to increase the US supply, presidential candidate John Kerry hopes voters will come to one conclusion – the severe shortage the United States now faces is President George Bush’s fault.

Over the past several days, the vaccine shortage has been injected squarely into the presidential race, as Bush defends his administration and Kerry tries to hold him responsible for the loss of nearly 50 million doses of vaccine - half this season’s expected supply.

Kerry, the Democratic presidential nominee, released a radio advertisement yesterday stoking fears over the shortage as congressional Democrats blamed Bush for not addressing well-documented problems in the vaccine industry.

The British government closed down a vaccine maker because 50 million doses were contaminated - most of those earmarked for the US market.

And those “well documented problems” were the result of government policy going back to the Clinton administration, that allowed people to sue vaccine makers for adverse reactions to the vaccine - some of them ridiculous. This drove costs through the roof which convinced most vaccine makers to get out of the business altogether. You can argue about whether trial lawyers reaped the benefits of such a policy, but the result was the same; there are as many manufacturers of vaccine in the country as their are fingers on one of your hands.

But since the Democrats made blaming Bush a national pastime - even for stuff that was out of his control -shouldn’t we now turn the tables and blame Obama for this radical mismanagement in government planning? How could he be so far off in his estimate of doses that would be available? Was it incompetence? Stupidity? Wishful thinking?

Obviously, we can’t use the Bush standard of blame. Obama is smart. He’s competent. He sometimes speaks in complete sentences. He says “nuclear” and not “nuclar.” He wrote two books - yeah two.

Those are all good reasons to hold Obama harmless for the laughable-if-it-wasn’t-so-serious shortage of flu shots. Come to think of it, maybe the Democrats should have held Bush harmless for circumstances beyond his control too.

I can dream, can’t I?

Never mind. The real reason that there is a shortage of Swine Flu vaccine is very simple: it’s damned hard to make:

Experts such as Sumaya explained that glitches can — and apparently did — occur at several points in the complex process of developing a vaccine, especially for a virus that was first identified in April.

“It shows how there are many steps before you get a vaccine that’s available — the production, the testing, the packaging, the allocation and distribution. And there may be problems at every step, so as you go from one to the other to the other that slows things down,” he said Thursday.

Sumaya was attending a meeting of the CDC advisory committee in Atlanta, where the experts were collecting information on vaccine supply and demand, as well as getting up to speed on the latest H1N1 developments, how the virus is spreading across the country, how many people have been hospitalized and how many have died.

In explaining the vaccine delay, Sumaya said that, first, the H1N1 virus did not grow as quickly as expected during a half-century old — and often-criticized — egg-based production technique.

Second, he said, “because there was kind of a rush to get things done, there were some packaging areas that they [federal officials] had thought wouldn’t take long, yet they did.”

“Even in the distribution, to find certain target groups so it reaches them first, we have to have a sense of what is going on across the country, which is a dynamic situation,” he added.

Then there are the twin demands facing vaccine manufacturers to produce two different vaccines at the same time — one for swine flu and one for seasonal flu.

There’s a longer than anticipated time to grow the antigen, safely package it for distribution (that British contamination snafu in 2004 was the result of inadequate safeguards in packaging), and get it to areas of the country in some kind of rough prioritization.

No sense in blaming government. I think I showed pretty convincingly that the CDC and HHS have been on top of this problem from the get go. But their best laid plans came acropper when Mother Nature refused to cooperate in the growing of the virus in chicken eggs. That, and as always, there were apparently some questions about how safe the vaccine actually is. The anti-vaccination, psuedo-science crowd is making more and more headway despite the science showing that modern flu vaccines are safe and effective. Some people are going to die because they believed that crap. I hope the Luddites can sleep at night.

So even though it would be very nice to blame Obama for the lack of Swine Flu vaccines, we must content ourselves with the usual - making fun of his ears, calling him out for his inability to speak contemporaneously without a teleprompter, and criticizing him for getting up in the morning - all the important stuff.

And did you notice? He’s a black man.

By: Rick Moran at 9:26 am | Permalink | Comments & Trackbacks (18)

4/27/2009
US DECLARES HEALTH EMERGENCY WHILE OBAMA GOLFS

The Obama administration has declared a public health emergency as a result of the increasing number of Swine Flu cases being reported around the country and the danger that the virus could become a pandemic.

Meanwhile, the Democrats are blaming Republicans. And the president went golfing.

For those of us who are somewhat rational and take reality seriously, we might ask how in the name of all that is good and holy can the Democrats blame Republicans?

Because no Republicans voted for the president’s stimulus bill which, as Don Surber of the Daily Mail blog explains, contained $900 million for flu preparedness:

Actually, Republicans voted against the entire spending bill, which was 874.44 times as large as that single appropriation.

If we follow this silly Democratic talking point, then for every dollar spent on fighting swine flu will cost taxpayers $874.44 using Nichols example.

What is more, Republicans were right. An emergency appropriation could be made after the fact - as we do every disaster be it hurricanes, tornadoes or blizzards. Is he saying by not appropriating money for these certain disasters that Democrats favor hurricanes, tornadoes and blizzards?

Nichols is just mouthing the White House words.

Indeed. This tactic is being used to cover up the gross negligence of the White House in failing to name people to posts who are desperately needed to deal with this crisis.

No Secretary of HHS, no head of the CDC, no Surgeon General - whoops.

But as Fox News.com reports, our president left the crisis in the capable hands of his Homeland Security Secretary while he went golfing. Janet Napolatino may not know anything about her job, but  unlike the president, at least she was on the job Sunday:

President Obama went golfing and the Department of Health and Human Services is short a secretary, so other U.S. officials took the controls Sunday as the Obama administration ramps up efforts to find and isolate U.S. cases of swine flu.During a White House briefing, Homeland Security Secretary Janet Napolitano announced that HHS will issue a public health emergency warning that will free up resources to address the outbreak that has hit 20 Americans in five states.

Richard Besser, acting head of the Centers for Disease Control and Prevention, said the agency is prepared to move millions of doses of the U.S. anti-virus stockpile to areas of early and potential outbreaks.

Besser said the flu’s spread is in its early stages and the current situation is “extremely unpredictable.” He said the government will provide “daily” updates on the number of confirmed cases and provide advice and intervene at the local level as conditions warrant.

Bad enough he’s playing golf but does he have to look this dorky while doing it?

Our “hip” president looks decidedly “suburban” in this picture. I guess they couldn’t find a hat big enough to cover the ears.

Glad he’s having a good time. Meanwhile, he’s running half a government with the two biggest crisis - the economic crisis and now a health crisis - taking place as the departments he needs to deal with them - Treasury and HHS - understaffed and directionless.

Meanwhile, none of this is getting in the way of preparations to celebrate the president’s 100 days in office. As Ben Pershing notes in the Washington Post blog Rundown, the flu news will put something in a crimp in Obama’s self-congratulatory orgy:

Even for presidents, the best-laid plans can sometimes go awry. So as Wednesday’s 100-day milestone approaches, watch closely to see whether the White House’s carefully choreographed effort to tout the administration’s accomplishments and lay the groundwork for more big-ticker initiatives is instead overshadowed by a public health crisis. Swine flu has dominated headlines for the last two days, presenting President Obama with an unexpected challenge. The U.S. has declared a “public health emergency,” though Janet Napolitano yesterday cautioned, “That sounds more severe than really it is.” Administration officials did say they expect many more casesprime-time press conference could end up being dominated by flu talk, which is certainly not how the White House drew it up.
of the flu to be discovered in the coming days, which ensures that the focus on this crisis will only grow as the week progresses. Is there anything Obama can or should be doing to address the crisis that he isn’t already? It doesn’t appear so, but it does appear that his Wednesday

Too bad. I was so looking forward to The One ticking off his list of “accomplishments” on Wednesday. Now those mean old reporters are going to ask questions like, “Mr. President. Are we ready for this crisis considering the fact that most of the people you should be depending on in this situation haven’t even been nominated yet?”

I don’t think even TOTUS could get him off the hook on that one.

By: Rick Moran at 11:20 am | Permalink | Comments & Trackbacks (25)

4/26/2009
IT’S SILLY TO BLAME A POROUS BORDER FOR SWINE FLU IN US

Yes, silly.

I’ve blogged for years about the spread of contagious diseases from around the world into the U.S. as a result of uncontrolled immigration. We’ve heard for years from reckless open-borders ideologues who continue to insist there’s nothing to worry about. And we’ve heard for years that calling any attention to the dangers of allowing untold numbers of people to pass across our borders and through our other ports of entry without proper medical screening - as required of every legal visitor/immigrant to this country - is RAAAACIST.

9/11 didn’t convince the open-borders zealots to put down their race cards and confront reality.

Maybe the threat of their sons or daughters contracting a deadly virus spread from south of the border to their Manhattan prep schools will.

I am as strong a supporter of guarding our borders and dramatically reducing illegal immigration as anyone but the attempt to hijack the Swine Flu story and portray it as a question of too many illegal immigrants coming into America spreading disease is so far off base as to be a laughable exaggeration.

The Chinese are fanatical about closing their borders and yet SARS became a huge problem for them. Disease doesn’t know about walls or barbed wire. Viruses don’t care if you have 100,000 soldiers guarding your border. If Swine Flu does become widespread, the overwhelming majority of people will catch it as a result of contact with an American citizen.

Even the beginnings of the spread of Swine Flu in the US cannot be traced to illegal immigrants. The kids in New York who contracted what appears to be a mild form of the disease got it in Mexico after a recent trip.  The Texas and California cases were also mild and still something of a mystery because none of the infected people were anywhere near pigs and hadn’t been to Mexico. As the CDC narrows its search to find “Patient Zero,” it is likely that individual would have recently been exposed to the bug  in Mexico.

But even if the original infection came from an illegal immigrant,  it is not reasonable to assume that if we had only closed the borders, we would have been any safer whatsoever. Millions of Mexicans have entered the US perfectly legally since the outbreak began and it a dead certainty that any serious spread of the disease would occur in this group rather than the tiny number of cases that could be attributed to illegals.

Adequate border protection will go a long way to preventing another terrorist attack. It will help relieve the burden on our schools, health clinics, and other social services from illegals who leech from the taxpayers after breaking the law to get here.

But to believe that closing the border to illegals  will have any effect on the spread or even containment of Swine Flu is refuted by the facts. It is estimated that anywhere between 500,000 and one million illegals pour across our border every year. Almost the same number - about 650,000 -  enter the US legally every day.

Let’s not bring unrelated issues into the discussion of Swine Flu.

UPDATE: HEY KIDS! LET’S BLAME AGRI-BUSINESS!

This is not only sillier than trying to drag illegal immigrants into the mix, it is dangerous rumor mongering as well:

Is Smithfield Foods, the world’s largest pork packer and hog producer, linked to the outbreak? Smithfield operates massive hog-raising operations Perote, Mexico, in the state of Vera Cruz, where the outbreak originated. The operations, grouped under a Smithfield subsidiary called Granjas Carrol, raise 950,000 hogs per year, according to the company Web site-a level nearly equal to Smithfield’s total U.S. hog production.

On Friday, the U.S. disease-tracking blog Biosurveillance published a timeline of the outbreak containing this nugget, dated April 6 (major tip of the hat to Paula Hay, who alerted me to the Smithfield link on the Comfood listserv and has written about it on her blog, Peak Oil Entrepreneur):

Residents [of Perote] believed the outbreak had been caused by contamination from pig breeding farms located in the area. They believed that the farms, operated by Granjas Carroll, polluted the atmosphere and local water bodies, which in turn led to the disease outbreak. According to residents, the company denied responsibility for the outbreak and attributed the cases to “flu.” However, a municipal health official stated that preliminary investigations indicated that the disease vector was a type of fly that reproduces in pig waste and that the outbreak was linked to the pig farms. It was unclear whether health officials had identified a suspected pathogen responsible for this outbreak.

From what I can tell, the possible link to Smithfield has not been reported in the U.S. press. Searches of Google News and the websites of the New York Times, Washington Post, and Wall Street Journal all came up empty. The link is being made in the Mexican media, however. “Granjas Carroll, causa de epidemia en La Gloria,” declared a headline in the Vera Cruz-based paper La Marcha. No need to translate that, except to point out that La Gloria is the village where the outbreak seems to have started. Judging from the article, Mexican authorities treat hog CAFOs with just as much if not more indulgence than their peers north of the border, to the detriment of surrounding communities and the general public health.

To sum up, a couple of newspapers and a couple of blogs have tried to make the connection between the evil Smithfield and a Swine Flu outbreak  and that swarms of flies feeding on the apparently untreated fecal matter is the way the disease spreads - at least how it began to spread.

I guess we can call the WHO and tell them to stop the investigation, that we’ve found the cause and the culprit. Aside from being incredibly irresponsible, I would think that the scientists at WHO and the Mexican health agency IMSS might want to look into it before rumor mongering newspapers and ignorant bloggers start spreading false information.

No explanation forthcoming as to how the disease mutated from one that spread through fly bites to one that apparently spreads human to human (no one is sure yet how the bug spreads). Neither is there an explanation for how these flies were able to travel hundreds of miles to infect others. But that doesn’t stop irresponsible journalists and bloggers from just making sh*t up as they go along.

We’re going to see a lot of this.

By: Rick Moran at 3:27 pm | Permalink | Comments & Trackbacks (14)

SWINE FLU PANICS MEXICO

Mexico has a full blown health crisis on its hands as deaths related to the Swin Flu virus have risen to 81 with more than 1300 cases reported.

As this BBC piece containing reader emails from Mexico shows, rumors that the crisis is even worse than the government is reporting are widespread:

I have a sister-in-law from San Luis Potosi state in Mexico and we were told that in San Luis Potosi there have been at least 78 deaths, just in that city alone, not 68 in all of Mexico, as is being reported. Schools have been closed until 6 May in this state and in other areas in Mexico. Also, many public venues are being closed, so this makes it more deadly and dangerous than has been stated.
Migdalia Cruz, Phoenix, Arizona, USA

It’s certainly been very quiet where I’m living in the Historic Centre of Mexico City, whereas normally the centre is almost uncomfortably packed at the weekend. Most people also seem to be wearing the face masks being handed out by the army around the city. There always seems to be a healthy mistrust of the government here, but I wouldn’t say I’m sensing a great deal of paranoia or panic. It does seem as though the unprecedented actions being taken by the government to contain the virus don’t match with the statistics being provided, however, so there is some doubt as to whether they’re just being overly cautious or whether things are a lot worse than what they’re telling the public.
Randal Sheppard, Mexico City

It’s pretty hard these days to cook the books on a health crisis - not with the WHO, the US, and Canada in the mix and looking over the Mexican’s shoulder. The Chinese consistently tried to downplay first the SARS epidemic and then the Bird Flu scare and were called out on it by the WHO several times.

Plus, you might note that in the first response, the woman wonders about the size of the problem when she reports 2nd hand information that 78 people have died in her sister-in-law’s state alone. This is how rumors lead to panic in a situation like this; somebody always hears how bad it is somewhere else and those figures don’t match up with the “official” story. This leads to distrust in government and a panic ensues.

There’s no doubt the fear is real and that the government response is indicative of a serious outbreak of a new, lethal virus. The question is, if it is being spread by human to human contact and if so, how much has the original virus mutated?

The outbreak in New York City is being treated very seriously by the city’s health department but if it is Swine Flu, the bug has apparently mutated and in the process, may have become less lethal.

This New York Times piece by Donald G. McNeil, Jr. reports on the condition of the suspected victims:

Tests show that eight students at a Queens high school are likely to have contracted the human swine flu virus that has struck Mexico and a small number of other people in the United States, health officials in New York City said yesterday.

The students were among about 100 at St. Francis Preparatory School in Fresh Meadows who became sick in the last few days, said Dr. Thomas R. Frieden, New York City’s health commissioner.
“All the cases were mild, no child was hospitalized, no child was seriously ill,” Dr. Frieden said.

Health officials reached their preliminary conclusion after conducting viral tests on nose or throat swabs from the eight students, which allowed them to eliminate other strains of flu. Officials were also suspicious since some St. Francis students recently had been to Mexico, where the outbreak is believed to have started.

If people are dropping dead in Mexico of the disease, how can those infected in the US have only “mild” symptoms?

It could be that the age of the victims differ between the two sites of the outbreak. Flu kills mostly the very old and very young. It overwhelms the immune system before the body’s natural defenses can be mustered to fight it.

However, the Times article seems to indicate that the virus killed young, healthy adults - and their own strength apparently contributed to their demise:

In each year’s flu season, most deaths are in infants and the aged, but none of the first ones in Mexico were in people over 60 or under 3 years old, a W.H.O. spokeswoman said. When a new virus emerges, deaths may occur in healthy adults who mount the strongest immune reactions. Their own defenses - inflammation and leaking fluid in lung cells - can essentially drown them from inside.

It could also be the same virus but the kids in New York contracted a later, mutated form of the bug. This would be unusual but not unprecedented. The bug mutates so that it can survive. If it is killing its host too quickly before it can set up shop in another host in order to replicate, evolution would favor a mutated form of the virus that didn’t kill quite as quickly, thus giving the virus more time to spread and the victim’s body more time to fight the disease. People get sick but not as sick as with the earlier strain of the virus. The mortality rate plummets but the pathogen spreads faster.

It appears from the New York Times article that the government - city, state, and federal - is ready for just such an emergency thanks to the Bush Administration’s preparedness when the Bird Flu scare emerged a few years ago. Millions of doses of Tamiflu (which appears to work on the Swine Flu virus) are available as are mountains of other supplies:

Because of fears of the H5N1 avian flu, both New York City and the United States have had detailed pandemic emergency plans in place since 2005, as well as stockpiles of emergency supplies and flu drugs (the plan can be read at http://www.pandemicflu.gov/).

Dr. Frieden said that for such an emergency, the city had extra hospital ventilators, huge reserves of masks and gloves and “millions of doses of Tamiflu,” an antiflu drug that thus far appears to work against the new swine strain.

President Calderone in Mexico has taken extraordinary measures to combat the spread of the virus including canceling most major sporting events, closing movie theaters, shutting schools, and generally preventing people from gathering in large crowds.

We’ll see if the press plays this straight or starts to generate scare headlines that will panic people into going to the hospital every time they sneeze. If that occurs, hospitals will be overwhelmed and the really sick people may die because of the delay in treatment.

President Obama may be about to be tested not by the Russians or the North Koreans, but by the smallest of God’s creatures - a primitive but deadly form of life that could very well tax our health care system and cause a lot of suffering. We’ll see if he’s up to the challenge.

By: Rick Moran at 7:23 am | Permalink | Comments & Trackbacks (24)