Who gets flu treatment first or at all?

[Guest guest]

the question itself is revealing.

_they_ want to decide who gets treatment.

(i.e. government friendly people ?!)

So _they_ forbid private buying of flu treatment in advance.

(although it would relax the public budget to buy these ! )

[Guest guest]

If pandemic hits Minnesota, who would be treated first?

State should use an ethical lens to decide who gets scarce health

resources, report says. By WARREN WOLFE, Star Tribune

Last update: January 30, 2009 - 11:41 PM

It seems a purely theoretical question right now: If a worldwide flu

pandemic reaches Minnesota, who should get the limited supplies of

antiviral drugs, face masks and ventilators?

Public health workers? The elderly? Police and firefighters? Pregnant

women?

But it's not just an exercise, a panel of public health officials and

ethicists warned Friday in a preliminary report released for public

comment.

A pandemic flu " will certainly occur, " the report said. If it is

severe, it will kill more than 100 million people worldwide. In

Minnesota, one in three people might become ill, 175,000 might be

hospitalized and more than 32,000 could die.

" Many people have a false sense of security because we haven't had a

pandemic yet, after all the publicity about 'bird flu,' '' said

Minnesota Health Commissioner Sanne Magnan. " However, that same avian

strain of influenza is still making people sick and causing deaths in

Asia and Africa, and it could still cause a pandemic.''

More than 100 experts commissioned by the Minnesota Department of

Health have been working their way through the ethical minefield that

boils down to this: Which jobs -- and whose lives -- are most

important to preserve in a crisis?

The state is asking for public response by March 16 to the report,

called " For the Good of Us All: Ethically Rationing Health Resources

in Minnesota in a Severe Influenza Pandemic. "

The report offers " an ethical framework in which to make those

decisions, " said Debra DeBruin, co-director of the project and

assistant director of the University Center for Bioethics. " We're not

trying to say which jobs are the most important. "

A rationing system should recognize the moral equality of everyone and

not be based on " ability to pay, quality of life, social or economic

status, political power, social worth, gender or duration of extended

life, " the report said.

Still, it offered a broad outline of which groups might get higher

priority for protection or treatment in a pandemic. Most supplies

should go to the public, with about 5 percent reserved for " key workers. "

Impact could be devastating

Three flu pandemics have swept across Minnesota in the last century,

including a severe outbreak in 1918-19 and moderate ones in 1957 and 1968.

A severe pandemic lasting up to two years could crush normal health,

business and social activities, with no guarantee of federal help, the

panel warned.

Vaccines will not exist until months after the pandemic begins.

Minnesota has stockpiled enough antiviral medicine to treat about 21

percent of the population in a first wave of the flu, and 2.4 million

masks for public health workers -- less than a three-week supply.

Fatalities in a severe flu pandemic likely will follow a W-shaped

distribution by age -- high rates among infants and the elderly, with

people ages 15-40 in the next tier.

" How do we avoid panic? By being as prepared as we can be, conducting

training exercises and having an effective, transparent plan to which

Minnesotans have contributed and with which they agree, " Magnan said.

The state wants public response to many key questions about rationing,

including which public roles are most important to protect and how age

should matter.

The panel said top priorities of rationing should be, " Protect the

population's health, protect public safety and civil order, and treat

people fairly. "

Flu vaccines and antiviral medications probably will be less effective

among infants and the elderly, the report noted, so they might receive

a lower priority for scarce supplies. They might be better protected

by preventing flu in those who care for them.

" Other things being equal, should you protect the young over the old? "

DeBruin said. " This is highly controversial. "

Page 2 of 2

Still, it offered a broad outline of which groups might get higher

priority for protection or treatment in a pandemic. Most supplies

should go to the public, with about 5 percent reserved for " key workers. "

Impact could be devastating

Three flu pandemics have swept across Minnesota in the last century,

including a severe outbreak in 1918-19 and moderate ones in 1957 and 1968.

A severe pandemic lasting up to two years could crush normal health,

business and social activities, with no guarantee of federal help, the

panel warned.

Vaccines will not exist until months after the pandemic begins.

Minnesota has stockpiled enough antiviral medicine to treat about 21

percent of the population in a first wave of the flu, and 2.4 million

masks for public health workers -- less than a three-week supply.

Fatalities in a severe flu pandemic likely will follow a W-shaped

distribution by age -- high rates among infants and the elderly, with

people ages 15-40 in the next tier.

" How do we avoid panic? By being as prepared as we can be, conducting

training exercises and having an effective, transparent plan to which

Minnesotans have contributed and with which they agree, " Magnan said.

The state wants public response to many key questions about rationing,

including which public roles are most important to protect and how age

should matter.

The panel said top priorities of rationing should be, " Protect the

population's health, protect public safety and civil order, and treat

people fairly. "

Flu vaccines and antiviral medications probably will be less effective

among infants and the elderly, the report noted, so they might receive

a lower priority for scarce supplies. They might be better protected

by preventing flu in those who care for them.

" Other things being equal, should you protect the young over the old? "

DeBruin said. " This is highly controversial. "

POSSIBLE PRIORITIES

FIRST: Key workers who are critical to limiting flu-related deaths or

to protecting overall health and keeping civil order, and key workers

who are also at high risk of getting the flu. In the general

population, groups such as pregnant women, young children and the

elderly are all at disproportionately high risk of contracting flu.

SECOND: Key workers whose jobs expose them to flu and a small number

of irreplaceable key workers. In the general population, groups at

high risk of flu, perhaps with higher priority given to younger people

than older.

THIRD: All other key workers, and groups in the general population at

moderate risk.

FOURTH: Everyone else.

http://www.startribune.com/local/38705357.html