Squeal like a pig!

[IslandTractor]

Perhaps you misread my complaint. I clearly disagree with you that the method of distribution is efficient and fair. By who's standards? In past years I could get the annual flu shot almost anywhere. Why is that immunization not available this year? Must I search through every remote clinic and drug store in the county to see who has vaccine? That seems far less than rapid or efficient. I'm not carping about H1N1 production, though I see public health officials on the news nightly saying there are doses available, but they are being rationed to "high risk" folks like the homeless and poor who have no job and have time to stand in line for hours on end to get a shot.

I know this is a special case this year with H1N1 and increased demand for the normal flu shot vaccines as well. It's my feeling that this is an expected outcome when government becomes even more involved in the production and distribution of all medicines. I don't mean for this to be political, it's just the quality of decisions and process seems to be hampered. Those we have chosen and paid to succeed are somehow failing us. Can we agree that there's a problem needing to be addressed? I don't think you are completely happy with this system either.

I can agree that any human system can be improved. Otherwise we don't agree much at all about this H1N1 business. Perhaps you are unaware of the logistics behind the production and distribution systems for vaccines. Vaccines are biological products that cannot be simply cranked out by running a factory 24/7 like widgets. The distribution system, as Bird has pointed out, includes both federal and state/county systems. I am defending only the federal and I can agree that at least in Texas there seem to be some problems at the state and county level.

Your notion that only the poor and homeless can get the vaccine seems to reflect prejudice more than fact. Bird pointed out that it was the rich folks in Texas who have easy access. The people having priority according to CDC for getting the vaccine are infants, children, pregnant women and individuals who have chronic disease. That is pretty much what is happening where I live. I waited in line for an hour to get my daughter vaccinated. Anyone who wanted to do so could get their kid vaccinated here in Massachusetts perhaps because we are a commie state that actually invests in public health and vaccine infrastructure and therefore has the highest childhood vaccine rates in the nation. By the way I think Texas has improved in recent years but when George Bush was governor Texas was in the bottom three or four states in the country for vaccination rates of children. So, perhaps it is government's fault in Texas but it is most likely the lack of government investment in public health than gross incompetence. I can imagine with the majority of folks in Texas seeming to take the "government is bad" approach that there has been little public or legislative support there for improving public health infrastructure. You get what you pay for.

Regarding the routine flu vaccination, that might be slightly delayed this year due to the focus on H1N1 but in general that vaccine was not given until about this time of year anyway. The real flu season typically starts in January so there is still plenty of time to get that vaccine. The hype as been about H1N1 obviously and as the vaccine production and distribution systems could not simply be doubled overnight there have been some understandable delays.

 

[Bird]

Bird pointed out that it was the rich folks in Texas who have easy access.

Well, I guess it's a waste of time, but you're really misunderstanding, and misquoting me, in this case. One company apparently got the H1N1 vaccine and was selling it to anyone with money. I haven't known of others doing that. The vaccine that has been distributed to private providers is supposed to go to the high risk population first, and at no charge, except that they are allowing private providers to charge $10 to $20 administrative costs but are not supposed to turn anyone away for inability to pay.

And I don't want to get into politics, which is prohibited on Tractorbynet, but there are other reasons for Texas having a lower rate of vaccinated children that what you apparently believe.

Then you say the "routine" or seasonal flu vaccine "in general was not given until about this time of year." Well, this year, we got our seasonal flu shots on Sept. 9, last year it was Sept. 27, and the year before that it wan't until Oct. 10, possibly the latest we've ever gotten them. Yep, things are different in your state, and you're making some erroneous assumptions about Texas.

 

[IslandTractor]

you're making some erroneous assumptions about Texas.

Well, I reread my note and it does sound harsh so I apologize to all you fine Texans. My point was not so much about Texas, though that was the example being discussed, but rather the notion that we expect the government to do everything we want (deliver an emergency vaccine in record time and distribute it perfectly) while at the same time failing to support that exact public health infrastructure (government). It is popular to rag on government. While the complaining is frequently understandable, when that complaining becomes pervasive and leads to distrust and cuts rather than engagement and improvements then things don't work perfectly when you need them to. This is the first time in history that a vaccine project like the H1N1 has been organized as quickly as it has been. The government (federal at least and some states) has done a pretty remarkable job.

 

[jinman]

Ed, I'm glad you responded the way you did in your last post, because I was not going to comment any further and maybe cause this thread to go down a forbidden path. I hope my comments only relate to healthcare. Everything you have said about the response to H1N1 is true regarding production. It has been a massive effort and one that has been handled as well as it can be under the existing conditions. That doesn't mean we can't improve, and our fine researchers will continue to work toward improvements.

Where there has been failure is when a public health official comes on television and talks about deaths from this flu and how the county is due to have 10,000 doses of vaccine by a certain date. People become very frightened when their children are involved and schools start closing like falling dominoes at the first outbreaks because public officials have warned of the coming possible pandemic. The media certainly shares some responsibility for "fanning the flames." Then, we hear that 10,000 doses are really not available as previously stated, but rather only 2,000 doses which will be given out on a first-come first-served basis at a single location. The high risk folks are described, but then we hear that all people who showed up and stood in line for several hours got the vaccination.

The disparity I want to point out is that people working cannot easily take off half a day from work to stand in line for what might happen. This method gives the advantage to those who are not employed or who are retired like me. The pictures shown on our television are mainly of poor and homeless getting the shots for free. How can this be fair?

Last night's news had the same public official addressing this problem by saying that they were working for a fair method for all groups. That's what I want. I think at least in our local area, the distribution of the annual flu vaccine and the H1N1 that has been made available has not been an equal distribution to all demographics. Since this has been controlled by the CDC, I fault them for their methods. Please don't zero in on H1N1. I'm talking the lack of distribution of both vaccines to rural and less densely populated areas like the counties around where I live. I have scanned the local newspapers and county websites. I find all these warnings and advice to get the shots, but nearly nobody has any vaccine nor any valid news of when there might be some available. Yes, I'm very frustrated with the system of distribution that seems to equal little to none while there is a massive amount of warning. The phrase "induced panic" seems to fit here.

Texas has unique issues with public health that are shared by all border states. I cannot discuss those issues because they delve into areas that are forbidden topics on TBN. I agree with that restriction and will honor it.

Edit: The public official I am referring to above is not an elected official, but rather a hired civil service employee.

 

[IslandTractor]

While I would defend the government's response in developing, producing and distributing the vaccine, I'd agree completely that this whole H1N1 thing has been grossly overblown. I think there has been an unfortunate synergy between the news media and public health officials to make the whole thing sound much worse than it really is. The news media in my opinion has been primarily responsible but they could not have done it without very willing public health officials who felt more comfortable screaming "fire" than trying to calm a public who were understandably fearful after hearing early news reports. The public health community has prepared for years for avian influenza (H5N1) which IS potentially a disaster and they were all too willing to pull the trigger and implement the plans they have been developing when H1N1 came around.

The early reports from Mexico were very concerning (150 deaths in a short time) but rather than use a rational response (eg : how many deaths in a normal year?, did anyone evaluate the cases to be sure these were really H1N1 cases? etc) which is the standard approach epidemiologists use in investigating an outbreak, the public health system just assumed the reports from Mexico were correct and implemented the disaster plan. Once the combination of nightly newcasts reporting each death and spead was linked with daily or twice daily interviews with CDC and WHO epidemiologists who really had not much more data than what the newsmedia was distributing, that was a recipe for disaster. Public health officials pressured for comment without adequate or good quality data will naturally take a conservative (ie radical) stance and while they would couch their comments vaguely, they always seemed to acknowledge and discuss the worst case scenario rather than being honest and saying that they needed more time to evaluate. Arguably the public would not have tolerated the combination of newsmedia crying wolf while the public health officials said "wait a minute" but IMO a more appropriate response would have been to be honest about the lack on information and discuss directly the issue of newmedia pressure with the public. Certainly we (the public) are not naive about how the 24 hour news cycle has often blown things out of proportion. The public health community did not confront that issue however and instead just jumped into their virtual fire trucks with sirens blaring.

The real problem seems to be that CDC and WHO were too respectful of sovereignty and egos in Mexico in the early stages. Mexico has a decent CDC of it's own but with nowhere near the resources that ours does. The Mexican CDC simply did not have the ability to do the investigations that needed to be done before the newsmedia ramped up the panic. Usually our CDC is quick to send in "epi aid" teams, rather like special forces, to assist other governments in situations like this. Because the Mexican CDC equivalent is respected as more than say the Angolan equivalent, our CDC sat back and waited to be asked for help rather than immediately suggesting they should send a team. That sort of relatively understandable screw up just cannot happen in the era of the 24hr news cycle, internet and cell phone.

Although it turns out that the whole panic was pretty much over nothing (the H1N1 epidemic really seems not significantly different from a regular flu), the really disturbing news is that despite the full court press, that the WHO/CDC etc were not able to prevent this virus from spreading worldwide in a few weeks. That bodes poorly for some time in the future if/when a truly pathogenic strain like H5N1 does get out of control.

 

[jnjpream]

Found out that the wife of the gentleman (Rocky) who built my house died from complications due to Swine Flu. She was in the hospital for a while, then they sent her home. Sounds like it came back a couple days later.

It's really too bad. She was a nice lady, and he is a great guy. Very down to earth. Summer of '08 she lost her Brother (Skip) in a motorcycle accident. He was another house builder. He and Rocky were close and built most of the houses in our neighborhood.

Been a tough couple of years for the guy.

If you don't feel well, take care of yourself..! Without your health you've got nothing.

 

[IslandTractor]

That is sad. We lose over 30,000 US citizens a year to flu. While most are elderly or previously ill, a distressing number of previously healthy individuals or kids die too.