Sunday, November 20, 2005

H5N1 Must read

From Canada's Globe and Mail, tip to the H5N1 Blog...
Salvation's Army

"Everyone who works at Mount Sinai during the pandemic will receive Tamiflu as a prophylactic," he says. But then he adds that "it might be that there is just not enough of the drug available."

All of a sudden, hands start shooting up like exclamation points.

One father wants to know if he should buy a $70 respirator from Home Depot for his asthmatic kids; a woman asks how much she should stockpile. Gradually, a fine, almost invisible mist of concern rises in the auditorium.

As Dr. Low says, everyone's greatest concern at the hospital during SARS was "taking it home to their families. And that's going to be one of the things in a pandemic."

If you thought the recent rioting in France was bad, wait until there's not enough Tamiflu to go around in a pandemic.

Heavy-duty stuff here, folks.
Serious reading. Very well-written.
Too long to read from the monitor. Printed out it takes six or seven pages. It won't be wasted ink or paper. You can pass it on to somebody who needs to know.
Do it now, read it later when you can pay attention.

Hospitals are grave places, after all, and Leslie Vincent has worked in them (as a cancer nurse, no less) for 30 years, ever since she began her nursing studies at McGill University at the age of 16. "When you're a nurse," Ms. Vincent says, "and you're helping someone who's dying to get in and out of bed every day, you feel their weakness. You experience them getting weaker every day."

But these difficulties never stop her. She can't change the fact that people die, but she can do something about how they die. This approach had helped her to the top of Mount Sinai, where she's senior vice-president of nursing — 1,200 employees, a budget of $115-million, a salary pushing a quarter of a million dollars a year. Not that the money matters that much to her: She still brings her lunch to work. She is still the chief nurse of the hospital.

During the SARS epidemic that made Mount Sinai world-famous, Ms. Vincent had to tell her employees that the hospital was taking in its own staff as SARS patients. It was one of the hardest days of her entire career.

So it is a matter of some note when Leslie Vincent, the salt of the nursing earth, is
scared by the thought of a flu pandemic. The problem is that the bird flu is so confounding, she's not sure this time any of them can make a difference.

It's not just the million practical details of preparing a hospital for an inevitable pandemic — whether there are enough ventilators (probably not), how the infected should be admitted (a flow-chart job no one wants), the gruesome issue of morgue overflow, or even the basic question of how to decide when a pandemic has actually begun.

Susan Poutanen, a microbiologist and infectious-disease consultant who is the vice-chairman of the flu committee, reminds everyone that they have already decided that rather than "relying on the Ministry of Health's stockpiles of Tamiflu, given the quantity that would be available to us from the ministry, it would be prudent for us to consider stockpiling our own" — i.e., the government's 12.4 million doses, which would treat a million people, aren't enough, so it's every hospital, business and essential service for itself.

It's a reasonable precaution: If hospital workers get sick, we're all finished.

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