# 704
A key ingredient of the United State's pandemic influenza plan is to acquire sufficient antiviral stocks to cover 25% of the nation. The plan envisioned is that the Federal government would buy roughly 60% of the doses, and individual states would purchase, at a deep discount, the rest.
Thus far, nearly every state in the union has gone ahead with these purchases.
Florida meanwhile teeters on the brink of zero-funding this initiative, leaving it's residents with no state funded stockpile, and totally reliant on the 14% coverage provided by the Federal Government.
Making matters worse, these percentages are based on a 10-pill course of treatment, which many doctors seriously question as being an adequate treatment course. It now appears that this 14% population coverage may drop to only 7%, if the number of pills required doubles.
No one knows, of course, if the next pandemic is imminent, and if it comes, how bad it will be and just how efficacious Tamiflu will be in its treatment. These are open questions that no one can answer.
Despite its limitations, the WHO (World Health Organization) strongly recommends the use of Tamiflu to treat the avian flu infection. It is, quite frankly, the only medicine we have in our arsenal that has shown real promise in treating humans infected with bird flu.
Right now, the WHO, the CDC, the UN, the HHS, and nearly every country in the world are preparing as if another pandemic is inevitable. It may come tomorrow, or it could be several years down the road. But they believe one will come.
The Florida State House of Representatives and State Senate appear to be ready to gamble that the bulk of the world's scientists are wrong about a potential pandemic and the value of having antivirals.
If they are right, and no pandemic comes, then the state will have saved $36 million dollars.
If they are wrong, and a pandemic does strike in the next 5 years, then they may find they have contributed to the deaths of thousands of Floridians.
I have no special insight into the reasoning behind the legislature's reluctance to fund the acquisition of Tamiflu. Media reports have indicated that some lawmakers worry about its shelf life (5 years +), or that the virus may become resistant to Tamiflu.
Both are genuine concerns. The H5N1 virus may develop Tamiflu resistance at some point, and should a pandemic fail to arrive in the next 5 years, the medicine will begin to lose it's potency.
So buying the Tamiflu is, admittedly, a gamble of sorts.
Just as in any wager, you put something at risk to hopefully win something of value. Here, the state risks $36 million dollars, in the hopes of saving thousands of lives. There are no guarantees, of course. That's why it's called gambling.
Failing to buy the Tamiflu, however, has a far greater downside than simply spending $36 million dollars on a medication we may not need, or that may not work when the time comes.
The State was to purchase 1,784,796 courses of the medication. Practically speaking, with the higher dose requirements, this would have probably treated 900,000 Floridians.
If a pandemic comes, at least 900,000 Floridians that would have received treatment, will not. Simple math.
There isn't enough data to know how many deaths would result from not having this medication during a pandemic. If a pandemic does erupt, historians will do those calculations after the carnage has passed.
They will look at the attack rate, mortality rate, and the ultimate effectiveness of the drug. And they will come up with a number.
And the residents of Florida will rightfully look towards our legislature for an explanation.
I hope they are working on a good one.
