Medical Rationing A Must For Severe Pandemic

The closer an influenza patient is to death during a severe pandemic where medical resources would be scarce, the more likely they’ll be excluded from admission to an intensive care unit. That’s the recommendation from a task force studying ethical dilemmas during pandemics.

Months before the world was introduced to the swine flu, the S.C. Department of Health and Environmental Control commissioned a task force to take a look at the state’s preparedness plan for a severe influenza pandemic.

“We found (we) had more work to do, DHEC does, particularly in dealing with scarcity of medical resources in a pandemic,” said Dr. Phil Schneider, an emeritus bioethics professor at CCU and co-chair of the SC Pandemic Influenza Ethics Task Force.

“There’s no point in putting treatment into a patient who will not benefit from it. Tough thing to say, but that’s what we’re going to be faced with in a full-fledged pandemic,” Schneider said.

A key component of battling influenza is ventilators. As of June, there were 1,284 ventilators in hospitals across the state, according to the task force.

How those would be rationed during a severe pandemic where tens of thousands could possibly benefit from a ventilator is an “ethical” choice, and one where the task force is weighing in.

“The doctors will have to decide who the sickest people are and who are the people who have the best chance to survive,” Schneider said.

To determine who will receive critical care, specifically ventilators, the task force recommends hospitals implement the Sequential Organ Failure Assessment (SOFA) System, which rates a patient’s mortality risk.

Through a series of testing, the patient will be given a score between 0-24. The higher the score, generally higher than 11, the closer one is to death and less likely they’ll receive critical care, Schneider said.

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Green Bay School Districts Prep For Swine Flu

Students heading back to class Tuesday will be greeted with a continued emphasis on hygiene as school districts look to prevent or limit the instances of swine flu. Meanwhile, schools and health departments continue to prepare for a possible pandemic of the H1N1 virus, creating and bolstering contingency plans in case large numbers of students or teachers fall ill.

They can’t, however, prepare for a host of unknowns, including when and how a vaccine will be available and administered or the timing and severity of a possible pandemic.

The Green Bay School District has a 50-plus page pandemic plan designed to prepare officials as much as possible.

“I feel good about the things I can control,” said Barbara Dorff, director of student services for the Green Bay School District. “The things I don’t feel good about are the fact that they don’t have vaccine ready yet, and they’re not really sure when it should be ready. … We just don’t have all the answers yet.”

Other questions include how much vaccine will be available and how and where it will be distributed, said Judy Friederichs, director of the Brown County Health Department.

via School districts prep for swine flu pandemic | greenbaypressgazette.com | Green Bay Press-Gazette.

Europe Braces for Swine Flu’s Potential

As children across Europe go back to class and staff return from vacation, governments are keeping a watchful eye on the H1N1 virus and are preparing for possible vaccinations, home schooling and the prospect of widespread absenteeism.

For now, governments have resisted closing schools preemptively, judging that the virus has not yet reached the scale where such a move would be beneficial. But they have been circulating contingency plans for schools and companies — an approach broadly supported by health experts.

Simon Cauchemez, an epidemiologist at Imperial College London, said that evidence from the spread of the virus in past months in the southern hemisphere, where it has been winter and where he said the disease had been mild in most cases, showed that there was no reason to shut schools ahead of time.

“I think the view is that we don’t want this kind of intervention unless your health system really cannot cope,” he said, referring to school closures.

Localities should wait and see whether health care systems in specific areas were able to handle the volume of swine flu cases, he said. If the volume of cases began rising to unmanageable levels, only then might it be sound policy to shut schools, he said.

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