Saturday, May 06, 2006

That Missing Vaccine Capacity

The New York Times
That Missing Vaccine Capacity

The more the federal government tells us how to prepare for a possible avian flu pandemic, the more apparent it becomes that we won't be prepared anytime soon. If a pandemic hits within the next several years, it will be up to hospitals, doctors, public health agencies and ordinary people to muddle through as best they can — with guidance, but little money, from the federal government.

The latest advice from the federal government, in a plan issued this week, makes it clear that a worst-case pandemic would indeed be bad. A third of the population might become infected, two million Americans might die, and 40 percent of the work force might be out of commission at the height of the outbreak. Nobody has the foggiest idea whether a pandemic will arrive in the near future or how severe one might be, but federal officials argue, persuasively, that we have to brace ourselves for the worst.

The 227-page document usefully spells out some 300 actions to be taken by federal agencies and the timetables for achieving them. It also offers advice to businesses, schools, individuals and others in the private sector. All of this is to the good. It makes sense to think through problems in advance rather than in the midst of a raging pandemic.

What troubles us most is what looks like a less-than-urgent push to develop a new vaccine production capacity that can quickly respond to an emergency. There is no overstating the importance of effective vaccines; they could greatly reduce the need for other costly and less effective measures to deal with a lethal new virus. To its credit, the Bush administration, as part of its $7.1 billion preparedness plan, has poured substantial money into developing and procuring vaccines and antiviral drugs. But its primary goal — to expand and modernize domestic production capacity to make enough vaccine for all Americans within six months — seems as distant as ever. Last fall officials said that goal might be reached in four to five years. Half a year later, the target is still five years away, and is contingent on future appropriations and the responsiveness of vaccine makers. Congress needs to look hard to see whether a more aggressive effort might convert the industry more quickly.

Meanwhile, the burden of caring for the sickest patients would fall on the nation's hospitals. Most of us probably assume that should we get sick, our local hospitals would of course take us in. But that confidence may be misplaced. The federal government has offered many pages of advice on what hospitals should do to prepare, but precious little money to help them do it. Given that many hospitals are already on the financial ropes, with their emergency rooms clogged, it seems unlikely that they could handle a sudden onslaught of very ill patients.

Some experts are estimating that $5 billion may be needed to get all hospitals prepared. That is a hefty sum that no one seems eager to pay — and all the more reason to get cracking on a faster way to make vaccines.