The U.S. government may be urging local officials and hospitals to get ready for a bird flu pandemic, but top hospital executives said Tuesday they cannot do everything that is being called for.
“If the federal government doesn’t help run this, it really isn’t going to go well,” Dr. Frank Peacock, who heads emergency preparedness at the Cleveland Clinic in Ohio, told a conference.
The H5N1 avian flu virus has picked up speed in birds, spreading to 20 new countries in the past six weeks. It cannot yet infect people easily, but it has killed 109 of the 194 confirmed infected with H5N1 in nine countries.
A few changes would allow the virus to evolve into a form passed easily from human to human, triggering what experts say would be devastating pandemic.
'Overdue and underprepared'
“We don’t know when it would come. But we do know that we are overdue and underprepared,” Health and Human Services Secretary Mike Leavitt told the emergency preparedness conference sponsored by U.S. News & World Report magazine.
Experts say the United States and other countries have too few drugs, supplies such as latex gloves, or even equipment such as ventilators to deal with a pandemic of a respiratory virus.
As he has been doing for months, Leavitt said people need to be prepared on an individual and local level and cannot expect much immediate help from the federal government.
“There is no way you can respond to every home town at the same time,” Leavitt said.
Ventilators instead of swimming pools
Maybe hospitals should be allocating money to buy ventilators instead of remodeling facilities such as swimming pools, Leavitt said.
Peacock said even large centers such as his lack the funding to do so.
“I think it is a good thing for the Secretary to say we have to stockpile ventilators. But I think a lot of us know we don’t have the resources to buy another two, three, four hundred ventilators,” he said.
Preparedness could come down to more than having the medical equipment.
“We may not have the staff needed to run those ventilators adequately,” said Vicki Running, who heads disaster planning at Stanford University Medical Center in California.
Day-to-day business is already overwhelming hospitals, according to Running. “We are operating at capacity,” she said.
And the for-profit health care industry allows no fat.
“I have been in Cleveland for a decade and we have closed three hospitals since I have been there,” Peacock said. “It is because we are a business and we have squeezed it for all we can.”
Dr. Edward Miller, chief executive officer of Johns Hopkins Medicine, said the Baltimore hospital and medical school had already spent $10 million preparing for a pandemic or other emergency.
“This is not a sustainable business plan,” Miller said.
“I don’t think anybody is capable of paying the entire price tag,” agreed Dr. Thomas Burke, executive vice president of the M.D. Anderson Cancer Center in Houston. “There are none of us who can afford to absorb those kinds of costs.”
Peacock said much of the response to a pandemic will involve very basic medical care — including triage, or sorting out which patients cannot be helped except through heroic measures.
“Those patients are going to get some morphine and get sat in a corner. That is the definition of a disaster — need exceeds resources,” Peacock said.
Then health workers will turn to patients who are more easily helped, and the very sickest may have to be allowed to die as comfortably as possible, he said.