OC In No Rush To Enter Flu Partnership

OCEAN CITY – The proposal to enter into an anti-viral purchase partnership program with the state of Maryland was presented to the Mayor and City Council Monday night.

Debbie Goeller, Worcester County Health Officer, and Joe Theobald, Director of Emergency Services, for the town of Ocean City, presented the Mayor and City Council with the potential partnership, which required an answer from the council by May 9.

The anti-viral purchase partnership provides an opportunity for local governments to purchase anti-virals for treatment of the ill, essential employees and their household family members during a pandemic influenza.

“I want to emphasize that this is not a plan for the general public,” said Goeller.

The anti-viral purchase would provide treatment for essential government employees and their family only, in an effort to secure a strong infrastructure in the event of a pandemic flu.

The partnership program started at the federal level thru the federal allocation of 578,754 treatment regimens to the state. Of those treatments, 368,027 remain for local government partnership purchase.

Goeller explained that a pandemic flu would be a novel virus, new to the community, that people would have no immunity to, making flu shots essentially useless. Anti-virals aim to treat, not cure, a pandemic flu. However, as the flu would be a novel virus, there is no guarantee that anti-virals would be successful in treatment.

In order to receive the anti-viral treatment, and to become a partner in the program, Ocean City officials would be required to sign a letter of intent by May 9, with a memorandum of understanding signed by May 21, leaving the council with only a few days to make a decision.

Participation in the partnership also requires that medication be stored by the local government, but administered under the control of the Department of Health and Mental Hygiene, to be dispensed at its direction.

Theobald noted that the town currently has no storage capability for the treatments, and would have to make arrangements.

“The good news about this is you can purchase this at a significantly discounted rate,” said Goeller, noting that treatments average at $80 per treatment through a physician, $15 a treatment through the program.  However, the town would still be paying for a treatment that may or may not be effective.

The shelf life of the treatments was also addressed, with Goeller explaining that all treatments must be destroyed after 84 months, and then repurchased. Disposal of the treatments is another concern, with states such as Colorado questioning where the destroyed treatments would ultimately end up, i.e. in drinking water.

Medical issues are a concern with the partnership, pointed out Goeller.

“There are problems with who’s diagnosing, who’s prescribing, the side affects, there are a lot of legal issues,” she said.

Ethical issues arise as well, with concern over how to define “essential” employees.

As of Monday, four counties in Maryland had joined in the partnership, purchasing anti-viral treatment, while four counties had declined to participate in the partnership reported Goeller.

“This is one of those situations where there really are no good decisions,” said Council member Nancy Howard. Howard also questioned how efficiently the treatments would be administered with distribution to be controlled at the state level.

“Something sounds like a drug company is behind this,” said Councilman Jim Hall, questioning why the council was being rushed over on an important issue.

Hall also questioned whether elderly and young children should be considered before government employees. Goeller explained that a pandemic flu usually poses a different situation than the seasonal flu, referring to the outbreak of 1918.

“In that pandemic flu situation, the people who were the most affected were the people who had good immune systems,” Goeller said.

Theoabld explained planning and education efforts are underway to prepare for a pandemic flu outbreak.

“We’re actually in pretty good shape, collectively, when we look at our plan for a pandemic,” said Theobald.

Goeller agreed that there are other options, such as planning and education, which can be used to prepare for a pandemic rather than purchasing anti-viral treatments.

“There are significant problems with this partnership,” advised Goeller. “I think that if the purchase of anti-virals by local government is a good plan now, it should still be a good plan in the future.”

The council agreed that there were too many negative factors regarding the partnership to make a hasty decision. No motion was made to move forward with the partnership.

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