Flu Scare Shows Partnership Importance

BERLIN – While there have been no confirmed cases of swine flu in Worcester County, county health officer Debbie Goeller asked the County Commissioners this week to reconsider a previous decision to not buy into a state flu medication partnership.

Goeller asked the commissioners, after she presented an extensive report on swine flu facts and county preparations during the Tuesday morning commissioner meeting, to reconsider purchasing anti-viral medications through a Maryland partnership program, which the commissioners chose not to join last May.

Goeller recommended against that purchase 12 months ago. Several things have changed, making the partnership purchase relevant. The virus is new and is spread from person to person, and the two medications offered last year, Tamiflu and Relenza, are effective against the swine flu, Goeller said.

The health officer said she is not sure if the anti-virals will be available through state and national stockpiles otherwise, although the anti-viral supply is available now. She does not know if the medications will be available later if the demand is strong.

The local stockpile would have been meant for essential personnel, government decision makers and their families, during an influenza pandemic. The medications, Tamiflu and Relenza, both considered effective against the swine flu strain, would have been good for 81 months, but would have required climate controlled storage. Neither medication is effective against all flu strains. Flu medications typically shorten symptoms by 24 to 36 hours.

“We have no evidence at all this would be effective in a pandemic situation,” said Goeller last year.

Last year, Goeller cited concerns over the inability to rotate the supply, potential disposal issues and liability issues arising from a government issuing medication, in her recommendation to not purchase those drugs. She also had questions over who would be assessing, diagnosing and prescribing the medication to patients.

“We’re not hurting by not having that,” Goeller said this week.

There is a strong supply of anti-virals available through the marketplace, according to Goeller. The anti-viral purchase will come back before the commissioners late this month.

Meanwhile, the county health department has set up an incident command center and is keeping track of the rapidly changing swine flu situation. Viral testing kits are available to any healthcare provider in the county within 15 minutes.

“We have been planning for this for awhile,” Goeller said. “We do have a pandemic flu plan, an isolation and quarantine plan and a continuity of operations plan. It’s really great to know they’re in place. In general, they’re working very, very well.”

The department is sending letters out to all county doctors as soon as the diagnostic or treatment algorithms change, Goeller said.

The county faces challenges with a service-oriented workforce, many of whom do not have sick days, or cannot afford to lose any pay.          

The county needs to work with employers and workers on that ability to take the necessary time off to prevent others from getting sick, she said.

Local advice to potential swine flu sufferers echoes that given in larger venues. Goeller asked anyone who suspects they have swine flu to call their doctor for an appointment rather than going to the emergency room. Anyone who decides to go to the hospital first, however, should call ahead to let staff prepare.

Theresa Owens, director of emergency services, also asked that anyone calling 911 with potential swine flu symptoms inform the dispatcher, to allow the emergency personnel to prepare.

“The ambulance will definitely still be dispatched to the site. It’s just that the responders will be protected,” said Owens.

The swine flu picture is changing so fast that one contagion-limiting procedure outlined by the county health department Tuesday morning was reversed Tuesday afternoon. The Centers for Disease Control are now recommending that schools with affected students remain open, contradicting a 14-day closure for schools with affected students recommended previously. Six Maryland schools, all on the western shore, have been closed.

“Because it’s a novel virus all the recommendations are subject to change,” said Goeller.

While Worcester County has no confirmed swine flu cases, the low severity seen now could change later. Dr. Andrea Mathias of the health department said that exposure tends to come in waves and broaden from there.

“It can fade in the summer and come back quite severely in the fall,” said Goeller.

           

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