County Says No Thanks To Influenza Partnership

SNOW HILL – A Maryland state initiative to stockpile anti-flu virus medication in case of a flu pandemic will not count Worcester County among its participants.

The County Commissioners voted unanimously this week to not pursue the anti-viral medication program after Worcester County Health Officer Debbie Goeller recommended against it.

The state of Maryland was asking for a letter of intent to join the program by May 9, a letter of understanding by May 21, and full payment by June 11, forcing a quick decision on the commissioners.

The initiative trickled down from a federal government program to make enough flu medication at discounted prices available to the states to stockpile for 25 percent of the population.

“In Maryland, there was an allocation of 578,000 doses,” said Goeller. “The state purchased 210,000 doses and then basically didn’t have the money to buy the rest.”

The program is intended to provide flu treatment to essential personnel and government decision makers and their families, during an influenza pandemic, Goeller explained.

“When I say treatment, it is for people who are sick. It is not a preventative thing,” she said.

The medications, Tamiflu and Relenza, are good for 81 months and must be stored in a climate-controlled environment.

In the event of a pandemic, Worcester County would have to get state permission to dispense the flu medication.

About half the counties who have considered participation have rejected the program, including Somerset, and half accepted.

Goeller expressed doubts over the medications’ usefulness in a pandemic.

“It’s uncertain. We have no evidence at all this would be effective in a pandemic situation,” she said.

There is evidence that seasonal flu viruses are becoming resistant to Tamiflu, she said. Flu medications typically do little more than reduce the duration of symptoms by 24 to 36 hours.

After 81 months, unused medication would be thrown away, leading to possible environmental implications for wildlife and in waterways.

There is no provision for rotating the stock of medication to always have current doses on hand, Goeller said.

There are also significant legal and medical issues surrounding the dispensing of medication by a county government.

Goeller said she is not aware of any precedent where a government treated an illness, rather than simply administering preventatives.

In a pandemic, there are also questions over who would be assessing and diagnosing patients, and prescribing the flu medication. There are also ethical issues over just who counts as essential personnel.

“You’re the chief here and we’re the Indians and we need to know your recommendations,” said Commissioner Bud Church.

“There are significant problems in the partnership. Anti-virals haven’t been proven to have effect in a pandemic situation,” Goeller said. “I can’t particularly recommend participation at this time.”

She added, “I’m very uncomfortable with the short time frame in which to make a decision when we have all these concerns.”

“I couldn’t agree with you more,” said Commissioner Louise Gulyas. “There’s too many variables here.”

“One word that jumped out at me: uncertain,” said Commissioner Judy Boggs. “I hate to make decisions based on so many unknowns.”