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PANDEMIC ALERT LEVEL
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Tracking the next pandemic: Avian Flu Talk

Hospitals can’t afford BF plan

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AlaskaAquarian View Drop Down
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    Posted: April 18 2006 at 10:01pm
We can't afford bird flu plans, hospital heads say

By Maggie Fox, Health and Science Correspondent Tue Apr 18, 7:08 PM ET

WASHINGTON (Reuters) - The U.S. government may be urging local officials and hospitals to get ready for a bird flu pandemic, but top hospital executives said on 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 Pea****, 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.
 

"We don't know when it would come. But we do know that we are overdue and underprepared," U.S. Health and Human Services Secretary  < =yqin =http://yq.search.yahoo.com/search method=post>   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.

Pea**** 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," Pea**** 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."

Pea**** 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," Pea**** 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.

 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: April 18 2006 at 11:36pm
Morphine and sat in a corner.
 
Those simple words paint a rather horrible  vivid image in my mind.Cry
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Post Options Post Options   Thanks (0) Thanks(0)   Quote fiddlerdave2 Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 12:16am
Individual preparations for survival only go so far.  Heavy, somewhat wasteful (from a "profit" point view)  infrastructure is required for hospitals and other institutions to be ready for an influx that a mass disaster like a pendemic will bring, and, as a duty to stockholders, would not be an appropriate use of investor resources.  I wonder how much difference there is in the principal of "common defense" against invaders, whether the invaders are communists or microbes.  Our military forces and nuclear arsenal is not at all "profitable" on a month to month basis, but many would argue the benefits are large and essential.  Perhaps we should regard societal pandemic preparedness the same way.  As this article indicates, as far as institutions go, there is and will be no preparedness.  Maybe there are some things that make sense for a government to do.  

Edited by fiddlerdave2 - April 19 2006 at 12:17am
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Bird flu would swamp hospitals
U.S. worst case? 2 million dead, no room for sickest
BY KRISTINA HERRNDOBLER
HEARST NEWSPAPERS

April 19, 2006

WASHINGTON -- Health care providers from around the nation said Tuesday that hospitals are woefully unprepared for a bird flu outbreak and likely would be overwhelmed by a pandemic.

Their frustration flared as the top federal health official warned that the U.S. government wouldn't be able to assist everyone in the event of widespread infection.

"Any community that fails to prepare with the expectation that the federal government or, for that matter, the state government will be able to step forward and come to their rescue at the final hour will be tragically wrong," Health and Human Services Secretary Mike Leavitt said at a conference on emergency preparedness.

W. Frank Pea****, chairman of emergency preparedness at the Cleveland Clinic, said the nation's hospitals can barely handle the surge in patients when the seasonal flu strikes. "The problem is we are just good enough for what happens now," he said.

About 36,000 people die in the United States from seasonal flu each year, according to the federal Centers for Disease Control and Prevention. Leavitt predicted a bird flu pandemic could kill 2 million.

Pea**** said that if his hospital is overwhelmed with patients, the sickest and hardest to treat "are going to get some morphine and get set in the corner" while patients who are easier to save get treated.

Once those patients are cared for, doctors will come back to the hard cases, but "the possibility is they will not survive," he said.

Panelists said supplies, such as beds, ventilators, masks and the like, would be in short supply. Employees to run the hospitals would also be in short supply, they said.

Copyright © 2006 Detroit Free Press Inc.

http://www.birdflubreakingnews.com/templates/birdflu/window.php?url=http%3A%2F%2Fwww.freep.com%2Fapps%2Fpbcs.dll%2Farticle%3FAID%3D%2F20060419%2FNEWS07%2F604190425%2F1009
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 7:41am
P
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a
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o
c
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, W. Frank
Good grief!
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AlaskaAquarian View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AlaskaAquarian Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 8:43am
LOL, sorry about that...didn't realize this board filtered that much! Censored

Edited by AlaskaAquarian - April 19 2006 at 11:34am
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Post Options Post Options   Thanks (0) Thanks(0)   Quote janetn Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 11:12am
Folks dont expect anything resembling care during a pandemic. You are truly on your ownAngry If you do not prepare for this as well as stockpiling food you will end up with you or a loved one in a nightmare situation. On a cot laying in your own excrement drowning in your own blood with nothing offered to you to ease your plight you will die alone in a hallway or gym somewhere. Please take this warning now and prepare to nurse the sick at home - at least you will be with people who care and have the time to care for you.
 
 
Healthcare in this country is a profit driven business. There is no way hospitals or the government are going to invest the dollars required to meet the surge capacity that a pandemic will create. There will be no supplies within days. Nurses will bail as soon as the PPEs run out and they see they are cannon fodder. Even if they stayed they wont be able to do anything without supplies. The powers that be have apparently decided your life and those whom you love are not worth the money to prepare. We spend trillions on the milatary, we waste billions on pork barrel projects, but we dont have the money to stockpile N95 masks to protect those careing  for the sick???????AngryAngry
 
Unfortunatly the will to do what is needed is not there, I dont see this changing. So learn bqsic skills and stockpile what medical supplies you can get your hands on.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote redcloud Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 12:06pm
You heard the man:

"I have been in Cleveland for a decade and we have closed three hospitals since I have been there," Pea**** said. "It is because we are a business and we have squeezed it for all we can."

It isn't good for the shareholders to spend money on what _might_ happen, and money rules above all else.
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Yes it's pretty sad that we don't have enough hospitals to care for our people.  Touchy topic, but it may help if only legal American citizens were treated...those breaking the law would have to wait.  something should be done to get the overcrowded hospital situation under control or our nurses and doctors are going to loose their minds from the stress. 
 
I know, I must LOVE to start trouble, I always bring up these touchy topics.
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AlaskaAquarian View Drop Down
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Wink Nikita, trouble follows me too. you're in good company!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Scotty Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 7:03pm
It isn't very fair to blame the lack of surge capacity on the profit motive. The same lack of surge capacity applies in countries that run a free national health service.

Exclusion of illegals is a different subject but once they are in the country there is little option but to allow them to access health care. There are many infectious diseases that have a tendency to start among the poorest in society before expanding into the general population. I don't think that North America has been hit with the current wave of Tuberculosis yet but if this does arrive then a failure to treat illegals would simply provide a pool of carriers.

The demand for health care is rising faster than any country can cope with and at some point rationing will need to be applied to the more exotic treatments.

BTW No trouble, No Debate, No Spice, No point.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote redcloud Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 7:13pm
It appears that the profit motive is involved:

http://www.truthout.org/issues_06/041906HA.shtml

Study: Health Insurers Are Near-Monopolies
    The Associated Press

    Tuesday 18 April 2006

"...The AMA study is the latest piece of evidence - and most comprehensive to date - showing the market power of a few companies, and a large number of regional nonprofit Blue Cross operations, is formidable and growing. And it comes as premiums continue to grow at near double-digit percentage rates.

    Critics say that carriers are not only creating monopolies and oligopolies in many regions, they also control the other side of the equation in what is known as monopsony power. That means in addition to having the most enrollees, they're also the biggest purchasers of health care and can dictate prices and coverage terms.

    It also makes it harder for new carriers to emerge, as pricing already has been set by the dominant carrier."
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Frisky Quote  Post ReplyReply Direct Link To This Post Posted: April 19 2006 at 10:12pm
    The past 27 years I have been an emergency medicine physician . A few days ago as I left the hospital I stopped a nurse and asked what was wrong with her eyes. It turned out she had been crying. The reason was a family member of one of her patients had chewed her out  calling her uncaring and unprofessional. The reason for the outburst was the family member had been in the ER for 2 hours  and was still in a bed in the hall. The nurse had to leave the ER to regain her composure. I started making jokes with her about  BF and what will happen then . They were the usual doctor/nurse type{i.e. mostly not repeatable}. It took little time and we were both laughing. But one of her funny stories was appropriately ironic. She told how she was the nurse who recently placed a patient in the hall and started caring for him. After a short time he notified her that he was a prominent attorney and her reply was  "Sir we treat everyone the same here and this is the best we can do." It turned out that he was the attorney whose lawsuits were one of the reasons for the recent closure of a local hospital. The day of that closure our volume went up about 15 a day.   ER Doc
It is better to give than to receive.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote redcloud Quote  Post ReplyReply Direct Link To This Post Posted: April 20 2006 at 2:25am
Frisky,

My grandfather, father, uncle, and brother-in-law were, or are, docs of various types - from internist to thoracic surgeon. My sister is an ER nurse. The ones who are dead or retired hated lawyers more than anything. The ones still practising hate the insurance companies more than lawyers. My brother-in-law who is 50 and an internist, is seriously considering getting out because of the insurance companies. He is paying more staff for collections and billing than he is for care.
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