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Anthrax vs. the flu

 
 
littlek
 
Reply Tue 29 Jul, 2003 08:09 am
Today's Boston Globe has a great article on how the budget is failing to fund common and widespread health issues while pouring loads of cash into terrorisms treatment and prevention.

Here are some stats:

$155 million less in Massachusetts for the Dept of Public Health's budget (30% less than 2 years ago). Some of the programs effected are:

-2.5 million for anti teen pregnancy campaigns (reduced nearly 75% since 2002). We have nearly 5,000 births to teens, 15-19.
-45.5 million for anti smoking program (reduced 95% since 2002). There were over 9,000 deaths caused by smoking in 2002.
-9.5 million for AIDS prevention (23%). 14,251 people living with AIDS in 2003, 249 deaths from AIDS in 2001.

We give this and more up for what?

The feds gave MA $32 million to help fund bioterrorism defense and research:

+1 million to help develop testing for infectious diseases like anthrax. 5 deaths nationwide from anthrax since 2001.
+2 million for a smallpox vaccination program. 0 deaths from smallpox since 1977.


The budgets have been slashed, the taxes have been cut - what are we to do for our neighbors who need help? Send them for smallpox vaccinations?

Quote:
''Our nation has an obligation to protect the American people, and I'm a great advocate for rebuilding the public health system on the preparedness front,'' said Dr. Georges Benjamin, executive director of the American Public Health Association. ''But a lot of people are concerned that the things that are really killing people aren't getting any attention. They're getting dwarfed by the higher-profile crises, even though many more people die of influenza every year than have died from anthrax and SARS combined.''

Boston Globe article
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Type: Discussion • Score: 1 • Views: 1,373 • Replies: 19
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Wilso
 
  1  
Reply Tue 29 Jul, 2003 08:14 am
Our government's riding that bandwagon too.
0 Replies
 
littlek
 
  1  
Reply Tue 29 Jul, 2003 08:39 am
I've got nothing against being prepared for anything. But, at what expense?

Hey Wilso, did you move?
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dlowan
 
  1  
Reply Tue 29 Jul, 2003 08:40 am
Not especially rational, is it?

Does it compare, in any way, with spending millions on things like heart/lung/liver etc transplant facilities - and next to nothing on prevention/early intervention?

Are the underlying psychologies similar?

(Mind you, to be fair - resource allocation is a guaranteed no-win for politicians - there is pressure to go for the high-profile, emotive, "sexy" stuff.)
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littlek
 
  1  
Reply Tue 29 Jul, 2003 08:44 am
Dlowan - it seems a little different. We treat the symptoms (liver transplants) rather than the cause (alcoholism). This article points to treating one disease at the expense of another.

Then again, if you look at society as a whole, treating the symptoms (displays of terrorism) instead of the cause (arrogance and bad communication), it might fit.

Does that make sense? Still haven't finished my coffee.
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dlowan
 
  1  
Reply Tue 29 Jul, 2003 08:53 am
What politician wants to be caught saying "We took a calculated risk - bummer" - if a lot more people die from a terrorist attack, I guess. Not that all this spending will necessarily stop that!

I would hate to be the ones making the decisions - nonetheless, I think the decisions you cite flawed.
0 Replies
 
the prince
 
  1  
Reply Tue 29 Jul, 2003 09:00 am
As far as politicians are concerned, whatever gets them the headlines !!

You have to admit - funding for treatment of "antharx" is far more glamorous than finding for treatment for "flu"!!!
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dyslexia
 
  1  
Reply Tue 29 Jul, 2003 09:12 am
glamour spending aka flag waving is far more salable than reality spending. homeland security is little more than buzzword politics with a potential actuality of <1% but its a feel good mantra. and a surefire vote getter.
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dlowan
 
  1  
Reply Tue 29 Jul, 2003 09:15 am
Actually, G, it is also the fear of the headlines if they make a rational decision to take certain risks, and the event/s they hoped would not happen occur.

Eg - they decide to cut back the bio-terrorism program by $10 and put it into early intervention in infant mental health (good programs looking like they can cut life-time health costs and criminal behaviour and violence etc by a lot - great net benefit to community possible).

There IS an anthrax attack - and it kills 1,000 people.

Headlines - "Fed Govt. cut $10 mill from biodefence program months before attack" - there is likely to be little reporting of the reasons behind the cut - and the populace will want to hang someone.

If we lose someone in the attack, or feel very threatened and horrified, we will likely join in the hanging.

I am being a bit of a devil's advocate - but these ARE hard decisions for ordinary, fallible people.
0 Replies
 
the prince
 
  1  
Reply Tue 29 Jul, 2003 09:21 am
Deb, you are right !!! Every politician has a love affair with the headlines, and would hate to see that relationship turn sour. In part, the media is also to blame for it - they do tend to sensationalize stuff.
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Scrat
 
  1  
Reply Tue 29 Jul, 2003 10:38 am
littlek - Interesting citation. Seems that we have to make choices with the resources available, and some people are going to be unhappy with those choices no matter what choices we make. I won't attempt to argue what the right choice is here, but I can see an argument that working to ensure that huge numbers aren't killed by bio-terror-type diseases may need to take a precedence for now over the need to prevent small numbers from succumbing to other diseases.

In a perfect world, we could save everyone. In one where we can't, the choices we have to make are never easy, and never satisfactory to everyone.
0 Replies
 
dlowan
 
  1  
Reply Tue 29 Jul, 2003 03:53 pm
Thing is Scrat, the numbers are waaaaay likely to go the other way - that is far more people succumbing early to preventable diseases, and far fewer, but much more heavily publicised, people succumbing to terrorism.
0 Replies
 
wenchilina
 
  1  
Reply Tue 29 Jul, 2003 06:53 pm
Scrat wrote:
bio-terror-type diseases may need to take a precedence for now over the need to prevent small numbers from succumbing to other diseases.

In a perfect world, we could save everyone. In one where we can't, the choices we have to make are never easy, and never satisfactory to everyone.


LOL Laughing

Salt is made from very dangerous chemicals, so look out.

Sodium is a highly reactive metal that like does stuff... and chlorine is like really dangerous.

Thus, put together they are like dangerous times a gazillion... STAY AWAY FROM THE SODIUM CHLORIDE...

hahahah. Well I'm getting a good chuckle anyway
0 Replies
 
littlek
 
  1  
Reply Tue 29 Jul, 2003 07:54 pm
giggle
0 Replies
 
Scrat
 
  1  
Reply Wed 30 Jul, 2003 12:29 pm
dlowan wrote:
Thing is Scrat, the numbers are waaaaay likely to go the other way - that is far more people succumbing early to preventable diseases, and far fewer, but much more heavily publicised, people succumbing to terrorism.

I think that there is little to no chance of the flu devastating huge numbers of our populace. I suspect the opposite to be true if small pox were released in one or more urban centers. And again, I'm not saying we should be doing all of one and none of the other, but you have to make choices and trade-offs and some arguments here seem to pretend we can have our cake and eat it too. If the government spent nothing on bioterror prevention, I'd be reading complaints about that here, instead of complaints that they are spending too much on it.
0 Replies
 
Walter Hinteler
 
  1  
Reply Wed 30 Jul, 2003 01:55 pm
Scrat wrote:

I think that there is little to no chance of the flu devastating huge numbers of our populace.


Depends really on what you call "HUGE"!

Quote:
U.S. Flu Deaths Up Sharply Since 1970s, Researchers Say

Wednesday, January 08, 2003

CHICAGO ?- Influenza has surpassed AIDS as a lethal killer and contributes to an average 36,000 annual U.S. deaths, largely because of a vulnerable aging population for whom the vaccine is often ineffective, government research shows.

The U.S. flu-related death toll surged fourfold from 16,263 in 1976-77 to 64,684 in 1998-99, the Centers for Disease Control and Prevention reported in Wednesday's Journal of the American Medical Association. Those numbers average out to 16,000 more deaths yearly than the previous estimate of 20,000.

Health and Human Services Secretary Tommy Thompson said the news "that influenza may be taking an even larger toll than we have realized" underscores the importance of flu shots, especially for older people.

Drug breakthroughs in the mid-1990s helped reduce U.S. AIDS deaths from 51,000 in 1995 to about 15,000 in 2001. But the main weapon doctors have against flu -- a vaccine -- has proven disappointingly ineffective in the most susceptible population: people 65 and older.

Older people are more prone to flu complications yet only about 65 percent of them get vaccinated. The annual shots do not protect aging immune systems as well as they do younger ones.

Annual flu shots have been recommended for people 65 and older since the 1960s and for those 50 and older since 2000.

The flu death toll pales in comparison to that of the worldwide influenza epidemic of 1918, which killed more than 20 million people, including 500,000 Americans.

But the new numbers frustrate public health experts who had hoped the development of flu vaccine about 40 years ago would have had a greater effect.

Vaccination rates are also dismal -- about 30 percent -- for another target group, people with high-risk conditions such as diabetes and heart disease, said Dr. Keiji Fukuda, a CDC epidemiologist.

Thompson noted that flu shots are free under Medicare and said new federal rules should help increase vaccination rates by allowing hospitalized Medicare patients to get flu shots without a doctor's order.

For the study, researchers developed a new statistical model to create a more accurate estimate of flu deaths using national mortality and virus surveillance data.

The new model shows that a more lethal virus strain has hit in recent years, contributing to the increase in deaths.

But between 1976 and 1999, the number of U.S. adults 85 and older doubled. And the researchers found that this age group was 16 times more likely to die of flu-related causes than people ages 65 to 69.

Flu can progress to pneumonia and other life-threatening lung infections and can weaken elderly people, making them more vulnerable to other serious ailments, such as heart disease.

The study also found that older people are disproportionately affected by another respiratory virus previously thought to be more common in children.

The researchers estimate there are 11,000 deaths annually from respiratory syncytial virus, which can cause severe cold-like symptoms and pneumonia.

Their study confirmed that RSV is the most common cause of viral death in children under 5. But to researchers' surprise, the study found that 78 percent of RSV deaths occur in people 65 and older.

"We've known for some time that influenza and RSV have a profound impact on public health," said CDC director Dr. Julie Gerberding. "However, these data indicate that the magnitude of the problem is larger than we once thought."

Vaccines against RSV are being developed.
0 Replies
 
littlek
 
  1  
Reply Wed 30 Jul, 2003 05:30 pm
That's pretty huge, Walter.
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Scrat
 
  1  
Reply Thu 31 Jul, 2003 01:43 pm
Walter - Perhaps you skimmed over this statement in your citation:

Quote:
But between 1976 and 1999, the number of U.S. adults 85 and older doubled. And the researchers found that this age group was 16 times more likely to die of flu-related causes than people ages 65 to 69.

It sounds to me like the rate of flu deaths is increasing because people are living longer and at older ages are more susceptible to the flu. In other words, if you live long enough, you eventually become frail enough that something like the flu can kill you.

Now, is that true of small pox?

Let me ask it this way: which would you rather catch; the flu or small pox?
0 Replies
 
Walter Hinteler
 
  1  
Reply Thu 31 Jul, 2003 01:55 pm
None of both, Scrat.

However, you said:

Quote:
I think that there is little to no chance of the flu devastating huge numbers of our populace.


You neither excluded seniors from 'population' nor asked especially what illness I would prefer.

Be assured, in both cases I had changed
a) my quotation,
b) my totally my response.
0 Replies
 
Scrat
 
  1  
Reply Thu 31 Jul, 2003 02:13 pm
Walter Hinteler wrote:
None of both, Scrat.

However, you said:

Quote:
I think that there is little to no chance of the flu devastating huge numbers of our populace.

And I stand by that statement.

Do you understand what your citation tells us: that elderly people are increasingly dying from the flu because medical science is allowing them to live far longer than ever before, and that they are reaching a point where their fragile systems can't handle the flu. This isn't a worsening of the flu, but an unfortunate reality of old age. Get old enough, and a cold can kill you.

Old people die. There's no way around that. I do not think the blessing that so many are living to be as old as they do today makes the fact that they may then die from something as simple as the flu "devastating", nor do I consider the numbers "huge". Also, the issue--according to your citation isn't a lack of treatment but that the treatment doesn't work when people get this old.

So (A) I do not see this as a problem in the way you do and (B) it does not appear to be a problem that is made worse by funding bio-terrorism prevention over flu prevention.
0 Replies
 
 

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