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    Wednesday, October 12, 2005

    Learning from the Past: One of the items in those "top secret" influenza preparedness plans that were available to the public for a year on the internet and that the New York Times found, was a section on "Lessons Learned from the Swine Flu.

    The swine flu situation was similar to the situation we find ourselves in today with the bird flu, except it had more urgency. In January 1976, there was an outbreak of a febrile respiratory illness in some soldiers at Fort Dix, New Jersey. In February, it had been identified as a new form of influenza - the Swine Flu. The signs were ominous for those whose job it is to worry about the next influenza pandemic. They were certain that this was the one. By March, the CDC recommended mass nationwide immunization, but manufacturer's balked at making the vaccine because there wasn't enough time to determine safety and efficacy - and they were worried about liability. Congress debated the issue of liability protection for the companies, but it wasn't until August that they reached an agreement that would shield the manufacturer's - and that was only because there was an outbreak of a deadly respiratory illness among the attendees of an American Legion conference. (After the legislation passed, it was discovered that the legionnaires did not have the flu, but an infection that came to be known as Legionnaire's disease.) A month later, the first shipment of vaccine went out. The vaccination program began in October, ten months after the first Swine flu cases were identified. Millions of Americans were vaccinated, but the program had to be halted two months later due to side effects of the vaccine.

    The pandemic never happened. Whether that was because of the immunization program or because the virus was just never that contagious or dangerous in the first place will probably never be known, but there's a good chance it was the latter since there was no epidemic in the ten months it took to get the vaccine to the public.

    Here's what the HHS authors of the report included in the lessons to be learned:

    • Drs. Feinberg and Neustadt were asked by the Carter administration to review the swine influenza program, focusing specifically on the decision-making process. They concluded in "The Epidemic That Never Was", Decision-making for the swine flu program had seven leading features. To simplify somewhat, they are:

    • Overconfidence by specialists in theories extrapolated from meager evidence.

    • Conviction fueled by a conjunction of some preexisting personal agendas.

    • Zeal by health professionals to make their lay superiors do right.

    • Premature commitment to deciding more than had to be decided.

    • Failure to address uncertainties in such a way as to prepare for reconsideration.

    • Insufficient questioning of scientific logic and of implementation prospects.

    • Insensitivity to media relations and the long-term credibility of institutions.

    In other words, don't be blinded by science.

    posted by Sydney on 10/12/2005 08:14:00 AM 0 comments


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