# 2562
It would hard for anyone to put it more clearly than how it was written in today's Press Release (highlighting/underscoring is mine) from the HHS.
Health care workers and emergency services personnel who could have direct contact with individuals who are ill during an influenza pandemic should be protected with antiviral drugs throughout the pandemic, even before these workers are exposed or become ill themselves, according to guidance released today by the U.S. Department of Health and Human Services.
Stockpiling these antiviral drugs and planning for their use is the responsibility of employers as part of comprehensive pandemic preparedness, the guidance said.
While these guidance documents don't legally mandate that employers stockpile antivirals (or take any other pandemic preparedness actions), they do put employers on notice that there is an expectation that they will comply.
To be very clear about what these two paragraphs are saying:
Health care and emergency response personnel should be placed on outbreak prophylaxis (essentially 1 tamiflu pill/day) for the duration of a pandemic wave.
For a 12 week wave, it will require 84 Tamiflu pills. And of course, that would just cover one wave.
The stockpiling and planning for the use of these antivirals is the responsibility of their employers.
An small ambulance service with 50 emergency personnel would need to stockpile at least 4,200 Tamiflu capsules. A hospital with 500 care-givers would need more than 42,000 doses.
With well over 10 million Health Care Workers in the United States, each needing roughly 8 (10-pill) courses of antivirals for a pandemic wave, the government estimates that the healthcare sector needs to stockpile 103 million courses.
Or more than 1 billion doses.
http://www.pandemicflu.gov/vaccine/antiviral_use.html
Two questions arise from all of this. The first of course is, will the private sector comply?
To date, there doesn't seem to be any huge move by the private sector to purchase antivirals. Part of the problem is the cost involved, of course. Even in bulk, Tamiflu is running about $6 a pill.
But other problems involving storage, security, and even the legal dispensing of a prescription drug come into play as well.
Few hospitals have publicly announced that they are stockpiling antivirals. Most have made no comment.
So, if the healthcare sector is aggressively stockpiling antivirals, it isn't readily apparent. Hopefully this latest guidance will convince more employers to begin preparing.
The second question is, what happens if they don't comply?
Now that it is on the record that the federal government expects health care workers and emergency responders to be protected with prophylactic antivirals during a pandemic, it is going to be difficult for any institution to argue that it isn't necessary.
When a hospital, or an emergency service, expects front-line personnel to show up to work during a pandemic, these people are going to (rightfully) expect to be protected.
And that means, among other things (like PPE's), prophylactic antivirals.
Employers who don't provide the recommended safeguards are likely to find many employees unwilling to work.
While some institutions may try to convince employees to work without antiviral protection, there is a very good reason why antivirals are being recommended by the HHS.
Without them, health care workers are at high risk of becoming infected during a pandemic.
Whether through attrition from illness, or from a refusal of employees to work without antivirals, a failure on the part of employers to properly prepare will likely leave many facilities very short handed during a crisis.
These recommendations should come as no surprise to hospital and emergency service administrators. These are precisely the same recommendations that appeared in the draft guidance 6 months ago.
There are, of course, arguments over whether Tamiflu will be protective during the next pandemic. The truth is, no one knows when, or even if, tamiflu resistance will form in a pandemic influenza strain.
For now, Tamiflu appears to be very effective as a prophylactic, at least based on how few cullers that have taken it have contracted the virus.
One final note.
While I'm not a lawyer, and can't offer a legal opinion, if I were the administrator of a hospital or an emergency service, I'd be talking to an attorney about my liability if I fail to provide adequate, and government recommended, protections to my staff during a pandemic.
Even non-health related businesses need to take a good hard look at their pandemic plans, and liabilities.
Like it or not, the private sector has been put on notice. They ignore these recommendations at considerable peril.
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