James Unland, Executive Editor
A Leading Physician Pandemic Planning and Risk
Assessment Expert
Makes Remarks on the "Swine Flu" (H1N1) Outbreak
Dr. Eric Toner, Senior Associate, Center for Biosecurity
is interviewed about the H1N1 outbreak, its implications and some lessons learned to date.
This interview was conducted on May 6, 2009 and runs about 25 minutes.
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HEAR DR. TONER'S INTERVIEW FROM 2006 RELATING TO AVIAN FLU
A Leading Physician Pandemic
Planning Expert Finds The Hospital Industry Utterly Unprepared
For Even A Mild Pandemic...Much Less The Present Deadly H5N1 Avian Virus
Adding That As For The Government, "They Don't Even Want To Talk About The
Numbers"
A Feature Audio Interview Appears Below With Dr.
Eric Toner of the Center for Biosecurity Get transcript in PDF format or HTML
Get the recent article by Dr. Toner and two of his
colleagues published in the Journal of Health Care Finance:
"Financial
Effects of an Influenza Pandemic on US Hospitals" (pdf)
Dr.
Eric Toner, a physician expert in hospital preparedness for pandemic influenza with
the highly respected University of Pittsburgh Medical Center's Center for Biosecurity, in a
wide-ranging interview, questioned both the federal government's underlying planning
assumptions and risk analysis relating to an avian flu pandemic as well as the
government's and the hospital industry's lack of preparedness regarding the true potential
scale of needed inpatient hospital resources in a pandemic, especially during the first
year when the H5N1 virus would require huge numbers of hospital intensive care beds.
"You can't make a
vaccine before a pandemic starts because you don't know exactly what the virus is going to
be...in that first year of a pandemic before a virus-specific vaccine is developed,
somewhere between a quarter and a third of the population could become infected, and if
there's a pandemic with this particular H5N1 virus, large percentages of people will be
sick, meaning severely ill. There has been almost no realistic preparedness on the
scale that is necessary in hospitals...no hospital is prepared for even a 1918 type
pandemic and an H5N1 pandemic could be much worse than that...the numbers are truly
frightening and far exceed our ability to care for high numbers of patients." Dr.
Eric Toner
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Note: this interview can be played in its entirety in a single 25-minute segment
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| Listen to Part 1 (running
time=4:23): Dr. Toner explains what we
are really talking about in terms of the disease 'avian flu' and notes that this is really
a severe pneumonia type of illness that is completely mischaracterized by the term 'flu.' "In the scenario in which the current avian flu virus, the H5N1 virus, turns into a pandemic virus, the health consequences will be phenomenal...this is so different from what we normally think of as flu...those who don't succumb to the illness would probably be on a ventilator for 10 days or so and in a hospital for several weeks, then recuperting at home for several months." |
Listen to Part 2 (running time=2:50): Asked why, when the A5N1 virus human death rate now exceeds 50%, the U.S. Government is projecting a 2% death rate?? ... Dr. Toner expresses skepticism over the government's planning assumptions. "Currently those people infected with H5N1 have had a case fatality rate in excess of 50%. The pandemic planning that has gone on in this country has been based on the 1918 pandemic and in that pandemic the case fatality rate was approximately 2.5%...but a 1918 pandemic is far from the worst case possible...the government doesn't want to talk about these numbers."
|
| Listen to Part 3 (running
time=6:03): Dr. Toner describes exactly why the first year of a pandemic can be so
dangerous in light of how long it takes to produce a pathogen-specific vaccine, and
why the symptoms of H5N1 require major medical interventions that are not practical
at home or any outside-of-hospital settings. "You can't make a pandemic vaccine before the pandemic starts...the first year or so following the start of a pandemic is going to be a terrible challenge...over that first year somewhere between a quarter and a third of the population could well be affected by this virus...huge numbers of people will require inpatient hospital intensive care, on mechanical ventilation, and the numbers would far exceed our present capacity to care for them." |
Listen to Part 4 (running time=8:40): Do either the government or the hospital industry comprehend the implications of a pandemic in respect to needed hospital resources?? ...Dr. Toner thinks not and believes that urgent focus is needed. "So far, there has been almost no realistic preparedness on the scale that's necessary in hospitals...no hospital is prepared for even a 1918 type pandemic, and an H5N1 pandemic could be much worse than that...I would say hospitals, many of which stuggle to keep their doors open, are not acutely aware of the problem for the most part and have not really taken this problem on. They feel that it's beyond their reach, that it's just too hard a problem. They can't imagine how they could cope and so they bury their heads in the sand. I think the CDC and other federal agencies are doing the same thing." |
| See the Center for Biosecurity's Updates | Read the Center's Critique of the U.S. Government's National Strategy for Pandemic Influenza |
| Read A Report on Hospital Preparedness | See List of the Center for Biosecurity's Articles by Topic |
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