Panflu Plan

Hospital bloc plans for pandemic
Thu, June 1, 2006
Hospitals decide protecting staff beats waiting for outbreak.
By HELEN BRANSWELL, CP

TORONTO -- A bloc of Canada's largest and most influential teaching hospitals has decided to buy enough of the antiviral drug Tamiflu to protect all of their employees from becoming ill during a pandemic -- a decision that will require huge and costly reserves of the drug.

The policy runs counter to the current federal, provincial and territorial thinking, which suggests saving limited stores of Tamiflu for the treatment of people who become sick rather than trying to stave off illness, a drug-intensive process called prophylaxis.

The move could place significant pressure on other hospitals and public health officials to follow suit; health-care unions elsewhere could demand the same level of protection in exchange for assurances their members will show up for work during a pandemic.

"I think there's really no reason why unions wouldn't say 'This is what we want' following that example," Dr. Perry Kendall, chief medical officer of health for British Columbia said of the announcement from the Toronto Academic Health Services Network, which comprises 12 hospitals, including the Hospital for Sick Children and St. Michael's Hospital.

Kendall and others suggested the decision reflects the high level of trauma that haunts health-care workers in Toronto as a result of the city's devastating SARS outbreak in the spring of 2003. That disease spread largely in hospitals and it took an extraordinary toll on health-care workers and their families.

The SARS experience means that a lot of health care workers in Canada wouldn't show up for work absent some sort of intervention. As the reveres have pointed out to me, used prophylactically, Tamiflu is pretty effective. Keeping enough on hand to use for the real duration of any pandemic wave is another matter. The Toronto Academic Health Service Network's decision is likely to be hugely controversial, however. Given limited supplies of the drug, it likely won't be available to the lay public if we start getting sick.