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Swine Flu

Swine Flu

News and Information on the Outbreak

Many States Do Not Meet Readiness Standards

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By Kimberly Kindy
Washington Post Staff Writer
Friday, May 1, 2009

More than two dozen states, including Maryland, as well as the District, have not stocked enough of the emergency supplies of antiviral medications considered necessary to treat victims of swine flu should the outbreak become a full-blown crisis, according to federal records.

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The medications are part of a national effort to be prepared for a pandemic, and the stockpiling program is being tested for the first time by the rapid spread of the H1N1 strain of the influenza virus. If a health crisis wiped out drug supplies in pharmacies and hospitals, or if families were unable to get to their doctors, local and state officials could quickly distribute stockpiled medications.

The Strategic National Stockpile, created during the Clinton administration a decade ago to provide a federally coordinated response to disasters, maintains a massive collection of antibiotics, vaccines, gas masks and other supplies in a dozen secret locations. The program was expanded in 2004 to include drugs needed in a pandemic and is designed to link with stockpiles kept by state governments, pharmaceutical companies and federal agencies.

But the District, Maryland and 26 other states are 10 million dosages short of the levels that the federal government has determined they should have in their stockpiles for a pandemic. The drugs -- in this case, Tamiflu and Relenza -- would be used to treat the illness, not to prevent it.

Federal agencies, which under the plan are expected to create their own stockpiles, are also falling short. The Postal Service, whose carriers could be needed to deliver medications in a pandemic, has no antiviral medications stocked.

The federal government has met its goal of accumulating 50 million courses of the antiviral medications. Officials said this week that the rollout of those drugs to states has gone smoothly. More than $6 billion has been invested in efforts to fight a pandemic, and President Obama this week asked for an additional $1.5 billion from Congress. The Department of Health and Human Services said yesterday that it will purchase an additional 13 million treatment courses.

"We have anticipated this within the United States," Health and Human Services Secretary Kathleen Sebelius said yesterday afternoon. "We are very aggressively addressing cases here, containment here, trying to move rapidly."

Along with the federal doses, the plan called for states together to create a cache of 30 million doses, but they have fallen short of that figure by one-third. Maine, for example, which has three confirmed cases of swine flu, has stockpiled no medications.

The District and Maryland fell short by hundreds of thousands of doses. Virginia is one of 15 states that has stockpiled more doses than called for in the federal guidelines. In the District, health officials stockpiled about 76 percent of the recommended doses, and in Maryland, the figure was about 70 percent, although officials there said they think they will be fully stocked by this fall.

The combined federal-state stockpile would provide enough medication to treat 25 percent of the population. Health officials believe that treatment at such levels would be sufficient to stop a pandemic.

Some states, however, were reluctant to invest in their share for two reasons: The drugs have a shelf life of four years, and they were proving ineffective for avian flu, which seemed to pose the greatest risk.

Some officials cited financial constraints, despite a 25 percent federal funding match for the antiviral medications.

"We purchased as much as we could with the funds we had," said Dena Iverson, spokeswoman for the District's health department.

Federal agencies were asked last year to create their own stockpiles. But the response has been uneven.

The Defense Department has stockpiled 8 million treatment courses for military service members and their families. The Postal Service, however, has no stockpile for its 330,000 mail carriers.

Even the agency in charge of the pandemic program, Health and Human Services, is behind schedule with its stockpiling effort. Last year, Robinson said, his department asked for $2 million for antiviral medications for its workers, but none have been purchased.

Staff writers Spencer S. Hsu, Lori Aratani and Ann Scott Tyson and news researcher Alice Crites contributed to this report.


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