Because my grandfather was one of the victims of the flu epidemic of 1918-19, I've always been diligent about getting my flu shots. But this year, as last year, regular flu shots are not available to everyone who wants them. One reason given is that companies that produce the vaccine risk losing millions when supply outpaces demand for the shots.

Now I read that many physicians are refusing requests for Tamiflu from people who want to protect themselves and their families in case of a pandemic of bird flu [front page, Oct. 22].

Our government is not purchasing anywhere near the amount of Tamiflu doses that would be needed if a pandemic occurred. Why not let individuals create additional demand for Tamiflu by getting prescriptions from their physicians? Such increased demand would motivate pharmaceutical companies to work with manufacturer Roche Pharmaceuticals to produce more Tamiflu.

Similarly, why not set up a subscription system for regular annual flu shots? Such a system would ensure companies producing vaccine of a base demand for their product. A surcharge for subscriptions could cover administration and also increase the availability of vaccine to those who couldn't afford to subscribe a year in advance.




President Bush recently raised the idea of deploying the National Guard in the event he needed to quarantine a region or multiple states because of a bird flu outbreak ["Troops Might Be Used to 'Effect a Quarantine,' Bush Says," news story, Oct. 5].

This is strange because he already has the uniformed Public Health Service, which is empowered to quarantine people under the Public Health Service Act. Its members would be assisted in quarantine duty by federal law enforcement agencies, including the U.S. Marshals Service and the FBI. The Public Health Service could ask for local assistance, but if a state is cordoned off, any National Guard troops who reside there would be included in the quarantine.

At the same time, Congress, presumably with the blessing of the president, was contemplating budget cuts at the federal level to help pay for the rebuilding of the Gulf Coast states. One of the cuts contemplated was to the budget of the Centers for Disease Control and Prevention, our first line of defense against any outbreak or epidemic.

Based on the above, I do not believe the administration knows how to manage a major disease outbreak or epidemic.



The writer is a regulatory consultant and formerly worked as an investigator for the Food and Drug Administration.