2009 pandemic preparedness in Florida

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This fall we will be hit by an influenza  pandemic in Florida. The question is how it will play out here considering the fact that there are four million uninsured Floridians, the third largest in the nation and a weekly average of 3 560 Floridians are projected to lose health coverage from January 2008 to December 2010.  Who will take care of the H1N1 influenza infected Floridians without healthcare insurance?  Will the influenza hit Florida harder due to the huge number of uninsured?

The WHO worst case scenario, for an out-of-control spread of H1N1 predicts that about 30 percent of the U.S. population, 90 million Americans could be infected, 9.9 million hospitalizations, 1,485,000 intensive-care-unit admissions and 1,903,000 deaths.  

The current recommendation is that 150 million people, half the population of the USA should be vaccinated against the A/H1N1, each person will probably need two doses of vaccines so 300 million doses are required to vaccinate the risk groups.  The priority groups are healthcare workers, pregnant women, young children and young people with complications.

According to Washington Post, 40 million doses will be delivered in September, 80 million doses will then be delivered monthly beginning in October, which means that the risk groups will not have been vaccinated by Christmas.

The fact that schools will have to close, at the same time as the health care system will be overloaded puts the uninsured in a very vulnerable situation. When the overstrained health care system has to select who to take care of, will the pick the insured first and uninsured second. The same selection will be made for the chosen few that will have access to the first shipments of influenza vaccine that is expected to be delivered in mid October,  the vaccine is supposed to be distributed to the risk groups first to pregnant women, people with asthma, neurological disorders and to the obese. Healthcare workers will also need to be vaccinated.

The FDA is likely to approve 2009 H1N1 vaccines before trial data can prove their safety and effectiveness against the virus. The agency doesn't normally approve vaccines while major clinical trials of safety and immunogenicity are ongoing, but considering the fact that WHO recommends to begin the immunization program mid October, combined with the fact that vaccine manufactures are getting only one-third as much antigen from the pandemic H1N1 strain as they normally get from the seasonal flu virus. That might mean vaccine makers won't be able to make as many doses as they planned might cause a delay in the deliveries of the 300 million doses needed to protect the most vulnerable in the USA.  

According to The Wall Street Journal, the U.S. government has signed contracts with four companies, Sanofo-Aventis, AstraZeneca, GlaxoSmithKline and Novartis, to a total cost of almost $1 billion to purchase components to make vaccines against the new H1N1 influenza virus.

The government will  pay for the H1N1 flu vaccine. However, the doctors are free to charge for the administration of the shot. The insurance companies will decide whether they will cover the doctor’ administration cost. As every insurer and each plan have different rules the doctor’s cost for administer the shot will be clearing out for each and every patient who will pay what. The uninsured will have to pay the doctor's cost out of their own pocket.

Here in Florida we are used to follow the reports on hurricanes that might hit our state, we look at predictions and try to prepare the best we can.  The pandemic flu will hit Florida this fall, the question is how bad it will hit, but it does not hurt to be prepared and informed.

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