Effect Measure

There’s a line forming for the pandemic vaccine that doesn’t yet exist. Sort of like a new Harry Potter book except it’s not first come first served. Like a sinking ship, it’s (pregnant) women and children first — or among the first. The deployed military? Police, I understand. But deployed military? They come ahead of critical infrastructure (power, water, communications) and older children? They come ahead of food and agricultural workers?

“Certain military personnel like deployed forces would get vaccinated before certain other military personnel,” HHS science adviser William Raub said in a telephone interview. (Reuters)

We haven’t yet seen the report setting out the vaccination priorities (as of this writing it has yet to appear on pandemicflu.gov) and so far it is only a draft for public comment.

And comment I hope will come. This is a subject that demands public discussion. My first reaction is that our military misadventures are already costing us dearly in blood, treasure and opportunity. Putting deployed military at the head of the line doesn’t make sense to me on any score. If the question is maintaining public order, we should use the police and in extremis a state’s National Guard. Pregnant women and toddlers are a reasonable priority as they are at high risk from pandemic flu virus, as are school aged children who act as transmitters. When they are sick they also prevent their parents from working. Doctors, health care workers and critical infrastructure all belong towards the head of the line, too. But deployed military? If we want them to get pandemic flu vaccine, let’s bring them home so they can get back to work making life better, not destroying it.

You can read more about the draft plans in Maggie Fox’s excellent Reuters piece linked in the pull quote. Presumably the report will appear on the internet soon.

Comments

  1. #1 Nancy
    October 24, 2007

    The draft appears to now be up at

    http://pandemicflu.gov/vaccine/prioritization.html

  2. #2 Sarah
    October 24, 2007

    Destroying life? What the….are you that out of touch?

  3. #3 revere
    October 24, 2007

    Sarah: Actually I am very much in touch. The invasion-induced loss of life is very stubstantial, in the hundreds of thousands according to the best (although imperfect) estimates. You may think they are lives worth spending for “bigger purposes.” I don’t.

  4. #4 Ryan
    October 24, 2007

    I attended the meeting of the Advisory Committee on Immunization Practices this morning at CDC in Atlanta, and there was a talk by the Interagency Working Group on pandemic flu planning.

    An interesting fact that was brought up: In each of the three public sessions where comments were solicited, the “most important” group to vaccinate, in the eyes of the public, was those whose jobs put them in danger of contracting the disease. Those at a higher risk of serious complications/death ranked only seventh overall.

    And although I sympathize with your motives, your comment disturbs me. Either you think the combat troops won’t be disproportionately affected (unlikely) or you think we shouldn’t vaccinate them so that more of them die and we stop fighting a war. Please clarify.

  5. #5 herman
    October 24, 2007

    Sarah,
    Revere’s commentary today is very important. He is not out of touch. I hope M.Randolph Kruger also participates in this discussion, since I enjoy reading his posts.
    It appears that over 1 million civilians in Iraq have been killed since the invasion. The US is 5% of the world’s population, and consumes 25% of the oil. Sarah, do these two facts influence you in any way? To murder people in order to steal their oil is evil, and that is what the US is doing in Iraq. Sarah, do you favor attacking Iran with nuclear weapons, even if it kills thousands of innocent civilians? How much human blood has to be shed so that the US can have oil? What exactly are your moral values in this regard?
    Revere’s discussion of who gets the vaccine is necessary now, because there is another possible cluster of 7 children in Indonesia who may be infected with bird flu. As these human clusters increase, the world moves closer to a possible pandemic.
    The world probably reached peak oil in 2006, and we are entering the downward path of oil supply, meaning life is about to become much more difficult. It is better for the US to reduce oil consumption than to kill innocent people in the middle east in order to steal their oil. Bush says we may be near WWIII. So if he turns the nukes loose on Iran, we may all may be dead soon. Is that what you want Sarah?

  6. #6 herman
    October 24, 2007

    Rayan,
    Bush started an unjust war in Iraq, using lies. Out troops should be withdrawn from Iraq now. Ryan, do you favor attacking Iran, and if so,why?

  7. #7 revere
    October 24, 2007

    Ryan: I think they are not the highest priority when it comes to protecting the community at home. They are not in our midst (although I wish they were), will not transmit to us because we aren’t in contact with them, and they are not doing work that protects us from influenza or makes our communities more resilient. All this is independent of the terrible enterprise in which they are engaged. Does that help?

  8. #8 Ryan
    October 24, 2007

    :) Yep. I read into your comments a more knee-jerk reaction than there apparently was.

    Although I might continue to play devil’s advocate and assert that vaccinating them would save more lives (related and unrelated to the pandemic, American and Iraqi) than not vaccinating, but not as many as bringing them home. Given the particularly perilous situation in many parts of Iraq, a ~20% debilitation might mean much worse things than a ~20% debilitation at home. i.e. Vaccine might be more effective in saving lives in a war zone, where we can’t afford to lose any troops.

    So, given the reality that a pandemic will not be the impetus that Bush needs to draw down our forces, it might not be a horrible idea to give them SOME level of priority.

    And Herman, nothing that I’ve said implies any support for the war in Iraq.

  9. #9 Rebecca Van Hout
    October 24, 2007

    I guess my take on it, is troops would be very likely to spread pandemic flu if they were not vaccinated, became infected (not unlikely in a place like Iraq) and brought it home. Look at what happened with the 1918 flu. The soldiers were some of the first to fall and spread it!

  10. #10 M. Randolph Kruger
    October 24, 2007

    Well you guys got it all wrong. You might find some credence in it regarding the National Guard troops being around for what? To get infected on orders? No vaccine so whats the beef? As for the they are in Iraq Jack and not here to back us up I am confused. If they are here, they are in garrison. Seems to me that Ft. Riley KS was where they were in garrison and they got sick. Also the same for Ft. Dix when they had the Swine Flu scare of the 70’s. Someone tell me I am wrong here. The Army wasnt put in charge in 1918 so what were the troops being used for? I’ll tell you. NATIONAL DEFENSE as required by law. Posse Commitatus prevents use of federal troops in civilian control areas… PERIOD. When those troops are nationalized they are then FEDERAL troops that are there for the defense of the nation and they do the bidding of the CIC. Its like the Dems saying that the reason there are fires in California are because of global warming, and that they cant put them out because BUSH has all the troops in Iraq. Nope… There are 18,000 Marines in San Diego alone. Until yesterday when Bush signed the emergency declaration at the request of Arnie, it was a states problem. Vaccinations? What are they going to vaccinate these people with, snake oil?

    Vaccinating the troops though for any disease deemed necessary by the Surgeon General is prudent… period. They have every aspect of life covered in the military. Just about everything we do in civilian life is patterned on the military way of doing things. They can keep generators going, they can run powerlines, they can keep order so the civilian authorities can work to bringing things back under civilian control. That control structure is in full swing and Arnie didnt screw around. He knew when he was whipped and called for reinforcements.

    If panflu breaks out you can forget Iraq. We would start a redeployment back to the US almost immediately but that redeployment would be back into an infection zone. Iraq and Iran would likely cease to exist as problems of any kind as the demand for oil would drop to 1930 levels if the population is hit with anything higher than 8% CFR. There were 150 million Americans then and we have double that now. Survivors would be very, very slow to recover from this and if it were a 61% CFR as it is now, it would take generations.

    The National and North American Panflu plan puts the military in charge ONLY on request of a state. The latest change in the post Katrina laws though allow for SOME troops to be placed under a states control but that time is limited. That is done under a Congressional review of need. VERY limited.

    Katrina lies at the feet of Blanco who wouldnt sign the order because those troops were not going to be under her control. She pissed and moaned for 3 days and people died. Panflu? These troops had better be vaccinated first. But what are we talking about here? We dont have an effective vaccine anyway so whats the difference? So far they are either so weak that it would take two liter bottles of the stuff to partially protect you maybe, or they are so strong (Websters), that you might kill a kid or one of these soldiers by giving it to them.

    Tempest in a tea cup.

  11. #11 M. Randolph Kruger
    October 24, 2007

    Hey Herman-I wouldnt call 100 bucks a barrel stealing unless you are a member of OPEC. We consume 25% of the worlds oil so we can act as their biggest customers. Stealing in my mind though is when I roll into Riyadh, Teheran, Kuwait with 4 mechanized battalions, kick the shit out of their government and then start loading tankers with oil for free. Summarily executing anyone of course who stands in the way.

    I would also like to point out that we are also the most prolific humanitarians in the world with all of the aid that is sent out from here. So they get to overcharge us so we can send them even more money. But as to the comment about Iran. Oh yeah, you cant bet your life on it that the mullahs are history in Teheran. They either totally dismantle their program or they are gone. No one has phoned them just yet to let them know.

    Iraqi oil production is pretty low right now. It would be nice if they did start producing more. We are no where near peak oil because of all the oil finds. I think you might want to review that. But you could be right. I dont worry too much about it either way. We hit Saddam because he was an asshole, and even with possibly flawed intel on the nuke side it was stellar on the amount of stuff he had. Phosgene, VX, Sarin, Tabun all were his poor mans nuke. Remember that was Hans Blix’s find, not ours. And remember that little convoy that we never stopped from leaving Iraq had enough to do us all. Where did it go? Why to Syria of course. They needed a few more techno guys though as they were fitting it up into their missiles last month and had a little spill that killed over 150. I saw a picture from space and the area around it for about three miles has no vegetation including desert plants.

    As for the 1 million Iraqi’s. Could someone PLEASE tell me where they are buried? Shit, that part really scratches my carbuncles. They must be stealth bodies. They get up in the night and run for the border of Iran to pick up Semtex and C-4. Scuse me for pointing that out. Anyway, lefties like to count. Right wingers like to bury them in marked graves and only get to count them once. We can account for about 100K of dead. The lefties say 600 to 1 milliion. So many lies, so little time to the election. Quite a few wounded, but in line with previous wars. Thats about 2.5 to each one dead. But to the lefties you get to count them 2, maybe 10 times over and ones that we shot, maimed or strafed according to Barack O-bomb-me. Sounds good with Katie C for the six o’clock news.

    But the post is about vaccinations. We have to have the troops here to handle the problems. They would leave Iraq and leave some there. but it would become a moot point in very short order. They would be dead there or here if there isnt a vaccine available and in line with whatever the CFR’s are at the time.

  12. #12 nsthesia
    October 24, 2007

    Randy,

    This discussion is indeed a tempest in a tea cup, but I seem to remember a major skirmish in the early days of our country over a little cuppa tea. This time, the tempest just might encompass the entire globe.

    I AM eternally grateful for your high verbal acuity, logical, unemotional thinking and frankly, your sheer verbosity. At least it gives this forum some kinda balance.

    I tend to experience severe vertigo from having to lean so far to the left to read some of these posts. I am a LIBRA, and we MUST be balanced. Thanks for the realignment!

  13. #13 Neal
    October 24, 2007

    Well, I was going to respond to herman…but, Randy does it so much better.

    No one I know wants the troops home more than I do. I have friends/family with boots on the ground in Iraq. But, the thought of the consequences of them not being there right now scares me even more.

  14. #14 herman
    October 24, 2007

    M.Randolph Kruger,
    I do not agree with much of what you have stated, but I enjoy reading your posts, and thanks for your comments.
    These issues really do need analysis.

  15. #15 herman
    October 24, 2007

    Neal,
    http://www.counterpunch.org/bricker10232007.html
    The war in Iraq, and the possible nuclear attack on Iran, is not about terrorism. It is about protecting the US oil supply. And Bush really is considering WWIII, as can be easily noticed by his recent comments.
    Alan Greenspan and Senator Chuck Hager have both stated the US is in Iraq to protect our oil supply. And the cost of the war in Iraq and Afghanistan for 2007 is $800 billion. How much oil can you buy for $800 billion, instead of killing people to take it? And Putin, on his visit to Iran, stated any attack on Iran would be equilivant to an attack on Russia, since they are allies. Do you see how dangerous this war for oil can be?
    For the US corporate and governmental elite, protecting the US oil supply from the Middle East is the highest priority.It is a higher priority than human life. Therefore the mission of the US military in Iraq will continue to be to kill for oil.
    And this same elite will garantee the our military gets the bird flu vaccine first. Blood for oil is a nihilistic, obscene, immoral priority.
    And this war for oil really could result in WWIII if Russia responds to a US attack on Iran; meaning we could all soon be dead. Is oil worth more than your life? And who is going to use the oil if we are all dead?

  16. #16 bar
    October 24, 2007

    Back a few posts I said the head of the line for vaccination would be government leaders, health workers and the military. I can understand why the government is not overly enthusiastic about publicizing themselves as in the first group, probably it is snuck in with “women & children”.

    At the risk of being labeled inhuman, I would like to point out that vaccinating women and children would do little to reduce the pandemic. Women and children should be kept isolated at home. Developing a cure, preventing civil disorder and maintaining the water supply all come before “women and children”.

    I think Randolph covered rather comprehensively why the “deployed military” were included. I also object to that “one million casualties”.

    Paraphrased, somebody (from a liberal university or organization I think) said “we collected this data under incredibly difficult conditions, we got some funny numbers so we ignored those. We aren’t going to publish the raw data we collected. Anyhow our conclusions are that there are one million more Iraqi fatalities than if our troops weren’t there.”

    Really!

    And btw, I don’t know if it’s just the Australian papers, but the news from Iraq seems to be that the progress of the war has turned.

    I cite: Major Al-Qaida leaders offed, Iraqi refugees reported returning home, more local volunteers for military/police training than can be accepted, various tribal leaders co-operating with US forces, unemployment rising and fatalities from terror incidents falling.

  17. #17 herman
    October 24, 2007

    bar,
    It is impossible to keep women and children isolated at home. They will be exposed to the bird flu virus, sooner or later. Revere has specified exactly who should be vaccinated first. Please do not ignore his wisdom. He knows much better than you or I what should be done in a pandemic. We should respect his knowledge.
    You are a victim of the propaganda machine. All the progress you report in Iraq is a lie. It is propaganda of the Bush war machine, a machine than may soon cause WWIII. How would you feel if a foreign army had invaded your country, destroyed your sewer system, your bridges, your water supply, and killed thousands of your citizens? And after they did all that, they stole your oil? Would you welcome them?
    Do hospitals in Iraq have what they need? No. Do the people have jobs? No. Do they have safe places to live? No.Do the citizens have adequate food? No.
    Why did 4 million leave the country? Was it because the US provided them with safe places to live? No. Is there air conditioning in the unbearable heat? Perhaps for one or two hours per day?
    Would you volunteer to live in Iraq for a week, to see how well the US military protects you? I doubt it.

  18. #18 M. Randolph Kruger
    October 24, 2007

    Oh now hang on for a second. Revere and I grate like two tectonic plates in Indonesia but bubs I think he is pretty much dead on most of the time on his medical stuff. He and Tom DVM go around and around too but its in deep respect.

    Herman, either we do the Iranians or Israel does. Their feelings towards Ms. Clinton are very well known and they dont plan to kowtow to her at all. In fact the rhetoric against her and her husbands handling of Iraq is almost as bad as GWB’s is now. We had ample opportunity to change the Executive Order that prevented the targeting of foreign heads of state under WJC but didnt. We were repeatedly shot at during the no-fly zone days and we simply knocked radar unit after radar units off the map. Then, the VX thing came out and that was indeed on Clintons watch. We were also attacked in the WTC’s under his watch and he did shit except launch 30 cruise missiles and missed.

    You post up about the propaganda machine. What was Kosovo? They were killing the shit out of each other over there for years and it wasnt an issue until the presidential penis got caught between Monica’s teeth. Thats not propaganda… thats DNA. It wasnt about sex even though I didnt like what he did. It was about lying to federal agents, then a federal grand jury and a federal judge. Now there is propaganda for you. But on to Iraq. You assert that they had all these things BEFORE we bombed the shit out of them. Not so Herman. The power was rationed but less than it is now. They had cholera every year, its worse this year because the government is so weak and cant keep the power on. Be advised the Kuwaiti’s just got a contract to put in generators that will be online by Xmas that will supply Baghdad and Tikrit, Fallujah. Thus that will allow for them to take their excess and put it on the grid. They are just about a Giga-watt or two off from getting that all together. By Xmas there will be a change. That is if there isnt a war with Turkey. Bad news. Bad policing of the Kurds. Bad stupid move on their parts to be attacking the Turks. But anyway the power will be up, there will be more water production as a result and of course sanitation. Another problem that is suggested is chemicals. Well those bears have been shitting in the woods (desert) for years without chemicals or anything but wells in the wadi’s. Saddam had also used water as a weapon by cutting it off to previously filled wetlands. That changed the flows up stream.

    Herman 4 million left the country because of the pay back that was starting. Shia’s outnumbered the rich Sunni’s by about 2 to 1. Would you hang around if there retribution killings going on?

    Watch this. NPR lefty run operation but it is informative.

    http://www.npr.org/templates/story/story.php?storyId=7411762

    As for going to Iraq, I would. No problem. My former unit is on site and while I wouldnt roam the tourist attractions I wouldnt hesitate. We dont need to kick any more doors down or strafe civilians as Barack would have you believe. They need to do it. Its inevitable though that they will. Strong man is hiding in the weeds waiting to make a dash for power. Not before we get Iran though.

  19. #19 Candles
    October 24, 2007

    Report said children to 35 months of age { toddlers } would receive vaccine . From 36 months on wards ? No mention of children and pan flu vaccines , in articles . Is this correct there are no provisions in place for children and panflu vaccines ? Reason for this question .. This article was posted today .
    Bird flu finds children’s lungs faster
    http://www.eurekalert.org/pub_releases/2007-10/bc-bff102307.php

  20. #20 Pandy
    October 25, 2007

    I won’t mention which state I live in, but from what I’ve determined, according to our State Health Department, law enforcement is going to have to fend for themselves.

    Vaccines will go to medical folks and vulnerable populations; Tamiflu will go to medical folks and people that are ill.

    However, law enforcement will be expected to continue their duties AND provide protection for hospitals, clinics, etc.

    While I have absolutely no complaints about medicos getting protected, I do have a problem with the state not making an attempt in protecting our guys and gals who are going to be protecting us.

  21. #21 ConnectRN/Public Health
    October 25, 2007

    I’ve brought this up before. Washington will make a priority list, but the vaccine will be going to the lowest common denominator – the local public health department. Some will follow the guidelines, others will have their own priority list. A community may see panflu affecting the young, or the old, or redheads, or whatever, and will establish its own “who’s first list”. We need recommendations from an ethical standpoint before the panflu arrives, but once its here you will probably see a restructing of those guidelines at the local level.

  22. #22 Olymom
    October 25, 2007

    Well, I could go for high priority for the military IF the guideline was written “vaccines are to go to those most vulnerable — namely healthy young people from the age of 14 to 30″ — H5N1 is similar to the 1918 flu in being most deadly to the young adults.

  23. #23 daedalus2u
    October 26, 2007

    Using nuclear weapons against Iran’s nuclear facilities wouldn’t kill thousands, it would kill hundreds of thousands or millions.

    The Iranian installation are reportedly some 50 feet underground. To destroy them requires high yield ground burst nuclear weapons. High yield ground bursts create massive fallout. About half the fission products end up as prompt fallout. Depending on weather, that could put lethal levels of fallout over tens of thousands of square miles. Fallout levels that would be 100% lethal with a few days of unprotected exposure. Millions of Iranians live within the potential lethal fallout zone(s).

    The prevailing winds are north, and would carry fallout from the nuclear installations on to the population centers, and then on to Russia. How many civilian deaths will Russia find acceptable before they tell Bush to stop?

    Who will prevail if Bush and Putin disagree on how many Russian civilian casualties are acceptable collateral damage?

  24. #24 Caledonian
    October 28, 2007

    I would expect that the first to be vaccinated would be those individuals necessary for the treatment of the people who *do* develop the disease: doctors and nurses.

    Then people who would be particularly vulnerable to the pandemic or who are especially likely to contract it: children, police officers, etc.

    What’s the point in innoculating the military first?

Current ye@r *