Thursday, April 30, 2009

Will Congress Take Steps Necessary to Protect the Public From the N1H1 Swine Flu?

On Thursday, April 30, 2009, the House Commerce Subcommittee of the U.S. Congress held a hearing on the N1H1 Swine Flu outbreak. This is just one of several recent hearings about the recent flu outbreak. As with other recent congressional hearings, the focus by most members of Congress was to attempt to elicit statements to protect U.S. agricultural outbreaks. Many members of Congress insisted that the recent N1H1 swine flu outbreak did not originate and have any connection with animals. One congressman ridiculed the idea of people wearing face masks to protect themselves and insisted that all travel on planes, buses and trains was totally safe. Testifying for the govenment were: Rear Admiral Craig Vanderwagen, MD, deputy Administrator of the U.S. Department of Health and Human Services; Rear Admiral Anne Schuchat, MD, Interim Science and Public Health Deputy Director of the CDC; and Dr. Josh Sharfstein, Acting FDA Administrator. While attempting not to antagonize members of Congress, they nevertheless did not agree to Congressional pressure to minimize the seriousness of the N1H1 swine flu outbreak. As an example, Rear Admiral Craig Vanderwagen discussed how the recent N1H1 swine flu outbreak emphasizes the need to better understand how diseases in animals can jump to humans. Also, Dr. Schuchat described how the current flu outbreak is not just the typical human NIH1 flu - but rather is a new flu consisting of genetic materials from four sources, including swine flu and asian flu. She also refused to agree to insistence that all reference to the swine flu be deleted from CDC websites, insisting that the efforts of the CDC was to properly the public and health professionals. This hearing emphasizes the different priorities of health officials and Congress. Health officials do not want to create a panic, but they nevertheless want to inform the public and encourage individuals to take the individual action appropriate on their part to help contain the outbreak. Congressional focus thus far, however, has been to try to minimize the seriousness of the outbreak so as to not affect the economy. Meanwhile, what seems to be lacking in the public information from both Congress and public health officials is how the N1H1 swine flu outbreak presents different risks for different people. Clearly, given the number of confirmed cases in New York City and the fact that people travel via subways and other mass transit as their primary means of transportation, wearing face masks might be an appropriate strategy for residents of New York City. Furthermore, in communities where the recent outbreak of the flu has been confirmed in a local school, face masks might also be appropriate. And, in fact, public health and school officials have determined it appropriate to close over 300 schools nationwide in 11 states across the country. As a consequence, one can ask whether Congress is serving the public interest when it holds hearings as it has and where individual Congressmen trying to minimize the outbreak and belittle local and individual efforts to curb the outbreak. As an example, is it not appropriate for a person with an immunity deficiency or respiratory problems to avoid crowded public places or to wear a face mask in such places. Yet, at the House Commerce Subcommittee hearing on the Swine Flu Outbreak, at least one congressman belittled people that wore a face mask -- and seemed to belittle people in Mexico wearing protective face masks. Is this the role of Congress -- i.e. to attempt to dictate health and science policy to health officials and scientists based upon concerns that sharing information about the outbreak might negatively affect the economy. Also, is it the role of Congress to belittle individuals with special circumstances that makes them more vulnerable to the flu, and thus to mock all individuals who wear a face mask, no matter what their individual circumstances. Finally, is this appropriate - for Congressmen to mock parents who feel the need to keep their children home from school, and to mock school districts who have felt it appropriate to close schools. Do we want a society where public health policy is dictated by the commerce committee of Congress, as opposed to scientists and public health officials - and the public's own common-sense and awareness of their own individual circumstances?