Sunday, April 16, 2006

Firefighters and bird flu

US firefighters get it (and so do firefighters in the UK).
Charlie Dickinson, Acting United States Fire Administrator, announced today a new information section on the USFA Web site to assist all firefighters and Emergency Medical Service (EMS) first responders to prepare for a national flu pandemic.

"The USFA has become keenly aware of the challenges and concerns of all first response personnel who may potentially be facing a national pandemic in the near future," said Dickinson. "The USFA is committed to provide fire/EMS service leaders, firefighters and EMTs and their families with the most up-to-date pandemic flu information, so check this page frequently."

The challenges of a pandemic versus an epidemic are expected to have a significant impact on all first responders, communities and families. An Epidemic is a contagious disease that spreads rapidly and extensively among many individuals in an area. A Pandemic is an epidemic over an especially wide geographic area and comes from the Latin word "pandemies" meaning "of all the people". And that is precisely why pandemics are so deadly and disruptive to society.(Firefighting News)
The International Association of Firefighters (IAFF) has developed some policy and operational recommendations for state and local departments. A preparedness checklist is here (.pdf). But an important issue raised by the IAFF (echoed by health care workers) is policy around prophylaxis of essential workers. Health care workers, fire and police are near the top of the list for getting any vaccine (although none is currently available) or antivirals like Tamiflu. All groups worry about side effects from drugs or vaccines that may not be adequately tested.
Fire fighters and emergency medical personnel who are injured or die as a result of receiving the flu vaccine or any prophylactic or antiviral treatment should be considered to be injured or killed in the line of duty. Because receiving these treatments is voluntary, it may be possible for local governments to claim that such illnesses are not job-related. The federal government needs to address this problem.

As it has done in previous health emergencies, the U.S. Congress has granted vaccine manufacturers immunity from lawsuits in order to encourage faster development of new vaccines. But unlike past efforts, Congress did not also create a compensation fund for those harmed by vaccines. A compensation fund should be established in both the United States and Canada for first responders harmed by the vaccine.

“The IAFF will continue with legislative efforts to provide a fair compensation system – such as the federal Vaccine Injury Compensation Fund – to assist our members and their families who may be injured from receiving the vaccine or coming into contact with someone who received it,” says President Schaitberger. Vaccine manufacturers and those who administer it have been offered immunity from liability through recent Homeland Security legislation.


The recent hurricane disasters illustrate the need for planning and preparation for effective and efficient response in an emergency. Some localities already have task forces established or are in the process of putting them together and developing their plans. It is critical for IAFF affiliates to have representatives on these task forces to ensure that policy and care delivery models are developed with first responders’ concerns at the forefront.

IAFF affiliates should also work to ensure that any member who experiences any adverse reaction from the vaccine be provided with immediate medical and follow-up care at no cost to the fire fighter. Furthermore, any fire fighter or emergency medical personnel who has an adverse reaction to the vaccine and is unable to perform his or her duties should be entitled to receive occupational disability benefits as provided by the employer for on-duty injuries or illnesses for the duration of the disability. Any leave of absence associated with an adverse reaction should be immediately classified and treated as a line-of-duty injury and all medical costs associated with the vaccination and adverse reaction treatment must be borne by the employer. (IAFF)
So we might be faced with health care workers, police and firefighters refusing to use prophylaxis because Dr. Frist and his patrons in Big Pharma wanted to evade accountability for products they may have known were dangerous or failed to take due care as to safety (here, here and here).

What a tangled web we weave.