Texas woman, 38, falls victim to US flu epidemic and exorbitant drug costs
13 February 2018
A 38-year-old teacher and mother of two died Sunday from complications stemming from the influenza epidemic currently hitting the US. Heather Holland of Weatherford, Texas fell ill last Monday and was diagnosed with the flu on Wednesday. Doctors prescribed Tamiflu, an antiviral medication widely used to treat the flu by lessening the severity of its symptoms.
But the second grade teacher did not take the medication because of its $116 price tag, according to her husband Frank. He eventually bought the prescription drug for her on Thursday when her symptoms did not improve.
“Friday night, things escalated and she ended up in the ICU,” Frank told weatherforddemocrat.com. “The doctors got the blood cultures back and they had to put her on dialysis early Saturday.” By then, Heather’s body had gone into septic shock, one of the most dangerous complications of the flu. She died the next day.
Heather, described by her husband as a passionate educator and a loving wife and mother, is just one of many victims of this year’s flu epidemic. Hers was one of 20 reported flu-related fatalities in the Dallas-Fort Worth area this flu season. Her death casts a grim light on the deplorable state of the US health care system and the government’s lack of preparedness and funding in the face of this season’s particularly deadly epidemic.
The latest report by the Centers for Disease Control and Prevention (CDC) shows that 63 children have died nationwide so far from the flu. Only pediatric deaths are tracked weekly by the agency. The CDC predicts yearly deaths from the flu in the range of 12,000 to 56,000 and warns that this year will be closer to the highest number, as there are no signs of the disease waning.
Flu virus activity is widespread in 48 US states. The South continues to be hard hit. At least 2,355 people have died of influenza and pneumonia across Texas through January, according to health officials. Medical officials in Louisiana say the state is on track to record some 1,000 flu-related deaths this season. The Georgia Department of Public Health says there have been at least 66 flu-related deaths in the state so far this year.
Alicia Budd, an epidemiologist in the Influenza Division of the CDC’s National Center for Immunization and Respiratory Diseases, believes there could be about 35 million illnesses and approximately 700,000 hospitalizations associated with the flu this season, comparable to conditions during the 2009 “swine” flu. One in 10 deaths nationwide is currently estimated to be flu-related.
At least three-quarters of those testing positive for the flu are infected by the Influenza A H3N2 virus, a particularly virulent strain. This year’s vaccine is a poor match, probably 30 percent effective or less. This is in part because, with current vaccines, H3N2, which rapidly mutates, is the strain most resistant to inoculation.
Many young and otherwise healthy people, outside of the usual high-risk groups that include pregnant women, small children and the elderly, are dying from the flu. Some of these deaths are attributed to secondary infections and conditions. Pneumonia, causing inflammation of the lungs, can hit when a patient starts feeling better a few days after the flu has struck.
Sepsis, which claimed Heather Holland’s life, can be triggered by infections in the lungs, kidneys, skin and gut as a result of the flu. A patient’s immune system can overreact as it releases chemicals into the bloodstream to fight infections, causing inflammation and damage to several organs.
Doctors, hospitals and pharmacies are still dealing with shortages of medical supplies and medicines. Florida pediatrician Dr. Lisa A. Cosgrove, who practices telemedicine in Georgia, Florida, Illinois and North Carolina, told CNN, “Tamiflu is becoming hard to find in Georgia.”
Hospitals are still struggling with IV bag and saline shortages, a direct result of the devastation still plaguing Puerto Rico as a result of Hurricane Maria. The island is home to one of the main manufacturers of IV bags.
It is under these conditions the US government agencies charged with protecting the health of Americans are facing cutbacks. The CDC estimates total yearly expenditures for flu outbreaks, in both direct and indirect medical costs, amount to $87.1 billion. But last year’s budget provided just $57 million for influenza pandemic planning.
The CDC has also been hit by a scandal forcing the head of the agency to resign. Dr. Brenda Fitzgerald, a former OB-GYN doctor and Georgia health commissioner, who was named by President Trump last summer to head the agency, stepped down from the post last week after reports surfaced that she traded in tobacco and health care stocks.
Among Fitzgerald’s investments are Japan Tobacco, a multinational that markets Winston and Camel cigarettes, known carcinogens; pharmaceutical giants Merck & Co. and Bayer; and health insurer Humana. In an appointment that typifies his administration, Trump tapped an individual whose beliefs and actions directly oppose the fundamentals of the agency she was to head.
The budget unveiled by the president Monday includes a sharp cut to the Department of Health and Human Services (HHS), which oversees the CDC. Trump’s proposed budget allocates just $68.4 billion to HHS, $17.9 billion less than the agency received in fiscal 2017, a draconian 21 percent decrease.
The development of a universal vaccine to fight influenza is one of the most critical challenges facing medical professionals and researchers. This could potentially protect against all strains of the flu over the course of a person’s lifetime, replacing the yearly—and often ineffective—vaccines.
The federal National Institutes of Health (NIH), while publicly declaring the development of a universal vaccine a priority, committed only $30 million in funding out of an already inadequate overall budget of $230 million last year to the project. The Biomedical Advanced Research and Development Authority, another federal agency, is spending an equally miserly $43 million on a project in pursuit of “game-changing influenza vaccines.”
As with all vital health needs in America, including pharmaceuticals, medical devices and treatments, research and funding for the development of a universal vaccine is left to the private sector and subordinated to profit.
French-based Sanofi Pasteur has signed a deal with SK Chemicals to get exclusive US and European rights to sell any vaccines developed through SK’s cell technology and more advanced vaccine technology that holds promise for the universal flu vaccine.
One of the reasons the current flu vaccine is relatively ineffective is that most of the vaccine is prepared in fertilized chicken eggs, a method that is particularly ineffective against this season’s predominant H3N2 strain. A more promising method is to prepare vaccines in “cultured cells,” which are removed from animals and grown under controlled conditions.
However, in the for-profit health care system in the US, rational development of vaccines is beholden to the profit-motive of the health care industry.