Fw: Immunized team could spread disease to family, friends, OMA warns

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----- Original Message ----- From: ilena rose

Sent: Saturday, February 01, 2003 10:52 AM

Subject: Immunized team could spread disease to family, friends, OMA warns

Smallpox response force faces unfair risk

Immunized team could spread disease to family, friends, OMA warns

http://canada.com/national/story.asp?id=%7B2AAF2E44-4F3E-4623-97AE-FB5C993D722E%7D

Mark Kennedy

The Ottawa Citizen

Saturday, February 01, 2003

Doctors in Canada's largest province are concerned a federal contingency plan for a possible bioterrorism smallpox attack puts them and other health-care workers at an unfair risk.

Under the plan, certain health-care workers across the country will be called upon to join a "national smallpox response force." They would be vaccinated in advance for smallpox, thereby making them immune from the deadly disease so they can treat the first victims of a smallpox attack and prevent its spread to others in the affected community.

The problem is that getting the smallpox shot carries risks of a serious adverse reaction or death. Moreover, those people who get the shot can spread the vaccine running throughout their body just by touching someone else -- say a family member -- which then puts that person at risk of developing serious side-effects.

Ontario doctors want a no-fault compensation scheme in place just in case they, other health-care workers, or their family members get sick or die as a result of the vaccination program for the smallpox response force.

Dr. Elliot Halparin, president of the Ontario Medical Association, wrote a letter to Ontario Health Minister Tony Clement this week in which he outlined those concerns and asked for a compensation scheme.

Dr. Ted Boadway, the OMA's executive director of health policy, said in an interview that a compensation scheme wouldn't be very costly and it's the right thing to do.

"We think that it is a reasonable social contract, or a reasonable societal bargain that when you ask someone to put themselves at risk for the purposes of the greater good, that you also say to them, 'And if you suffer that consequence, we will look after you.' "

He said the OMA has asked Clement "to champion this cause and get it fixed."

"Otherwise, who's going to step forward if they're expected to take all the risks themselves?"

In Toronto, an aide to Clement said yesterday that Ontario is discussing the issue with the federal government. A spokesperson for Health Canada also said the government is reviewing the matter. "The decision to offer federal compensation has not yet been determined," said Tara Madigan.

She said the government will also use other means to "reduce the risk," including "stringent selection criteria," the availability of therapies in the event of side-effects, and the "informed consent" of people who become part of the response force.

The decision ultimately lies with the federal government, which initiated the development of the contingency plan in recent months in conjunction with provinces, which are now tasked with putting many of its elements in place.

Governments say the odds of bioterrorists using smallpox are low. But an executive summary of the smallpox contingency plan states: "The deliberate or accidental release of the smallpox virus into today's largely unvaccinated and highly mobile population would wreak far-reaching havoc in medical, social and economic terms."

Health Canada intends to stockpile 10 million doses of smallpox vaccine by summer as a precaution against an attack. If an outbreak occurs, Canada will employ a "search and contain" strategy in which infected victims are isolated and treated by health-care workers.

Others within the same geographic area who may have been exposed will be vaccinated. At the heart of the emergency response will be the members of the response force.

Dr. Boadway said an estimated 1,000 people -- doctors, nurses, possibly lab technicians and others -- would be part of the group in Ontario to be pre-vaccinated. The risks of smallpox vaccination are "not trivial," he said.

He said one out of every 250,000 who are vaccinated would die, and many more would become ill. Studies from the 1960s suggest one in 1,000 will face complications, some serious, including a severe skin rash or encephalitis that may kill or cause permanent neurological damage

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