Saturday, March 15, 2008

Dr John Hick Interviewed by the Star Tribune

"But when we get hit hard with a bad outbreak, people are going to be saying, 'Why didn't you prepare for this?' And there won't be any good answers."
Dr. John Hick


You may have noticed that media coverage of the shortage of ventilators that will happen in the next pandemic has reduced somewhat recently. The coverage peaked about 2 years ago and has been slowly dropping in frequency. This week there were two stories, one in the Wall Street Journal (link here) and also a very interesting article in the Star Tribune of Minneapolis St Paul Minnesota. Warren Wolf of the Star Tribune interviewed Dr. John Hick of Hennepin County Medical Center about the recent shortage of ventilators in Minnesota hospital intensive care units. (link here)

Dr. John Hick is very prominent in the pandemic flu planning literature. He is the medical director for an emergency-preparedness compact of Minnesota hospitals. He has been involved with many planning committees and has authored several articles dealing with the expected scarcity of key medical supplies including ventilators in a pandemic. He is also frequently referenced in other major articles on this subject. He is clearly one of the leading thinkers on this issue. He is one of the authors in a document I recently reviewed entitled Mass Medical Care with Scarce Resources: A Community Planning Guide. (link here)

Dr. Hick, as you can expect, is usually somewhat more restrained in his comments in his major written articles. In fact, I have even criticized him previously for not pushing hard enough, or looking at enough options. In this interview however, he is a little more open. I was very impressed with his comments and will be re-quoting several of them here.

The Star Tribune article is about a recent shortage of ventilators in Minnesota hospital intensive care units that had many hospitals renting extra ventilators and had several hospitals directing patients with respiratory problems elsewhere for care. Dr Hick was asked about the “crisis” and said he did not think it was a real crisis but that it was a little too close for comfort.

He then linked the temporary shortage of ventilators they experienced to the real problem he perceives. "Even if we hit a temporary local crisis, we can deal with that. What worries me -- what keeps me awake sometimes -- is what will we do when we get a regional or national pandemic? That's going to happen. It's just a question of when and how bad.”

He then says the shortage will cause unnecessary deaths. "The truth is, in a major crisis like a pandemic we may be forced to triage patients because we just won't have the hardware, and some will die.” He said a major disaster or flu outbreak could "tip us over the balance and people would die for lack of ventilators."

The article then says; Hick has urged state officials to stockpile ventilators, "but in a year when we're cutting health care spending, buying ventilators at $50,000 each in case of emergency is kind of a hard sell.”

Hick concludes with, “This is a scary situation and it ought to make people nervous, We got through last week and we can do it again -- we probably will. But when we get hit hard with a bad outbreak, people are going to be saying, 'Why didn't you prepare for this?' And there won't be any good answers."

Thank you Dr. Hick. For telling it like it is.

No comments: