Apr 20, 2007 (CIDRAP News) – Faced with the reality that an effective vaccine is not likely to be available for at least the first several months of an influenza pandemic, some corporations are buying antiviral medications for their employees—both to protect them and to improve the chances that the company could keep providing vital products and services through a pandemic.Few companies have revealed their plans concerning the use of antivirals, but two of them recently described their plans to supply employees with oseltamivir (Tamiflu): the US division of Roche, the company that makes Tamiflu, based in Nutley, N.J., and Public Service Enterprise Group (PSEG), an energy company that serves nearly 2 million electric customers and 1.6 million gas customers in New Jersey.Tamiflu is a neuraminidase inhibitor that the World Health Organization (WHO) recommends as the treatment of choice for people infected with H5N1 avian influenza; it is regarded as the best hope for treatment if H5N1 evolves into a pandemic strain. The WHO lists the other licensed neuraminidase inhibitor, zanamivir (Relenza), as a second option for treating H5N1.Roche and PSEG are among the first large companies to supply their employees with Tamiflu, and their experiences may hold lessons for other companies considering such programs.Employee antiviral programs gain momentumAntiviral programs for businesses range from modest stockpiles that would cover only certain at-risk employees to more comprehensive plans intended to cover all workers and even their families.Roche spokesman Terry Hurley told CIDRAP News that 350 corporations have purchased Tamiflu for their employees. Companies don’t order the drug directly from Roche; they obtain the medication either from distributors that ship it to a company clinic, from a pharmacy benefits manager (PBM) that mails the medication to employees, or from local pharmacies.The idea of companies supplying their employees with antiviral medication, however, has generated some controversy. When Roche rolled out a pandemic planning Web site last July to market Tamiflu to companies, some medical and policy experts charged that the company was favoring more lucrative corporate requests over government stockpile orders.Mike McGuire, vice president of anti-infectives for Roche, said the company waited until its production capacity reached 400 million treatment courses per year before following though with its employee program. The company’s US facilities can produce 80 million treatment courses annually, he said. “Once we filled a number of government orders around the world, had enough for seasonal orders, and had enough to fill our other orders, then we decided to fill our own,” he said.The decision to stockpile or supply antiviral medications isn’t an easy one for businesses. Medication cost is one factor to consider, said Stuart Weiss, MD, an emergency medicine physician, pediatrician, and disaster planning expert who has worked for government agencies and healthcare organizations. Also, employee antiviral programs should include a strong educational component and medical screening, which also add to program costs, he said.”Just giving someone a box of pills without the educational component is wrong,” said Weiss, who is a founding partner of MedPrep Consulting Group, based in New York City.Other factors that companies may weigh when considering an employee Tamiflu program include the drug’s 5-year shelf life and scientific uncertainty about efficacy and dosing against an emerging pandemic influenza strain. Antiviral-resistant H5N1 strains have been isolated from a few patients in Vietnam and Egypt. The WHO suggested this week that physicians might consider doubling the standard dosage of Tamiflu for H5N1 patients.Weiss said companies shouldn’t substitute an employee antiviral program for a comprehensive pandemic plan. “Just buying antivirals in a vacuum is a waste of time and resources,” he said. Plans to protect employees should also involve social distancing, personal protective equipment, and other mitigation strategies.Why now?Representatives from both Roche and PSEG said the decision to supply employees with Tamiflu represents the next step in their pandemic planning. “We need to still be able to produce lifesaving drugs [during a flu pandemic], and we’re extremely proactive,” McGuire said. The unpredictability of a pandemic drove Roche’s decision to have the drug ready for employees ahead of time. “We’re not even sure the doctors will be in their offices when the pandemic hits,” he said.Ronald Mack, MD, medical director at PSEG, based in Newark, N.J., said the company takes the threat of a pandemic very seriously. “We have been sensitized to this type of threat by our past experience responding to 9/11, SARS [severe acute respiratory syndrome], anthrax, the Northeast blackout [of August 2003], and the terrorist threats against downtown Newark,” he said.Implementing an employee Tamiflu program for a large organization takes time, Mack said. “We considered that it would be difficult to do for the first time under urgent circumstances, which would produce competition for resources, and elected to act now,” he said.Who receives it?All Roche employees are eligible to receive Tamiflu, said Ann Peterka, MD, the company’s director of employee health services. The company plan is intended both to maintain the company’s ability to continue producing essential drugs and to protect employees, she said.”We provided Tamiflu to all of our employees since everyone will be needed to get the business back to normal once a pandemic wave has subsided,” Peterka said. “And since we have a critical role in ensuring that we are able to supply Tamiflu to all of our stakeholders during a pandemic without interruption, it is important to protect our employees from getting infected so we have the best chance of accomplishing this objective.”Alex Nawotka, director of commercial operations at Roche, said covering all employees will help company operations return to normal more quickly after pandemic waves pass. “We felt that all of our employees are important in that effort,” he said.PSEG’s Tamiflu program also includes employees’ spouses, dependent children, and domestic partners, Mack said. The goals are to further protect employees and decrease their worries about their families during a pandemic, he said. “The sense is that our workers would not appear [for work] unless they felt that their families were secure. We are a very family-oriented company—multigenerational employment is not unusual,” he added.Neither company was willing to reveal how much Tamiflu would be supplied to each employee or family member.Steps for prescribingSources at both PSEG and Roche say the employee Tamiflu program is just one facet of a broader pandemic flu awareness program, and employees are educated before doctors screen and prescribe them the drug. Other elements include hygiene messages on hand washing and cough etiquette.Roche employees must complete a computerized educational module before they qualify for the Tamiflu program, Peterka said. After they finish the module, they meet with a company doctor who reviews their medical histories, clears them to receive the drug if no contraindications are found, and gives them Tamiflu packaging materials to review. Roche has contracted with a physician network that can do the screenings on- or off-site, she said.After an employee has completed the educational material and met with a physician, the prescription is sent to a PBM, which mails the employee his or her Tamiflu supply.At PSEG, employees attend one of several group information sessions, held February through May and led by physicians, Mack said. Employees complete three brief forms—a medical history, a privacy statement, and an education acknowledgement form—and meet individually with a physician. Those who are cleared to receive Tamiflu are given a supply of the drug, along with instructions for taking it.In June, after employee prescriptions are processed, said Mack, family members will go through a similar process to receive their supplies of Tamiflu.What triggers taking the drug?Another issue for employee antiviral programs is what to tell workers about when to take the drug. Using it for treatment means using it only during the illness, but taking it for prevention during a pandemic could mean taking it for many weeks. Roche and PSEG take different approaches on this point.Roche said its employee Tamiflu program follows World Health Organization guidelines for seasonal flu treatment and prevention (the WHO says that antivirals can be used preventively as well as for treatment). However, Peterka said employees are told to consult a medical practitioner before they take the drug. “We don’t want them self-diagnosing,” she said.Mack said for now PSEG intends for employees to use the antiviral medication to treat flu symptoms in the event of a known pandemic but not for prevention. “This may be modified if an actual pandemic evolves,” he said.Maintaining awarenessBoth companies said their Tamiflu programs are just one element of ongoing pandemic communication with employees. Mack said PSEG uses seasonal flu as “practice” for a pandemic; for example, the company makes it easy for employees to get their seasonal flu shots by offering them during work at company expense.Roche and PSEG have installed touchless water faucets and towel dispensers and have posted educational messages on proper handwashing techniques and cough etiquette.The Tamiflu program isn’t a one-shot educational push, Nowatka said. Some of the ongoing efforts at Roche are aimed at teaching employees the difference between seasonal flu, pandemic flu, and the common cold, he said. “We use a variety of venues: e-mail, kiosks, posters, and weekly newsletters,” he said.See also: WHO guidelines for pharmacologic management of H5N1 patients, May 2006Apr 19 WHO statement mentioning possible high-dose oseltamivir treatment for H5N1 patients
The Dept. of Public Safety released the Annual Security and Fire Report on Tuesday, which contained crime statistics for the past three years and outlined crime and safety policies for all USC campuses.Colleges and universities that participate in federal aid programs are required to publish crime reports under the Clery Act of 1990.The data indicates a decline in burglaries and robberies between 2011 and 2013 but shows an increase in forcible sexual assaults over the same period. Burglaries fell from 83 cases in 2011 to 28 in 2013 and robberies dropped from 34 cases to 17. Forcible sexual offenses increased from 24 cases to 33 over the same period. Disciplinary referrals for liquor law violations more than doubled from 200 cases in 2011 to 563 cases in 2013.Vice Provost for Student Affairs Ainsley Carry said that the increase in reported sexual offenses is expected as the university has taken steps to make the process of reporting such crimes easier and more accessible.“We’ve created a culture and environment where people should feel safe reporting [sexual assault],” Carry said. “We know that our numbers should increase.”Carry said that he expects the numbers to decrease as the university continues implementing cultural and educational programs aimed at reducing sexual violence on campus.The report breaks down the crime statistics for the University Park campus into four geographic zones: on-campus, student housing, public property and non-campus. Public property includes streets, sidewalks and parking facilities, while non-campus includes off-campus student housing and other university buildings outside campus boundaries. Crimes reported directly to LAPD are also included in a separate category.
In fight vs corruption, Duterte now points to Ayala, MVP companies as ‘big fish’ Ex-pros Robby Celiz and Gary David added 11 points apiece for Bataan, which turned a close game into a rout in the fourth quarter after putting the clamps on Batangas’ shooters.“It was a big factor that the crowd was behind us and the guys were really inspired tonight,” said Bataan coach Jojo Lastimosa, whose team closed out the game on an 11-0 run. “Everybody just stepped up.”FEATURED STORIESSPORTSGinebra beats Meralco again to capture PBA Governors’ Cup titleSPORTSAfter winning title, time for LA Tenorio to give back to Batangas folkSPORTSTim Cone, Ginebra set their sights on elusive All-Filipino crownThe Risers also got solid efforts from former University of Santo Tomas center Jeepy Faundo and Pamboy Raymundo in the second half, even as the Athletics ran out of steam after a strong start.It was the first loss of Batangas in the tournament and just third overall since the Rajah Cup, where the Athletics went 16-2 en route to the crown. Volcano watch: Island fissures steaming, lake water receding Sports Related Videospowered by AdSparcRead Next Bataan Risers’ Pamboy Raymundo. Photo from Maharlika Pilipinas Basketball LeagueBALANGA CITY, Bataan— Feeding off the energy of a boisterous home crowd, Bataan used a strong finishing kick to stun inaugural champion Batangas City-Tanduay, 81-67, Wednesday night for its first victory in the Maharlika Pilipinas Basketball League Datu Cup at Bataan People’s Center.Former Ateneo stalwart Vince Tolentino fired 12 points and grabbed 10 rebounds on top of five assists as the Risers, who went winless in two home games last season, delivered a memorable home debut to atone for their opening-game setback to Manila.ADVERTISEMENT Tim Cone, Ginebra set their sights on elusive All-Filipino crown Carpio hits red carpet treatment for China Coast Guard PLAY LIST 02:14Carpio hits red carpet treatment for China Coast Guard02:56NCRPO pledges to donate P3.5 million to victims of Taal eruption00:56Heavy rain brings some relief in Australia02:37Calm moments allow Taal folks some respite03:23Negosyo sa Tagaytay City, bagsak sa pag-aalboroto ng Bulkang Taal01:13Christian Standhardinger wins PBA Best Player award Christopher Tolkien, son of Lord of the Rings author, dies aged 95 Lions, Tams reach semis Don’t miss out on the latest news and information. Jury of 7 men, 5 women selected for Harvey Weinstein rape trial Lights inside SMX hall flicker as Duterte rants vs Ayala, Pangilinan anew MOST READ LATEST STORIES Bicol riders extend help to Taal evacuees Cloudy skies over Luzon due to amihan Taal victims get help from Kalayaan town Earlier, Navotas hammered out a second straight victory following a 59-55 triumph at the expense of Caloocan Supremos-Longrich.Levi Hernandez and Kyle Neypes combined for 27 points, but it was the Clutch’s airtight defense down the stretch that ensured coach Ritchie Ticzon’s charges stayed unbeaten despite committing 28 turnovers.“We turned the ball over so many times and that is something we need to address,” Ticzon said.ADVERTISEMENT View comments