Every day the government funding impasse continues, say the media, children with cancer will not be able to receive advanced clinical treatments. John Burklow, a spokesman for the National Institutes of Health, related this statistic in a news conference yesterday afternoon.
The kids with cancer who will be turned away are only a sideshow, however. Some of the scariest effects concern American health in the aggregate. Over half of the workers in the government's Department of Health and Human Services (more than 40,000 people) have been furloughed. Included:
- Food and Drug Administration
- Centers for Disease Control
- National Institutes of Health.
All official U.S. websites are sporting a warning box on the landing page that reads like this:
"Due to the lapse in government funding, only web sites supporting excepted [from the shutdown] functions will be updated unless otherwise funded. As a result, the information on this website may not be up to date, the transactions submitted via the website may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted.
Updates regarding government operating status and resumption of normal operations can be found at http://www.usa.gov."
Department of Health and Human Services
The Department of Health and Human Services is the government’s main health, medical, and disease agency. Its mission: to protect the health of all Americans and provide essential human services, especially for those who are the least able to help themselves. Many HHS personnel are first responders to national emergency:
- Emergency support functions
- National disaster medical system
- Medical surge capability
- Strategic national stockpile of medicines and vaccines
- Federal medical stations and medical reserve corps
- Public health administration
Staff at HHS who work with lab animals are still on the job. However, we all need to watch what we eat: there are no food import inspectors during the shutdown, so we're at the mercy of tons of contaminated fish (91% of which are imported), bad veggies (50%), and toxic fruit (20%). (The Department of Agriculture will continue its monitoring of meat and poultry during the shutdown.)
Also very concerning: Should Tropical Storm Karen, now brewing on the nation's Gulf coast, transform into a major hurricane like Katrina or Sandy, the health hazards cannot be underestimated. Rainfall-induced flooding, storm surge, high winds, and related storms all accompany tropical cyclones. Without swift, coordinated, and effective emergency response, states like Louisiana, Florida, and the Carolinas risk not only massive destruction, but also widepread injury, disease, and death.
Food and Drug Administration
The U.S. Food and Drug Administration supplies consumers and patients with information for staying safe and healthy. It serves health professionals and the community with medical product safety cautions and adverse event/problem reporting. Almost half (45%) of this agency's personnel are now on furlough. FDA also provides the nation's routing food inspections from the Department of Health and Human Services. As noted above, this safeguard has vanished because of the slowdown.
FDA also runs activities for scientists and researchers. These include the National Center for Toxicological Research, which investigates poisons new and old. The agency also oversees clinical trials and critical path initiatives. For industry as well as patient safety, the FDA presents guidance, runs product registration and listing, and oversees imports.
Schuyler Velasco of the Christian Science Monitor sees this agency as chronically underfunded, having lost $209 million of its $85 billion in the March sequester budget cuts and handling 2,100 fewer inspections than last year. During the week before the shutdown, FDA managed to approve a new drug to treat major depressive disorder (September 30) and a neoadjuvant breast cancer treatment and also awarded seven grants for pediatric developments. However, the bucks will also stop here.
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention comprise the nation's health protection and security agencies. CDC personnel work 24/7 to protect the United States from health and safety threats, both foreign and domestic.
The emergency operations center will have trouble maintaining the agency’s emergency capability, according to Brad Plumer at the Washington Post. Lab testing has also been cut back.
CDC has had to furlough 9,000 employees (about 70%), said spokeswoman Barbara Reynolds. The shutdown means that CDC can no longer effectively monitor or track multi-state disease outbreaks like Hepatitis A, the Cyclospora stomach bug (which has sickened 643 people in 25 states since June), and the amoeba Naegleria fowleri, which polluted the water system of Louisiana's St. Bernard Parish several weeks ago and literally ate the brain of a 4-year-old, killing him.
Surveillance for other emerging infectious diseases will also diminish. CDC's work to track and prevent HIV/STDs, tuberculosis, and MERS will be limited or discontinued. The agency will not be conducting routine inspections of BSL3 and BSL 4 labs.
“The vast majority of the CDC is actively in the process of shutting down,” Reynolds said. “We’ve gotten really good at trying to find outbreaks, but our strong network is getting weaker.”
The shutdown has also affected many more individuals by limiting the country's seasonal flu program. With "Chinese bird flu," H5N1, and H7N9, influenza has evolved into an increasingly lethal disease. The shutdown won't affect the availability of flu shots this fall (135 to 140 million doses of vaccine are currently being produced), but it may limit CDC’s ability to warn people at high risk and respond to uneven or rogue illness.
The shutdown may also curtail our ability to assimilate this season's disease results and prepare next year’s flu shot. Within a few weeks, CDC researchers are sscheduled to begin analyzing this year’s viruses to determine next year’s multi-strain vaccine. ABC News has reported that this year's season has seen the earliest and most intense outbreak of deadly flu in a decade.
On September 16, CDC issued a new report about a rising and serious health threat we face today--antibiotic resistance. Reducing it requires "urgent and immediate collaboration among public health, clinical medicine, agriculture, industry, and policy makers." Urgency has surrendered to lethargy thanks to the shutdown.
The cuts will also stop CDC from supporting state and local partners with infectious disease surveillance.
National Institutes of Health
The National Institutes of Health handle the nation’s ongoing and new medical research. The group supports scientific studies that turn discovery into health. Its Clinical Center is the world's largest research hospital. NIH has had to furlough 75% of its staff because of the shutdown.
More than 1,400 ongoing clinical trials of new medicines in people with serious and even mortal conditions will be able to continue. However, the shutdown means certain death or incapacity for some sick people in need, regardless of their health insurance status. The agency will not be able to offer evolving therapies to any new patients or to start any trials of potentially disease-reducing or life-sustaining therapies during the shutdown. Four new protocols [clinical trials] are reportedly ready to start next week, but they risk delay or cancellation if the shutdown continues.
Possible political ramifications of the Obamacare dispute
According to a longstanding and respected independent national poll released Tuesday, American voters oppose Congress shutting down the federal government to block implementation of the Affordable Care Act by a three-to-one margin. The House of Representatives has even blocked a center-right budget deal that some influential Republicans initially backed, but then turned down at roll call time. The impassioned battle cry being heard: federal government is bad for us, and Americans do not want or need governing (although, to the contrary, at least 47% of us are lazy sloths looking for handouts).
American voters also oppose blocking an increase in the nation's debt ceiling (deadline: October 17), by well over a two-to-one margin (64-27%). The poll finds voters almost evenly divided on Obamacare and federal budget deficit issues. However, only one-third of Americans think Congress should defund the health care law. The President's approval rating has dropped to 45%.
Looking at the 2014 Congressional races, voters now pick a generic Democrat over a generic Republican candidate by an 11% margin, the widest Democratic lead measured so far, according to Peter A. Brown, assistant director of the Quinnipiac University Polling Institute. "On almost all questions, voters see President Obama as more reasonable, and better able to handle the issues. But it is not because the president is beloved…. Voters are angry at almost everyone in Washington over their inability to keep the trains running, but they are madder at the Republicans than the Democrats."
Based in Chicago, Sandy Dechert has been covering science and health for Examiner.com since the webzine's official startup. In the health area, she has covered the creation, enactment, and progress of the Affordable Care Act (Obamacare). Sandy began investigating MERS before the disease was officially named and H7N9 human influenza on the day the Chinese announced it. Sandy's science articles appear frequently in Examiner's women's and sexual health columns and under environment and energy, as well as elsewhere in the digital world.
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