Brigham City council votes 3-2 to purchase Tamiflu for city employees

By Amy Macavinta

April 7, 2008 | BRIGHAM CITY -- City Council members narrowly passed a motion to use public tax dollars purchase a small amount of the antiviral Tamiflu for select city employees in the event of a pandemic that may or may not take place.

Part of serving the public is to tackle a lot of "what if" questions and come up with the best possible solutions. This week, the council had to ask one another "what if" there was a global outbreak of influenza similar to the one that killed millions of people in 1918-19.

For Jim Buchanan, the city's emergency services director, one of his first questions after the initial "what if" is who is going to provide services to the public if city personnel are too ill. The city has an opportunity to purchase Tamiflu for their employees at a much discounted rate, but even that raises a lot of questions and concerns.

"My job is to be Mr. Gloom and Doom," said Buchanan. "I am the bearer of bad news. I am not an expert on the pandemic flu, whether we buy the Tamiflu, or whether we buy Bayer aspirin."

Tamiflu is an antiviral medication that can lessen the severity of the flu. Type A Influenza typically runs its course in 10-12 days. With early treatment, that can sometimes be shortened to six to eight days.

The city's cost would be just under $20 for each course of treatment. It can be prescribed as a 12-week prevention course, or only on the occurrence of illness. With just over 230 city employees, the expense adds up quickly. And, to complicate matters, Tamiflu has a seven-year shelf life.

The council must decide whether to purchase the Tamiflu for all of their employees, or just some of them. And then, they must decide who gets the medication in the event of a pandemic.

To help the council make a more informed decision on purchasing the drug for their employees, Buchanan invited Michael C. Shaw, M.D. and Keith Larsen from the Bear River Mental Health Department in Logan to speak to the council on the pros and cons of treatment. According to Larsen, the Tamiflu will still be prescriptive. So while the city is buying it ahead of time, it will be stored with the health department and a doctor will still have to provide a positive influenza diagnosis and write a prescription.

"[The health department] is not pushing Tamiflu," said Larsen, "but we do want to make it available."

Shaw, who has a family practice in Brigham City, said he could only provide information to the council based upon his own personal experience and observation. To be effective, treatment must begin within 24-48 hours of experiencing symptoms.

"It helps," said Shaw. "How much it helps depends on how soon treatment is started."

Shaw brought up another concern with the city purchasing Tamiflu. When comparing the shelf life of the medication to the rate of need, the city assumes the risk of losing a great deal of money. "If you look at history, there have been three pandemics," said Shaw. "So you could buy this five times to cover one pandemic."

The city is very conscious of the need to continue providing critical services to the public in the event of a pandemic. But they wrestled with the decision.

Councilwoman Ruth Jensen was concerned that there is no protection offered to the elderly and the homeless, two groups that are particularly susceptible to the influenza. And yet the city was considering the use of public tax dollars to provide the antiviral to its employees.

On the other hand, Mayor LuAnn Christensen wants to be able to do that for city employees.

"I would almost feel like there was blood on my hands if I didn't do everything I could to help our employees," she said.

However, Buchanan was quick to point out that the city's purchase of Tamiflu "has nothing to do with the individual health" but instead is meant to help the community by getting that person well and back to work as quickly as possible.

Purchasing a preventative course of medication for all city employees would be a considerable expense, but Councilman Scott Erickson said it was unlikely that every employee would become ill, even in a pandemic. In a formal motion, he suggested the city purchase enough medication to treat half of the city employees, with those doses to be distributed based upon the necessity of the employee's position.

This brought the cost down to roughly $2,000. The motion passed 3-2.

However, the city has not yet determined who will receive the medication if a pandemic is declared. Shaw advised the council that consideration should be given to the community's need for a particular position or service ­ not to the person filling that position.

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