Not Made in the USA
DOBBS: New desperate measures tonight by the federal government trying to deal with a critical shortage of the medication used to treat flu symptoms in children. The Centers for Disease Control has now authorized emergency measures to quote, "stretch the supply of TAMIFLU liquid", which includes the allowance of TAMIFLU that has passed its expiration date and other measures to stretch the supplies as well -- Kitty Pilgrim reports.</s>KITTY PILGRIM, CNN CORRESPONDENT (voice-over): In this Walgreen's Drug Store in New York the pharmacist is stretching the supply of liquid TAMIFLU by what is called compounding, breaking open capsules and mixing the contents with liquid.</s>STACIA WOODCOCK, PHARMACIST, WALGREENS: The manufacturer let us know back in September that there was not going to be enough of the liquid suspension to go around, so we were very proactive, got out to our pharmacists, got a recipe from the manufacturer to be able to make an extemporaneous compound.</s>PILGRIM: The CDC this week announced major pharmacies like Walgreen's and Walmart are doing this and other pharmacies should also.</s>DR. ANN SCHUCHAT, CDC: We do encourage pharmacies to be able to do compounding so that our pediatric supplies will stretch as far as possible.</s>PILGRIM: Liquid TAMIFLU used to treat swine flu is in short supply. Roche the Swiss manufacturer says it has ramped up production in the U.S. since the pandemic broke out last spring and will be producing 400 million doses of TAMIFLU next year. An estimated 20 percent of production will be inside the United States. Roche today says it intentionally shifted its production away from TAMIFLU liquid making capsules instead because capsules provide 25 times the dosage in the same amount of time it takes to make one dose of the liquid for a child, so now it's up to pharmacists to make the drug usable for infants by compounding.</s>EDITH ROSATO, NATIONAL ASSN. OF CHAIN DRUG STORES: The pediatric suspension is usually dispensed for infants or for children that cannot swallow tablets and also for adults that can't swallow tablets. So it's used pretty frequently.</s>PILGRIM: Liquid TAMIFLU is now in such short supply the FDA in July and again in October issued emergency measures to extend some lots of TAMIFLU for use beyond their expiration dates on the package. So for example, one lot of TAMIFLU due to expire May 31st, 2005 can now be used until February 28th, 2010.</s>PILGRIM: Now the FDA says using the expired TAMIFLU identified by lot number is perfectly safe. They've set up a Web site for consumers to see if their expired TAMIFLU is still usable. The CDC recently released 300,000 doses of liquid TAMIFLU from the national stockpiles to hospitals around the country but the CDC says that will not be enough to deal with the pandemic and the number of children who will need the medication. Lou?</s>DOBBS: Let's be really clear what the CDC is saying here is that there's a critical, critical shortage of TAMIFLU and that they are drawing them on the adult supplies to meet that demand and what will be the impact then on the availability of supplies for adults?</s>PILGRIM: There's no -- there's no estimate on that...</s>DOBBS: So this is...</s>DOBBS: This is truly triage?</s>PILGRIM: Yes.</s>DOBBS: Is what this is.</s>PILGRIM: Yes, this is emergency measures that they are just trying to figure out how to cope. But there's no estimate -- they just started doing this, so there's no estimate on how much of this has to be converted to the children's dosage.</s>DOBBS: This is extraordinary and thank you, Kitty, and we'll be staying on top of this throughout. Thank you -- Kitty Pilgrim. Well, the CDC today conceded that production of the swine flu vaccine is way behind schedule. Patients and doctors across the country are now reporting shortages -- in some case, severe shortages, and long lines awaiting the vaccine. Our Lisa Sylvester today experienced those delays firsthand when she took her son for his vaccination. Lisa, tell us what happened.</s>LISA SYLVESTER, CNN CORRESPONDENT: Yeah, you know this is something else when you actually sort of see this firsthand. And you know the first thing I have to say is -- to explain to people is you can't get the swine flu vaccine from your pediatrician, we couldn't get it from our family doctor, so the only place that we could go to was our local county health clinic, the Montgomery County, Maryland Clinic and they were offering hours -- they were only offering hours once a week, Wednesday, today, from 9:00 to 12:00. Now, my friend Jacqueline, she got there early at 8:00 this morning and we thought we were being really smart about this, getting there at 8:00 in the morning, an hour before they opened. But what we found out is that there were hundreds of people already in line. Some people started arriving at 12:30 in the morning the night before. What is really in high demand are those injectable shots. These are shots of the vaccine that only pregnant women, people with asthma and health problems can get and the county, Montgomery County Maryland had only had 200 doses of this -- of the injectable vaccine and they very quickly ran out. And so they don't now, as of this moment, they do not have any more injectable shots. That only leaves the other option, which is the nasal flu mist. And today they administered about 1,300 doses. But you know there are just so many people coming up and they just don't have enough to go around.</s>UNIDENTIFIED MALE: There are people here today probably really do need to be vaccinated, you know and can't get anything but that shot because of some underlying condition or age or whatever and that won't.</s>UNIDENTIFIED FEMALE: I went in to get it this morning and got up about 7:00 and look at the line. It's bad.</s>UNIDENTIFIED FEMALE: We got here about 7:45, 7:30 and waited for two and a half, three hours only to find out that they only had 200 injectables.</s>SYLVESTER: You know at one point the line stretched up for four blocks. In fact they had so many people they brought in port-a- potties and they started handing out water. All told in our case for my son we ended up waiting four hours and then he is right at 2 and so he was able to get the flu mist when it all said and done, but he actually has to go back in 28 days. If you get this and for kids between the ages of 2 and 10, they actually need two doses and that's what we're being told in order to be effective, so yes, we waited for four hours, yes he ended up getting the flu mist, but we also have to go back in 28 days.</s>DOBBS: Well and I suspect you're amongst the most fortunate people there, lots of people as you said not getting any vaccination whatsoever, whether the injectable or the inhalant. Any suggestion at all as to -- on the part of the public health authorities there, as to when vaccine will be made available?</s>SYLVESTER: You know that's the big question. In fact, this afternoon I spoke to county officials and I asked them that very question, so when. But the way it works is it's going from the federal government down to the state level, down to the county level and so the county officials are saying, we don't know. And that's so unfortunate because they can't really tell people. They are scheduling more clinics this upcoming week, but they said you know we might have to scale it back a little bit depending on what we have because again they have no injectable shots. They only have the nasal flu mist. Right at this moment, they are keeping their fingers crossed hoping but -- and it's not just the story here in Maryland. This is a story, the same all across the country and it's very worrisome for parents.</s>DOBBS: Very worrisome for parents and it has to be absolutely terrifying for those expecting children, pregnant mothers as Kitty Pilgrim has been reporting throughout can't take the inhalant. They have to have the injectable. They can't have that live virus in the inhalant.</s>SYLVESTER: Right.</s>DOBBS: And have to have the injectable.</s>SYLVESTER: Yeah. And that is so true. It's pregnant women, it's kids who are under 2, it's people who have asthma or underlying health problems and the problem is the only option they have is the injectable. They can't do the nasal flu mist. And what -- what can they do when they show up at the county and the county says, I'm sorry, we're out. And these are for people who even did show up you know in the wee hours of the morning.</s>DOBBS: And we still haven't heard what your family doctor said, your pediatrician said. They have no better information obviously.</s>SYLVESTER: Yeah, they are still in line. Everybody is still waiting.</s>DOBBS: Oh, boy, as are millions of people all over the country. Thank you very much Lisa -- Lisa Sylvester. Part of the reason for the widespread swine flu vaccine delay is that three of the four approved manufacturers produce their vaccine overseas. Now only one of these companies and it's not even an American company, it's Sanofi Pasteur, it's producing all of its vaccine for the U.S. market in the United States. But it's the only company doing so and it's only 75 million doses. The Centers for Disease Control has ordered over a quarter of a billion doses and only a fraction of that is on the way here, right now as we understand it's something in the neighborhood of 9.8 million doses. We're not only, of course, dependent on foreign companies for medications, vaccines, but critical medical supplies as well. And now there are new concerns about whether there will be enough supplies to control -- to help control the spread of the swine flu. There are already mask shortages all around this country. And most of those masks are made of course overseas -- Ines Ferre with our report.</s>INES FERRE, CNN CORRESPONDENT (voice-over): The CDC recommends using N95 respirators and other masks for dealing with swine flu patients. It recently recognized there is a shortage of respiratory protection but won't estimate by how much. One manufacturer estimates that at least 50 percent of the respirators for H1N1 swine flu are made in China. When it comes to surgical masks, 90 percent are made abroad in countries like Mexico, China and Thailand. One U.S. mask manufacture says too much production in now overseas.</s>MIKE BOWEN, PRESTIGE AMERITECH: If there's a pandemic America won't be able to supply its own need because we're pretty much it. And all of the other manufacturers have left the country. And we think that China will probably at some point if this didn't work, we think that China will probably keep their products for themselves.</s>FERRE: The American Nurses Association says some of their nurses have already reported shortages of approved masks in some locations.</s>NANCY HUGHES, AMERICAN NURSES ASSOCIATION: This has been something that has been in pandemic planning for several years. And the N95 is the minimal protection that we would need. So we're falling short already. It's very concerning because we want to see that nurses are protected on the job.</s>FERRE: In 2007, the Department of Health and Human Services predicted that if we were to have a 1918-like pandemic, there would be a shortage of respiratory protection and that's an area HHS said America would need 5.3 billion respirators and 26.9 billion surgical masks, far more than the number currently in stockpiles.</s>FERRE: And the CDC predicts a large gap between supply and demand of respiratory equipment and is telling health care workers to stretch their supply. Now some hospitals are asking nurses to use one mask per shift unless it gets wet or contaminated. Normal procedure is to change it with each new patient, Lou.</s>DOBBS: This is remarkable. What we are witnessing just in the last five minutes of your reporting and Kitty's, this is a nation right now that's not prepared for a pandemic. This is a nation whose primary public health agencies, which last spring in late winter were sending masks to Mexico to help with their outbreak. We now are a nation with critical shortages and we're supposed to be the advanced nation that has very sophisticated public health agencies and sophisticated planning and obviously there are shortfalls.</s>FERRE: And the manufacturers are telling me that they are slammed -- I mean they're saying they're working around the clock.</s>DOBBS: Again, this country has allowed two things to happen. One is we have only 20 percent of the pharmaceutical companies that we once did in this country. We're now dependent on foreign manufacturers for pharmaceutical companies and we are reliant upon China and other producers for necessary medical equipment. It's crazy. All right, Kitty, thank you very much. Thank you very much, Ines. Well, I'll have a few thoughts about the swine flu pandemic and these shortfalls and our government response and lack of response to it. Join me on the radio Monday through Fridays for "The Lou Dobbs Show" 2:00 to 4:00 p.m. each afternoon on WOR 710 radio in New York. Join US tomorrow as we focus on this issue and go to loudobbs.com to get the local listings for "The Lou Dobbs Show" on the radio in your area, subscribe to our daily Podcast. Check out the loudobbs.com "Independent American" store. By the way, all of the products in the loudobbs.com "Independent American" store are, they're very rare because all of the products there are made in America. And please follow me on loudobbsnews on Twitter.com. Up next, we'll have a lot more on the swine flu vaccine shortage. Some of the nation's top experts on controlling the virus join us here and you don't want to miss what they have to say. And despite our struggling economy, colleges are hiking tuition fees, putting even more strain on American families. Why are we putting up with this? That's next. Stay with us. We'll be right back.