H1N1 Influenza

Floor Speech

By:  Paul Broun
Date: May 5, 2009
Location: Washington, DC


H1N1 INFLUENZA -- (House of Representatives - May 05, 2009)

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Mr. BROUN of Georgia. Thank you, Dr. GINGREY, for yielding.

As you were discussing the past flu epidemics and the 1976 swine flu that happened back then, I was practicing medicine in rural southwest Georgia. At the time, of course, the recommendations were for everybody in this country to get a swine flu vaccine. As a practitioner, I was concerned about that, and I was asked by many of my own patients should they get this flu vaccine. And, frankly, I was not recommending it because, as I looked at the data that were available at that time, I just really questioned the wisdom of exposing people to the vaccine. So I was not recommending it to my own patients. I did not get the vaccine myself. And actually, in my practice, which was a very busy general practice in rural southwest Georgia, I did not have one single patient come down with swine flu, not the first one. But I had several patients get Guillain-Barre syndrome from the vaccine. One was a good friend of mine who was a newspaper publisher in the community, and he struggled and his family struggled with his paralysis. But people died.

A lot of folks don't consider that these vaccines aren't innocuous. There are side effects and can be tragic side effects and can lead to death. More people died from the vaccine than died from the swine flu back then.

Just Monday I was chairing a facility at the vet school at the University of Georgia, in Athens, Georgia, and went into a biocontainment lab, a level 3 biocontainment lab. There's a researcher there who's doing probably the cutting-edge technology research on this infection that we have out in the public today. He came from the CDC before he came to the University of Georgia, and he deals with these viruses. They have some pretty potent viruses in their laboratory there. And he told me that a week ago he was telling the CDC and the people in the Federal Government, anybody who would listen, NIH, et cetera, that this virus did not have the characteristics of being what we call in medicine a very virulent virus. In other words, it was not one that was going to create a lot of infections and severe infections in this country.

I asked him, why do we see in Mexico people dying at a greater rate than we do here? And he said, well, we really don't have the data of how many people are infected down there. But from what he could ascertain, and he was part of the group who was studying the virus in Mexico, and he said that down there the people who are getting the virus, this current infection, and who were having severe difficulties and were dying principally were people that had other what we in medicine call comorbid conditions. In other words, they had respiratory problems. They had other illnesses that created a problem where they would develop secondary infections and die.

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Mr. BROUN of Georgia. I appreciate the gentleman's

bringing that up.

You're exactly right. Any death is tragic and we in medicine try to prevent all deaths. When I graduated from the medical college in Georgia just like you did, I think you were a year ahead of me there in Augusta or maybe two, but I took the Hippocratic oath. They don't do that in medical school because the Hippocratic oath says, ``I shall do no harm,'' and it says ``I shall not perform an abortion,'' and Roe v. Wade has changed that; so medical schools are not taking the Hippocratic oath anymore because there are doctors that are doing harm. They're killing babies through abortion. I am very pro-life, and I know that life begins at fertilization, and I want to protect all life. And it's tragic whenever a life is taken, whether it's an unborn child or whether it's a 23-month-old child that that died like this one from this H1N1 type A flu or whether it's an elderly person. But what happens, and particularly has happened in this case, is I think the gentleman is exactly right that the media has overblown this.

There is a lot of misunderstanding when the World Health Organization, the WHO, says there is a pandemic. What does that mean? Most people in America think, well, people are going to be dying in wholesale lots all over this country as they did in the early part of the last century. Well, the World Health Organization, when they talk about a pandemic, they just mean there's flu in multiple areas, and it doesn't mean that people are going to be dying. In fact, the flu in America has been very mild. Most people, as it was in 1976, who have contracted the flu go about their business. And that is a danger in that people, if they start running a fever, they need to stay home, whether it's with this flu episode or any flu episode. They need to take care of themselves. If they run a fever more than a day or two, as a primary care physician, I would tell them they need to see their physician. Now, they don't need to take antibiotics.

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Mr. BROUN of Georgia. Certainly I would be happy to discuss how I approach patients. In fact, I've had patients come in and say, Dr. Broun, I don't want to get the flu. I want some Tamiflu or I want Relenza. And, frankly, taking it prophylactically may help, but the thing that we are doing is we are spending a lot of money to take that, and once they take the preventative, if just a few weeks later they get exposed, then they could still get the flu. It doesn't have a lasting effect.

So what we do know is that taking these antivirals like Tamiflu and Relenza, if you take those very early on in the course when people first start getting a fever, when they first start aching all over, when they first start getting the runny nose and the cough and the sore throat, if they'll go to their doctor then and be evaluated to see if they indeed do have the flu and then get on the medicines, that's the best way, most cost-effective way of treating this.

Now, a lot of patients will come in the office and say, I've got the flu, I want antibiotics, or they'll call on the phone and say, Dr. Broun, I'm running a fever, I need an antibiotic. Well, most fevers aren't susceptible to antibiotics because most fevers are due to viral illnesses. Even allergies can cause fevers. Fever in itself doesn't indicate that a patient needs an antibiotic.

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Mr. BROUN of Georgia. No, I would say that they don't need a culture unless they're at high risk. In other words, if they had been in Mexico, particularly Mexico City, which is apparently where the nidus of this infection began--we don't really know for sure, but if people have been in Mexico City, if it's within the incubation period, which is about a week, and start running a fever, then maybe it is a good idea for them to have the culture done or the flu test done to see if this is indeed the swine flu.

But the thing is, the treatment that they are going to get, even if they have the H1N1 flu is not any different than if they have any other of the viruses. The big question is, do they need antibiotics or not? Do they need the antiviral, the Tamiflu-Relenza types of medications, or are they better off with penicillin or some of these other high-powered drugs that are on the market today?

And a CBC, a complete blood count, will help the doctor to understand whether they have a viral infection or bacterial infection. If their white blood count is high, if they have what we say is a left shift, in other words if they have types of white blood cells that indicate a bacterial infection, then they do need antibiotics. They do need a bacterial culture just to see if any of the antibiotics that the doctor prescribes are going to eradicate that particular bacteria.

But as I mentioned earlier, most fevers, most colds, most pneumonias, most bronchitis, most ear infections are not caused by bacterial infections. So utilizing antibiotics in those cases is a huge waste of money, it exposes the patients to developing allergies to those antibiotics. Plus, it also sets up a situation where people can develop a superinfection.

So they need to be evaluated, but let the doctor direct how that care is going on. Hopefully, that answers your question.

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Mr. BROUN of Georgia. You are exactly right, Dr. Gingrey. Putting people on antibiotics or just taking Tamiflu because you are scared is not a good utilization of your money. And certainly the health system is overburdened by the misuse or overuse of antibiotics and all kinds of drugs.

But you brought up a good point too that I wanted to focus on just a second.

And the thing is, if a child starts or a person, adult, starts running a fever, if they don't have any other health problems, if they don't have chronic lung disease, if they don't have severe asthma or chronic bronchitis, if they don't have diabetes where they are more liable to develop infection, secondary infections, if somebody is basically healthy, then waiting for 24 hours is not going to hurt those healthy people, in all likelihood. It's worthwhile monitoring that patient, just seeing what they do, treating the fever with some Tylenol or Advil, one of those types of medicine.

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Mr. BROUN of Georgia. The gentleman is exactly right. The severity of the illness makes a big difference. Dr. Gingrey, you had been talking about the doctor taking the time to do a history and physical, which is extremely important. I want to point out here, just to go off on a tangent for just a moment, as we see what the majority here in this House is trying to propose, this push towards socialized medicine, doctors aren't going to have time to take a proper history and physical because they are going to be pushed to ration care.

And so that socialized medicine that's being pushed by the leadership in the House and the Senate is not the way to go, and it's going to hurt people more than help people. And it's going to be disastrous economically.

But getting back to the flu, if somebody is concerned, they need to look at the possibility of this person having the flu. My daughter called me up just the other day when this was so hot in the news, and she was concerned she might have the flu. Well, she is a stay-at-home mom. She hasn't been out to be exposed to

anybody where she would get the flu.

So people need to have a little common sense about this as they think about this. Just because it's in the news doesn't mean that they are going to get it. Just because WHO is saying that there is a pandemic, that just means that people in multiple areas have the flu, and it doesn't mean that people are going to be dying in wholesale lots.

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Mr. BROUN of Georgia. Well, you are exactly right. And we have had over 400 cases that have been reported here. In fact, there have been several cases in our own State of Georgia that have been diagnosed serologically, which means through the testing that they do, indeed, have the type-A H1N1 flu, but in most cases it's very mild.

And the people that are dying, this 23-month-old infant, as well as the lady in Texas, both by reports, we don't know for sure, by reports, those people had other conditions that led them to have the possibility of secondary infections.

The way I remind my colleague--I don't have to remind my colleague, because he knows very well that the way people die from flu is through pneumonia, through respiratory difficulties and, and they will develop severe respiratory stress syndrome or some other types of respiratory problems or will develop pneumonia and die from the pneumonia. Frequently, it's a bacterial pneumonia with these co-morbid, as we say in medicine, conditions that give them the greater possibility of developing those types of things. But going to your doctor, or even consulting your doctor or even the doctors and nurse by phone is, I think, an appropriate reaction in not being afraid as the American public are.

As I mentioned, my friend at the University of Georgia has been telling the people within government, the government entities, the CDC and all, that this particular flu is not of epidemic proportions. It's not one that is going to be very virulent and, thus, is not going to create a lot of severe problems besides these two deaths, which are tragic. We have had very little problems in America with the flu.

And my friend also said with it being more widespread in Mexico, he doesn't really have the data but he thinks that probably in Mexico, where we have seen people die, a whole lot more than here, that it's probably the same proportion of deaths that we see with every flu epidemic. So people shouldn't be afraid.

He also tells me that there is a possibility that next fall we are going to see this same H1N1 flu virus come back to America and come back as a potential infection, viral infection, on a bigger scale; but people should just do the commonsense things to help them from having the flu, which means they should wash their hands. If somebody is running a fever, they should talk to the doctor and not send the child to school who is running a fever.

They need to make sure that they keep their fingers out of their nose and keep their hands out of their mouth and things like this. It may be just common sense.

I have had some of the liberals who don't particularly like me in my district complain about my making those recommendations, but people don't think about those things. And it's important to do those commonsense things to prevent yourself from getting the flu. So we need to just do those commonsense epidemiological measures of trying to prevent ourselves from getting the flu and not be afraid.

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Mr. BROUN of Georgia. Dr. Gingrey is exactly right. And I want to know what this $1.5 billion or $2 billion that the President has proposed to spend on this flu outbreak is going to be spent on? Is it going to be a useful expenditure? Is it going to be needed?

We saw in 1976 under President Ford when they spent all that money that actually caused more harm than good. More people died and had disease from the vaccine. Now, we have better technology; in fact, the gentleman at the University of Georgia has just some outstanding technology today where they can help develop vaccines very quickly. But still, it takes a while to produce enough vaccines to be able to help if they are needed. And what we see in this particular flu outbreak is that I don't think they are needed. I don't think we need to be appropriating $1.5 billion or $2 billion for the H1N1 flu. We need to give those funds to our military personnel to keep them from dying in Afghanistan or Iraq.

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Mr. BROUN of Georgia. While we are talking about defense, let me point out something else, too, that was a cost decision evidently by this administration. The North Korean Government fired off a rocket. It wasn't quite successful, but they are working on intercontinental ballistic capability, and they are developing nuclear weapon technology in North Korea. We know that without a question. The day after the North Koreans fired off their rocket, our President announced that he was going to cut the antimissile defense spending. And we need that spending. We need an antimissile defense system in this country more than we ever have.

President Reagan suggested that we develop an umbrella over this country, an umbrella that would make nuclear weapons totally obsolete. But this administration wants to cut that antimissile spending which we desperately need and is, in fact, one of the most important constitutional functions of the Federal Government.

We need the F-22 Raptor. We need the antimissile defense system. I don't think we need to spend $1.5 billion on a flu vaccine when already the research shows that it is not going to be very virulent.

Before I yield back, I would like to make a very strong point here. We are stealing our grandchildren's future by borrowing and spending. We are borrowing too much, we are spending too much, we are taxing too much, and it has to stop. And we need to spend on things that are critical, that are constitutional, that have to do with our national defense, that have to do with our national security. And we need to drive things by science and not by hysteria. This hysteria over the flu is driving the media and is driving the administration, driving the leadership here. We have got to stop that.

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Mr. BROUN of Georgia. Very quickly, I want to bring out that the economic health of the government is very important for fiscal health, too. I think a lot of people who may be dying in Mexico is because of their poor economic health, and we are going down a road now with this tax-and-cap policy that is being fostered by the Democratic majority to tax energy, which is going to create a tremendous downturn in our economy. It is going to put people out of work. And we have got to stop that, too, because it is going to affect the physical health of those people who aren't able to buy their insurance, who aren't able to go to the drug store and buy their Tamiflu or their antibiotics. So economic health is going to be critical for physical health, and we have got to stop this cap-and-tax policy that Nancy Pelosi and company are trying to force down the throats of the American people.

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