US gov shutdown may mean some kids with cancer won't be treated, CDC's outbreak detection programs also halted


NIH Clinical Center [Wikipedia]

The ongoing federal government shutdown in the United States affects national health services in ways you may not realize, including cancer treatment activities at the National Institutes of Health, and disease outbreak detection programs at the Centers for Disease Control and Prevention.

For as long as the shutdown continues, the National Institutes of Health will turn away about 200 patients each week from its clinical research center, including children who have cancer. All existing patients at NIH will be treated, but no new patients will be admitted, and no studies.

NIH director Francis Collins explains how the slow-motion political disaster affects the nation's federal medical research facilities in this WSJ interview (paywalled).

He told the Journal that about 200 patients per week who would otherwise would be admitted to NIH's Clinical Center in Bethesda, Maryland, to participate in clinical trials will be turned away for as long as the shutdown lasts. That number includes an estimated 30 children per week, most of whom are cancer patients.

"NIH would continue patient care for current NIH Clinical Center patients, minimal support for ongoing protocols, animal care services to protect the health of NIH animals, and minimal staff to safeguard NIH facilities and infrastructure," according to a Department of Health and Human Services memo [PDF].

But under the shutdown, "NIH would not admit new patients (unless deemed medically necessary by the NIH Director."

Generally speaking, the types of cancer patients who end up in clinical trials at NIH are patients who do not have other options for treatment. Their disease may be at an advanced state, progressing fast; they may have an unusual form of disease that oncologists don't know how to control with established treatment protocols. In other words, for some, these programs are the end of the line.

And some of the patients who are at the end of the line are children.

Brad Plumer at the Washington Post puts it in context:

[T]he rules of the shutdown mean that the Clinical Center "would not be accepting new patients or initiating new clinical protocols during a hiatus," the memo said. So, as a result of the budget impasse, there will be a certain number of patients who have exhausted all their options, were hoping to undergo treatment at the NIH Clinical Center, and won't get admitted — at least until the shutdown is resolved.

Does that sound like "non-essential" services to you?

And back to that HHS memo for a related topic: here's how the shutdown affects the Centers for Disease Control.

CDC would be unable to support the annual seasonal influenza program, outbreak detection and linking across state boundaries using genetic and molecular analysis, continuous updating of disease treatment and prevention recommendations (e.g., HIV,
TB, STDs, hepatitis), and technical assistance, analysis, and support to state and local partners for infectious disease surveillance.

The government shutdown is temporary, of course, and one could argue that a week of these health services going dark is no big deal. But for some people, it will be a whole lot more of a big deal than others. And a close inspection of exactly which federal government functions go dark, and which stay online–well, that tells you a lot about where our nation's priorities lie.

More coverage of the US government shutdown in Boing Boing's archives.