Tuesday, November 21, 2006

November 20 Flu Update

WHO's David Nabarro makes a vital point....global defenses to the flu are one thing, but the first and perhaps deciding response might be local.

But he also said governments around the world must be poised to aggressively contain any localised outbreak in humans and to limit the fallout - and keep essential services running - in the event of a human influenza pandemic.

"It doesn't require a lot of thinking to understand what the magnitude of the impact of a pandemic will be," he said. "We are not talking about a health crisis, but a social, economic and governance crisis."

President Bush says that bird flu is still a priority for him.

Britain is being warned by a leading scientific society that the country's reliance on Tamiflu leaves it vulnerable if a resistant strain emerges. (I think this concern is overstated in that I don't think the meager stockpiles of Tamiflu that countries have will really impact a raging pandemic even if the virus is sensitive to the drug).

The US government ordered 2.7 million more doses of pre-pandemic vaccine.

CIDRAP has this story as well.

The BBC gives a reasonable answer to the question of whether people should be worried about the bird flu.

Professor John Oxford, a virologist at Queen Mary School of Medicine, London, said: "Things have changed tremendously over the last 12 months.

"Every major vaccine manufacturing group has now got an H5N1 vaccine in production. A year ago, that didn't seem possible.

"And the stockpiles of antiviral drugs are increasing."

Recombinomics on a potential human case in the Sudan.

Russia has opened a "big" bird flu lab....(I'd note here that I don't think size is exactly the top criteria).

UN article on how government intervention has paid off in Vietnam.

University of New Hampshire specialists are using satellites to track the bird flu.

Finally, a set of must read articles. CIDRAP has HHS guidelines on mass casualty events, including a significant section on an influenza pandemic. These guidelines are mind-boggling, and we can hope they remain on a planner's bookshelf forever. (How would you like to be your city's bed czar)

A centerpiece of the report is a case study on pandemic influenza. The authors list preparations for and responses to each stage of a pandemic, from the current prepandemic period to increased and sustained transmission in the United States. For example, during the worst stage of a pandemic, the authors suggest a "bed czar" be appointed to monitor the supply of hospital beds and equipment and make assignments based on availability.
Nov 2006 AHRQ report "Providing mass medical care with scarce resources: a community planning guide"


At 7:45 PM, Blogger Wulfgang said...


Hoorah for Dr. David Nabarro, for telling the avian influenza issues candidly and bluntly, with a "no holds barred" approach. His descriptive choice of words are appropriate and accurate for a worst case situation, for example: "... social, economic and governance crises", " ... horrible pandemic", ".. socio-economic meltdown". While most people may find these words melodramatic and alarming in today's context of everyday living, they are not. It's all a matter of perspective. As he points out, all nations must be in a position to stamp out any human-to-human epidemic quickly and localize it, otherwise, we could face a quickly spreading pandemic that could fracture the very social and economic fabric of society. Once the horse of death leaves the barn, there may be no stopping it, until it runs its course. Nations may employ all the anti-virals they have in their limited inventories, but that will only buy time.

The fact still remains, it is unlikely that any vaccine will be available to stop it for nearly a year from onset. He says that preparation for a pandemic is continuous and will be long term. Believe it.

We have not achieved a level of science or technology to stop it thusfar. What's more, the methods we must depend upon to stamp out H5N1 are crude and uncertain - as we are finding out. Some countries may even be worsening the problem by innoculating hundreds of millions of poultry and flooding third world villages with Tamiflu. I believe we have have deluded ourselves into thinking we have dodged a bullet. We may have temporarily in the short term, but the every day mutation and resistance process of these viruses grind on.

The H5N1 virus doesn't even have a "social distancing" term in its vocabulary.



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