Tuesday, February 13, 2007

February 12 Flu Update

CIDRAP reports two deaths in Indonesia, one reported previously. Also news from South Korea and Pakistan.

Helen Branswell must read on more research on the issue of immunity. Does ongoing exposure to H1N1 help to protect people from H5N1?

The U.S. researchers said that years of exposure to the human flu subtype H1N1 - one of two types of influenza A viruses that circulate in flu season - may provide some protection against the H5N1 virus that has ravaged poultry flocks in large parts of Asia and killed at least 166 people over the last three years.

Pakistan says it is watching closely, and has no human cases.

Helen Branswell with more follow up from Indonesia drawing a line in the sand.

"It has the capacity to undermine the capacity of the world to produce pandemic vaccines if they proceed in a conventional, business-as-usual way," says Dr. David Fedson, a retired academic and flu vaccine industry expert.

Excellent Washington Post editorial on the bird flu prep, urging CDC to reconsider some of its recommendations during the comment period.

Others point out that the guidelines, which advise people to avoid crowded spaces such as train cars or offices, do not address the needs of poorer Americans (among others) who must take public transportation or who can't telecommute. As the CDC gathers comment and updates its interim guidelines, it must consider how state and local governments might deal with the potentially massive social costs of school closures and work stoppages.

I don't know how much longer I am going to keep blogging this, but a brouhaha has erupted in Britain over the Hungarian poultry. Hungary disputes that it was the problem. Apparently, it all came down to a discarded wrapper (doesn't it always).

Lunar New Year is starting, which means feasts. Which has Hong Kong on alert.

Bird vaccine patch would allow supplies to stretch 10X.

From Britain, during a pandemic those who are infected will be asked to send a friend to the drug store or the mail box.

Story posted in Tennessee about how ready we are for the bird flu.

Effect Measure on telecommuting in a pandemic. Could bandwidth demands cause low-priority hogs like YouTube to go dark?

Revere also notes that the US poultry industry continues to insist that it couldn't happen here.


At 7:27 PM, Blogger Wulfgang said...


Well, time to get the old keyboard clacking again.

Sighhhh… what a dilemma cultural differences can be for us socially challenged people. I guess the operative words for female nurses and Physician Assistants in Pakistan are now “lady health workers”. At first glance, I had to check the date of the article to make sure it wasn’t the year 1897, versus 2007. It is a current article, so I guess I’ll just have to add this term to my everyday lexicon, especially when I’m in health care settings – that should work out well.

I found the Washington Post article quite interesting, in the respect, that at some point in the pandemic planning process, everyone has to realize a couple of fundamental things: for example, schools and large public gathers of people will only serve as incubators that will perpetuate and accelerate the influenza pandemic. Also, we are all sympathetic to the “poor” argument, but it may come down to the “needs of many, outweighing the needs of a few”. We will never be able to solve all the issues that are associated with planning for a world wide influenza emergency, and at some reasonable point, scientists, social activists and other varied self-interest groups, need to recognize this. I will admit, the federal and state governments could do ten thousand times more, when it comes to stockpiling adequate emergency supplies and reserves, especially for the needy.

Your article from Great Britain has some straightforward messages that the US should perk up to. The Brit’s strategies to have antiviral drugs delivered via post office and couriers is amazingly simple and efficient. Note the additional message that they consider schools as “the most extreme mixing environment for respiratory tract infections” (unlike some social scientists in the US), and the final message: “I don’t think people have got to grips with the magnitude of the problem”. As far as I am concerned, the US is about 12-18 months behind the planning activities of some select countries, like Great Britain, Switzerland, Japan, Hong Kong and a host of others. We better get our head out of the sand on some of these fundamental decisions and issues, make critical decisions and stop trying to appease every self serving interest group in the US. It comes down to leadership.

I really disagree with Revere on his article, “YouTube and pandemic flu”, and think he missed it by a mile. Doesn’t happen often, but it never ceases to amaze me how naïve smart people can be. Where I really have major heartburn, is the belief’s that: “the internet is amazingly fault tolerant… the technology intrinsically finds a workaround… and the choke point is the last few miles”. This in my opinion. is all conventional wisdom that falsely leads one to believe that, “personal needs would trump business needs”.

The entire internet system is not nearly as robust as Revere alludes to.

IT pandemic continuity plans typically assume interruptions and disasters will be either local or regional in scope, and can be over come by simplistic approaches, like cross-training for maintenance, adding intranet portals, increasing remote gateways – all things which will allow remote work accommodations and keep the systems up. The internet is in actuality, a global scale system, highly vulnerable for attacks, and with little effective infrastructure monitoring systems for protection against cyber attacks. Most of the entire global DNS system was developed during the 70’s and 80’s, and it suffers from performance under stress, fundamental weaknesses, and potential breaking points. When it was developed, it focused nearly solely on functionality, and gave no consideration to faults, misconfiguration’s, or malicious attacks. Overwhelmingly, it suffers from disparate technologies – for example, different sites may use entirely different operating systems and speeds, which in normal times work adequately, but when under extreme duress, will fail. Ongoing daily network management and maintenance that makes the internet extremely vulnerable, and susceptible to interruption includes: security, performance and both HW and SW problems. The result of all this is that the internet will crater within a 2-3 weeks during an emerging pandemic.

Over the last five years, nearly all major websites, have been victims of distributed denial of services (DDOS) type cyber attacks, usually by one of the following virus methods – boot or file infecting, macro’s, polymorphic, or stealth. Computer viruses behave will behave in the same way as the pandemic biological influenza virus, person to person replicated themselves - they will be passed from computer to computer. Always remember this when it comes to the global internet system: networks are used as tools for attackers and theoretically, a large increase in usage during a pandemic, will increase exposure. It will happen.

The fact that businesses will need to cooperate, I agree with, because there is no government enforcement agency to restrict, prioritize traffic or regulate any band-width – this is Easter Bunny thinking. Who is going to do this – the “cyber police”? Communications will be critical during a pandemic, just as it proved true in Katrina – but neither the states, nor the federal government, nor business in general have learned from that disaster.

It seems, that the only reliable communications during Katrina were: private cell phones (for a short while), military communications, and guess what folks…. Major network mobile news cam trucks. It wasn’t the internet.

It isn’t a “last mile problem” in my mind, more like “The Green Mile”.



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