Thursday, February 01, 2007

January 31 Flu Update

There is a confirmed bird flu death in Nigeria. There are four other suspected deaths.

This has not been uncommon....Australia is working on a vaccine for the Indonesian strain of the virus. Indonesia has apparently decided their permission was required since it is called the "Indonesian" strain.

ProMed on Nigeria--notes that the woman who died was reported by Nigeria last week to be confirmed negative.

In a related matter, the Indonesians are ready to declare bird flu a national disaster.

CIDRAP on Nigeria and other stories from the world.

Revere checks in on CDC doing some public announcements for bird flu. Revere views it as long overdue---not necessarily a sign of impending doom.

In a related topic, Daily Kos, a major political (lefty) blog has taken a special interest in bird flu, with posts coming up all week.

Revere also blogs the science behind a flu vaccine patch....

Shanghai is funneling bird flu cases to two medical centers, (or, planning to).

Russia's Head Doctor is not concerned about a recent bird flu outbreak.

More reports in Philippines about local areas fighting bird flu.

Lloydminster, Alberta is preparing to prevent the bird flu.


At 4:47 AM, Blogger Orange said...

Commented post on behalf of Wulfgang...


I will dispose of my remarks about Indonesia rather quickly this evening. I have placed the article that describes them wanting permission and exercising “property rights” over the Australian CSL pandemic vaccine, where it belongs – in my “idiotically insane” file. For a country like Indonesia, where H5N1 has proven to be endemic and firmly embedded in their society, and who has taken very little serious action to date (other than declaring a national disaster), this is pretty brazen on their part. Let’s just say, I have extreme difficulty understanding certain cultural mentalities.

I would like to comment on the CDC Press Conference today and my thoughts on the subject.

As both Revere and the Daily Kos articles point out, today’s CDC briefing, was the first in a series of planned Public Service Announcements (PSA’s) to “get the message out” and communicate what national pandemic guidelines are being put into place for the states. I agree that these PSA’s are not a “ratcheting up”, and should not be viewed as an ominous development.

However there are some major hidden issues and subtleties embedded in the CDC and HHS messages that everyone needs to be aware of when officials describe the approach to national pandemic planning, much akin to categories 1-5 hurricanes. And of course, a Cat 5-type pandemic would be synonymous to a 1918-like worst case catastrophic event .

From the perspective of a government insider, there are still many major issues to be resolved with what we are hearing. In particular, the national approach and guidelines soon to be issued, assume most people at various levels of the pandemic will voluntarily comply with social distancing and self-quarantine guidelines. The government’s position is that “reason” rather than force, as well as public education, will be the most effective tool to get people to act appropriately and they will be most likely to do the “right thing”. The thought process that follows is most people will voluntarily comply with self-quarantining procedures and orders, out of fear for their own safety. This would probably, admittedly in my opinion, work out very well in a Cat 1, 2, or even 3 type avian pandemic, but it absolutely will not, if the pandemic escalates. The CDC and HHS are in reality promoting a Canadian “SARS” version of quarantine, in which state and national authorities will appeal to American’s “basic humanity”, to help voluntarily contain the pandemic. In Canada in 2003, public health authorities merely requested that people who might have been exposed to SARS, to voluntarily quarantine themselves in their homes, and the government provided food, supplies and compensation for lost wages even.

However, once a Cat 4 or 5 1918-like pandemic is evident, the rules and assumptions can change dramatically, and all government officials tend to avoid or decline to discuss the use of force. All government pandemic planners are reticent to discuss in public the use of military or police run quarantines. The issue that all government and military planners agonize and wrestle with are – in a Cat 4 or 5 pandemic, will Americans politely obey quarantine requests, or would they defy orders, cross quarantine lines, even panic or riot in the densely packed cities ?

Would the nation’s under-funded and understaffed public health infrastructure, as well as food suppliers and pharmacies, be quickly overwhelmed during a Cat 4 or 5 national emergency crisis? Most of us within the government believe it would. Thus far, there has been little integrated serious planning for this vulnerable situation by local, state and federal health agencies, law enforcement and emergency management agencies. It’s easy to imagine inconsistent instructions from government officials, poor coordination, and rumors and misinformation abounding, as communications systems break down – like Katrina. It’s also easy to imagine the resultant inundation of hospital emergency rooms with the worried sick (both from the ordinary flu and the pandemic version, like say, is occurring in Asia), as well as looting of pharmacies and retail centers. In such a severe 1918-like scenario, law enforcement and/or the military would have no choice but take aggressive action and restore order.

Planning for an actual worst case pandemic is an arduous and emotional national exercise, which may well require use-of-force guidelines, in order to preserve civil order and slow transmission to buy precious time to manufacture a vaccine. We simply cannot afford to have thousands upon thousands of worried people, rushing the hospitals and demanding services. Sooner or later, the CDC and HHS, and the White House, will have to publish these types of guidelines, in addition to the usual “social distancing” steps, closing of school, church stadium and public venue measures, and restricting public transportation actions. At some point, simply asking people to stay at home, will not work any longer and discontentment and alarm will be set in motion.

Be glad you live in the United States, Orange.

In mainland China, they threaten to shoot people who violate quarantines.



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