Saturday, March 31, 2007

March 29 Flu Update

This is, quite possibly, the most serious flu news in some time. A physician in Indonesia who treated a boy who had bird flu is now sick, though said to be getting better. Others have noted that healthcare workers are among the first people who will be infected if the virus goes H2H.

Avian outbreaks continue to spread in Bangladesh.

This story from Vietnam says that most experts believe bird flu will become a pandemic in "months."

The Student paper at Syracuse says you should consider the threat of a pandemic, but do no panic.

Perhaps trying to recapture the PR high ground, Indonesia now supports the establishment of an international influenza information exchange.

Last week the NY Times ran a comprehensive flu article which summed up the state of play today. Here, the author is interviewed on a podcast.

A UNICEF campaign in Nigeria is aiming to protect women and children.

The University of Rochester is getting funds to research bird flu.

Kuwait notes that even with no human cases, the virus is still dangerous.

In Toledo, OH, a flu summit is held. They seem to be facing the problem pretty head on. Note the story of the parade in 1918 that was held--and what happened to the flu after that.

The bird flu task force is now finding its way to remote areas of the Philippines.

Monticello, IN, held some pandemic sessions this week.

Revere writes that if we are going to use Tamiflu as we want to--widely, during a pandemic--than you have to expect the unusual adverse event.

4 Comments:

At 11:44 AM, Blogger Wulfgang said...

Orange;

Yes, your news report about the doctor in Indonesia being treated for suspected bird flu, is deeply concerning and serious. This is especially true, when we look at the events ongoing there, in the broader context. This is my view of the situation currently going on, which is much worse than what is being officially reported:

• There are fairly reliable machine translated reports from the Indonesian clinics and hospitals, reporting that multiple (more than two, possibly three) groups of doctors, nurses and HCW’s are being treated and observed for bird flu infected symptoms.
• The subject doctor of your article is known to have worn the customary PPE while treating patients.
• The case fatality rate (CFR) in Indonesia has actually increased and is approaching the phenomenal 78-80% range, and the daily infections being treated continue to climb steadily.
• There appears to be unsubstantiated clusters of infections of individuals forming, who are definitely not family related, indicating human-to-human transmission of the virus is taking place. Many of them are no long associated with dead or infected poultry.
• Current prophylaxis methods, mainly through the employment of the “Tamiflu Blanket” approach, which essentially serves to smother the outbreaks, are becoming ineffectual – as indicated by the climbing CFR rate and number of infections. This is the main driver behind the recent decision to double-up on the Tamiflu doses to patients. They must somehow manage to bring the death rate down.
• The unique extensive geographical area involved, extreme population density, coupled with the propensity for natural disasters (tsunami’s, floods, earthquakes, mudslides, etc) and almost non-existent government response and state of denial, almost preclude making any progress towards getting the virus under control. Indonesia appears to be only one major natural disaster away from an H5N1 epidemic catastrophe.
• I believe that it is these types of dire situations and events, that drove both Indonesian Health Minister, Siti Fadiliah Supari, and President Susilo Bambang Yudhoyono, towards the virus sample standoff/boycott with the WHO. All three parties know the situation is bad, and bound to get worse. Hence, we have a sudden reversal in events, and even have the GISAID initiative suddenly being formed (maybe, too little, too late – I don’t view this as a PR campaign at all).
• I also believe this very dismal Indonesian situation, is propelling the other 10-member Association of Southeast Asian nations in the area, into heightened pandemic readiness exercises. They absolutely must have a workable plan to snuff out the early signs of a pandemic, or face a modern day disaster which is unparalleled in human history.

This all is adding up to deep cause for concern, but not alarm, at this point. Taken collectively, these occurrences do appear to be representing the stochastic type events and data, which would indicate a grave epidemic environment in formulation there.

If the H5N1 poultry outbreaks in Bangladesh cannot be brought under control, and spreads further to India, and they start experiencing human illnesses in those two populated countries (similar to Indonesia and Egypt), then valuable resources will be diverted away from Indonesia, to stem those outbreaks immediately. Singapore Tamiflu and other antiviral reserves will flow massively to these other two countries, instead of Indonesia. Then Indonesia is a write-off in my view. This simple but plausible hypothetical situation I have just described, would cause alarm bells to ring around the world.

Your second most interesting article on your list today, is the editorial from the Vietnam News Service (VNS). The article is indeed very curious to me. It is extremely well written and straightforward, and noting its obvious source, it does indicate to me that the author probably is basing his “ Most experts predict that global spread of the next pandemic will take place within a few months” statement – on regional source speculation circulating there. Based on other information and events happening in the Asian/Indo-China, this is in my opinion, entirely plausible, and should not be instantly dismissed as idle conjecture.

People, including myself, pick up my very best inside information, from casual conversations with others associated with pandemic meetings, as well as influenza activities they are participating in, or aware of.

My final comment is in regard to the Syracuse University article, written by Meghan Overdeep (what a last name), which has some interesting and insightful points to it. While certainly I sense her youthful optimism and positive spirit about “not panicking”, since the government is “quietly mobilizing for the worst-case scenario”, and “its rolling around in the heads of our nation’s brightest scientists behind closed doors. It’s being debated by our trusted politicians – not splashed across the news”.

While entirely true statements, Ms. Overdeep, the plans are woefully inadequate for a worst-case pandemic event. The subject needs to be splashed across the news for individuals and families to prepare in earnest. While our country is certainly capable of handling another Katrina or 9/11 type disaster, it will not be able to provide the critical assistance needed in anything beyond a 1918-type pandemic.

The entire system will break down during a severe pandemic. People like fellow student, Jonathon Jennings, and many others in my opinion, will end up paying the ultimate price for being unprepared, and will become an unfortunate statistic.

His motto is to: “wash your hands, brush your teeth and don’t sleep around”.

My motto and advice to you Jonathon, especially if you were my son is: “If money is your hope for independence you will never have it. The only real security that a man will have in this world is a reserve of knowledge, experience, and ability”. (Henry Ford)

I have very little doubt a pandemic is on the way. The two key questions are how soon, and how severe.

Wulfgang

 
At 5:58 PM, Blogger Orange said...

Interesting post, Wulfgang. One note: these machine translated reports have been hanging around as long as I have been doing this blog. How do you determine--before the fact--whether one is more reliable than another.

I recall machine translations of Chinese troops swarming into villages to seal off villages where the flu had already hit pandemic level. Doesn't seem to have been true at all.

I fully understand that the MSM is not gathering everything and doesn't have access to all the facts. Still, that doesn't make alternative sources more reliable, either.

Where are these clusters? I have seen nothing.

In short, I don't really see anything any different than what has been going on for the past three years.

 
At 6:52 PM, Blogger Wulfgang said...

Orange;

I don’t wish to clog up your website with machine translations and link references, which admittedly, one has to use extreme caution, especially when grinding through the texts, word for word. However, they do exist on several blog sites. I know this seems like a chicken response, and I will e-mail you separately with some details.

Perception, like beauty, is in the eye of the beholder.

Wulfgang

 
At 8:14 PM, Blogger Orange said...

Wulfgang--I don't doubt they are out there. I was serious--how do you differentiate on these reports? I find it difficult, especially because it looks like information.

 

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