Monday, April 23, 2007

April 23 Flu Update

More on the Kuwait outbreak reported yesterday. Ostriches, near the Saudi Border.

Revere has a story on how fragile the healthcare system is--with some examples from around the world about the effect of a pandemic on healthcare delivery--even routine healthcare delivery.

The President of the Philippines has ordered the protection of migratory birds in coastal area.

Myanmar has reduced bird flu restrictions after a lack of outbreak in specific region.

A Hong Kong foundation has donated 3 million euros to the bird flu fight.

Yemen starts to talk national planning for bird flu.

Flu planning is ongoing in Longmont, Colorado.

No Church is doing more planning for bird flu. More from the Anglican Church of Toronto.

Dr. Yaffe explained that, unlike SARS, which was primarily a hospital-acquired infection, influenza is a community-based infection. “You go to the supermarket, you go to the bank, you go on transit, you go out with friends – that’s how you are going to get it,” she said.

1 Comments:

At 6:22 PM, Blogger Wulfgang said...

Orange;

You really have a couple of thought provoking articles in your suite today.

First, Revere as usual, has done an excellent job, highlighting what a “hard landing” the health care system will have during a pandemic. I would call it a definite “crash and burn landing” situation, but he’s the expert. Without a doubt, our entire health care system will be the first part of our North American infrastructure to crater, especially since most hospitals, physicians and clinics will be ill prepared.

What most planners overlook, fundamentally, is that HCW’s as an entity, are not immune to a pandemic virus any more than the general population, anywhere. They will suffer from the same viral “attack rates” as all of us will, and on average, probably even suffer higher fatalities per capita, since they will be more exposed. To further add fuel to the fire, there are currently no incentives or inclination on the part of hospital management, to make the necessary investment in order to stockpile any semblance of the needed supplies and PPE, that will be required during the onset of a pandemic. This will be undoubtedly, the weakest link in the armor. As a nation, we can dump hundreds a millions of dollars a month in the rat hole called Iraq, but we can’t seem to offer hospitals and clinics any measly incentives to prepare for a pandemic. Everybody go figure out that logic.

It is quite easy to imagine the emergency rooms and hospital staffs being overwhelmed within days of an emerging pandemic. The popular coined term, “estimated surge” of people, is an understatement – it will be a “tidal wave or tsunami” of ill people, who are customarily used to normal health care and physician treatment, who will realize quickly that they will not be able to get adequate treatment. Talk about the potential for a societal meltdown.

In your Longmont, Colorado article, which describes their doctors efforts to get engaged and involved in their local pandemic planning activities, I notice they are even considering a discussion of what priorities to establish for available vaccines, as well as where “dirty hospitals” (assumed to be for quarantined and infected individuals) will be designated and located. This is very interesting, hearing the term “dirty hospitals” – it’s the first time I’ve actually come across this particular term and the concept. As far as priorities being established for available vaccines – I think this will be rather moot – in my view, we are all looking at a minimum timeframe of a year before one is available.

This means a possible excruciating wait of twelve months for all of us, during which time we might have to face several waves of the pandemic, perhaps even in different mutated deadly viral forms. The worst of the pandemic may in fact have already past, before a viable vaccine is available. If 1918 is the best guide we have, everybody better hope and pray that the H5N1 virus, with a 60% average fatality rate to date – attenuates. If it does not, everybody better have some Amish or Mennonite friends to fall back on, and learn how to self-medicate.

The primary issue I see related to HCW’s as an essential group, is what measures the national, provincial and state governments are taking, to make sure these critical individuals receive first priority when it comes to extremely limited quantities of pre-pandemic vaccines. I would think, since physicians and all HCW’s are our “first line of defense” in a pandemic, that it would be prudent to make them (and their families) one of the highest vaccine priorities. Maybe there’s some kind of secret plan we are all unaware of, but I have really not heard this discussed in public at all. Maybe the American Medical Association or the DHHS or CDC will get tuned into this potential Achilles Heal.

I agree completely with you about the Anglican Church of Toronto. Judging from the article, this appears to be a rather extraordinary group of talented, competent and well-informed individuals who understand the fundamental issues and challenges of realistically planning for a pandemic. As the Canon Douglas Graydon points out, “the pandemic has the potential to overwhelm the government, social and healthcare resources in communities, parishes need to think locally in planning for such an event”.

The article really makes me want to join their local parish – but, I believe we would eventually have a falling-out, over my viewpoints on self protection and what to do with bad guy’s who are intent are harming others (my fertilizer theory). I just don’t think the good padre there in Toronto would agree with me either on my pandemic philosophy of “pre-emptive self defense” and “responsible justice”.

As the old saying goes: “Eighty percent of success is related to attitude rather than competency”.

Wulfgang

 

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