Tuesday, May 22, 2007

May 22 Flu Update

Bird flu found in domestic poultry in Pakistan, 10,000 birds reported culled.

Third bird flu outbreak in Central Vietnam.

After arduous negotiations, WHO has a draft virus sharing agreement.

Scientific American has results of an important study. One of the sleeping giants of a pandemic is (in my opinion) absenteeism among healthcare workers. That includes healthcare workers who would be sick even without a pandemic, those who have pandemic flu, those with family members with pandemic flu, and those who don't show up out of fear. These absenteeisms will hamper the ability of the healthcare system to deal with a patient surge.


Note this:

About 50 percent of the hospital workers said "yes" they would report to work, while 42 percent said "maybe" and 8 percent said "no, even if I would lose my job."

Doctors (73 percent) were more likely than nurses (44 percent) or other hospital personnel (33 percent) to indicate that they would report to work in the event of bird flu pandemic.


China has a food problem--related to, but not limited to, bird flu. Specifically, there are emerging consumer confidence issues on food produced in China, and bird flu outbreaks do not help the situation. My guess is this will drive them further underground, though it presents a wonderful opportunity to gain confidence through transparency.

HHS has a flu blog for five weeks--and it features some members of the real flu blogosphere. I really didn't think HHS had this in them, but it is surprisingly progresive. Good on ya!(CIDRAP reports)

Here's the link to the blog itself. Here's what Secretary Leavitt said in his first post... (and hey, no one asked me to participate, but I'm being a grown up about it).

In order to extend the value of this one-day conference, the Department of Health and Human Services is also hosting this blog summit as part of an ongoing effort by the Department to help Americans become more prepared. While the comments made on this blog may not always represent the views of the Department of Health and Human Services, we think there is value is having an open dialogue about this very important issue.

Revere (I wonder if he is going to be on the HHS blog?) notes that yesterday's news that OIE seems flu on the wane is at odds with other evidence--and that, to his view, things seem to be pretty much the same.

ProMed reports on OIE news from Vietnam and Bangladesh.

San Diego is doing pandemic awareness training.

The Turkey industry--wisely--is preparing for potential problems related to bird flu, after seeing what happened in Suffolk.

5 Comments:

At 3:23 PM, Blogger NJ. Preppie said...

Orange,

Ha Ha- don't feel bad! Perhaps you weren't invited to be on the HHS blog, because you don't use a real name and photo on your site (unless you really are an orange).
I love the work you do, it saves me so much time in searching for the significant news. Thank you! And Wulfgang's post are an indispensable part, like the dessert after the news.

 
At 6:42 PM, Blogger Wulfgang said...

Orange;

I don’t think I have every read an article that was so off base, as your main feature from Scientific American, and its discussion of the survey which reveals that many health care workers won’t report to work during a pandemic.

First of all, it’s not about “not doing a very good job at educating our healthcare workers about what measures would be in place to keep them safe and how successful these measures would be”. Not at all.

And I’m not even a health care worker and know this.

As usual, authorities and people in responsible position’s, do not understand the motivations and realities of people and human nature – and I’m talking specifically about the hospital medical administrator’s, planner’s and heads of government – and misinterpret the problem and what the data really reveals.

First of all, count the 42% “maybe” responses, who said they might report to work as “no’s”, and add it to the 8% who said they would not report to work even if they lost their job, and you have the correct answer: the correct answer is that at very best, only 50% would report to work, and at least 50%, or higher, would not.

The issue is not about education, after all, we are talking about a very highly educated and intelligent group of individuals – health care workers, the “infantry”, who already work on the “front lines”. If they wanted to risk their lives, they would be over in the rat hole called Iraq, or working in the Peace Corps in some God-forsaken desolate country in Africa.

The issue in my mind is about providing assurance that hospitals and clinics have enough supplies, PPE, and that an acceptable margin of safety exists for the HCW’s themselves, and their families. No convincing acceptable safety margin, equals no HCW’s during the crises. The SAR’s template as a model, is not convincing enough to anyone (even me), since an influenza pandemic would be far worse.

Herein, lies the Achilles heel of our entire pandemic planning activities – our entire health care system, under extreme duress during a national emergency, is most likely to quickly collapse.

I contend that today’s health care workers, for the most part, know that neither hospitals nor the world is adequately prepared for a pandemic, should it occur today. Pandemic vaccines will not be available to inoculate the public for several more years, so the pandemic situation would be at best (a) a Tamiflu and quarantine battle from inception, and, (b) once the wheels fall off that approach, it would be a catastrophic palliative situation.

Here’s where the rubber really hits the road Doctor Irvin, from personal experience: I live in hurricane country. The last three Category 5 hurricane mass evacuations, saw most of the doctors and nurses split along with the rest of us, up to 80% evacuated. A few stayed, but most vacated along the evacuation routes like the rest of us.

A pandemic situation would be far worse than a Cat 5 hurricane.

And you are surprised at this survey ?

Give me a break here – this isn’t a made-for-TV-Hollywood-movie-drama, we’re talking about. Above all, HCW’s know death is a one way trip.

Wulfgang

 
At 3:00 PM, Anonymous mpb said...

I wasn't invited either. However, I did leave a comment at the secretary's post. It was accepted; it was published (I saw it); but I neglected to screenprint it. The comment today no longer appears.

It was comment #200. I admitted it was whiney, but prep and info out here at the frontier of North America panflu has been extremely frustrating.

Now should I worry that not only won't the Secretary respond to my inquiries of last year, but now I'm on a list and my comments are banned?

 
At 3:19 PM, Blogger Orange said...

That's interesting. One of the problems with big institutions (like corporations and government) blogging is that they find it hard to accept criticism and let it remain for anyone to see. So, the free and open format of the web and blogs is lost to them.

 
At 12:20 AM, Anonymous mpb said...

I was able to get the comment posted again, and it stuck.

I don't know that it will do any good.

Have you been tracking the comments over there?

 

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