Tuesday, December 18, 2007

December 17 Flu Update

Declan Butler of Nature takes a welcome look at the situation in Pakistan. Note the comments, too....

The Pakistan cluster highlights the obstacles faced by the WHO in containing the spread should a pandemic strain of H5N1 appear. The strategy calls for early diagnosis of cases, in the hope that blanket treatment with antivirals will stamp out an emerging pandemic before it spirals out of control. Computer models suggest that for this to have any chance of succeeding, WHO would have a window of three weeks for this diagnosis at most.

Revere looks at the flu situation today, where WHO is urging quicker reporting as part of its Tamiflu blanket strategy. Revere goes on to wonder if we wouldn't be better off preparing for what happens AFTER the pandemic.

Pakistan story confirms eight sick people.

CIDRAP looks at the Pakistan situation.

A new avian outbreak is reported in Benin (Africa).

More bird flu in Poland.

The new outbreak in Germany has caused EU protection measures to go into place.

ProMed on Saudi Arabia and Germany.

CIDRAP looks at new break outs in countries listed above.

Indonesia says bird flu will require long term fight. (Note quoted case fatality rate of 87.5%)

WHO claims bird flu is contained in Burma.

Because of the outbreak in Germany, Denmark is ordering poultry to be kept indoors.

A legislator in Taiwan worries that a bird flu outbreak in China could be used as force majeure to cancel elections in Taiwan.

Seven US states have not taken the Federal Government up on its offer to help purchase Tamiflu.

In British Columbia, a quarter of people would stay home due to flu fears.

Businesses are urged to make continuity plans for a pandemic.

CIDRAP has the next in its series of best pandemic practices, focusing this time on the plans of an organization of disaster relief agencies.


At 6:36 PM, Blogger Wulfgang said...


As your Declan Butler article points out, present strategies for stamping out a bird flu outbreak before it spins out of control, depend almost exclusively on catching it within the three week window of opportunity. Other sophisticated models I have heard discussed, say that once it spirals out of control beyond the standard 3 km protection zone (quarantine circumference) and infections proceed unabated outside the 10-15 km surveillance radius, then it is a sure-fire pandemic and beyond control. How close the Pakistan situation actually proceeded to, is anybody’s guess at this point.

I think Revere has made the correct observations and conclusion in his commentary. We need to view poultry vaccines and culling as primitive tools in the bird flu battle, which are likely to ultimately fail, and we must prepare for the likelihood and inevitable consequences of a pandemic. We cannot overlook the obvious. As I read your Earthtimes article about Indonesia needing to “expand and intensify surveillance for both human and poultry cases”… and that “ a plan for wet-market reform has been drafted”… this is the same old cow manure that they discussed over a year ago. Not much has happened since then. In addition, as the Mizzima News article points out about the latest human infection case in Burma, there are contradictions: local unnamed residents believe there are other human infections that have not been reported, and H5N1 infected ducks from China may be involved. But we all know China has no poultry infections, don’t we? At least they admit to none.

This all leads me to conclude that if a pandemic emerges in the near future, we are so unprepared, that we will have a much bigger problem than high employee absenteeism in critical business sectors, as your Vancouver BC article frets about. We will have a crisis that will be well beyond the “spiritual care” capability of National Voluntary Organizations Active in Disaster (NVOAD). People will need far more than God’s comfort. In my view, I don’t even think FEMA or the Red Cross is prepared for what we could be facing, in fact I know they are not. Imagine ten FEMA Regional Offices that are understaffed and overwhelmed with sick and dying employees, and those few individuals who are healthy will refuse to leave their family members unprotected. Deadly influenzas know no boundaries and all living human beings everywhere in every age group will be susceptible. We will in my mind face an out-of-control situation.

Where is the disaster relief going to come from then ? We don’t have enough troops in the National Guard, or equipment, to support the entire US and North America territory, in a pandemic disaster. Anybody who thinks we do, is naïve. FEMA has learned to handle regional disasters, like the current ice storms and power outages in the Midwest, quite well. But think about it, setting up temporary generators with full healthy crews are one thing: 50-70 per cent absenteeism and threats of violence, will render efforts almost useless. It will take the combined effort of all ten FEMA Regions, the National Guard, the Reserves (what’s left) and the active military at all US bases combined, to deal with a rampant pandemic.

In my mind, it will take this kind of emergency mobilization to keep our infrastructure and way of life intact. Many of the US States and governors are ill prepared for a full scale national emergency, they have inadequate stockpiles of antivirals, emergency medical and foods supplies, and their emergency pandemic operations plans are untested. Our public health care system will collapse and implode after the first surge of several million infected patients.

If this is what Revere has in mind in preparing for the likelihood and inevitable consequences of a pandemic, I’m all for it.



Post a Comment

Links to this post:

Create a Link

<< Home