Saturday, January 12, 2008

January 11 Flu Update

CIDRAP covers the firestorm over reported comments from OIE on whether pandemic risk was "overblown." Two notes--first, media reports differ on what he said. Second, regardless, here's what Dr. David Fedson says:

"The statement [suggesting the risk of a pandemic is minimal] ignores history," said Fedson, who also is on the IDSA's Pandemic Influenza Task Force. "The history is a pandemic coming out of nowhere in 1918 and causing great global disruption. . . . A statement like this, if people pay attention, has the practical effect of telling people they don't need to worry, they don't need to be prepared."

Fedson said infectious diseases have caused major die-offs in several mammalian species in recent years, and humans are subject to the same threats. For example, about a third of the lions on Africa's Serengeti Plain died of distemper virus in the early 1990s, and more than 50% of gorillas and chimpanzees have died of Ebola virus infection in this decade, he said.

"Given what we know of the capability of flu viruses in general and this virus in particular, we have to take it seriously and . . . prepare for a pandemic that could cause a very high mortality," Fedson said. "We have to recognize that we're as vulnerable as the gorillas and chimps."

CIDRAP on the recently reported illness in Indonesia.

A Guam official was training for a pandemic in Hawaii.

Welsh officials say they are workin' the plan.

British officials say that the sick swans flew in from Europe during a December cold snap.

There's more outbreak news from Vietnam.

This gives you an idea of the cultural battle to be fought with bird flu. Egyptians believe that it was god, not birds that killed people there. Mix in anti-government feelings, and you have trouble getting compliance.

The Inspector General from the Department of Energy casts pandemic warning.

Poultry farmers in Ireland are warned to be careful for bird flu.

France elevates its flu threat level to moderate.


At 7:19 PM, Blogger Wulfgang said...


I’m glad Dr. Bernard Vallat’s controversial comments have been challenged by IDSA chairperson Dr. Kakthy Neuzil, Dr. David Halvorson and Dr. Michael Osterholm at the U. of Minnesota, as well as Dr. Fedson. Of course, I’m on the side of the fence that says science and history point to a looming influenza pandemic – sometime in the near future.
Unfortunately however I think this is much ado about nothing, and I do not believe Dr. Vallat’s comments will make any difference one way or another to most people. Quite simply, nearly everybody I know is not concerned about the bird flu, mainly because so far, it is only proven to be a disease of birds – and they simply don’t care. On the other token, all these same people who aren’t concerned, are also ignoring the warnings of Dr. Nabarro, Neuzil, Halvorson, Osterhom and Fedson. As far as I can determine, most people view bird flu in the same vein as preparing for an earthquake, a flood, a hurricane or a tsunami… you can’t predict when it will occur, so why expend unnecessary resources for something that “might never happen”. It could be mild, or it might be worse, but why worry about something that is so remote, that the likelihood of getting hit by lightning is much higher ? I would call this type of thinking, “just in time personal crisis planning”, just like everything else. Complacency at it’s worst.

As further evidence, one simply needs to look no further than to your article about the critical Inspector General (IG) report of the DOE. As the IG points out, the DOE senior management is not engaged, they have not coordinated with the HHS or state officials about distributing pandemic vaccines or antivirals, the DOE has not implemented a process for identifying employees who will be absent, nor have they seriously planned for working remotely, or implemented telecommuting strategies. Most probably, even their IT department is under prepared and has no viable long term pandemic plan. They no doubt have probably not even conducted any pandemic real time exercises.

From my discussions with other federal employees at numerous other agencies, this is scenario is pretty typical, because pandemic continuity of operations plans, are mostly all paper documents, stuffed away in file drawers (to be pulled out when the auditors and inspectors come around) in most all federal government agencies. In my opinion, this is a very sad and dangerous situation. I am quite sure most senior government executives are taking the same view as most people: why expend unnecessary resources on something that may never happen ? If one does occur, wait until it becomes a necessity and national priority, and see how severe it actually is, before spending time and money on final preparations.

The danger in all of this of course is the uncertainty and extraordinary risk it represents to everyone – it could be significant, in fact it could alter the way we live and change living conditions as we now know it. The very few scientists and physicians I trust, in my own federal agency, believe as Drs. Nabarro, Neuzil, Halvorson, Osterhom and Fedson, do. They firmly believe it’s coming, and there is high probability it could be extremely severe, in fact far beyond any of our individual imaginations or life experiences to date.

The problem is … nobody knows when the big bad boogey man is going to show up.



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