Wednesday, May 07, 2008

May 6 Flu Update

A WHO conference is starting in Geneva about bird flu. Very interesting. Here is the salient point:

The risk of a human influenza pandemic remains real and is probably growing as the bird flu virus becomes entrenched in poultry in more countries, health officials warned on Tuesday.

CIDRAP has this story as well. The statement below should get the ball rolling....

"We are concerned that the spread through migratory birds hasn't stopped. Once the virus is established in birds it is difficult to get rid of the virus and the risk (to humans) remains unless countries develop good control of transmission in birds," he told Reuters.

CIDRAP's story includes a look back at what WHO issued the last time it gave flu guidance in 2005. Note emphasis on the containment strategy.

The World Health Organization has published a new pandemic influenza preparedness plan that puts increased emphasis on the possibility of delaying a flu pandemic to buy time for improving the world's defenses against it.

There has been a bird flu outbreak in Seoul.

No PEOPLE in Seoul have bird flu, based on this report....

but it hasn't stopped people from flocking (sorry) to their doctors.

Supari continues to talk in Indonesia, emphasizing cultural issues at heart of dispute with US.

Bill Gates will go to Indonesia to talk influenza vaccine.

Officials in York, PA are urged to have a pandemic plan.

Massachusetts schools have a plan to close during a pandemic.

A pandemic flu outbreak could force the schools to close for up to four weeks, or more if 30 percent of the district’s students and teachers become ill.

Weymouth High School would become a secondary hospital to receive patients who are seriously ill if South Shore Hospital is inundated during a pandemic.

“When you get to a 30 percent absenteeism rate, it will be time to close the schools down,” said Elaine Pisciottoli, a coordinator for the school district’s emergency crisis response management during a recent school committee meeting.

Trent University is looking at the need for better anti-virals, especially as Tamiflu resistance grows.


At 6:04 PM, Blogger Wulfgang said...


I don’t see anything really new in your first few articles: they indicate that the “risk of a human influenza pandemic is growing”, and “probably expanding” and the “spread of bird flu through migratory birds hasn’t stopped” – no surprise there. What continues to puzzle me is the same question that Revere always asks: why do we seem to be concentrating solely on disease control, surveillance, non-pharmaceutical interventions and pandemic communications ? What about vastly expanding the world wide health care management and social systems and bolstering the medical infrastructure in countries ?

As it stands today throughout North America (and most of the world for that matter), clearly a virulent influenza pandemic would overwhelm emergency and social services everywhere. Already, the emergency systems of hospitals throughout the entire US are overwhelmed by the day-to-day volume of acutely ill patients, so much so, that most are routinely turning away ambulances because there is no place to put new patients. Especially in the larger cities, nearly all hospitals currently do not have enough ER beds, intensive-care beds and regular beds, ventilators and PPE to treat the large influx of patients that a pandemic would generate in a very short timeframe. If anyone doubts what I am saying, then you haven’t been to an ER in the last couple of years. Just look at number of poor nations of the world and the food riots we are seeing recently. The food crisis in the US has yet to explode into public view: it’s already visible in the long lines at soup kitchens and other charities in the cities, as record numbers of Americans (28 million) are depending on food stamps just to feed themselves and their families. If Congress were really serious about preparing for an influenza pandemic, they would ram an increase to the food stamp nutrition program – immediately.

Another comment I would like to make, pertains to your Weymouth, Massachusetts article, which describes their approach to a pandemic by “closing their schools, once 30 per cent of their district’s students and faculty became ill”. This is too late and no doubt is based on their past health experiences dealing with normal seasonal influenza regional epidemics. In my view, a pandemic as virulent and deadly as 1918 or much greater (H5N1 has an average worldwide CFR of 61% to date), will necessitate that schools and public venues and gatherings be closed IMMEDIATELY, rather than wait until an arbitrary percentage threshold of illness is reached, if the plan is to be effective. To wait until 30 per cent are ill, virtually guarantees that the novel and highly transmissible human influenza virus at that point has spread throughout classrooms, homes, families and the community.

There will be only one practical way to protect individuals during a deadly influenza pandemic, and that is for them to self isolate and self quarantine, as quickly as possible, for as long as possible, and even that is not a surefire approach that it will guarantee not getting the disease. To believe that teachers are going to teach classes during a pandemic using a face mask, is really rather ridiculous.



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