Don’t Worry. Be Happy.
The resistance to the idea that a pandemic could once again sweep the globe is enormous. I hear it every day from skeptics, who, like the residents of New Orleans, maintain `it can’t happen here’.
Whether H5N1 proves to be the culprit or not, we will see another pandemic like 1918. This year, next year, ten years from now . . . it will happen.
For my Floridian and gulf coast friends, let me paint a scenario that you can readily relate to.
It’s August, and for 10 days the National Hurricane Center has been watching a tropical wave as it moved off the coast of Africa and moved westward across the Atlantic. While it has shown brief signs of intensification, it still remains a weak system, and now it sits stationary, 400 miles east of Miami.
The conditions are ripe for development. Warm seawater temperatures, low wind sheer, and the steering currents are weak.
It could, overnight, spin up into a Hurricane. We know that this has happened before. In two days, it could be a CAT 5 storm, headed . . . well, it could go anywhere.
If you live in Miami, what do you do?
Maybe this system never develops, or if it does, perhaps it only ramps up to a Category 1 storm. A nuisance but not a disaster. Even if it does grow immensely strong, it could still turn north and go out to sea. Right now, it’s a potential threat. The amount of warning time you would have, if it decided to intensify and move west is probably 48 hours.
What to do? What to do?
This is precisely where we stand with H5N1.
It’s out there, it has the potential to strike without much warning, and it could be devastating. But… it could also dissipate, or never reach disastrous proportions.
If you’re smart, and live in a hurricane zone, you already have shutters for your windows, two weeks worth of food and bottled water, and an evacuation plan in mind.
If you don’t have the sense God gave a gopher, you are like many of the residents of New Orleans on the Eve of Katrina, woefully unprepared and only hours away from disaster.
Keep on believing it can’t happen here. Ignore history.
Maybe you’ll get lucky.
Tuesday, January 31, 2006
Between Iraq and a Hard Place
It is an all too familiar pattern.
We saw it in China, Vietnam, Thailand, Turkey . . . and now Iraq.
Suspicious deaths. Negative tests for H5N1. Government denials. And then, weeks later, the admission that those early tests were `faulty’.
Yesterday, an unnamed UN official leaked to an AP reporter that the 15-year-old girl who died in Iraq on January 17, despite strident assurances by WHO and the Iraqi Health Minister to the contrary, actually died of avian flu. Her uncle died last Friday of a respiratory illness, and the assumption is that he too, had H5N1.
Within a couple of hours of hitting the newswires, WHO and the Iraqi Health Minister confirmed that new tests had revealed the girl died of Avian Flu. The first two negative tests were wrong. The Iraqi Health Minister publicly appealed for International help in combating this threat.
Like I said, a familiar pattern. But this time with a couple of twists.
First, the Health Minister alluded to the fact that there were other `suspicious’ cases in the country. As many as thirty.
And, for the first time, we have an admission from WHO that this may be a case of limited H2H transmission. Maria Cheng of the World Health Organization said yesterday:
Given the World Health Organization’s strident reassurances that H5N1 has up to now, only been contracted from direct contact with birds, this is a significant announcement.
That this should happen in Iraq is particularly troubling. We have 160,000 American Troops stationed there, and many areas of the country are not only remote, they are unsecured. Getting epidemiologists and doctors into the countryside safely, will be a challenge.
While we will have to see a much larger cluster, or multiple clusters, of patients before H2H transmission can be documented, it is hard to find a worse place, geo-politically, for this outbreak to fulminate.
Containment, with warring factions all around, will be difficult. Getting timely information, doing sereoprevalence studies, and providing medical care will be nearly impossible.
While it’s too soon to jump to the conclusion that H2H has actually occurred, Iraq needs to be watched closely over the next few weeks.
It is an all too familiar pattern.
We saw it in China, Vietnam, Thailand, Turkey . . . and now Iraq.
Suspicious deaths. Negative tests for H5N1. Government denials. And then, weeks later, the admission that those early tests were `faulty’.
Yesterday, an unnamed UN official leaked to an AP reporter that the 15-year-old girl who died in Iraq on January 17, despite strident assurances by WHO and the Iraqi Health Minister to the contrary, actually died of avian flu. Her uncle died last Friday of a respiratory illness, and the assumption is that he too, had H5N1.
Within a couple of hours of hitting the newswires, WHO and the Iraqi Health Minister confirmed that new tests had revealed the girl died of Avian Flu. The first two negative tests were wrong. The Iraqi Health Minister publicly appealed for International help in combating this threat.
Like I said, a familiar pattern. But this time with a couple of twists.
First, the Health Minister alluded to the fact that there were other `suspicious’ cases in the country. As many as thirty.
And, for the first time, we have an admission from WHO that this may be a case of limited H2H transmission. Maria Cheng of the World Health Organization said yesterday:
There is a possibility this is a case of limited human-to-human spread of the virus, Cheng acknowledged. "Based on the evidence we have right now, I don't think we can rule it out."
"We still don't have a lot of details about the context of these cases; whether or not they both had contact with sick chickens or just how much contact they had. But given that he was said to have taken care of her when she was ill, that certainly does raise our level of concern."
Given the World Health Organization’s strident reassurances that H5N1 has up to now, only been contracted from direct contact with birds, this is a significant announcement.
That this should happen in Iraq is particularly troubling. We have 160,000 American Troops stationed there, and many areas of the country are not only remote, they are unsecured. Getting epidemiologists and doctors into the countryside safely, will be a challenge.
While we will have to see a much larger cluster, or multiple clusters, of patients before H2H transmission can be documented, it is hard to find a worse place, geo-politically, for this outbreak to fulminate.
Containment, with warring factions all around, will be difficult. Getting timely information, doing sereoprevalence studies, and providing medical care will be nearly impossible.
While it’s too soon to jump to the conclusion that H2H has actually occurred, Iraq needs to be watched closely over the next few weeks.
Sunday, January 29, 2006
And this Just In . . .
Terror attack a big worry, but bird flu more likely, leaders say
The Associated Press
DAVOS, Switzerland - The global threat that most preoccupies the world's business leaders is the deadly H5N1 bird flu virus, according to a study released at the World Economic Forum.
Other global risks, such as terrorist attacks and the possibility of an even bigger oil price shock, were deemed just as dangerous, but less likely to happen in the coming year, said the ''Global Risks 2006'' report. The five-day forum attracted 2,340 global leaders, including former President Clinton, Microsoft's Bill Gates, Goldman Sachs Group Inc. President Lloyd Blankfein and Harvard University President Lawrence Summers. Other attendees, included 23 theologians and 15 heads of state.
Full Article
So, if I'm crazy to worry about this, I'm in good company.
Terror attack a big worry, but bird flu more likely, leaders say
The Associated Press
DAVOS, Switzerland - The global threat that most preoccupies the world's business leaders is the deadly H5N1 bird flu virus, according to a study released at the World Economic Forum.
Other global risks, such as terrorist attacks and the possibility of an even bigger oil price shock, were deemed just as dangerous, but less likely to happen in the coming year, said the ''Global Risks 2006'' report. The five-day forum attracted 2,340 global leaders, including former President Clinton, Microsoft's Bill Gates, Goldman Sachs Group Inc. President Lloyd Blankfein and Harvard University President Lawrence Summers. Other attendees, included 23 theologians and 15 heads of state.
Full Article
So, if I'm crazy to worry about this, I'm in good company.
Mixed Messages
It seems that for every step we take in pandemic awareness, we take a step back. The media is uncertain how to present this issue, afraid on one hand to dismiss what could be the biggest story of the century, while reticent to invest themselves into another Y2K/SARS dud.
The news business (and it is a business) is funded by advertising. Cars, big screen TV’s, Airlines, etc. To shout too loudly that instead of buying that new automobile or taking that vacation, you should be buying sacks of rice and beans, is to bite the hand that feeds them. There are safer stories to cover: the bashing of political parties, celebrity scandals, or the insanity in the mid-east. None of these affect advertising revenue.
And, unlike the stories usually presented, reporting on the prospect of a pandemic requires some thought, and intelligence. Were talking about subjects like antigen shift, RNA replication, and the prospect of adverse affects from the, as yet unavailable, vaccine. Not exactly the sort of subjects that the Twinkies behind the news desk are likely to be conversant with.
Occasionally, a bit of light escapes from our broadcasters, as in the case of a recent broadcast of Meet The Press with Tim Russert. Guests in a round table discussion included Tom Brokaw and Ted Koppel. While discussing the difficulties in covering the Avian Flu threat, Tom Brokaw admitted that he and his wife were stockpiling supplies and were prepared to hunker down in their country home in the event of a pandemic. Ted Koppel admitted that he had not begun to prepared, but was going to start immediately.
Both apparently take this threat seriously.
Meanwhile, the WHO (World Health Organization) has unveiled their `bunker' (their term, not mine) in Geneva, where they plan to uplink live satellite feeds to TV stations worldwide in many languages, updating the spread of the pandemic. Sort of an Influenza Channel, with maps, graphics, authoritative on-air personalities, and timely flu advisories.
I can see it now . . .
When Oprah Winfrey gave away a couple of hundred cars last year to her studio audience, it was widely covered by the national and local news outlets. Last week, she devoted a show to Avian Flu, and the need to prepare, and there was scarcely a word on the mainstream media about it.
One has to wonder what will it take to get the attention of the media?
And if and when that does happen, will it be too late?
It seems that for every step we take in pandemic awareness, we take a step back. The media is uncertain how to present this issue, afraid on one hand to dismiss what could be the biggest story of the century, while reticent to invest themselves into another Y2K/SARS dud.
The news business (and it is a business) is funded by advertising. Cars, big screen TV’s, Airlines, etc. To shout too loudly that instead of buying that new automobile or taking that vacation, you should be buying sacks of rice and beans, is to bite the hand that feeds them. There are safer stories to cover: the bashing of political parties, celebrity scandals, or the insanity in the mid-east. None of these affect advertising revenue.
And, unlike the stories usually presented, reporting on the prospect of a pandemic requires some thought, and intelligence. Were talking about subjects like antigen shift, RNA replication, and the prospect of adverse affects from the, as yet unavailable, vaccine. Not exactly the sort of subjects that the Twinkies behind the news desk are likely to be conversant with.
Occasionally, a bit of light escapes from our broadcasters, as in the case of a recent broadcast of Meet The Press with Tim Russert. Guests in a round table discussion included Tom Brokaw and Ted Koppel. While discussing the difficulties in covering the Avian Flu threat, Tom Brokaw admitted that he and his wife were stockpiling supplies and were prepared to hunker down in their country home in the event of a pandemic. Ted Koppel admitted that he had not begun to prepared, but was going to start immediately.
Both apparently take this threat seriously.
Meanwhile, the WHO (World Health Organization) has unveiled their `bunker' (their term, not mine) in Geneva, where they plan to uplink live satellite feeds to TV stations worldwide in many languages, updating the spread of the pandemic. Sort of an Influenza Channel, with maps, graphics, authoritative on-air personalities, and timely flu advisories.
I can see it now . . .
Today in Chicago there is a 40% chance of scattered Fluies, rising to 60% by early evening. Best take along your masks and gloves today. The wait time to be seen at local emergency rooms is expected to climb to 18 hours later today, and no rooms or ventilators are available. Moving on to Cincinatti . . .Yet despite all of this, and dire warnings from the United Nations, the WHO, and even our own President, few are paying attention. The news media glosses over the threat, and people assume it is overblown.
When Oprah Winfrey gave away a couple of hundred cars last year to her studio audience, it was widely covered by the national and local news outlets. Last week, she devoted a show to Avian Flu, and the need to prepare, and there was scarcely a word on the mainstream media about it.
One has to wonder what will it take to get the attention of the media?
And if and when that does happen, will it be too late?
Saturday, January 28, 2006
The Proper First Aid Kit
Obviously, every home should have one, pandemic or not. But in looking around the web, I’ve examined a number of commercially available first aid kits, and I’m not impressed. If all you want a pretty box with some band-aids, Neosporin, and some gauze pads to handle cuts and scrapes, I suppose they are adequate. But in no way would I consider them suitable for a real emergency. And for the prices they are asking, you’d be better off building your own.
To that end, I’ve put together my recommendations for a minimum first aid kit. This is based on the items I used most often as a paramedic that do not require advanced training. Obviously, there are more items that could be added. Think of this as a starting point. And a first aid kit is not the same as your med-kit. This is the bag you grab when someone is injured or suddenly ill, and will use in the first 15 minutes of an emergency.
If there is interest, I’ll put together suggestions for a more complete medical kit later.
First, you need a carrying case. Tackle boxes work well for this, as do soft canvas bags with pockets. This carrying case should be light and durable, and large enough to organize and hold all of the items you need. Water resistance is a plus.
As far as the contents, I recommend:
Latex Gloves: These needn’t be sterile. They are for your protection. A bag of 50 is about $4. Keep 4 to 6 in the kit at all times.
N95 Masks: I keep 3 or 4 tucked away in my kit. One for me, the rest for possibly infectious patients.
Sterile Gauze Pads: 4x4’s are the most useful size. You will use these more than any other item. Have plenty of them on hand.
Kling roller bandage: 2nd most useful item. Have several rolls of 2 inch and 3 inch.
Cravat or Triangular Bandage: Buy one or you can make your own out of an old bed sheet.
Large Trauma Dressing: For when a 4x4 won’t do.
Paper Tape: Better than adhesive tape. Replace every year or two, as heat degrades them.
Ace Bandage: 2 inch and 4 inch.
Band aid Assortment: Not really needed in an emergency, but nice to have.
Alcohol wipes: Very handy
Hand Sanitizer: Small squeeze bottle. About 50 cents.
Thermometer: Inexpensive digital ones can be bought for about $4.
Stethoscope: Cheap ones are about $15.
BP Cuff: The battery operated digital ones are good enough. Manual ones are better, but do require a bit of practice to do it right.
Note Pad/Pen: Keep track of vitals
Bandage shears: Not just for cutting bandages. Can be used to cut away clothing.
Penlight flashlight: See in the dark, and check pupil reactions.
Ambu-bag/Airways: A bit expensive, but I won’t leave home without one. Sure beats doing mouth-to-mouth. About $50.
Cervical Collar: Foam collar stores easily and can be purchased for under $10.
Cold Packs: Not essential, but nice to have
Sterile eyewash: Generally in a squeeze bottle. Non-sterile is better than none at all.
Aspirin: To administer in the event of a suspected heart attack.
Tweezers: Nice to have, not required.
As stated, this is just a start. There are some items, like wire splints, that are nice to have, but you can do just about as well with a rolled up magazine/newspaper and some kling bandage. An emetic, such as syrup of Ipecac can be handy, but when used with the wrong type of poisoning (ie. Corrosives or petroleum products) can do more harm than good.
A pouch or two of a sports drink, like Gatorade, is a nice addition. Great for heat exhaustion, dehydration.
Someone, I’m sure, will point out the lack of a first aid manual. Frankly, you need to know how to handle emergencies before they occur. You won’t have time to look up something in a first aid manual while your patient is bleeding out or turning into a smurf. If it makes you feel better, though, add one.
Having a first aid kit is important, but if you haven’t taken a first-aid course, and don’t have a CPR certification, you are kidding yourself about your ability to handle an emergency. Contact you local Red Cross chapter or CERT program and see if they offer classes. CPR instructors are usually also available thru your local fire department.
Obviously, every home should have one, pandemic or not. But in looking around the web, I’ve examined a number of commercially available first aid kits, and I’m not impressed. If all you want a pretty box with some band-aids, Neosporin, and some gauze pads to handle cuts and scrapes, I suppose they are adequate. But in no way would I consider them suitable for a real emergency. And for the prices they are asking, you’d be better off building your own.
To that end, I’ve put together my recommendations for a minimum first aid kit. This is based on the items I used most often as a paramedic that do not require advanced training. Obviously, there are more items that could be added. Think of this as a starting point. And a first aid kit is not the same as your med-kit. This is the bag you grab when someone is injured or suddenly ill, and will use in the first 15 minutes of an emergency.
If there is interest, I’ll put together suggestions for a more complete medical kit later.
First, you need a carrying case. Tackle boxes work well for this, as do soft canvas bags with pockets. This carrying case should be light and durable, and large enough to organize and hold all of the items you need. Water resistance is a plus.
As far as the contents, I recommend:
Latex Gloves: These needn’t be sterile. They are for your protection. A bag of 50 is about $4. Keep 4 to 6 in the kit at all times.
N95 Masks: I keep 3 or 4 tucked away in my kit. One for me, the rest for possibly infectious patients.
Sterile Gauze Pads: 4x4’s are the most useful size. You will use these more than any other item. Have plenty of them on hand.
Kling roller bandage: 2nd most useful item. Have several rolls of 2 inch and 3 inch.
Cravat or Triangular Bandage: Buy one or you can make your own out of an old bed sheet.
Large Trauma Dressing: For when a 4x4 won’t do.
Paper Tape: Better than adhesive tape. Replace every year or two, as heat degrades them.
Ace Bandage: 2 inch and 4 inch.
Band aid Assortment: Not really needed in an emergency, but nice to have.
Alcohol wipes: Very handy
Hand Sanitizer: Small squeeze bottle. About 50 cents.
Thermometer: Inexpensive digital ones can be bought for about $4.
Stethoscope: Cheap ones are about $15.
BP Cuff: The battery operated digital ones are good enough. Manual ones are better, but do require a bit of practice to do it right.
Note Pad/Pen: Keep track of vitals
Bandage shears: Not just for cutting bandages. Can be used to cut away clothing.
Penlight flashlight: See in the dark, and check pupil reactions.
Ambu-bag/Airways: A bit expensive, but I won’t leave home without one. Sure beats doing mouth-to-mouth. About $50.
Cervical Collar: Foam collar stores easily and can be purchased for under $10.
Cold Packs: Not essential, but nice to have
Sterile eyewash: Generally in a squeeze bottle. Non-sterile is better than none at all.
Aspirin: To administer in the event of a suspected heart attack.
Tweezers: Nice to have, not required.
As stated, this is just a start. There are some items, like wire splints, that are nice to have, but you can do just about as well with a rolled up magazine/newspaper and some kling bandage. An emetic, such as syrup of Ipecac can be handy, but when used with the wrong type of poisoning (ie. Corrosives or petroleum products) can do more harm than good.
A pouch or two of a sports drink, like Gatorade, is a nice addition. Great for heat exhaustion, dehydration.
Someone, I’m sure, will point out the lack of a first aid manual. Frankly, you need to know how to handle emergencies before they occur. You won’t have time to look up something in a first aid manual while your patient is bleeding out or turning into a smurf. If it makes you feel better, though, add one.
Having a first aid kit is important, but if you haven’t taken a first-aid course, and don’t have a CPR certification, you are kidding yourself about your ability to handle an emergency. Contact you local Red Cross chapter or CERT program and see if they offer classes. CPR instructors are usually also available thru your local fire department.
Good News … Maybe…
New Bird Flu Vaccine Is 100 Percent Effective in Animal Tests
By Thomas H. Maugh II, Times Staff Writer
Pennsylvania researchers have produced a bird flu vaccine made from a genetically engineered human cold virus and shown that it protected 100 percent of vaccinated mice and chickens.
While production of a conventional flu vaccine requires months of work and large numbers of fertilized chicken eggs, the researchers reported Thursday that they prepared their vaccine in only 36 days, growing it in a laboratory dish.
Complete story
This is genuinely good news, and a huge step forward in vaccine research. But before we pop the Champaign corks and declare victory over the flu virus, we need to examine this story a little closer.
First, it has only been tested on a limited number of mice and chickens. Human trials haven’t even been started.
Second, the use of a common cold virus as a vector is problematic. Some people may be immune to this virus, and therefore the vaccine may not work
Third, production in a lab dish is not the same as gearing up to produce enough vaccine for the entire country, or for the world.
Fourth, this vaccine, like any vaccine, may have side effects. In 1976 the Swine Flu vaccine was abruptly retracted when a number of recipients died.
Fifth, if the vaccine is not widely available before a pandemic begins, then the distribution of it, and the vaccination of the public becomes very problematic. How many people will go stand in long lines to receive a shot if an epidemic is underway? Most vaccines require a couple of weeks to provide immunity.
I applaud the researchers at this university, and genuinely hope their new vaccine proves to be as effective as early studies indicate. But there is a big gap between growing an experimental vaccine in a lab dish, and actually inoculating 300 million Americans.
This is a step forward. But it is a long way from having a cure.
New Bird Flu Vaccine Is 100 Percent Effective in Animal Tests
By Thomas H. Maugh II, Times Staff Writer
Pennsylvania researchers have produced a bird flu vaccine made from a genetically engineered human cold virus and shown that it protected 100 percent of vaccinated mice and chickens.
While production of a conventional flu vaccine requires months of work and large numbers of fertilized chicken eggs, the researchers reported Thursday that they prepared their vaccine in only 36 days, growing it in a laboratory dish.
Complete story
This is genuinely good news, and a huge step forward in vaccine research. But before we pop the Champaign corks and declare victory over the flu virus, we need to examine this story a little closer.
First, it has only been tested on a limited number of mice and chickens. Human trials haven’t even been started.
Second, the use of a common cold virus as a vector is problematic. Some people may be immune to this virus, and therefore the vaccine may not work
Third, production in a lab dish is not the same as gearing up to produce enough vaccine for the entire country, or for the world.
Fourth, this vaccine, like any vaccine, may have side effects. In 1976 the Swine Flu vaccine was abruptly retracted when a number of recipients died.
Fifth, if the vaccine is not widely available before a pandemic begins, then the distribution of it, and the vaccination of the public becomes very problematic. How many people will go stand in long lines to receive a shot if an epidemic is underway? Most vaccines require a couple of weeks to provide immunity.
I applaud the researchers at this university, and genuinely hope their new vaccine proves to be as effective as early studies indicate. But there is a big gap between growing an experimental vaccine in a lab dish, and actually inoculating 300 million Americans.
This is a step forward. But it is a long way from having a cure.
Thursday, January 26, 2006
Timing is everything
In yesterday's column I warned that, if a pandemic happens, you will be on your own. I've also warned that the supply chain may break down, and that the global economy is at risk. Today two news items appeared that seem to back up my contentions.
WASHINGTON A federal health official has warned a gathering of mayors that they cannot expect the federal government to save their cities in the event of a bird flu pandemic.
Read the entire AP article
And then there's this from the World Economic Council's report issued in Davos, Switzerland today. As reported in the Guardian Unlimited :
Avian flu has the potential to develop into a global pandemic that would be as devastating as the Black Death of the 14th century, the World Economic Forum warned yesterday in its assessment of the risks threatening stability and prosperity.
In a worst-case outcome, experts charged with weighing up systemic dangers said there might be riots to gain access to supplies of vaccines, a collapse of public order, a partial flight from the cities and large-scale migration.
Read the entire article
While no one knows if Avian flu will turn into a pandemic, the world suddenly is taking notice of the dangers, and concern is spreading through the highest levels of government and business.
In yesterday's column I warned that, if a pandemic happens, you will be on your own. I've also warned that the supply chain may break down, and that the global economy is at risk. Today two news items appeared that seem to back up my contentions.
WASHINGTON A federal health official has warned a gathering of mayors that they cannot expect the federal government to save their cities in the event of a bird flu pandemic.
Read the entire AP article
And then there's this from the World Economic Council's report issued in Davos, Switzerland today. As reported in the Guardian Unlimited :
Avian flu has the potential to develop into a global pandemic that would be as devastating as the Black Death of the 14th century, the World Economic Forum warned yesterday in its assessment of the risks threatening stability and prosperity.
In a worst-case outcome, experts charged with weighing up systemic dangers said there might be riots to gain access to supplies of vaccines, a collapse of public order, a partial flight from the cities and large-scale migration.
Read the entire article
While no one knows if Avian flu will turn into a pandemic, the world suddenly is taking notice of the dangers, and concern is spreading through the highest levels of government and business.
Wednesday, January 25, 2006
You Will Be On Your Own
One of the grim realities of a pandemic is, that in large measure, you will be on your own. In the face of a massive outbreak, there is little that FEMA or local government can do to help you. If there is one common message (albeit hidden in `polite’ language) from our state and federal government, it is that individuals must take responsibility for themselves.
A pandemic is not like a Hurricane or an earthquake. It is not a localized event. The cavalry will not be dispatched from a neighboring state to assist you, and the Feds will be spread far too thin to make much of an impact.
If you fail to stockpile food, you will likely go hungry for some time. You could even starve to death. FEMA will not be arriving in your neighborhood to dispense ice, water, and MRE’s. Grocery stores will likely close, and stay closed for days, weeks, or longer. They will sell out to bare shelves when a pandemic starts, and deliveries of new stock may not arrive for some time. When they do arrive, there will be long lines of very hungry people, some of whom may be infected, to deal with.
Right now, the government is telling every individual to stockpile food, but they aren’t saying for how long. FEMA recommends at least 2 weeks supply, but this isn’t for a pandemic, this is for routine disasters like hurricanes, floods, and earthquakes. On Oprah yesterday, Dr. Osterholm suggested 4 to 5 weeks. That, I believe is a minimum.
Pandemics come in waves, usually 2 or 3, over a period of 1 to 2 years. Each wave can last 6 to 12 weeks. There is usually a lull of a couple of months between waves. Yes, there are still infections, but the numbers go down. During these lulls, it is possible that stores may be restocked. Not guaranteed, but possible.
It makes sense then, to plan on having a 3-month supply of food on hand for your family. That won’t cover you if the stores are not restocked, but few of us have the room or the money to stockpile a two-year supply of food. Not that there aren’t some people who are doing that. There are. I know of some people who are shooting for a 5-year supply.
For many of you, you may be thinking that it is impossible to buy, and store, a 3-month supply of food. I suppose, for some, that may be true. But most of us can set aside a closet, or boxes under our beds, and fill them with cheap, heat and eat, canned foods. A family of 4 can survive on $3 a day, if push comes to shove. No, you won’t be happy with your meals, but you won’t be eyeing the family cat and trying to figure out if it’s a roaster or a fryer, either.
The cheapest foods, rice and dried beans, take a long time to cook. If you are sure you will be able to cook, then these are fine. But the possibility of power outages exist, and even interruptions in gas deliveries. Better to go with foods that can simply be heated, or at the very least, quickly cooked.
I visited a `discount’ grocery store the other day, and found 40 ounce cans of macaroni with beef (well, tiny specks of something brown, anyway) for a dollar a can. Boxes of Instant rice (14 ounce) for a dollar. Corned beef in a can for a dollar. Pasta for about 40 cents a pound. Spaghetti Sauce for a dollar a can. And gravy mixes for .33 cents apiece.
All of these items can be heated, or cooked, in 5 to 10 minutes. A $20 camp stove, and some 1lb propane bottles, and you are in business.
No, you won’t be waking up to French toast in the mornings, or serving 5 course meals at dinner. We are talking about survival here. One-pot meals. Probably twice a day.
Water will be another problem. You need to figure on 1 gallon per person/day. A family of 4 would need nearly 500 gallons to survive for 3 months. Storing that much water, for most of us, is impossible. But storing a week or two supply can be easily done. A supply of bleach on hand will allow you to treat any suspect water (even from your tap) that you may acquire once your stored supplies run dry.
As far as hospitals go, during a pandemic, the odds are they will be quickly overwhelmed. Most flu victims will be stuck at home, and will never have access to ventilators, antibiotics, or doctors. During a normal flu season, hospitals often exceed capacity. During a pandemic, they will become a madhouse.
There are roughly 105,000 respiratory ventilators in the United States, spread across thousands of hospitals. During a pandemic, millions of people may need them all at the same time. You do the math.
IF a pandemic occurs, you had better plan on treating your family members at home. Only a lucky few will find a hospital bed. Fewer still will have access to a ventilator. As far as medicines are concerned, the stockpile of anti-virals will be exhausted very early on in an epidemic, as will antibiotics. In short, for the vast majority of victims, there is very little that the hospitals will be able to do that you cannot at home.
While this is a grim assessment, I believe it is realistic. Of course, a pandemic may not happen this year, or even next. But it will happen at some point. And right now, with Avian Flu simmering in the 3rd world, we are at tremendous risk.
The difference between surviving it, and becoming a dry statistic, will be your willingness and ability to prepare in advance.
One of the grim realities of a pandemic is, that in large measure, you will be on your own. In the face of a massive outbreak, there is little that FEMA or local government can do to help you. If there is one common message (albeit hidden in `polite’ language) from our state and federal government, it is that individuals must take responsibility for themselves.
A pandemic is not like a Hurricane or an earthquake. It is not a localized event. The cavalry will not be dispatched from a neighboring state to assist you, and the Feds will be spread far too thin to make much of an impact.
If you fail to stockpile food, you will likely go hungry for some time. You could even starve to death. FEMA will not be arriving in your neighborhood to dispense ice, water, and MRE’s. Grocery stores will likely close, and stay closed for days, weeks, or longer. They will sell out to bare shelves when a pandemic starts, and deliveries of new stock may not arrive for some time. When they do arrive, there will be long lines of very hungry people, some of whom may be infected, to deal with.
Right now, the government is telling every individual to stockpile food, but they aren’t saying for how long. FEMA recommends at least 2 weeks supply, but this isn’t for a pandemic, this is for routine disasters like hurricanes, floods, and earthquakes. On Oprah yesterday, Dr. Osterholm suggested 4 to 5 weeks. That, I believe is a minimum.
Pandemics come in waves, usually 2 or 3, over a period of 1 to 2 years. Each wave can last 6 to 12 weeks. There is usually a lull of a couple of months between waves. Yes, there are still infections, but the numbers go down. During these lulls, it is possible that stores may be restocked. Not guaranteed, but possible.
It makes sense then, to plan on having a 3-month supply of food on hand for your family. That won’t cover you if the stores are not restocked, but few of us have the room or the money to stockpile a two-year supply of food. Not that there aren’t some people who are doing that. There are. I know of some people who are shooting for a 5-year supply.
For many of you, you may be thinking that it is impossible to buy, and store, a 3-month supply of food. I suppose, for some, that may be true. But most of us can set aside a closet, or boxes under our beds, and fill them with cheap, heat and eat, canned foods. A family of 4 can survive on $3 a day, if push comes to shove. No, you won’t be happy with your meals, but you won’t be eyeing the family cat and trying to figure out if it’s a roaster or a fryer, either.
The cheapest foods, rice and dried beans, take a long time to cook. If you are sure you will be able to cook, then these are fine. But the possibility of power outages exist, and even interruptions in gas deliveries. Better to go with foods that can simply be heated, or at the very least, quickly cooked.
I visited a `discount’ grocery store the other day, and found 40 ounce cans of macaroni with beef (well, tiny specks of something brown, anyway) for a dollar a can. Boxes of Instant rice (14 ounce) for a dollar. Corned beef in a can for a dollar. Pasta for about 40 cents a pound. Spaghetti Sauce for a dollar a can. And gravy mixes for .33 cents apiece.
All of these items can be heated, or cooked, in 5 to 10 minutes. A $20 camp stove, and some 1lb propane bottles, and you are in business.
No, you won’t be waking up to French toast in the mornings, or serving 5 course meals at dinner. We are talking about survival here. One-pot meals. Probably twice a day.
Water will be another problem. You need to figure on 1 gallon per person/day. A family of 4 would need nearly 500 gallons to survive for 3 months. Storing that much water, for most of us, is impossible. But storing a week or two supply can be easily done. A supply of bleach on hand will allow you to treat any suspect water (even from your tap) that you may acquire once your stored supplies run dry.
As far as hospitals go, during a pandemic, the odds are they will be quickly overwhelmed. Most flu victims will be stuck at home, and will never have access to ventilators, antibiotics, or doctors. During a normal flu season, hospitals often exceed capacity. During a pandemic, they will become a madhouse.
There are roughly 105,000 respiratory ventilators in the United States, spread across thousands of hospitals. During a pandemic, millions of people may need them all at the same time. You do the math.
IF a pandemic occurs, you had better plan on treating your family members at home. Only a lucky few will find a hospital bed. Fewer still will have access to a ventilator. As far as medicines are concerned, the stockpile of anti-virals will be exhausted very early on in an epidemic, as will antibiotics. In short, for the vast majority of victims, there is very little that the hospitals will be able to do that you cannot at home.
While this is a grim assessment, I believe it is realistic. Of course, a pandemic may not happen this year, or even next. But it will happen at some point. And right now, with Avian Flu simmering in the 3rd world, we are at tremendous risk.
The difference between surviving it, and becoming a dry statistic, will be your willingness and ability to prepare in advance.
Tuesday, January 24, 2006
FEAR FACTOR PT. 1
In my daily tour of the Internet Flu sites, I’m seeing an extraordinary level of panic being expressed, and with each day that passes, the tenor of the discussions are becoming more shrill. In one forum, I suggested that people consider volunteering to help out during a pandemic, and was immediately shouted down by a number of posters as being irresponsible for even suggesting it. THE ONLY SENSIBLE THING TO DO IS BARRICADE YOURSELF IN YOUR HOME FOR A YEAR! MAYBE TWO! LEAVING YOUR HOME PUTS EVERYONE AT RISK!
Why the visceral, almost violent response?
I’m no psychologist, but I can guess. These people have completely invested themselves in the idea of surviving in a post-pandemic world. Many have spent thousands, perhaps tens of thousands of dollars, preparing to barricade themselves in their homes for a year or more. For someone to suggest that it might be reasonable to leave their home, to help tend to the sick or provide some other community service, undermines their whole rationale for mortgaging the house to buy sacks of cracked wheat, automatic weapons, and full containment suits.
They believe that the air outside of their home will be filled with flu virus particles, and that even stepping into their backyard risks infection. They are buying expensive respirators, devising decontamination rooms, and are warning family members that if they leave the house once a pandemic alert is raised, they will not be allowed back in. At the very least, the returning family member will be forced into quarantine in the garage for a minimum of two weeks.
I’m sorry, but if things get that bad, we’re all screwed.
These folks have taken a potentially bad scenario and have made it much worse in their own minds. Avian Flu is a genuine threat, but right now, it’s only a threat. If it should become a pandemic, there is no scientific reason to believe that the flu virus will be so pervasive in the air that to walk outside is to risk contamination. These folks have morphed the flu virus into a Biohazard Level 4 threat, like ebola. Partially, I believe, because of the unusually high death rate associated with avian flu.
How then is the flu transmitted? What are the real risks?
The flu virus is shed by its carrier either through the respiratory system or through the digestive system. In other words, by coughing or sneezing, or by feces. The virus can remain alive on dry surfaces for as long as 48-72 hours, and has been detected in bird feces from between 6 and 35 days.
This is why hand washing is so important. We touch contaminated surfaces, like doorknobs or telephones, and we then touch our mouths, nose, or eyes, and become infected. Frequent hand washing has proven to be the most effective way to reduce the transmission of the flu virus. I strongly urge the use of hand sanitizers, even when we are not in a pandemic. We may laugh at Adrian Monk, but he would probably survive a pandemic.
The real bugaboo for most people is the idea that the flu virus is airborne. And here, there are a lot of misconceptions.
Yes, the flu virus may be expelled into the air when someone sneezes or coughs. If you are in close proximity, you could inhale these virus particles that are generally encapsulated in droplets of moisture. Droplets, however, are heavy. They do not remain airborne for very long. Minutes, maybe less. And the flu virus is vulnerable to UV rays from the sun, and desiccation. It will not float indefinitely in the air.
Ahh, people say. The virus can become aerosolized, and can `float’ without a droplet. There is some evidence that this is true. However, the virus cannot exist in this form for long. This is not anthrax, which can persist for decades. It’s a fragile organism. It has never even been shown that it can be distributed through ventilating systems in office buildings.
Simply put, if you stay away from infected people, and wash your hands frequently, the odds are you won’t get infected.
Obviously, the closer you come to an infected person, the higher the likelihood of transmission.
How close, is too close?
Indoors, sharing the same air, entering the same room with an infected person has some risk. Outdoors, my personal comfort level would be 30 feet. The use of masks, gloves, and gowns further reduces the chances of infection.
Medical personnel are exposed similar viruses every flu season. Some do catch the flu, but most don’t. They take routine precautions, and they are reasonably safe.
Yes, but couldn’t this virus mutate into some super contagious form we’ve never seen before?
The law of averages says: Anything that can happen, will. So yes, it is possible. And if that happens, the rules definitely change. But we have no evidence of avian flu becoming that sort of pathogen. To date, it’s been extraordinarily difficult to catch.
If a pandemic comes (still an `if’), we will probably be advised to stay home, avoid exposure, and only essential workers will be asked to report to their jobs. Restaurants, movie theatres, sporting events, and shopping malls will probably be closed. Public funerals may be outlawed. Indeed, entire cities may be quarantined, travel restrictions and martial law may be imposed. It will not be pretty.
But the odds are you can still step out into your back yard without undo fear. Is the risk absolutely zero? No. There is always some risk in everything we do.
Just remember, during the best model we have for a pandemic, the Spanish Flu of 1918, more than 70% of the country never contracted the flu, even though most of them were exposed.
The realities of a flu pandemic are bad enough. There’s no need to make it worse than it is.
In my daily tour of the Internet Flu sites, I’m seeing an extraordinary level of panic being expressed, and with each day that passes, the tenor of the discussions are becoming more shrill. In one forum, I suggested that people consider volunteering to help out during a pandemic, and was immediately shouted down by a number of posters as being irresponsible for even suggesting it. THE ONLY SENSIBLE THING TO DO IS BARRICADE YOURSELF IN YOUR HOME FOR A YEAR! MAYBE TWO! LEAVING YOUR HOME PUTS EVERYONE AT RISK!
Why the visceral, almost violent response?
I’m no psychologist, but I can guess. These people have completely invested themselves in the idea of surviving in a post-pandemic world. Many have spent thousands, perhaps tens of thousands of dollars, preparing to barricade themselves in their homes for a year or more. For someone to suggest that it might be reasonable to leave their home, to help tend to the sick or provide some other community service, undermines their whole rationale for mortgaging the house to buy sacks of cracked wheat, automatic weapons, and full containment suits.
They believe that the air outside of their home will be filled with flu virus particles, and that even stepping into their backyard risks infection. They are buying expensive respirators, devising decontamination rooms, and are warning family members that if they leave the house once a pandemic alert is raised, they will not be allowed back in. At the very least, the returning family member will be forced into quarantine in the garage for a minimum of two weeks.
I’m sorry, but if things get that bad, we’re all screwed.
These folks have taken a potentially bad scenario and have made it much worse in their own minds. Avian Flu is a genuine threat, but right now, it’s only a threat. If it should become a pandemic, there is no scientific reason to believe that the flu virus will be so pervasive in the air that to walk outside is to risk contamination. These folks have morphed the flu virus into a Biohazard Level 4 threat, like ebola. Partially, I believe, because of the unusually high death rate associated with avian flu.
How then is the flu transmitted? What are the real risks?
The flu virus is shed by its carrier either through the respiratory system or through the digestive system. In other words, by coughing or sneezing, or by feces. The virus can remain alive on dry surfaces for as long as 48-72 hours, and has been detected in bird feces from between 6 and 35 days.
This is why hand washing is so important. We touch contaminated surfaces, like doorknobs or telephones, and we then touch our mouths, nose, or eyes, and become infected. Frequent hand washing has proven to be the most effective way to reduce the transmission of the flu virus. I strongly urge the use of hand sanitizers, even when we are not in a pandemic. We may laugh at Adrian Monk, but he would probably survive a pandemic.
The real bugaboo for most people is the idea that the flu virus is airborne. And here, there are a lot of misconceptions.
Yes, the flu virus may be expelled into the air when someone sneezes or coughs. If you are in close proximity, you could inhale these virus particles that are generally encapsulated in droplets of moisture. Droplets, however, are heavy. They do not remain airborne for very long. Minutes, maybe less. And the flu virus is vulnerable to UV rays from the sun, and desiccation. It will not float indefinitely in the air.
Ahh, people say. The virus can become aerosolized, and can `float’ without a droplet. There is some evidence that this is true. However, the virus cannot exist in this form for long. This is not anthrax, which can persist for decades. It’s a fragile organism. It has never even been shown that it can be distributed through ventilating systems in office buildings.
Simply put, if you stay away from infected people, and wash your hands frequently, the odds are you won’t get infected.
Obviously, the closer you come to an infected person, the higher the likelihood of transmission.
How close, is too close?
Indoors, sharing the same air, entering the same room with an infected person has some risk. Outdoors, my personal comfort level would be 30 feet. The use of masks, gloves, and gowns further reduces the chances of infection.
Medical personnel are exposed similar viruses every flu season. Some do catch the flu, but most don’t. They take routine precautions, and they are reasonably safe.
Yes, but couldn’t this virus mutate into some super contagious form we’ve never seen before?
The law of averages says: Anything that can happen, will. So yes, it is possible. And if that happens, the rules definitely change. But we have no evidence of avian flu becoming that sort of pathogen. To date, it’s been extraordinarily difficult to catch.
If a pandemic comes (still an `if’), we will probably be advised to stay home, avoid exposure, and only essential workers will be asked to report to their jobs. Restaurants, movie theatres, sporting events, and shopping malls will probably be closed. Public funerals may be outlawed. Indeed, entire cities may be quarantined, travel restrictions and martial law may be imposed. It will not be pretty.
But the odds are you can still step out into your back yard without undo fear. Is the risk absolutely zero? No. There is always some risk in everything we do.
Just remember, during the best model we have for a pandemic, the Spanish Flu of 1918, more than 70% of the country never contracted the flu, even though most of them were exposed.
The realities of a flu pandemic are bad enough. There’s no need to make it worse than it is.
A Chinese Puzzle
For months the World Health Organization has been negotiating with China to obtain samples of the H5N1 virus collected within China. And for months, China has stalled, sending `bit’s and pieces’ of information, but never sending the information requested.
What, exactly, is China hiding?
They’ve admitted to detecting Avian flu in poultry, and in wild birds. They’ve even admitted to having 10 human victims. Something is rotten in Beijing.
There are persistent, but unconfirmed rumors, that far more human victims of avian flu exist (or at least, did exist) in China than are being reported. Accurate news, however, is hard to get. China is a highly regulated society, and has jailed more journalists than any other country.
Many of these reports come from dissidents, and so their veracity is difficult to measure. They have an agenda, and would like nothing more than to paint the Chinese government in a bad light. We are left with little concrete evidence one way or the other.
What we do know is that China covered up the SARS epidemic early on, back in 2003, and their failure to deal with the problem allowed it to spread. Now they are holding back vital information from WHO. Information that could tell us how the virus is mutating.
With the world possibly on the brink of a pandemic, China is playing a very dangerous game, with all of our lives.
For months the World Health Organization has been negotiating with China to obtain samples of the H5N1 virus collected within China. And for months, China has stalled, sending `bit’s and pieces’ of information, but never sending the information requested.
What, exactly, is China hiding?
They’ve admitted to detecting Avian flu in poultry, and in wild birds. They’ve even admitted to having 10 human victims. Something is rotten in Beijing.
There are persistent, but unconfirmed rumors, that far more human victims of avian flu exist (or at least, did exist) in China than are being reported. Accurate news, however, is hard to get. China is a highly regulated society, and has jailed more journalists than any other country.
Many of these reports come from dissidents, and so their veracity is difficult to measure. They have an agenda, and would like nothing more than to paint the Chinese government in a bad light. We are left with little concrete evidence one way or the other.
What we do know is that China covered up the SARS epidemic early on, back in 2003, and their failure to deal with the problem allowed it to spread. Now they are holding back vital information from WHO. Information that could tell us how the virus is mutating.
With the world possibly on the brink of a pandemic, China is playing a very dangerous game, with all of our lives.
Sunday, January 22, 2006
PREPARING FOR A PANDEMIC
I’ve spent a good deal of time on the Flu discussion boards this past week and it is evident that a number of people are attempting to prepare themselves for TEOTWAWKI (The End Of The World As We Know It). People are stockpiling a year’s worth of food or more, trying to acquire anti-viral medications, and are planning on isolating themselves for the duration.
While I do not plan to go that far, I won’t criticize those that do. Everybody has to make their own determination as to what they feel they must do to protect themselves. If heading for the hills, or barricading yourself in your home with a shotgun and a closet full of dehydrated foods increases your comfort level, then by all means, do so.
For most of us, these are not practical preparations. Few of us have an isolated cabin in the woods to bug out to. Most of us couldn’t purchase and store a years worth of food in our homes if we had to. There are practical limits to what we can do.
What then are prudent preparations?
In order to figure that out, we must first look at the likely ramifications of a pandemic.
Our best model is the Spanish Flu Pandemic of 1918. It killed (depending on whom you believe) between 20 and 100 million people over the span of 2 years. It came in 3 waves, the first relatively mild, the second wave a few months later was horrific, followed by a third, less virulent wave the following year.
Isolation and quarantine were used to combat this pandemic, and yes, some people did starve to death in their homes. Social isolation has been suggested as a precautionary measure by our own government, and plans are being worked out to close schools at the first sign of a pandemic in our country. Many businesses may close. There could even be disruptions in food deliveries and essential services.
FEMA now recommends that all American Families keep a 2-week supply of food, water, and prescription medicines in their homes in the event of a disaster. Up until Katrina devastated New Orleans, their recommendation was for 72 hours. As we all now know, that was completely inadequate.
At a minimum, we all should strive for this level of preparedness. Even if a pandemic does not fulminate, there are other disasters that could befall us. Hurricanes, earthquakes, and terrorist attacks to name a few.
Personally, in the face of a pandemic, I believe that having 30 to 60 days worth of supplies would be prudent. During the height of a pandemic, do you really want to expose yourself unnecessarily by going to the grocery store? And of course, even if you are willing to risk it, there could be disruptions in deliveries and long lines to endure.
A couple of hundred dollars worth of canned goods (heat and eat) stored in your basement or closet would seem to be cheap insurance. With it, you won’t starve to death, although after your 20th can of ravioli, you might die of boredom.
Water storage is, for most of us, more problematic. At a gallon a day per person, a family of four would have to store 120 gallons of water to last a month. Do it if you can, but at a minimum, you should have enough water for a week.
Prescription medicines are difficult for many of us to stockpile. Insurance programs often limit the quantity you can obtain to a 30 day supply. If you are dependant upon certain meds, talk to your doctor, and try to get an extra Rx. You may have to pay for it yourself, but it could save your life.
Beyond that, there are a few items I would recommend that every family keep on hand.
Bleach : Unscented. Can be diluted 10:1 or even 50:1 and used as a disinfectant. It can also be used to treat suspect water. At about $1 a gallon, it makes sense to keep a couple of extra gallons on hand. Get a couple of spray bottles (or recycle empties).
Antiseptic Hand Soap: Frequent hand washing is your best protection against the Flu. Antibacterial liquid hand soap should be at every sink. We should all wash our hands several times each day, even in normal times. During a pandemic, it should become an obsession.
Hand Sanitizer : Every surface you touch could have the flu virus on it. Touch a door knob, or the handlebar of a grocery cart, and then touch your face, and you are risking infection. Get small pocket-sized bottles for everyone in your house, and make sure they use it. Larger bottles can be purchased to refill the small bottles. This stuff is cheap, I purchased several bottles at a Dollar Store the other day, and it could save your life.
N95 Masks : This is controversial, but I’ll throw it in because they are relatively cheap. Some experts doubt that masks do much good. The flu virus is incredibly small and can easily pass through the fibers of most masks. But the virus is usually contained inside a water droplet (cough or sneeze), and these masks can generally filter those. I picked up a case of 25 at the Home Depot the other day for $16.99.
Latex gloves : A box of these can be purchased for around $7.00. If you have a latex allergy, get the vinyl ones instead. They can be used when dealing with a sick family member, or when outside the home. They will (hopefully) serve as a constant reminder not to touch your face with your hands.
First Aid Kit : Every home should have one. Better to create one yourself (cheaper, too), but commercial ones can be had for $20 to $30.
Misc Items : Manual can opener, toilet paper, paper towels, extra garbage bags, flashlights, a battery operated radio. AND EXTRA BATTERIES.
There are, of course, many other things you could do to prepare, but I feel these are the absolute minimum preparations we all should make. Total cost? Well, for a family of 4, it can probably be done for $300.00.
The Avian flu, if it does turn into a pandemic, may not hit us here for months. If $300 is too much to spend all at once, you may still have time to stock up, a little at a time.
While it may seem a daunting task, these sorts of preparations can be done in stages. Start with laying in a 72-hour supply. Then increase that to a one-week supply. Then shoot for 2 weeks. The point being, any preparation you make is better than no preparation at all.
For those of you who are reading this and think that these recommendations are far too little, I would not disagree. Remember, these are minimum recommendations.
My advice, stock up now. Avoid the rush.
I’ve spent a good deal of time on the Flu discussion boards this past week and it is evident that a number of people are attempting to prepare themselves for TEOTWAWKI (The End Of The World As We Know It). People are stockpiling a year’s worth of food or more, trying to acquire anti-viral medications, and are planning on isolating themselves for the duration.
While I do not plan to go that far, I won’t criticize those that do. Everybody has to make their own determination as to what they feel they must do to protect themselves. If heading for the hills, or barricading yourself in your home with a shotgun and a closet full of dehydrated foods increases your comfort level, then by all means, do so.
For most of us, these are not practical preparations. Few of us have an isolated cabin in the woods to bug out to. Most of us couldn’t purchase and store a years worth of food in our homes if we had to. There are practical limits to what we can do.
What then are prudent preparations?
In order to figure that out, we must first look at the likely ramifications of a pandemic.
Our best model is the Spanish Flu Pandemic of 1918. It killed (depending on whom you believe) between 20 and 100 million people over the span of 2 years. It came in 3 waves, the first relatively mild, the second wave a few months later was horrific, followed by a third, less virulent wave the following year.
Isolation and quarantine were used to combat this pandemic, and yes, some people did starve to death in their homes. Social isolation has been suggested as a precautionary measure by our own government, and plans are being worked out to close schools at the first sign of a pandemic in our country. Many businesses may close. There could even be disruptions in food deliveries and essential services.
FEMA now recommends that all American Families keep a 2-week supply of food, water, and prescription medicines in their homes in the event of a disaster. Up until Katrina devastated New Orleans, their recommendation was for 72 hours. As we all now know, that was completely inadequate.
At a minimum, we all should strive for this level of preparedness. Even if a pandemic does not fulminate, there are other disasters that could befall us. Hurricanes, earthquakes, and terrorist attacks to name a few.
Personally, in the face of a pandemic, I believe that having 30 to 60 days worth of supplies would be prudent. During the height of a pandemic, do you really want to expose yourself unnecessarily by going to the grocery store? And of course, even if you are willing to risk it, there could be disruptions in deliveries and long lines to endure.
A couple of hundred dollars worth of canned goods (heat and eat) stored in your basement or closet would seem to be cheap insurance. With it, you won’t starve to death, although after your 20th can of ravioli, you might die of boredom.
Water storage is, for most of us, more problematic. At a gallon a day per person, a family of four would have to store 120 gallons of water to last a month. Do it if you can, but at a minimum, you should have enough water for a week.
Prescription medicines are difficult for many of us to stockpile. Insurance programs often limit the quantity you can obtain to a 30 day supply. If you are dependant upon certain meds, talk to your doctor, and try to get an extra Rx. You may have to pay for it yourself, but it could save your life.
Beyond that, there are a few items I would recommend that every family keep on hand.
Bleach : Unscented. Can be diluted 10:1 or even 50:1 and used as a disinfectant. It can also be used to treat suspect water. At about $1 a gallon, it makes sense to keep a couple of extra gallons on hand. Get a couple of spray bottles (or recycle empties).
Antiseptic Hand Soap: Frequent hand washing is your best protection against the Flu. Antibacterial liquid hand soap should be at every sink. We should all wash our hands several times each day, even in normal times. During a pandemic, it should become an obsession.
Hand Sanitizer : Every surface you touch could have the flu virus on it. Touch a door knob, or the handlebar of a grocery cart, and then touch your face, and you are risking infection. Get small pocket-sized bottles for everyone in your house, and make sure they use it. Larger bottles can be purchased to refill the small bottles. This stuff is cheap, I purchased several bottles at a Dollar Store the other day, and it could save your life.
N95 Masks : This is controversial, but I’ll throw it in because they are relatively cheap. Some experts doubt that masks do much good. The flu virus is incredibly small and can easily pass through the fibers of most masks. But the virus is usually contained inside a water droplet (cough or sneeze), and these masks can generally filter those. I picked up a case of 25 at the Home Depot the other day for $16.99.
Latex gloves : A box of these can be purchased for around $7.00. If you have a latex allergy, get the vinyl ones instead. They can be used when dealing with a sick family member, or when outside the home. They will (hopefully) serve as a constant reminder not to touch your face with your hands.
First Aid Kit : Every home should have one. Better to create one yourself (cheaper, too), but commercial ones can be had for $20 to $30.
Misc Items : Manual can opener, toilet paper, paper towels, extra garbage bags, flashlights, a battery operated radio. AND EXTRA BATTERIES.
There are, of course, many other things you could do to prepare, but I feel these are the absolute minimum preparations we all should make. Total cost? Well, for a family of 4, it can probably be done for $300.00.
The Avian flu, if it does turn into a pandemic, may not hit us here for months. If $300 is too much to spend all at once, you may still have time to stock up, a little at a time.
While it may seem a daunting task, these sorts of preparations can be done in stages. Start with laying in a 72-hour supply. Then increase that to a one-week supply. Then shoot for 2 weeks. The point being, any preparation you make is better than no preparation at all.
For those of you who are reading this and think that these recommendations are far too little, I would not disagree. Remember, these are minimum recommendations.
My advice, stock up now. Avoid the rush.
EOW REVIEW – January 22, 2006
It’s been a busy week for avian flu watchers.
As far as we know, Avian flu is still only transmissible from birds to humans (B2H). Human to Human (H2H) transmission, if it exists, is inefficient, and not likely to cause a pandemic at this time. The worry is that this ability to infect H2H will change. For now, the World Health Organization’s (WHO) pandemic alert level remains at level 3.
The Major Headlines for the past week are:
DIRECTOR OF WHO SAYS PANDEMIC THREAT IS `GREAT’
NATIONS PLEDGE 2 BILLION DOLLARS TO FIGHT AVIAN FLU
MUTATIONS FOUND IN AVIAN FLU MAKE HUMANS MORE VULNERABLE
TWO MORE CHILDREN IN INDONESIA DIE OF AVIAN FLU (Total dead: 14)
OUTBREAK IN TURKEY, 21 confirmed cases, up to 200 suspected cases, 4 fatalities
TURKEY ACCUSES NEIGHBORS OF HIDING FLU CASES
BIRD FECES INFECTIOUS FOR UP TO 35 DAYS
AVIAN FLU CAUSES MULTI-ORGAN FAILURE
INCUBATION TIME FOR AVIAN FLU MAY BE UP TO 17 DAYS
CALIFORNIA RELEASES PANDEMIC PLAN
OPRAH WINFREY SHOW TO COVER AVIAN FLU NEXT TUESDAY
ANALYSIS:
Watching the events unfold is like watching a slow motion train wreck. News comes out in drips and drabs, and the reporting is suspect. The WHO, which has said they could be on the scene of any outbreak in 24 hours, finally arrived on the ground in Turkey 7 days after the first deaths were reported. A week-long religious holiday in Turkey has delayed testing of many suspected cases. News out of Turkey is now filtered through a government spokesperson.
WHO has released a new fact sheet on Avian Flu, and their description of the clinical picture of Avian Flu patients is not comforting. Nearly all cases descend into pneumonia, and internal bleeding and multi-organ failure is common. The usefulness of anti-viral medications such as Tamiflu is now suspect. Among confirmed cases, the mortality rate remains at roughly 50%, Unknown is how many undiagnosed cases exist.
California, among other states, has released its pandemic plan. It calls for social isolation (closing of schools, businesses, etc.) to limit the spread, and for people to be prepared to care for flu victims at home. It recommends preparation (food, water, Rx’s), and stresses the need for good flu hygiene (hand washing).
The Insurance Industry has released a report whereby they expect up to 1.9 million fatalities in the United States if the flu turns into a pandemic. Some experts consider this a low figure.
A quick search of google news stories show roughly 80 mainstream news stories about avian flu in the last 24 hours, yet public concern appears to be minimal. Next Tuesday, Oprah will do an hour long show on Avian flu, and this is likely to raise public awareness of the situation.
For now, it is still a waiting game. H2H transmission has not been documented, and if it exists, we should be seeing more cases than we are right now. WHO admits there may have been some limited cases of H2H transmission, but is unable to document them.
If the current strain of Avian Flu mutates (and that is still an `if’), we should see a large bloom of cases over the course of a week. That will be the signal that things have gone badly. If this happens, there is still the possibility of containment, although much will depend on where it happens, and the speed and effectiveness of the local response.
Realistically, it could be months or even years before a catastrophic mutation of the virus occurs. Indeed, it might never happen. Anyone who says they know what is going to happen is just deluding themselves. Outbreaks of high pathogen diseases occur worldwide on almost a daily basis, and usually burn themselves out, rather than spread.
Still, we are probably closer to the brink of a pandemic than we have been in decades.
Expect to hear a lot of opinions over the next few weeks regarding the flu. Once the Oprah show airs, pundits will take to the airwaves. There will be those who downplay the threat, while others will see this as a coming apocalypse. The truth is probably somewhere in between.
For now, all we can do is watch the situation carefully and make prudent preparations in case the worst happens. I will address preliminary flu preps in my next post.
It’s been a busy week for avian flu watchers.
As far as we know, Avian flu is still only transmissible from birds to humans (B2H). Human to Human (H2H) transmission, if it exists, is inefficient, and not likely to cause a pandemic at this time. The worry is that this ability to infect H2H will change. For now, the World Health Organization’s (WHO) pandemic alert level remains at level 3.
The Major Headlines for the past week are:
DIRECTOR OF WHO SAYS PANDEMIC THREAT IS `GREAT’
NATIONS PLEDGE 2 BILLION DOLLARS TO FIGHT AVIAN FLU
MUTATIONS FOUND IN AVIAN FLU MAKE HUMANS MORE VULNERABLE
TWO MORE CHILDREN IN INDONESIA DIE OF AVIAN FLU (Total dead: 14)
OUTBREAK IN TURKEY, 21 confirmed cases, up to 200 suspected cases, 4 fatalities
TURKEY ACCUSES NEIGHBORS OF HIDING FLU CASES
BIRD FECES INFECTIOUS FOR UP TO 35 DAYS
AVIAN FLU CAUSES MULTI-ORGAN FAILURE
INCUBATION TIME FOR AVIAN FLU MAY BE UP TO 17 DAYS
CALIFORNIA RELEASES PANDEMIC PLAN
OPRAH WINFREY SHOW TO COVER AVIAN FLU NEXT TUESDAY
ANALYSIS:
Watching the events unfold is like watching a slow motion train wreck. News comes out in drips and drabs, and the reporting is suspect. The WHO, which has said they could be on the scene of any outbreak in 24 hours, finally arrived on the ground in Turkey 7 days after the first deaths were reported. A week-long religious holiday in Turkey has delayed testing of many suspected cases. News out of Turkey is now filtered through a government spokesperson.
WHO has released a new fact sheet on Avian Flu, and their description of the clinical picture of Avian Flu patients is not comforting. Nearly all cases descend into pneumonia, and internal bleeding and multi-organ failure is common. The usefulness of anti-viral medications such as Tamiflu is now suspect. Among confirmed cases, the mortality rate remains at roughly 50%, Unknown is how many undiagnosed cases exist.
California, among other states, has released its pandemic plan. It calls for social isolation (closing of schools, businesses, etc.) to limit the spread, and for people to be prepared to care for flu victims at home. It recommends preparation (food, water, Rx’s), and stresses the need for good flu hygiene (hand washing).
The Insurance Industry has released a report whereby they expect up to 1.9 million fatalities in the United States if the flu turns into a pandemic. Some experts consider this a low figure.
A quick search of google news stories show roughly 80 mainstream news stories about avian flu in the last 24 hours, yet public concern appears to be minimal. Next Tuesday, Oprah will do an hour long show on Avian flu, and this is likely to raise public awareness of the situation.
For now, it is still a waiting game. H2H transmission has not been documented, and if it exists, we should be seeing more cases than we are right now. WHO admits there may have been some limited cases of H2H transmission, but is unable to document them.
If the current strain of Avian Flu mutates (and that is still an `if’), we should see a large bloom of cases over the course of a week. That will be the signal that things have gone badly. If this happens, there is still the possibility of containment, although much will depend on where it happens, and the speed and effectiveness of the local response.
Realistically, it could be months or even years before a catastrophic mutation of the virus occurs. Indeed, it might never happen. Anyone who says they know what is going to happen is just deluding themselves. Outbreaks of high pathogen diseases occur worldwide on almost a daily basis, and usually burn themselves out, rather than spread.
Still, we are probably closer to the brink of a pandemic than we have been in decades.
Expect to hear a lot of opinions over the next few weeks regarding the flu. Once the Oprah show airs, pundits will take to the airwaves. There will be those who downplay the threat, while others will see this as a coming apocalypse. The truth is probably somewhere in between.
For now, all we can do is watch the situation carefully and make prudent preparations in case the worst happens. I will address preliminary flu preps in my next post.
Saturday, January 21, 2006
The Gift that keeps on Giving
Aside from the new clinical findings in the WHO avian flu fact sheet released yesterday, the other big news was that the virus can live in bird feces for up to 35 days in the winter, and for nearly a week in the summer
From the fact sheet :
Bottom line here is that even if this virus doesn’t become an efficient H2H (Human to Human) transmissible disease, the danger from exposure to birds and their droppings is very real.
If and when infected birds are detected in your area (not yet found in the US), then precautions will need to be taken regarding exposure to birds and their droppings. Children, in particular, will need to be warned not to touch birds, living or dead. Family pets, who might come in contact with birds or their droppings, could possibly bring the virus into the home.
While B2H (bird to human) transmission will not create a pandemic, it can still have tragic results.
Aside from the new clinical findings in the WHO avian flu fact sheet released yesterday, the other big news was that the virus can live in bird feces for up to 35 days in the winter, and for nearly a week in the summer
From the fact sheet :
Apart from being highly contagious among poultry, avian influenza viruses are readily transmitted from farm to farm by the movement of live birds, people (especially when shoes and other clothing are contaminated), and contaminated vehicles, equipment, feed, and cages. Highly pathogenic viruses can survive for long periods in the environment, especially when temperatures are low. For example, the highly pathogenic H5N1 virus can survive in bird faeces for at least 35 days at low temperature (4oC). At a much higher temperature (37oC), H5N1 viruses have been shown to survive, in faecal samples, for six days.
Bottom line here is that even if this virus doesn’t become an efficient H2H (Human to Human) transmissible disease, the danger from exposure to birds and their droppings is very real.
If and when infected birds are detected in your area (not yet found in the US), then precautions will need to be taken regarding exposure to birds and their droppings. Children, in particular, will need to be warned not to touch birds, living or dead. Family pets, who might come in contact with birds or their droppings, could possibly bring the virus into the home.
While B2H (bird to human) transmission will not create a pandemic, it can still have tragic results.
WHO’s on First
WHO, the World Health Organization, released an update to their Avian Flu Fact sheet yesterday, and it contains some worrisome information.
WHO AVIAN FLU FACT SHEET
Two clinical features of the Avian Flu are particularly troubling.
First, unlike normal Flu, which has an incubation period of 2 to 3 days, the Avian flu appears to incubate from 2 to 8 days, and as long as 17 days. Victims could carry the disease for more than two weeks before falling ill. It is unknown for how long before symptoms appear that the victim might be contagious.
Second, the Avian Flu apparently targets multiple organs in the human body, and is not just a respiratory illness. The following comes from the WHO fact sheet, and describes the course of the illness in humans :
While all of this may seem overly technical, the bottom line is, this is not your father’s influenza. This disease attacks the body in many insidious ways, and in severe cases, the treatment options are very limited.
WHO, the World Health Organization, released an update to their Avian Flu Fact sheet yesterday, and it contains some worrisome information.
WHO AVIAN FLU FACT SHEET
Two clinical features of the Avian Flu are particularly troubling.
First, unlike normal Flu, which has an incubation period of 2 to 3 days, the Avian flu appears to incubate from 2 to 8 days, and as long as 17 days. Victims could carry the disease for more than two weeks before falling ill. It is unknown for how long before symptoms appear that the victim might be contagious.
Second, the Avian Flu apparently targets multiple organs in the human body, and is not just a respiratory illness. The following comes from the WHO fact sheet, and describes the course of the illness in humans :
Initial symptoms include a high fever, usually with a temperature higher than 38oC, and influenza-like symptoms. Diarrhoea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients.
Watery diarrhoea without blood appears to be more common in H5N1 avian influenza than in normal seasonal influenza. The spectrum of clinical symptoms may, however, be broader, and not all confirmed patients have presented with respiratory symptoms. In two patients from southern Viet Nam, the clinical diagnosis was acute encephalitis; neither patient had respiratory symptoms at presentation. In another case, from Thailand, the patient presented with fever and diarrhoea, but no respiratory symptoms. All three patients had a recent history of direct exposure to infected poultry.
One feature seen in many patients is the development of manifestations in the lower respiratory tract early in the illness. Many patients have symptoms in the lower respiratory tract when they first seek treatment. On present evidence, difficulty in breathing develops around 5 days following the first symptoms. Respiratory distress, a hoarse voice, and a crackling sound when inhaling are commonly seen. Sputum production is variable and sometimes bloody. Most recently, blood-tinted respiratory secretions have been observed in Turkey. Almost all patients develop pneumonia. During the Hong Kong outbreak, all severely ill patients had primary viral pneumonia, which did not respond to antibiotics. Limited data on patients in the current outbreak indicate the presence of a primary viral pneumonia in H5N1, usually without microbiological evidence of bacterial supra-infection at presentation. Turkish clinicians have also reported pneumonia as a consistent feature in severe cases; as elsewhere, these patients did not respond to treatment with antibiotics.
In patients infected with the H5N1 virus, clinical deterioration is rapid. In Thailand, the time between onset of illness to the development of acute respiratory distress was around 6 days, with a range of 4 to 13 days. In severe cases in Turkey, clinicians have observed respiratory failure 3 to 5 days after symptom onset. Another common feature is multiorgan dysfunction, notably involving the kidney and heart. Common laboratory abnormalities include lymphopenia, leukopenia, elevated aminotransferases, and mild-to-moderate thrombocytopenia with some instances of disseminated intravascular coagulation.
While all of this may seem overly technical, the bottom line is, this is not your father’s influenza. This disease attacks the body in many insidious ways, and in severe cases, the treatment options are very limited.
A Day At the Oprah
The past 24 hours has brought a fair amount of news. Some good, some not so good.
The best news is that on Tuesday, January 25th, Oprah will devote all or part of her show to the Avian Flu. The queen of daytime TV talk has more gravitas than all of our government officials put together. If she takes Avian flu seriously (early reports indicate she does), then the nation will, too.
It remains to be seen how informative the show will be, but it is a good sign that people are beginning to pay attention.
Meanwhile, in Turkey, and in Eastern Europe, the news (what little we get) is not so encouraging.
The Agriculture Minister of Turkey is accusing other countries in the region of hiding and covering up bird flu outbreaks, and even human infections. Countries on his list appear to include Syria, Iran, and Greece. These countries vehemently deny these charges.
A disturbing report from a newspaper in nearby Moldavia states that the government there is covering up an Avian Flu outbreak of 200 people, with 17 fatalities. This story has not been confirmed by any other source and remains suspect.
Sadly, internal politics, and intra-country rivalries play a big part in what we hear, and in the local response to the Avian flu threat. Many of the countries where H5N1 is now appearing have repressive governments, and little freedom of the press. It is nearly impossible to determine the validity of outbreak reports, or the veracity of governmental denials.
If these reports are true, and the governments are simply covering up, then the Avian flu is at an even greater risk of exploding into the human population.
Time will tell.
The past 24 hours has brought a fair amount of news. Some good, some not so good.
The best news is that on Tuesday, January 25th, Oprah will devote all or part of her show to the Avian Flu. The queen of daytime TV talk has more gravitas than all of our government officials put together. If she takes Avian flu seriously (early reports indicate she does), then the nation will, too.
It remains to be seen how informative the show will be, but it is a good sign that people are beginning to pay attention.
Meanwhile, in Turkey, and in Eastern Europe, the news (what little we get) is not so encouraging.
The Agriculture Minister of Turkey is accusing other countries in the region of hiding and covering up bird flu outbreaks, and even human infections. Countries on his list appear to include Syria, Iran, and Greece. These countries vehemently deny these charges.
A disturbing report from a newspaper in nearby Moldavia states that the government there is covering up an Avian Flu outbreak of 200 people, with 17 fatalities. This story has not been confirmed by any other source and remains suspect.
Sadly, internal politics, and intra-country rivalries play a big part in what we hear, and in the local response to the Avian flu threat. Many of the countries where H5N1 is now appearing have repressive governments, and little freedom of the press. It is nearly impossible to determine the validity of outbreak reports, or the veracity of governmental denials.
If these reports are true, and the governments are simply covering up, then the Avian flu is at an even greater risk of exploding into the human population.
Time will tell.
Friday, January 20, 2006
Lies, Damned Lies, and Statistics
One of the most worrisome numbers bandied around by the media has been the 50% mortality rate with Avian Flu. Out of roughly 160 persons confirmed to be infected, 80 have died. This one `fact’ has been repeated hundreds of times, and many have simply accepted it as the truth.
While it is possible that the Avian Flu could have a 50% death rate, it is by no means certain.
During the last great pandemic, the Spanish Flu of 1918, between 20,000,000 and 100,000,000 people died. Why the large disparity in numbers? We simply didn’t keep good records. At some point, even in the United States, exact numbers gave way to estimates.
Today, many experts use 40 million to 60 million fatalities worldwide. This translates to about a 5% mortality rate. Even at the highest estimate, we are around 10%.
Today, the world’s population is 4 times greater than it was in 1918, and our ability to spread the disease is greatly enhanced by air travel, which did not exist in 1918. A similar pandemic could kill between 100 million and 400 million people.
What we simply don’t know right now is how many people have actually contracted the avian flu. We know of 160 people who became ill enough to go to the hospital, and of those, half of them died. There could easily be hundreds, even thousands of `mild’ cases of avian flu that simply went unreported.
Until a seroprevalence study is undertaken, where thousands of people are tested for H5N1 antibodies, we simply don’t know if these mild cases exist or not. If they do, then Avian Flu may be far less deadly than currently thought.
As the major outbreaks have occurred in China and in Vietnam, the ability to do this sort of testing has been limited. Hopefully, it will be done in Turkey, but there are political forces at work that may hinder that attempt.
During the Spanish Flu outbreak in 1918, fewer than half the population actually caught the flu. Some people, for unknown reasons, even when exposed, did not catch the virus. With all flu outbreaks, this seems to hold true. Some of us have a natural immunity.
This is not to minimize the impact of an Avian Flu pandemic. Even a 5% fatality rate, assuming 1/3rd of the world’s population caught the virus, would result in 100 million deaths. In the United States, it would translate into 5 million fatalities.
It is important to realize that, historically, during a pandemic, half of the population never gets sick. And of those that do, 95% survive.
While there is no guarantee that next pandemic will follow suit, it is a far less dire outlook than the media now paints.
One of the most worrisome numbers bandied around by the media has been the 50% mortality rate with Avian Flu. Out of roughly 160 persons confirmed to be infected, 80 have died. This one `fact’ has been repeated hundreds of times, and many have simply accepted it as the truth.
While it is possible that the Avian Flu could have a 50% death rate, it is by no means certain.
During the last great pandemic, the Spanish Flu of 1918, between 20,000,000 and 100,000,000 people died. Why the large disparity in numbers? We simply didn’t keep good records. At some point, even in the United States, exact numbers gave way to estimates.
Today, many experts use 40 million to 60 million fatalities worldwide. This translates to about a 5% mortality rate. Even at the highest estimate, we are around 10%.
Today, the world’s population is 4 times greater than it was in 1918, and our ability to spread the disease is greatly enhanced by air travel, which did not exist in 1918. A similar pandemic could kill between 100 million and 400 million people.
What we simply don’t know right now is how many people have actually contracted the avian flu. We know of 160 people who became ill enough to go to the hospital, and of those, half of them died. There could easily be hundreds, even thousands of `mild’ cases of avian flu that simply went unreported.
Until a seroprevalence study is undertaken, where thousands of people are tested for H5N1 antibodies, we simply don’t know if these mild cases exist or not. If they do, then Avian Flu may be far less deadly than currently thought.
As the major outbreaks have occurred in China and in Vietnam, the ability to do this sort of testing has been limited. Hopefully, it will be done in Turkey, but there are political forces at work that may hinder that attempt.
During the Spanish Flu outbreak in 1918, fewer than half the population actually caught the flu. Some people, for unknown reasons, even when exposed, did not catch the virus. With all flu outbreaks, this seems to hold true. Some of us have a natural immunity.
This is not to minimize the impact of an Avian Flu pandemic. Even a 5% fatality rate, assuming 1/3rd of the world’s population caught the virus, would result in 100 million deaths. In the United States, it would translate into 5 million fatalities.
It is important to realize that, historically, during a pandemic, half of the population never gets sick. And of those that do, 95% survive.
While there is no guarantee that next pandemic will follow suit, it is a far less dire outlook than the media now paints.
The Tip of the Iceberg
Over the past week, four children in Turkey have died, officially, of Avian Flu. Depending on whom you believe, between 20 and 200 other people in Turkey have been infected. In the far east, in Indonesia, 2 more children have died. Officially, the death toll is around 80 worldwide. Roughly half of those confirmed to have been infected, have died. This, if it holds up, is a staggering mortality rate.
There are reports, unconfirmed, of scores more that have succumbed, particularly in China, where tests were not performed and the bodies were burned immediately. The Chinese government has historically not been forthcoming when dealing with health threats or any news that might cast China in a poor light.
As far as we know, all of these victims have had direct contact with poultry, or birds, and contracted the disease directly from this B2H contact. The WHO has admitted, tho, that they have not fully investigated all of these deaths, and that it is possible some of these were Human to Human (H2H) transmission. If so, the virus is not easily passed between humans, else we’d have seen many more cases.
But we do know the virus has mutated over the past few months, and that these mutations make it easier for humans to acquire the virus. Additional mutations are inevitable. Each time the virus takes up residence in a new host, it has the opportunity to mutate. If someone has a standard flu, and is co-infected with the Avian (H5N1) flu, the possibility exists that a hybrid will be created. One that retains the lethality of the H5N1 and has the contagiousness of H3N2, or seasonal flu.
And that is the WHO’s worst nightmare.
So far, that hasn’t happened. In fact, it may never happen.
Imagine you have a deck of cards, randomly shuffled. You deal the first 5 cards off the top of the deck. What are the odds of dealing a Royal Flush? About 640,000 to 1. Probably about as likely as the H5N1 mutating into a highly lethal H2H flu.
It is a low probability event.
But deal 640,000 hands, and the odds are, at least once a Royal Flush will be dealt.
As of today, hundreds, perhaps thousands, of flu `hands’ have been dealt. Each day that number increases. At some point, the odds say that the right combination will come up. At least that’s the worry.
Of course, there are many combinations besides a Royal Flush that could prove disastrous. Perhaps 4 of a kind produces a virulent, but slightly less deadly flu. The odds of dealing 4 of a kind, btw, are only a little over 4000 to 1.
It is assumed that millions of wild birds carry the H5N1 `bird flu’ virus. Sometimes the birds die, but often they simply carry and spread the disease. Each day that passes, more birds contract the virus, and spread it as they do their seasonal migrations. So far, infected birds have been found in Asia, Russia, and now Eastern Europe. This spring, the infection is expected to reach Europe and Africa. It could also reach Canada and the United States later this year.
The threat is two-fold. Direct infection from birds, or a H2H mutation. Either way, the disease is likely to spread. The only question is, how fast will it spread? Complicating matters, nearly all mammals can contract this flu. Dogs, cats, pigs, horses . . . .
It is conceivable that your cat, valiant hunter of small birds, might kill an infected bird and bring the virus into your home. Or you dog may find a dead bird and become infected. Not a pleasant thought.
In Asia, and now in Turkey, they are culling poultry in an attempt to eradicate the disease. This may help, but does nothing about the birds in the wild. To try to kill all of the infected birds in the world is impossible.
What then, can be done?
The primary threat is a mutation. If this happens, human spread will be rapid. Our best hope is that it is detected early and quarantine can be established so it can be contained. With much of the infected bird population residing in 3rd world countries, often with repressive governments who are either unable or unwilling to address the problem, the risks of a mutation going undiscovered for days or even weeks is enormous. That would be enough time for a pandemic to get started.
This week, at an Avian Flu conference, the nations of the world have pledged nearly 2 Billion dollars to 3rd world nations to help fight this disease. Whether this is enough, and if it will be spent wisely, is something only time will tell.
So we are left with a great unknown. There is a potentially devastating disease simmering quietly in the wild. It must mutate further to become an effective H2H disease, but the potential is certainly there.
Scientists are divided as to whether this will happen. A few believe it is unlikely. Many believe it is inevitable. The head of the World Health Organization (WHO) says the odds of a pandemic are `great’.
For now, all we can do is watch and wait. And yes, prepare.
There are dozens of unanswered questions. As I blog, I will try to address as many of these as possible, although answers may be difficult to discern. The social, economic, and medical implications of a pandemic are simply enormous.
Over the past week, four children in Turkey have died, officially, of Avian Flu. Depending on whom you believe, between 20 and 200 other people in Turkey have been infected. In the far east, in Indonesia, 2 more children have died. Officially, the death toll is around 80 worldwide. Roughly half of those confirmed to have been infected, have died. This, if it holds up, is a staggering mortality rate.
There are reports, unconfirmed, of scores more that have succumbed, particularly in China, where tests were not performed and the bodies were burned immediately. The Chinese government has historically not been forthcoming when dealing with health threats or any news that might cast China in a poor light.
As far as we know, all of these victims have had direct contact with poultry, or birds, and contracted the disease directly from this B2H contact. The WHO has admitted, tho, that they have not fully investigated all of these deaths, and that it is possible some of these were Human to Human (H2H) transmission. If so, the virus is not easily passed between humans, else we’d have seen many more cases.
But we do know the virus has mutated over the past few months, and that these mutations make it easier for humans to acquire the virus. Additional mutations are inevitable. Each time the virus takes up residence in a new host, it has the opportunity to mutate. If someone has a standard flu, and is co-infected with the Avian (H5N1) flu, the possibility exists that a hybrid will be created. One that retains the lethality of the H5N1 and has the contagiousness of H3N2, or seasonal flu.
And that is the WHO’s worst nightmare.
So far, that hasn’t happened. In fact, it may never happen.
Imagine you have a deck of cards, randomly shuffled. You deal the first 5 cards off the top of the deck. What are the odds of dealing a Royal Flush? About 640,000 to 1. Probably about as likely as the H5N1 mutating into a highly lethal H2H flu.
It is a low probability event.
But deal 640,000 hands, and the odds are, at least once a Royal Flush will be dealt.
As of today, hundreds, perhaps thousands, of flu `hands’ have been dealt. Each day that number increases. At some point, the odds say that the right combination will come up. At least that’s the worry.
Of course, there are many combinations besides a Royal Flush that could prove disastrous. Perhaps 4 of a kind produces a virulent, but slightly less deadly flu. The odds of dealing 4 of a kind, btw, are only a little over 4000 to 1.
It is assumed that millions of wild birds carry the H5N1 `bird flu’ virus. Sometimes the birds die, but often they simply carry and spread the disease. Each day that passes, more birds contract the virus, and spread it as they do their seasonal migrations. So far, infected birds have been found in Asia, Russia, and now Eastern Europe. This spring, the infection is expected to reach Europe and Africa. It could also reach Canada and the United States later this year.
The threat is two-fold. Direct infection from birds, or a H2H mutation. Either way, the disease is likely to spread. The only question is, how fast will it spread? Complicating matters, nearly all mammals can contract this flu. Dogs, cats, pigs, horses . . . .
It is conceivable that your cat, valiant hunter of small birds, might kill an infected bird and bring the virus into your home. Or you dog may find a dead bird and become infected. Not a pleasant thought.
In Asia, and now in Turkey, they are culling poultry in an attempt to eradicate the disease. This may help, but does nothing about the birds in the wild. To try to kill all of the infected birds in the world is impossible.
What then, can be done?
The primary threat is a mutation. If this happens, human spread will be rapid. Our best hope is that it is detected early and quarantine can be established so it can be contained. With much of the infected bird population residing in 3rd world countries, often with repressive governments who are either unable or unwilling to address the problem, the risks of a mutation going undiscovered for days or even weeks is enormous. That would be enough time for a pandemic to get started.
This week, at an Avian Flu conference, the nations of the world have pledged nearly 2 Billion dollars to 3rd world nations to help fight this disease. Whether this is enough, and if it will be spent wisely, is something only time will tell.
So we are left with a great unknown. There is a potentially devastating disease simmering quietly in the wild. It must mutate further to become an effective H2H disease, but the potential is certainly there.
Scientists are divided as to whether this will happen. A few believe it is unlikely. Many believe it is inevitable. The head of the World Health Organization (WHO) says the odds of a pandemic are `great’.
For now, all we can do is watch and wait. And yes, prepare.
There are dozens of unanswered questions. As I blog, I will try to address as many of these as possible, although answers may be difficult to discern. The social, economic, and medical implications of a pandemic are simply enormous.
A Humble beginning
Over the last couple of weeks, the Avian Flu has suddenly made the national news. I’ve been watching it for months, following its early outbreaks in Asia with interest, but now, with a cluster of human cases in Turkey, the threat seems all too real.
Right now, WHO (the World Health Organization) denies that there is Human to Human (H2H) transmission. It is, according to them, strictly a Bird to Human (B2H) vector. I don’t know. WHO has been accused of being slow to react, and there appear to have been cover-ups in China, and other Asian nations over the past couple of years, clouding the issue and masking the true number of victims. The Turkish officials claim they’ve done everything possible to contain the outbreak, but rumors of disarray and deceit regarding their response abound.
Two weeks ago, the US government quietly unveiled a website, www.pandemicflu.gov , where they urged Americans to stock up on food and medicine in preparation of a possible pandemic. Still, no high profile announcements by government officials. Where is the Surgeon General? Or the President? If this is a real and imminent threat, why are there no public service announcements running on every TV channel?
It feels like the government doesn’t want to cause a panic, but wants to be able to say they warned us if the worst happens. Yesterday, the state of California unveiled its pandemic flu `plan’. It stresses the need for people to take care of their own in their homes, and not to depend on hospitals. It also says people should stock up on supplies.
But it doesn’t say for how long!
Newspapers are saying 2 weeks. But that, on its face, seems ridiculous. The last great pandemic was in 1918 . . . it lasted 2 years, and killed tens of millions. The exact number is unknown.
Last year’s Hurricane Katrina, which destroyed New Orleans and much of the Mississippi coastline, proved how inefficient the Federal government is at handling a large, but localized disaster. How will they cope with a global pandemic? Not well, I fear.
The Internet is the best, and probably the worst, source of information. In recent weeks I’ve joined several Avian Flu websites, and have kept up with the constant flow of information, and misinformation on the subject. Fear, skepticism, and outright paranoia abound. The news media, late in covering the situation, seems to get things wrong a lot, and that simply feeds the panic and suspicion.
A few people are stocking up, preparing for a pandemic. But for the vast majority of Americans, this is simply not on their radar screens. They watch TV, argue politics, work at their jobs, and raise their families in blissful ignorance. Who will win American Idol this year is far more important than a possible pandemic.
I, of course, don’t know if the threat is real, or overblown. Pandemics have happened before, and they will surely happen again. And the world seems more vulnerable today than ever before. Modern Medicine, for all its advances, seems incapable of handling this sort of disaster. Anti-viral drugs are seen as being largely ineffective, and in short supply. A vaccine? Well, right now, there isn’t one. Treatment will be, for most of us, no better than in 1918.
The biggest problem today is knowing what to believe. Who (not WHO) to trust. The stakes are enormous, and many stand to profit or lose heavily in a pandemic. Quack cures are beginning to show up on the Internet, and with the lack of a real medical arsenal to fight this disease, I fear many will waste time, money, and possibly endanger their lives by resorting to them.
Among `true believers’, those that are certain a pandemic is just around the corner, many are planning on isolating themselves in their homes, or heading for the hills, preparing to survive Armageddon. A small minority of the population, granted, they are stockpiling food, medicine, and even weapons to last a year or longer. They believe isolation, and self-sufficiency, are the only way to survive.
If the pandemic threat is real, and imminent, then I am woefully unprepared. My living situation, my health, and my finances all leave me vulnerable. There is, hopefully, still time to prepare. But how much preparation is warranted, and how feasible it is to even attempt, is hard to know.
Can one realistically barricade themselves in their home for months on end? And if they could, is that really a protection against a pandemic? I suppose, for those living in the country, with land, and a garden, and a cellar full of supplies, it might work. But most of us do not live in the country. We live in cities, or communities, and have families and friends. Do we abandon those ties completely? If it becomes every man (or family) for themselves, what then will be our legacy?
The questions here are moral, ethical, and logistical. And there are no easy answers.
The format of this blog will be freeform. Basically, I will proffer whatever I’m thinking on the subject on any given day. I will post news stories of interest. Even rumors. This is not a news site. It’s about how the world is coping with the flu threat. Internationally, nationally, and in my little corner of the world.
My blog. My rules. If you don’t like it. Don’t read it. I’m not squarely in the camp of `We’re all gonna die!” nor am I a skeptic. I honestly don’t know what is going to happen.
For what its worth, along the way I will try to give my analysis of the news and rumors, along with my preparations.
All I can say is, it should be an interesting ride.
Over the last couple of weeks, the Avian Flu has suddenly made the national news. I’ve been watching it for months, following its early outbreaks in Asia with interest, but now, with a cluster of human cases in Turkey, the threat seems all too real.
Right now, WHO (the World Health Organization) denies that there is Human to Human (H2H) transmission. It is, according to them, strictly a Bird to Human (B2H) vector. I don’t know. WHO has been accused of being slow to react, and there appear to have been cover-ups in China, and other Asian nations over the past couple of years, clouding the issue and masking the true number of victims. The Turkish officials claim they’ve done everything possible to contain the outbreak, but rumors of disarray and deceit regarding their response abound.
Two weeks ago, the US government quietly unveiled a website, www.pandemicflu.gov , where they urged Americans to stock up on food and medicine in preparation of a possible pandemic. Still, no high profile announcements by government officials. Where is the Surgeon General? Or the President? If this is a real and imminent threat, why are there no public service announcements running on every TV channel?
It feels like the government doesn’t want to cause a panic, but wants to be able to say they warned us if the worst happens. Yesterday, the state of California unveiled its pandemic flu `plan’. It stresses the need for people to take care of their own in their homes, and not to depend on hospitals. It also says people should stock up on supplies.
But it doesn’t say for how long!
Newspapers are saying 2 weeks. But that, on its face, seems ridiculous. The last great pandemic was in 1918 . . . it lasted 2 years, and killed tens of millions. The exact number is unknown.
Last year’s Hurricane Katrina, which destroyed New Orleans and much of the Mississippi coastline, proved how inefficient the Federal government is at handling a large, but localized disaster. How will they cope with a global pandemic? Not well, I fear.
The Internet is the best, and probably the worst, source of information. In recent weeks I’ve joined several Avian Flu websites, and have kept up with the constant flow of information, and misinformation on the subject. Fear, skepticism, and outright paranoia abound. The news media, late in covering the situation, seems to get things wrong a lot, and that simply feeds the panic and suspicion.
A few people are stocking up, preparing for a pandemic. But for the vast majority of Americans, this is simply not on their radar screens. They watch TV, argue politics, work at their jobs, and raise their families in blissful ignorance. Who will win American Idol this year is far more important than a possible pandemic.
I, of course, don’t know if the threat is real, or overblown. Pandemics have happened before, and they will surely happen again. And the world seems more vulnerable today than ever before. Modern Medicine, for all its advances, seems incapable of handling this sort of disaster. Anti-viral drugs are seen as being largely ineffective, and in short supply. A vaccine? Well, right now, there isn’t one. Treatment will be, for most of us, no better than in 1918.
The biggest problem today is knowing what to believe. Who (not WHO) to trust. The stakes are enormous, and many stand to profit or lose heavily in a pandemic. Quack cures are beginning to show up on the Internet, and with the lack of a real medical arsenal to fight this disease, I fear many will waste time, money, and possibly endanger their lives by resorting to them.
Among `true believers’, those that are certain a pandemic is just around the corner, many are planning on isolating themselves in their homes, or heading for the hills, preparing to survive Armageddon. A small minority of the population, granted, they are stockpiling food, medicine, and even weapons to last a year or longer. They believe isolation, and self-sufficiency, are the only way to survive.
If the pandemic threat is real, and imminent, then I am woefully unprepared. My living situation, my health, and my finances all leave me vulnerable. There is, hopefully, still time to prepare. But how much preparation is warranted, and how feasible it is to even attempt, is hard to know.
Can one realistically barricade themselves in their home for months on end? And if they could, is that really a protection against a pandemic? I suppose, for those living in the country, with land, and a garden, and a cellar full of supplies, it might work. But most of us do not live in the country. We live in cities, or communities, and have families and friends. Do we abandon those ties completely? If it becomes every man (or family) for themselves, what then will be our legacy?
The questions here are moral, ethical, and logistical. And there are no easy answers.
The format of this blog will be freeform. Basically, I will proffer whatever I’m thinking on the subject on any given day. I will post news stories of interest. Even rumors. This is not a news site. It’s about how the world is coping with the flu threat. Internationally, nationally, and in my little corner of the world.
My blog. My rules. If you don’t like it. Don’t read it. I’m not squarely in the camp of `We’re all gonna die!” nor am I a skeptic. I honestly don’t know what is going to happen.
For what its worth, along the way I will try to give my analysis of the news and rumors, along with my preparations.
All I can say is, it should be an interesting ride.
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