Hiatus and some Advice
Tomorrow, I'll be making a road trip and will be gone for 5 days, so this blog will not be updated until Saturday, March 4th.
In the meantime, watch the news coming out of Asia. Europe and Africa are getting all the press, but S.E. Asia is a major hotspot for avian flu.
Disturbing reports of a mutated virus found in humans in Indonesia are, thus far, unverified. The authorities on the ground (and from the WHO and our own CDC) have been less than transparent. Data is being withheld. Scientists worldwide are clamoring for access, and are being denied.
Chinese officials have warned of a possible `massive outbreak' in bird flu this spring. Coming from the Chinese government, which has steadfastly maintained they were in control of the situation, this reference to `massive' is especially worrisome.
The reports of deaths, and infections, in Indonesia continue. The true extent of the problem is difficult to know. Right now, it doesn't appear to be a H2H outbreak, but the history thus far has been we find out several weeks after the fact.
There is new concern this weekend that other mammals may become vectors, a bridge between birds and humans. Swine, dogs, cats (my guess), even horses and seals have been proffered as possible carriers.
With Iraq on the verge of civil war and open warfare in the streets of Nigeria, two of the hottest breeding grounds for avian flu have bigger fish to fry. Erradication and control of avian flu is simply not their biggest problem.
India continues to claim they've contained the bird flu outbreaks, even as reports of additional bird die offs come in from other states.
And in France, 11,000 turkeys died this week in what was considered to be a bio-secure turkey farm. Quarantine measures are in effect.
While it is unlikely that the pandemic has begun, remember: Keep your eye on the Sparrow.
Saturday, February 25, 2006
New York State Panflu Plan
At long last, NY has released its pandemic plan. It's a 400 page document, filled with charts and graphs, and lots of information. The bottom line, however, is that a pandemic must be handled on the local level (county/city), and all counties in NY have until August to submit their pandemic plans.
A synopis of the plan follows :
Health and government experts acknowledge that a pandemic producing widespread serious illness could significantly impact all sectors of society. The health care system would be overburdened; businesses could experience a dramatic reduction in their workforce as employees become ill, remain home to care for sick family members, or are absent due to child care issues if schools close in response to a pandemic.
In the event of a pandemic, people would be urged to help reduce influenza transmission by being diligent about hygiene (washing hands frequently, covering their cough, disinfecting telephones, desktops and other surfaces that people frequently touch). It would also be crucial for individuals with flu-like symptoms to refrain from going to work, school or anywhere else they might spread germs.
New Yorkers would be advised to stockpile a supply of non-perishable food, water, medications and essential household items to avoid having to go out in public if social distancing is recommended.
http://tinyurl.com/khz8y
Additional comments were made yesterday by the public health department of NY state.
Schools and business would be shut down, the governor could declare martial law and residents would be told to stockpile food and water if a killer flu pandemic sweeps into New York, a newly released state preparedness plan reveals.
At long last, NY has released its pandemic plan. It's a 400 page document, filled with charts and graphs, and lots of information. The bottom line, however, is that a pandemic must be handled on the local level (county/city), and all counties in NY have until August to submit their pandemic plans.
A synopis of the plan follows :
Health and government experts acknowledge that a pandemic producing widespread serious illness could significantly impact all sectors of society. The health care system would be overburdened; businesses could experience a dramatic reduction in their workforce as employees become ill, remain home to care for sick family members, or are absent due to child care issues if schools close in response to a pandemic.
In the event of a pandemic, people would be urged to help reduce influenza transmission by being diligent about hygiene (washing hands frequently, covering their cough, disinfecting telephones, desktops and other surfaces that people frequently touch). It would also be crucial for individuals with flu-like symptoms to refrain from going to work, school or anywhere else they might spread germs.
New Yorkers would be advised to stockpile a supply of non-perishable food, water, medications and essential household items to avoid having to go out in public if social distancing is recommended.
http://tinyurl.com/khz8y
Additional comments were made yesterday by the public health department of NY state.
Schools and business would be shut down, the governor could declare martial law and residents would be told to stockpile food and water if a killer flu pandemic sweeps into New York, a newly released state preparedness plan reveals.
[snip]
“The federal plan calls for quarantine and isolation, and we follow the federal plan,” Novello said. “We would use it only at the beginning of the pandemic. When the pandemic is all over the place, it is useless for us to use quarantine and isolation.”
Whether this, or any other plan, will work in a pandemic is up for debate. The point is, your Federal, State, and (hopefully) local governments are taking the pandemic threat seriously.
Are you?
Friday, February 24, 2006
Every Army needs an Anthem
I figure if any great songs will come out of the next pandemic, we’d better start writing them now.
The Seeds of Destruction
(with apologies to Barry McGuire’ Eve of Destruction)
The Avian Flu, it is exploding
Infected birds, with viral loading
Towns are quarantined, with much foreboding
A few humans die, but not worth noting
And eating German birds is now verboten
but you tell me, over and over and over again,
my friend
That you don’t believe we’ve sown the seeds
of our destruction
No you don’t believe we’ve sown the seeds
of our Destruction
Can’t you hear what I’m tryin to say?
When the antigen shifts there’s no running away
It can cross continents in only a day
No caskets remain only hundreds of mass graves
And only ones that are left, are hiding in a dark cave
but you tell me, over and over and over again,
my friend
That you don’t believe we’ve sown the seeds
of our destruction
When the virus hits, your lungs start coagulating
Antibodies arrive, proteins accumulating
I can’t get Tamiflu, so its sambucol I’m taking
And for a vaccine, six billion of us are waiting
We shoulda been ready, that’s the price of procrastinating
but you tell me, over and over and over again,
my friend
That you don’t believe we’ve sown the seeds
of our destruction
No you don’t believe we’ve sown the seeds
of our Destruction
Getting a Grippe
I had a bird
Its name was Enza
I opened the door
And in-flew-Enza
(Children’s song circa 1918)
The Spanish Flu (aka `the Grippe’), changed everything. Read John Barry’s book, The Great Influenza, and you will quickly grasp the enormity of what a pandemic can do. The U.S. government enacted draconian laws, in the name of national security, preventing newspapers from publishing the truth about the disease. A campaign of disinformation was begun, even as bodies were piling up on street corners, telling Americans that this was just an ordinary flu.
This decision, to keep the truth from the American people, most certainly cost many lives. Newspapers urged people not to succumb to `Spanish Hysteria’, and insisted that more people died of `worry’ than from the flu.
Towards the end of 1918, when 7,000 people a day were dying in the United States, the true scope of the pandemic was becoming obvious to everyone, despite official government denials.
Some historians argue that WWI was ended in large measure because both sides were so incapacitated by the Flu that the only option was to sign a treaty. While the horrors of mustard gas, and trench warfare cannot be overstated, it is sobering to realize that more Americans died from the flu than perished on the battlefields of Europe.
Was the Spanish Flu an aberration? A one-time event in our human history?
Sadly, no. There have been dozens of other pandemics recorded over the past 500 years. Some milder than 1918, and some every bit as virulent. But 1918 was the last bad one, and there were in place a number of factors that made it particularly bad.
First, we had hundreds of thousands of soldiers overseas and in training camps here in the United States. National security, in a time of war, was given a high priority, and so the truth was hidden from the people. And with the advent of efficient steamship travel, you could travel from Europe to America in a matter of a few days.
Sound familiar?
Today, we can travel between continents in hours, not days. We have large numbers of troops in areas of the world where Human-to-Human H5N1 is most likely to break out. And after 9/11, and given the war in Iraq, national security (and the restriction of information) is a high priority.
We have all the ingredients needed to generate the perfect viral storm. H5N1 is in the wild, it is mutating, and it has already infected a limited number of people.
Given the other contributing factors, and their eerie similarities to 1918, it’s no wonder that scientists are having trouble sleeping at night.
I had a bird
Its name was Enza
I opened the door
And in-flew-Enza
(Children’s song circa 1918)
The Spanish Flu (aka `the Grippe’), changed everything. Read John Barry’s book, The Great Influenza, and you will quickly grasp the enormity of what a pandemic can do. The U.S. government enacted draconian laws, in the name of national security, preventing newspapers from publishing the truth about the disease. A campaign of disinformation was begun, even as bodies were piling up on street corners, telling Americans that this was just an ordinary flu.
This decision, to keep the truth from the American people, most certainly cost many lives. Newspapers urged people not to succumb to `Spanish Hysteria’, and insisted that more people died of `worry’ than from the flu.
Towards the end of 1918, when 7,000 people a day were dying in the United States, the true scope of the pandemic was becoming obvious to everyone, despite official government denials.
Some historians argue that WWI was ended in large measure because both sides were so incapacitated by the Flu that the only option was to sign a treaty. While the horrors of mustard gas, and trench warfare cannot be overstated, it is sobering to realize that more Americans died from the flu than perished on the battlefields of Europe.
Was the Spanish Flu an aberration? A one-time event in our human history?
Sadly, no. There have been dozens of other pandemics recorded over the past 500 years. Some milder than 1918, and some every bit as virulent. But 1918 was the last bad one, and there were in place a number of factors that made it particularly bad.
First, we had hundreds of thousands of soldiers overseas and in training camps here in the United States. National security, in a time of war, was given a high priority, and so the truth was hidden from the people. And with the advent of efficient steamship travel, you could travel from Europe to America in a matter of a few days.
Sound familiar?
Today, we can travel between continents in hours, not days. We have large numbers of troops in areas of the world where Human-to-Human H5N1 is most likely to break out. And after 9/11, and given the war in Iraq, national security (and the restriction of information) is a high priority.
We have all the ingredients needed to generate the perfect viral storm. H5N1 is in the wild, it is mutating, and it has already infected a limited number of people.
Given the other contributing factors, and their eerie similarities to 1918, it’s no wonder that scientists are having trouble sleeping at night.
Wednesday, February 22, 2006
One Flu over the Cuckoo's Nest
In 1997, Hong Kong took the extraordinary step of culling all of the poultry in the city after H5N1 was discovered, and they went 6 years without another reported case. Their decisive action, as difficult as it may have been, bought us precious time.
Today, we are hearing more and more reports that governments and private industries are covering up, or simply mismanaging, outbreaks of Avian Flu.
In India, where up until a few days ago officials claimed they had no bird flu, we now learn that massive poultry die offs occurred in January, and that thousands of dead birds were secretly buried.
In Nigeria, live poultry markets were kept open, even after H5N1 was detected, so as not to inspire panic in the population. In some cases, where culling of poultry was ordered, local officials were not told why, and took no precautions.
In Russia, several mass deaths of poultry were officially blames on Newcastle disease earlier this month. Officials denied Bird Flu was responsible. Today, we are told, Oops! It was Bird Flu. Sorry about that.
It seems that at every turn, there is some interest, public or private, that is determined to deny or delay that Bird Flu has arrived. And by doing so, but fiddling while Rome burns, instead of taking decisive action, the infection is allowed to spread.
This is about money being more important than public safety. A clear case of shortsighted stupidity. Insanity on a grand scale.
Each day that passes, our ability to contain this virus diminishes. It is becoming endemic, aided and abetted by our own stupidity, throughout the world.
We probably can’t stop it now, all we can hope to do is slow it down. But I see little sign that there is the political courage to do that. Money and power and greed all supercede common sense.
If you have a cancer, you’d best cut it out before it spreads.
Anything less, and the patient dies.
Tuesday, February 21, 2006
The Frog in the Pot
There is an old story that says if you throw a live frog into a pot of boiling water, he will immediately jump out. If you throw a frog into a pot of cool water, and gradually bring it to a simmer, he will stay and happily cook himself to death.
Over the past couple of years, 6 Billion frog-surrogates have been happily oblivious as the temperature of our water has slowly, inexorably, been rising. Only a precious few have noticed anything amiss. Today, we are seeing bubbles starting to rise from the bottom of the pan, and it's getting damned uncomfortable.
Avian Flu has suddenly appeared in a dozen or more countries over the past few weeks. Undoubtedly, the virus has been slowly infiltrating these nations for months, but only over the past 20 days have their governments acknowledged its presence.
In 1997, when bird flu first appeared in Hong Kong, quick decisive action by officials stopped the spread. ALL Poultry was culled in the city. It was expensive. But it worked. Bird flu disappeared for 6 years.
Today, instead of acting quickly, governments are denying they have a problem. They are refusing to test birds until massive die offs occur, and by the time they admit a problem exists, the virus has become endemic in the wild. It’s one thing to eradicate the virus in a city like Hong Kong, quite another to remove it from a country the size of India.
A week ago, Indian Officials were still saying that bird flu could not enter their country. That sick birds couldn’t fly over the Himalayas Mountains. They were protected by this natural barrier. Today, they are frantically culling hundreds of thousands of birds, and desperately trying to locate anyone who might be infected.
And so it goes. Germany, France, Iraq, Iran, Turkey, Bulgaria, Romania, Egypt, Israel, Palestine, Nigeria . . .
As of today, 30 countries admit to having, or having had, avian flu detected within their borders.
While they slept, while some scoffed at bird flu as `science fiction’, the virus has crept in and has infected their nations.
How many other countries are hiding the true facts? How many more will, due to an inability to conceal the truth, come forth over the next few weeks and admit they have the virus?
How many incubators can we have running full tilt before a pandemic begins?
Fasten your seatbelts. It’s gonna be a bumpy ride.
There is an old story that says if you throw a live frog into a pot of boiling water, he will immediately jump out. If you throw a frog into a pot of cool water, and gradually bring it to a simmer, he will stay and happily cook himself to death.
Over the past couple of years, 6 Billion frog-surrogates have been happily oblivious as the temperature of our water has slowly, inexorably, been rising. Only a precious few have noticed anything amiss. Today, we are seeing bubbles starting to rise from the bottom of the pan, and it's getting damned uncomfortable.
Avian Flu has suddenly appeared in a dozen or more countries over the past few weeks. Undoubtedly, the virus has been slowly infiltrating these nations for months, but only over the past 20 days have their governments acknowledged its presence.
In 1997, when bird flu first appeared in Hong Kong, quick decisive action by officials stopped the spread. ALL Poultry was culled in the city. It was expensive. But it worked. Bird flu disappeared for 6 years.
Today, instead of acting quickly, governments are denying they have a problem. They are refusing to test birds until massive die offs occur, and by the time they admit a problem exists, the virus has become endemic in the wild. It’s one thing to eradicate the virus in a city like Hong Kong, quite another to remove it from a country the size of India.
A week ago, Indian Officials were still saying that bird flu could not enter their country. That sick birds couldn’t fly over the Himalayas Mountains. They were protected by this natural barrier. Today, they are frantically culling hundreds of thousands of birds, and desperately trying to locate anyone who might be infected.
And so it goes. Germany, France, Iraq, Iran, Turkey, Bulgaria, Romania, Egypt, Israel, Palestine, Nigeria . . .
As of today, 30 countries admit to having, or having had, avian flu detected within their borders.
While they slept, while some scoffed at bird flu as `science fiction’, the virus has crept in and has infected their nations.
How many other countries are hiding the true facts? How many more will, due to an inability to conceal the truth, come forth over the next few weeks and admit they have the virus?
How many incubators can we have running full tilt before a pandemic begins?
Fasten your seatbelts. It’s gonna be a bumpy ride.
Saturday, February 18, 2006
WHAT THE EXPERTS ARE SAYING
This is a bomb that will impact the world.
-- Thommy Thompson, Former Secretary, US Health and Human
Services
[The H5N1 pandemic] is an absolute certainty. When it comes to a
pandemic we are overdue and we're under-prepared.
-- Mike Leavitt, Secretary, US Health and Human Services
Anything we say before a pandemic occurs feels like an exaggeration. But any level of preparation that is conducted after is inadequate. So one might ask, is this Y2K all over again? Is this just crying wolf? The reality is this will happen at some point in time.
-- Mike Leavitt, Secretary, US Health and Human Services
The number of people infected will go beyond billions because between 25 and 30% will fall ill.
-- Klaus Stohr, Director, WHO Global Influenza Center
This is a very ominous situation for the globe. It is the most important
threat we are facing right now.
-- Julie Gerberding, US Centers For Disease Control and Prevention
We don't know what the fatality will be but we can expect it to be very high. There will be enourmous economic dislocation. Stock markets will close, international travel and trade will be limited.
-- Peter Cordingley, WHO regional spokesman
The best we can do is try to survive it. We need a Manhattan Project
yesterday.
-- Paul Gully, Deputy Chief Public Health Officer, Canada
Short of thermonuclear war, I have a hard time imagining anything in my lifetime that would be as horrible.
-- Laurie Garrett, US Council on Foreign Relations Senior Fellow for Global Health
We're dealing here with world survival issues -- or the survival of the
world as we know it.
-- David Nabarro, United Nations Senior System Coordinator for Avian and Human Influenza
We can now, in principle, consider the bird population of Europe infected. I fear it might be endemic in Europe by now.
-- Albert Osterhaus of Erasmus University in Rotterdam, The
Netherlands February 15, 2006
There would be no mutual aid, we'd have to take care of this ourselves. -- Florida Governer Jeb Bush
February 15, 2006
If a pandemic hits it's going to be very, very serious for the whole world -- not only the deaths that will occur, but the world economy will tank. People will go and lock themselves in closets. They won't shop, they won't go to movies, they won't get on airplanes, they won't stay in hotels.
-- J.W. Marriott Jr, head of Marriott International Inc.
February 15, 2006
Only two mutations are needed for it to become easily transmissible
among humans. I wake up every morning thinking that today could be the day that I will see a report about a strange case of bird flu among
humans.
-- David Nabarro, United Nations Senior System Coordinator for Avian and Human Influenza
It is no matter if the flu pandemic will occur or not, it will occur. What we don't know yet is when.
-- Joxel Garci, deputy director, Pan American Health Organization
The arrival of a pandemic influenza would trigger a reaction that would change the world overnight. A vaccine would not be available for a number of months after the pandemic started, and there are very limited stockpiles of antiviral drugs. Foreign trade and travel would be reduced or even ended in an attempt to stop the virus from entering new countries. It is likely that transportation would also be significantly curtailed domestically, as smaller communities sought to keep the disease contained.
-- Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy, Associate Director of the Department of Homeland Security's National Center for Food Protection and Defense, and Professor at the University of Minnesota's School of Public Health
Right now there is not sufficient surveillance to detect all cases of avian influenza in humans or in animals.
-- Dr. Heymann Executive Director of Communicable Diseases, World Health Organization
I would not be surprised if in a period of several months to a year we
would see this even in the United States.
-- Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases
February 17, 2006
This is a bomb that will impact the world.
-- Thommy Thompson, Former Secretary, US Health and Human
Services
[The H5N1 pandemic] is an absolute certainty. When it comes to a
pandemic we are overdue and we're under-prepared.
-- Mike Leavitt, Secretary, US Health and Human Services
Anything we say before a pandemic occurs feels like an exaggeration. But any level of preparation that is conducted after is inadequate. So one might ask, is this Y2K all over again? Is this just crying wolf? The reality is this will happen at some point in time.
-- Mike Leavitt, Secretary, US Health and Human Services
The number of people infected will go beyond billions because between 25 and 30% will fall ill.
-- Klaus Stohr, Director, WHO Global Influenza Center
This is a very ominous situation for the globe. It is the most important
threat we are facing right now.
-- Julie Gerberding, US Centers For Disease Control and Prevention
We don't know what the fatality will be but we can expect it to be very high. There will be enourmous economic dislocation. Stock markets will close, international travel and trade will be limited.
-- Peter Cordingley, WHO regional spokesman
The best we can do is try to survive it. We need a Manhattan Project
yesterday.
-- Paul Gully, Deputy Chief Public Health Officer, Canada
Short of thermonuclear war, I have a hard time imagining anything in my lifetime that would be as horrible.
-- Laurie Garrett, US Council on Foreign Relations Senior Fellow for Global Health
We're dealing here with world survival issues -- or the survival of the
world as we know it.
-- David Nabarro, United Nations Senior System Coordinator for Avian and Human Influenza
We can now, in principle, consider the bird population of Europe infected. I fear it might be endemic in Europe by now.
-- Albert Osterhaus of Erasmus University in Rotterdam, The
Netherlands February 15, 2006
There would be no mutual aid, we'd have to take care of this ourselves. -- Florida Governer Jeb Bush
February 15, 2006
If a pandemic hits it's going to be very, very serious for the whole world -- not only the deaths that will occur, but the world economy will tank. People will go and lock themselves in closets. They won't shop, they won't go to movies, they won't get on airplanes, they won't stay in hotels.
-- J.W. Marriott Jr, head of Marriott International Inc.
February 15, 2006
Only two mutations are needed for it to become easily transmissible
among humans. I wake up every morning thinking that today could be the day that I will see a report about a strange case of bird flu among
humans.
-- David Nabarro, United Nations Senior System Coordinator for Avian and Human Influenza
It is no matter if the flu pandemic will occur or not, it will occur. What we don't know yet is when.
-- Joxel Garci, deputy director, Pan American Health Organization
The arrival of a pandemic influenza would trigger a reaction that would change the world overnight. A vaccine would not be available for a number of months after the pandemic started, and there are very limited stockpiles of antiviral drugs. Foreign trade and travel would be reduced or even ended in an attempt to stop the virus from entering new countries. It is likely that transportation would also be significantly curtailed domestically, as smaller communities sought to keep the disease contained.
-- Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy, Associate Director of the Department of Homeland Security's National Center for Food Protection and Defense, and Professor at the University of Minnesota's School of Public Health
Right now there is not sufficient surveillance to detect all cases of avian influenza in humans or in animals.
-- Dr. Heymann Executive Director of Communicable Diseases, World Health Organization
I would not be surprised if in a period of several months to a year we
would see this even in the United States.
-- Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases
February 17, 2006
Polyidiotitis : Diagnosis and Treatment.
It has been said that the first casualty of any war is the truth. Undoubtedly true. During an emergency, the first casualty is usually common sense. During a large-scale event, such as a Pandemic, Earthquake or Hurricane, Polyidiotitis, an insidious and serious disease, runs rampant.
No one is immune, and the symptoms may not always be obvious early on. Even professional responders have been known contract this oft times embarrassing and sometimes deadly disease. Etiology of this disorder is poorly understood, but clustering of cases is common, suggesting a human-to-human vector.
Person’s afflicted with this disease often exhibit the following symptoms. Rapid pulse, increased blood pressure, rapid, oft times shallow breathing, and bizarre psychiatric manifestations that include, but are not limited to, a feeling of invulnerability or immortality. This may be a dissociative disorder, as victims of Polyidiotitis seem to lose any vestige of situational awareness. They develop a narrow focus, a tunnel vision of sorts, that diminishes their ability to make rational decisions.
Clearly there is a disconnect in the patient between reality their perception thereof. Victims of this disease may argue, quite convincingly, that there is absolutely nothing wrong. When confronted, they may even become combative.
Those in close contact with these subjects must take care not to become afflicted themselves (see Lemming’s Disease).
A paradoxical response is sometimes seen in Polyidiotitis, characterized by denial and decent into a semi-fugue state. These victims, while not exhibiting the classic symptoms of Polyidiotitis, are just as profoundly affected. They often fail to take action, or prepare, in the face of an advancing threat. Indeed, their dissociation may be so complete that they simply are unable to accept that any threat exists.
For reasons not yet known, this paradoxical response has been found to be most prevalent in politicians, business leaders, and people in authority.
While the manifestations of Polyidiotitis can vary widely from subject to subject, there are certain commonalities the clinician must look for. The most widespread of these is an utterance when faced with a clearly dangerous situation, referred to by specialists as “Famous Last Words Syndrome”, that generally involves the phrase, “Hey, guys. Watch me do this!”
This is a devastating, but clearly diagnostic sign. By this time, however, the disease has fulminated to the point of crisis, and the victim may no longer be salvageable.
Early detection and intervention is the key. Watch for these specific warning signs.
If a subject stocks up on canned food, selecting items with bulging lids because `there’s more food in those’, they may have Polyidiotitis.
If a subject buys and installs a generator inside their house or garage, they may have Polyidiotitis.
If a subject insists that candles or kerosene lanterns are safer that battery operated lights during a power outage, they may have Polyidiotitis.
If a subject decides to drive or walk around their neighborhood during the eye of a Hurricane, or travels long distances to view an area of destruction after the storm, they may have Polyidiotitis.
If a subject fails to evacuate, or board up their home, or if they fail to have adequate supplies on hand to weather the storm, they may have (paradoxical response) Polyidiotitis.
If a subject insists, regardless of an apparent threat, that “It can’t happen here”, they may have irreversible (paradoxical response) Polyidiotitis.
Treatment: Until additional research is completed, treatment options are limited. Containment should be of paramount concern, as the potential for widespread contamination is serious. Talk therapy, or in extreme cases, temporary confinement, appear to be the only courses of action. While victims may be stabilized by such measures, this is not indicative of a cure. Relapses are common.
In summary: Attempts to have Polyidiotitis placed on the CDC’s list of Rapidly Emerging Infectious Diseases has thus far failed. Nevertheless, researchers believe that, given the rate of growth of this disorder, it is only a matter of time before the true depth of this epidemic is fully appreciated.
Today there is no cure. While scattered cases are reported everyday, true outbreaks seem to occur just before, during, and after large-scale natural disasters. Thus far, these outbreaks, much like flare ups of Ebola in equatorial Africa, are self-limiting.
However, it should be noted that the susceptibility to this disease seems to be increasing. Previous generations, while not immune, appear to have had some natural resistance. Environmental toxins (ie. TV, music videos, video games, and unprotected exposure to mass media) may play some part in the development of this disease.
More research is clearly needed.
It has been said that the first casualty of any war is the truth. Undoubtedly true. During an emergency, the first casualty is usually common sense. During a large-scale event, such as a Pandemic, Earthquake or Hurricane, Polyidiotitis, an insidious and serious disease, runs rampant.
No one is immune, and the symptoms may not always be obvious early on. Even professional responders have been known contract this oft times embarrassing and sometimes deadly disease. Etiology of this disorder is poorly understood, but clustering of cases is common, suggesting a human-to-human vector.
Person’s afflicted with this disease often exhibit the following symptoms. Rapid pulse, increased blood pressure, rapid, oft times shallow breathing, and bizarre psychiatric manifestations that include, but are not limited to, a feeling of invulnerability or immortality. This may be a dissociative disorder, as victims of Polyidiotitis seem to lose any vestige of situational awareness. They develop a narrow focus, a tunnel vision of sorts, that diminishes their ability to make rational decisions.
Clearly there is a disconnect in the patient between reality their perception thereof. Victims of this disease may argue, quite convincingly, that there is absolutely nothing wrong. When confronted, they may even become combative.
Those in close contact with these subjects must take care not to become afflicted themselves (see Lemming’s Disease).
A paradoxical response is sometimes seen in Polyidiotitis, characterized by denial and decent into a semi-fugue state. These victims, while not exhibiting the classic symptoms of Polyidiotitis, are just as profoundly affected. They often fail to take action, or prepare, in the face of an advancing threat. Indeed, their dissociation may be so complete that they simply are unable to accept that any threat exists.
For reasons not yet known, this paradoxical response has been found to be most prevalent in politicians, business leaders, and people in authority.
While the manifestations of Polyidiotitis can vary widely from subject to subject, there are certain commonalities the clinician must look for. The most widespread of these is an utterance when faced with a clearly dangerous situation, referred to by specialists as “Famous Last Words Syndrome”, that generally involves the phrase, “Hey, guys. Watch me do this!”
This is a devastating, but clearly diagnostic sign. By this time, however, the disease has fulminated to the point of crisis, and the victim may no longer be salvageable.
Early detection and intervention is the key. Watch for these specific warning signs.
If a subject stocks up on canned food, selecting items with bulging lids because `there’s more food in those’, they may have Polyidiotitis.
If a subject buys and installs a generator inside their house or garage, they may have Polyidiotitis.
If a subject insists that candles or kerosene lanterns are safer that battery operated lights during a power outage, they may have Polyidiotitis.
If a subject decides to drive or walk around their neighborhood during the eye of a Hurricane, or travels long distances to view an area of destruction after the storm, they may have Polyidiotitis.
If a subject fails to evacuate, or board up their home, or if they fail to have adequate supplies on hand to weather the storm, they may have (paradoxical response) Polyidiotitis.
If a subject insists, regardless of an apparent threat, that “It can’t happen here”, they may have irreversible (paradoxical response) Polyidiotitis.
Treatment: Until additional research is completed, treatment options are limited. Containment should be of paramount concern, as the potential for widespread contamination is serious. Talk therapy, or in extreme cases, temporary confinement, appear to be the only courses of action. While victims may be stabilized by such measures, this is not indicative of a cure. Relapses are common.
In summary: Attempts to have Polyidiotitis placed on the CDC’s list of Rapidly Emerging Infectious Diseases has thus far failed. Nevertheless, researchers believe that, given the rate of growth of this disorder, it is only a matter of time before the true depth of this epidemic is fully appreciated.
Today there is no cure. While scattered cases are reported everyday, true outbreaks seem to occur just before, during, and after large-scale natural disasters. Thus far, these outbreaks, much like flare ups of Ebola in equatorial Africa, are self-limiting.
However, it should be noted that the susceptibility to this disease seems to be increasing. Previous generations, while not immune, appear to have had some natural resistance. Environmental toxins (ie. TV, music videos, video games, and unprotected exposure to mass media) may play some part in the development of this disease.
More research is clearly needed.
Friday, February 17, 2006
TONITE: ON CNN ANDERSON COOPER 360 10pm EST
A segment on Avian Flu.
HEADS UP: FOX NEWS SPECIAL SUNDAY NIGHT
http://www.foxnews.com/story/0,2933,185165,00.html
The Fox website indicates they will explore a `worst-case' scenario, and what it will mean to the United States.
We'll see if they get it right.
Saturday Morning Edit: Watched CNN and was very dissapointed. Very little info, and they concentrated on the `bird flu' aspects as opposed to the `panflu' prospects of a pandemic. Oh, they mentioned the possibility, but glossed over it.
Sigh. Guess they didn't want to upset their adverstisers.
A segment on Avian Flu.
HEADS UP: FOX NEWS SPECIAL SUNDAY NIGHT
Sun., Feb. 19 at 10 p.m.
Repeats Monday at 1 a.m. ET
Hosted by Newt Gingrich
http://www.foxnews.com/story/0,2933,185165,00.html
The Fox website indicates they will explore a `worst-case' scenario, and what it will mean to the United States.
We'll see if they get it right.
Saturday Morning Edit: Watched CNN and was very dissapointed. Very little info, and they concentrated on the `bird flu' aspects as opposed to the `panflu' prospects of a pandemic. Oh, they mentioned the possibility, but glossed over it.
Sigh. Guess they didn't want to upset their adverstisers.
Thursday, February 16, 2006
GOVERNOR JEB BUSH: YOU CAN'T SUGAR COAT THIS
Better late than never, the governor of the State of Florida has come out and is urging Floridians to prepare for a pandemic. After a meeting with Federal and State Health officials today Bush made the following statements.
Gov. Jeb Bush said the state doesn't have all the hospital beds it would need if a real pandemic were to emerge and had no prospects for changing that. And by its very nature, a pandemic would affect the whole country -- so there'd be no place to send the people that Florida's hospitals couldn't handle.
``There would be no mutual aid, we'd have to take care of this ourselves,'' Bush said.
The problems would be myriad: besides overflowing hospitals, schools would close and many business would be crippled by absenteeism; there might be runs on food, cash, water and other critical items; and the state's economic engine _ tourism _ could be devastated.
``You can't sugarcoat this,'' Bush said.
read the entire news article at http://tinyurl.com/b7ldb
Gee, you'd almost think he's been reading my blog.
Better late than never, the governor of the State of Florida has come out and is urging Floridians to prepare for a pandemic. After a meeting with Federal and State Health officials today Bush made the following statements.
Gov. Jeb Bush said the state doesn't have all the hospital beds it would need if a real pandemic were to emerge and had no prospects for changing that. And by its very nature, a pandemic would affect the whole country -- so there'd be no place to send the people that Florida's hospitals couldn't handle.
``There would be no mutual aid, we'd have to take care of this ourselves,'' Bush said.
The problems would be myriad: besides overflowing hospitals, schools would close and many business would be crippled by absenteeism; there might be runs on food, cash, water and other critical items; and the state's economic engine _ tourism _ could be devastated.
``You can't sugarcoat this,'' Bush said.
read the entire news article at http://tinyurl.com/b7ldb
Gee, you'd almost think he's been reading my blog.
Hard Choices Ahead
If a pandemic comes, the American people are in for a genuine shock. We are used to having modern medicine available, with hospital beds, antibiotics, and even ventilators should we need them. The idea that those things might not be available hasn't sunk in for most Americans. Even those who watched in horror at the destruction of New Orleans, still believe `it can't happen here'.
What happens when a hospital has 10 ventilators and 100 patients who will die without one. Simple answer: 90 will die. The tougher question is, which ones?
How do we decide who gets a ventilator and who does not. Once someone is placed on a vent, if someone else shows up who is younger, or richer, or more important . . . do we take the first person off the vent and give it to them?
At what point do we decide that a patient isn't likely to survive, and remove the vent so someone else can have it?
These same decisions will have to be made regarding Tamiflu, antibiotics, hospital beds, and someday even a vaccine. All will be in short supply.
The odds are, a few days or weeks into a pandemic, if you go to a hospital with a sick child, you will be turned away.
Terrible decisions may need to be made in the home, too. If someone at home gets sick, who exposes themselves to them in order to try to nurse them back to health? Does that person stay quarantined with the sick person, to spare the rest of the family?
And the biggest moral,ethical, and potentially legal dilemma people are likely to run into during a pandemic is that of a flu victim, in extremis (near death), whom you could spare a good deal of pain and agony by administering a sedative or a narcotic.
We’re not talking a `normally lethal’ dose. Just enough to take the edge off, perhaps reduce the coughing spasms, and even allow the patient to sleep.
But implicit in doing so, is the understanding that these meds may depress the Central Nervous System, depress respirations, and will likely hasten their death by a few hours.
While this is done routinely for end stage cancer patients by many doctors, and may be seen as humane by some, could you do it to (or for) your spouse or child?
On the other hand, could you allow a loved one to continue to suffer, knowing you had at your disposal medicine that would calm them down, reduce their pain, and allow them to rest easily?
ARDS is a terrible way to go. Respiratory distress, spontaneous pnuemothorax, pulmonary edema, wracking coughs, internal bleeding . . .
What price should a dying patient pay for another hour or two of life. What matters more, quality or quantity of life. If we are talking only a few hours difference, which would you choose?
I know my answer, as I have crossed this bridge before.
But you need to seriously think about it.
If a pandemic comes, the American people are in for a genuine shock. We are used to having modern medicine available, with hospital beds, antibiotics, and even ventilators should we need them. The idea that those things might not be available hasn't sunk in for most Americans. Even those who watched in horror at the destruction of New Orleans, still believe `it can't happen here'.
What happens when a hospital has 10 ventilators and 100 patients who will die without one. Simple answer: 90 will die. The tougher question is, which ones?
How do we decide who gets a ventilator and who does not. Once someone is placed on a vent, if someone else shows up who is younger, or richer, or more important . . . do we take the first person off the vent and give it to them?
At what point do we decide that a patient isn't likely to survive, and remove the vent so someone else can have it?
These same decisions will have to be made regarding Tamiflu, antibiotics, hospital beds, and someday even a vaccine. All will be in short supply.
The odds are, a few days or weeks into a pandemic, if you go to a hospital with a sick child, you will be turned away.
Terrible decisions may need to be made in the home, too. If someone at home gets sick, who exposes themselves to them in order to try to nurse them back to health? Does that person stay quarantined with the sick person, to spare the rest of the family?
And the biggest moral,ethical, and potentially legal dilemma people are likely to run into during a pandemic is that of a flu victim, in extremis (near death), whom you could spare a good deal of pain and agony by administering a sedative or a narcotic.
We’re not talking a `normally lethal’ dose. Just enough to take the edge off, perhaps reduce the coughing spasms, and even allow the patient to sleep.
But implicit in doing so, is the understanding that these meds may depress the Central Nervous System, depress respirations, and will likely hasten their death by a few hours.
While this is done routinely for end stage cancer patients by many doctors, and may be seen as humane by some, could you do it to (or for) your spouse or child?
On the other hand, could you allow a loved one to continue to suffer, knowing you had at your disposal medicine that would calm them down, reduce their pain, and allow them to rest easily?
ARDS is a terrible way to go. Respiratory distress, spontaneous pnuemothorax, pulmonary edema, wracking coughs, internal bleeding . . .
What price should a dying patient pay for another hour or two of life. What matters more, quality or quantity of life. If we are talking only a few hours difference, which would you choose?
I know my answer, as I have crossed this bridge before.
But you need to seriously think about it.
You have to Crawl before you can Talk
In recent days, the news crawl on the 24 hour cable networks have begun to include multiple avian flu alerts. Quarantines in Iraq. Dead Swans in Germany. Avian Flu spreading in Nigeria. More Deaths in Indonesia.
Not a lot of detail, but useful in it’s way.
By continually scrolling these stories, people are getting used to the idea that there really is a story here. Every once in awhile, the news stations actually run a 3 minute story, complete with pictures of birds being culled by moon-suited health workers. Slowly, almost excruciatingly so, the media has started ramping up the coverage, and the threat is beginning to sink into the collective consciousness.
It’s a start. But until Larry King or Bill O’Reilly devote massive airtime to avian flu, we still have a long way to go. We need prime time specials on the major networks. Public service announcements (and not at 3am) on all channels. We need to spend at least as much time covering this as we expend on celebrity news. Brad Pitt, Anjolina Jolie, and Jennifer Aniston are important, but maybe not quite as important as a killer pandemic.
The wire services, like AP and Reuters, have begun to cover this story, although newspapers tend to bury these articles, instead of running them on page 1.
Recent headlines include:
Bird flu ‘could take 142m lives’ (CNN.com)
US mobilizes global effort against bird flu
Bird flu pandemic would spark global downturn: report
Bird flu could kill 214,000 Australians
Two suspected bird flu patients die in Indonesia
Europe stands guard against bird flu
Alarming headlines. 142 Million deaths possible (considered a low estimate by some), economic implications, global mobilization efforts.
And yet, somehow, none of this is on the average American’s radar screen.
Hopefully, that will change. Hopefully the avian flu will wait, allowing the clueless time to play catch up. But right now, I’m not hopeful.
In recent days, the news crawl on the 24 hour cable networks have begun to include multiple avian flu alerts. Quarantines in Iraq. Dead Swans in Germany. Avian Flu spreading in Nigeria. More Deaths in Indonesia.
Not a lot of detail, but useful in it’s way.
By continually scrolling these stories, people are getting used to the idea that there really is a story here. Every once in awhile, the news stations actually run a 3 minute story, complete with pictures of birds being culled by moon-suited health workers. Slowly, almost excruciatingly so, the media has started ramping up the coverage, and the threat is beginning to sink into the collective consciousness.
It’s a start. But until Larry King or Bill O’Reilly devote massive airtime to avian flu, we still have a long way to go. We need prime time specials on the major networks. Public service announcements (and not at 3am) on all channels. We need to spend at least as much time covering this as we expend on celebrity news. Brad Pitt, Anjolina Jolie, and Jennifer Aniston are important, but maybe not quite as important as a killer pandemic.
The wire services, like AP and Reuters, have begun to cover this story, although newspapers tend to bury these articles, instead of running them on page 1.
Recent headlines include:
Bird flu ‘could take 142m lives’ (CNN.com)
US mobilizes global effort against bird flu
Bird flu pandemic would spark global downturn: report
Bird flu could kill 214,000 Australians
Two suspected bird flu patients die in Indonesia
Europe stands guard against bird flu
Alarming headlines. 142 Million deaths possible (considered a low estimate by some), economic implications, global mobilization efforts.
And yet, somehow, none of this is on the average American’s radar screen.
Hopefully, that will change. Hopefully the avian flu will wait, allowing the clueless time to play catch up. But right now, I’m not hopeful.
Tuesday, February 14, 2006
Fear and Loathing on the Internet
As bird flu has spread now to Africa, the tempo of fear among many of those preparing for a pandemic has moved up another notch. The mantra I hear, repeated again and again, is that it would be suicide to leave your home for any reason during a pandemic wave.
While I admit that there is some personal risk to doing so, I have repeatedly argued that we need to fight any pandemic like an invading army. If we allow our fears to force us into hiding, we will be picked off one by one by either the virus or our failed infrastructure. Without power, water, operating sewers, hospitals, and law enforcement, how many of us can really survive for months or possibly years?
With few exceptions, my viewpoint is countered with jeers and catcalls. People resent the idea that some of us might want to consider risking our personal safety to keep hospitals open, the lights on, and food and medicine moving. I guess it’s like the guy who works too hard at the office, and everybody hates him because he makes the rest of the employee’s look bad.
Has our society really been reduced to the level of George Costanza knocking over little old ladies in a nursing home to make it to the exit during a fire drill? Is the concept of personal sacrifice, to save others, really dead? Are our own skins so precious, that it is better not to risk them, even if it means a child next door will starve, or a potential vaccine won’t be delivered?
It’s a depressing thought.
Luckily, there still remain a few that have expressed their desire to help others during a pandemic. Doctors, nurses, cops, respiratory therapists, and a few others. But they can’t do it alone. Without backup, without support personnel, they are doomed to fail.
We need an army, willing to go into battle, even at great personal risk, in order for our society to survive a pandemic. Utility workers, garbage collectors, mortuary removal personnel, cooks and housekeeping personnel in hospitals, correctional officers, truck drivers, and even people who can do little more than walk a security patrol for a neighborhood watch. They all are essential personnel.
Some will fall. Indeed, tragically, some may even bring the virus home with them.
It is a risk that we must take, unless we are willing to standby and watch our infrastructure fail. And with that failure will come more deaths, more despair, and a much longer-term problem than an 18 month pandemic.
I’ve no desire to die in a pandemic. I’m not a hero. This virus scares the hell out of me. But I’d rather go down swinging, fighting the good fight, than barricaded in my home with power the out, my food supplies dwindling, and watching society devolve around me.
Foolish? Perhaps. Maybe even fluicidal. But it’s something I can live with.
As bird flu has spread now to Africa, the tempo of fear among many of those preparing for a pandemic has moved up another notch. The mantra I hear, repeated again and again, is that it would be suicide to leave your home for any reason during a pandemic wave.
While I admit that there is some personal risk to doing so, I have repeatedly argued that we need to fight any pandemic like an invading army. If we allow our fears to force us into hiding, we will be picked off one by one by either the virus or our failed infrastructure. Without power, water, operating sewers, hospitals, and law enforcement, how many of us can really survive for months or possibly years?
With few exceptions, my viewpoint is countered with jeers and catcalls. People resent the idea that some of us might want to consider risking our personal safety to keep hospitals open, the lights on, and food and medicine moving. I guess it’s like the guy who works too hard at the office, and everybody hates him because he makes the rest of the employee’s look bad.
Has our society really been reduced to the level of George Costanza knocking over little old ladies in a nursing home to make it to the exit during a fire drill? Is the concept of personal sacrifice, to save others, really dead? Are our own skins so precious, that it is better not to risk them, even if it means a child next door will starve, or a potential vaccine won’t be delivered?
It’s a depressing thought.
Luckily, there still remain a few that have expressed their desire to help others during a pandemic. Doctors, nurses, cops, respiratory therapists, and a few others. But they can’t do it alone. Without backup, without support personnel, they are doomed to fail.
We need an army, willing to go into battle, even at great personal risk, in order for our society to survive a pandemic. Utility workers, garbage collectors, mortuary removal personnel, cooks and housekeeping personnel in hospitals, correctional officers, truck drivers, and even people who can do little more than walk a security patrol for a neighborhood watch. They all are essential personnel.
Some will fall. Indeed, tragically, some may even bring the virus home with them.
It is a risk that we must take, unless we are willing to standby and watch our infrastructure fail. And with that failure will come more deaths, more despair, and a much longer-term problem than an 18 month pandemic.
I’ve no desire to die in a pandemic. I’m not a hero. This virus scares the hell out of me. But I’d rather go down swinging, fighting the good fight, than barricaded in my home with power the out, my food supplies dwindling, and watching society devolve around me.
Foolish? Perhaps. Maybe even fluicidal. But it’s something I can live with.
Sunday, February 12, 2006
IS THE CURE WORSE THAN THE DISEASE?
The overriding sentiment among those who are prepping for a pandemic is to isolate themselves and their families, perhaps for a year or longer, and wait for the pandemic to burn out. I understand this reaction, and most of you know, I have grave misgivings about what this strategy will mean for our society.
If everybody hunkers down, utilities will fail, medicines and food will not be delivered, and if a vaccine becomes available, there will be no one to distribute it, or inoculate the public. The Domino effect, I fear, will kill far more than the virus.
And by isolating ourselves, are we simply prolonging the pandemic? When will it be safe to emerge? When reported cases in your area go down? What happens when people emerge, still without immunity, and a new wave starts up? How long before you can be sure the virus has disappeared? Two years? Five years?
The number of people in our society that will be able to prep for that kind of isolation will be pitifully small. Most will be lucky to be able to hold out a couple of months.
The concept of a `cure’ for your family, locking the doors, barring the windows, and waiting it out is not going to be as easy as you might think. While most of you may be thinking about long evenings spent by candlelight, playing scrabble, monitoring your defenses, and preserving the `family unit’, the realities are likely to be far different.
I spent 13 years living aboard a sailboat with my wife and cat. I cruised among a subset of society that, of their own volition, had chosen that lifestyle. Most were couples. Some were happy. Many were not, and good marriages of many years were destroyed in a matter of months. Until you’ve lived under stressful conditions, in close quarters, 24/7 with one or more other people, you have no idea what you are in for.
And remember, the stress level sitting at anchor in paradise and enduring the occasional storm, sipping rum drinks, soaking up the sunshine, and munching on fresh lobster was less than you are likely to encounter in a barricaded home during a pandemic.
If the power goes out, you will either be too hot or too cold. If the sewers back up because the lift stations go down for lack of electricity, you will be faced with major sanitation problems, and may have to leave the house to bury the waste. Your diet will be bland and repetitive, and for many, short rations. TV and Internet may be non-existent. If you are receiving news from the outside, it is only likely to heighten your fears. And if you see fires burning on the horizon, or looters in the street, your panic is likely be overwhelming.
After awhile, you may find yourself caressing a butcher knife while you examine your spouse’s neck veins from across the dining room table. If you fear that the virus threatens you, consider that domestic violence and severe psychiatric illness may well become endemic among those who are sequestered.
What will you do when the cabin fever becomes over whelming? It’s a real consideration. Maybe you can handle it. But can your spouse? Or your kids? What happens if you discover your 15-year-old daughter has been sneaking out her bedroom window at night to meet her friends down the block? Are you going to banish her from the house? Quarantine her in the garage for two weeks? I’m sure either of those solutions is going to help the family unit bond.
What happens if a family member is injured beyond your ability to care for them. A child is burned, or perhaps an appendix bursts. Will you draw straws to determine who takes the child out of the house in search of medical care, with the understanding that the `loser’ will not be allowed to return?
I could cite hundreds of other sequestering nightmares, but I will stop here.
The question remains, is strict isolation for months on end really realistic? And is the price we pay as a society, the loss of infrastructure, worth it? While the virus may claim a million or more victims in the US, how many more will die from our reluctance to assume some risks and fight back?
In short, is this cure worse than the disease?
The overriding sentiment among those who are prepping for a pandemic is to isolate themselves and their families, perhaps for a year or longer, and wait for the pandemic to burn out. I understand this reaction, and most of you know, I have grave misgivings about what this strategy will mean for our society.
If everybody hunkers down, utilities will fail, medicines and food will not be delivered, and if a vaccine becomes available, there will be no one to distribute it, or inoculate the public. The Domino effect, I fear, will kill far more than the virus.
And by isolating ourselves, are we simply prolonging the pandemic? When will it be safe to emerge? When reported cases in your area go down? What happens when people emerge, still without immunity, and a new wave starts up? How long before you can be sure the virus has disappeared? Two years? Five years?
The number of people in our society that will be able to prep for that kind of isolation will be pitifully small. Most will be lucky to be able to hold out a couple of months.
The concept of a `cure’ for your family, locking the doors, barring the windows, and waiting it out is not going to be as easy as you might think. While most of you may be thinking about long evenings spent by candlelight, playing scrabble, monitoring your defenses, and preserving the `family unit’, the realities are likely to be far different.
I spent 13 years living aboard a sailboat with my wife and cat. I cruised among a subset of society that, of their own volition, had chosen that lifestyle. Most were couples. Some were happy. Many were not, and good marriages of many years were destroyed in a matter of months. Until you’ve lived under stressful conditions, in close quarters, 24/7 with one or more other people, you have no idea what you are in for.
And remember, the stress level sitting at anchor in paradise and enduring the occasional storm, sipping rum drinks, soaking up the sunshine, and munching on fresh lobster was less than you are likely to encounter in a barricaded home during a pandemic.
If the power goes out, you will either be too hot or too cold. If the sewers back up because the lift stations go down for lack of electricity, you will be faced with major sanitation problems, and may have to leave the house to bury the waste. Your diet will be bland and repetitive, and for many, short rations. TV and Internet may be non-existent. If you are receiving news from the outside, it is only likely to heighten your fears. And if you see fires burning on the horizon, or looters in the street, your panic is likely be overwhelming.
After awhile, you may find yourself caressing a butcher knife while you examine your spouse’s neck veins from across the dining room table. If you fear that the virus threatens you, consider that domestic violence and severe psychiatric illness may well become endemic among those who are sequestered.
What will you do when the cabin fever becomes over whelming? It’s a real consideration. Maybe you can handle it. But can your spouse? Or your kids? What happens if you discover your 15-year-old daughter has been sneaking out her bedroom window at night to meet her friends down the block? Are you going to banish her from the house? Quarantine her in the garage for two weeks? I’m sure either of those solutions is going to help the family unit bond.
What happens if a family member is injured beyond your ability to care for them. A child is burned, or perhaps an appendix bursts. Will you draw straws to determine who takes the child out of the house in search of medical care, with the understanding that the `loser’ will not be allowed to return?
I could cite hundreds of other sequestering nightmares, but I will stop here.
The question remains, is strict isolation for months on end really realistic? And is the price we pay as a society, the loss of infrastructure, worth it? While the virus may claim a million or more victims in the US, how many more will die from our reluctance to assume some risks and fight back?
In short, is this cure worse than the disease?
A SIGN OF THE TIMES
One of the best websites for getting getting avian flu information is the FluWiki. It was set up by public health officials and scientists, and it is a virtual think-tank for all things fluish.
Today, someone asked if maybe we weren't all spending too much time on the wiki. Many of us check in several times each day. With apologies to David Letterman, I present . . .
Top 10 signs you may be obsessing about Avian Flu.
10. You look for shopping carts with heavy duty shocks.
9. You not only plan to cut down all the trees in your backyard, you are planning to do a midnight clear cutting of your neighbor’s yard as well.
8. You’ve tried repeatedly to warn Sylvester to stay away from Tweety-bird.
7. You’ve bought a windshield squeegee with a 10 foot handle
6. The stock boys at every supermarket in town know you by your first name, and run when they see you coming.
5. You’ve installed an in-line chlorinator for your lawn sprinkler system.
4. The Flu Wiki logo is burned into your monitor’s screen
3. If a pandemic doesn’t happen, your backup plan is to use your preps to open a pharmacy.
2. You’ve started telling your spouse that you’re surfing porn sites instead of admitting you’re back on the wiki again.
And the number one sign you may be obsessing about Avian Flu
1. You can use Orthomyxoviridae and hemagglutinin in the same sentence.
One of the best websites for getting getting avian flu information is the FluWiki. It was set up by public health officials and scientists, and it is a virtual think-tank for all things fluish.
Today, someone asked if maybe we weren't all spending too much time on the wiki. Many of us check in several times each day. With apologies to David Letterman, I present . . .
Top 10 signs you may be obsessing about Avian Flu.
10. You look for shopping carts with heavy duty shocks.
9. You not only plan to cut down all the trees in your backyard, you are planning to do a midnight clear cutting of your neighbor’s yard as well.
8. You’ve tried repeatedly to warn Sylvester to stay away from Tweety-bird.
7. You’ve bought a windshield squeegee with a 10 foot handle
6. The stock boys at every supermarket in town know you by your first name, and run when they see you coming.
5. You’ve installed an in-line chlorinator for your lawn sprinkler system.
4. The Flu Wiki logo is burned into your monitor’s screen
3. If a pandemic doesn’t happen, your backup plan is to use your preps to open a pharmacy.
2. You’ve started telling your spouse that you’re surfing porn sites instead of admitting you’re back on the wiki again.
And the number one sign you may be obsessing about Avian Flu
1. You can use Orthomyxoviridae and hemagglutinin in the same sentence.
AND THE SURVEY SAYS . . . .
February 09, 2006 10:01 AM US Eastern Timezone
Avian Flu Threat Shakes Doctors' Confidence: Pri-Med Research
BOSTON--(BUSINESS WIRE)--Feb. 9, 2006--Two-thirds of physicians are concerned about the threat of an avian influenza pandemic in the US, and more than half believe an outbreak poses a serious risk for Americans, according to a nationwide survey of primary care clinicians by Pri-Med Research.
Fewer than one in five primary care practitioners believe they are adequately equipped today to treat infected patients. Over 50% express little or no confidence in the government's ability to manage a flu pandemic at the local, state, federal or international level. 91% of practitioners surveyed also feel that the current availability of anti-viral medications is inadequate to meet an avian flu crisis.
Primed is a respected provider of continuing education for physicians across the country. This survey was of primary care physicians and was taken before the African outbreak.
76% are concerned over an International Outbreak of Avian Flu.
66% are concerned over a pandemic in the United States.
54% believe an outbreak poses a serious risk to Americans.
21% believe they are equipped to handle an outbreak in their community
9% believe they will have adequate anti-virals on hand to counter a pandemic.
LESS THAN 25% believe that State, local, or Federal officials can handle an outbreak.
AND ONLY 9% have an emergency response plan in place at this time to handle a pandemic in their community.
February 09, 2006 10:01 AM US Eastern Timezone
Avian Flu Threat Shakes Doctors' Confidence: Pri-Med Research
BOSTON--(BUSINESS WIRE)--Feb. 9, 2006--Two-thirds of physicians are concerned about the threat of an avian influenza pandemic in the US, and more than half believe an outbreak poses a serious risk for Americans, according to a nationwide survey of primary care clinicians by Pri-Med Research.
Fewer than one in five primary care practitioners believe they are adequately equipped today to treat infected patients. Over 50% express little or no confidence in the government's ability to manage a flu pandemic at the local, state, federal or international level. 91% of practitioners surveyed also feel that the current availability of anti-viral medications is inadequate to meet an avian flu crisis.
Primed is a respected provider of continuing education for physicians across the country. This survey was of primary care physicians and was taken before the African outbreak.
76% are concerned over an International Outbreak of Avian Flu.
66% are concerned over a pandemic in the United States.
54% believe an outbreak poses a serious risk to Americans.
21% believe they are equipped to handle an outbreak in their community
9% believe they will have adequate anti-virals on hand to counter a pandemic.
LESS THAN 25% believe that State, local, or Federal officials can handle an outbreak.
AND ONLY 9% have an emergency response plan in place at this time to handle a pandemic in their community.
Boil, Boil, Toil and Trouble
It’s been a busy couple of days on the flu front. More deaths in Indonesia, reports of children coughing up blood in Nigeria in and around the poultry die offs, confirmation of Avian Flu in birds in Greece , Italy, and Bulgaria, and an ominous statement by David Nabarro at the UN.
We’ll start with David Nabarro.
A year ago, scientists said the H5N1 virus needed, perhaps, 10 specific mutations before it could turn into a pandemic strain. Late last year, it was announced we were down to needing only 5.
On Friday, Dr. Nabarro, in a newspaper interview, stated we were down to needing only 2 more mutations. The UN has been very careful not to overstate the situation. They know the power of words, and are very precise in how they use them. This admission is looked upon as a very strong warning by those watching the situation.
In Italy, where the winter Olympics opened on Friday night, the suspicion has been strong for weeks that they have been withholding information regarding avian flu in their country. Turkey, weeks ago, accused it’s neighboring countries of hiding the truth.
Well, shortly after the opening ceremonies began, Italy admitted they had found infected birds. Greece admitted the same, almost at the same time. Curious timing, to say the least. But hey, at least they didn’t scare off any tourists from coming to the games.
Cases keep popping up in Indonesia. Two women, ages 22 and 37, from the town of Bekasi, a town just east of the capital, Jakarta, died within hours of each other last week. Lab tests confirmed they died of Avian flu.
The news out of Iraq is spotty. We know that 70,000 doses of Tamiflu are en route. And that 50 villages remain under quarantine. Sounds like they have a problem. But details are not being released.
And the big news is Africa. Hundreds of thousands of dead chickens in Nigeria. Lab tests confirm Bird Flu. Unconfirmed reports of sick, or dying children. Almost no public health system in place. And rampant poverty abounds.
Avian Flu in Africa is the World Health Organizations 2nd worse nightmare (a pandemic is #1). A large percentage of the population is immuno compromised from HIV. Estimates run up to 25% . People with Immune systems dysfunctions are known to harbor, and shed, the virus for much longer than those with normally active immune systems. This provides a better host for the virus, and gives it more time to mutate.
Worse, people die of strange diseases every day in Africa. Most of the time, they just bury the dead and never investigate. Everything from dysentery, typhoid, cholera, and ebola … plus a bunch of diseases you’ve never heard of, are endemic there. There is a report of 52 children dieing this week in one village alone. Avian Flu? No way to know. Could be anything. But it illustrates how difficult it will be to track any outbreak in Africa.
Reliable testing laboratories in Africa are nearly non-existant. Health officials have had little luck convincing people to accept polio vaccines, because of superstitions and distrust of outsiders. Convincing these people to give up their chickens, for some, the only source of food or wealth in their lives, will be nearly impossible.
Africa is the perfect petri dish for avian flu to grow in. And it may well be weeks after an epidemic breaks out, before we even know it.
It’s been a busy couple of days on the flu front. More deaths in Indonesia, reports of children coughing up blood in Nigeria in and around the poultry die offs, confirmation of Avian Flu in birds in Greece , Italy, and Bulgaria, and an ominous statement by David Nabarro at the UN.
We’ll start with David Nabarro.
A year ago, scientists said the H5N1 virus needed, perhaps, 10 specific mutations before it could turn into a pandemic strain. Late last year, it was announced we were down to needing only 5.
On Friday, Dr. Nabarro, in a newspaper interview, stated we were down to needing only 2 more mutations. The UN has been very careful not to overstate the situation. They know the power of words, and are very precise in how they use them. This admission is looked upon as a very strong warning by those watching the situation.
In Italy, where the winter Olympics opened on Friday night, the suspicion has been strong for weeks that they have been withholding information regarding avian flu in their country. Turkey, weeks ago, accused it’s neighboring countries of hiding the truth.
Well, shortly after the opening ceremonies began, Italy admitted they had found infected birds. Greece admitted the same, almost at the same time. Curious timing, to say the least. But hey, at least they didn’t scare off any tourists from coming to the games.
Cases keep popping up in Indonesia. Two women, ages 22 and 37, from the town of Bekasi, a town just east of the capital, Jakarta, died within hours of each other last week. Lab tests confirmed they died of Avian flu.
The news out of Iraq is spotty. We know that 70,000 doses of Tamiflu are en route. And that 50 villages remain under quarantine. Sounds like they have a problem. But details are not being released.
And the big news is Africa. Hundreds of thousands of dead chickens in Nigeria. Lab tests confirm Bird Flu. Unconfirmed reports of sick, or dying children. Almost no public health system in place. And rampant poverty abounds.
Avian Flu in Africa is the World Health Organizations 2nd worse nightmare (a pandemic is #1). A large percentage of the population is immuno compromised from HIV. Estimates run up to 25% . People with Immune systems dysfunctions are known to harbor, and shed, the virus for much longer than those with normally active immune systems. This provides a better host for the virus, and gives it more time to mutate.
Worse, people die of strange diseases every day in Africa. Most of the time, they just bury the dead and never investigate. Everything from dysentery, typhoid, cholera, and ebola … plus a bunch of diseases you’ve never heard of, are endemic there. There is a report of 52 children dieing this week in one village alone. Avian Flu? No way to know. Could be anything. But it illustrates how difficult it will be to track any outbreak in Africa.
Reliable testing laboratories in Africa are nearly non-existant. Health officials have had little luck convincing people to accept polio vaccines, because of superstitions and distrust of outsiders. Convincing these people to give up their chickens, for some, the only source of food or wealth in their lives, will be nearly impossible.
Africa is the perfect petri dish for avian flu to grow in. And it may well be weeks after an epidemic breaks out, before we even know it.
Friday, February 10, 2006
THE UN COORDINATOR FREAKS OUT
David Nabarro, the U.N. coordinator on avian and human influenza/Senior System Coordinator, when asked if a pandemic was inevitiable, recently said "we are all standing on the edge of a deep precipice and not knowing how far we are going to fall when it happens."
"Not only I am 'freaking out', to use the correspondents expression, and not mine, not only is that worry or anxiety because of the impact of a possible pandemic, but there is also that worry and anxiety because so many people when I talk to them about getting prepared seem to imply that we have months ahead to get prepared
I say to them it might not be months, it could be that we get human to human transmission tomorrow, so please act as though it is going to start tomorrow, don't keep putting off the difficult issues".
As some wag on one of the forums stated. It sounds like he's got something he want's to get off his chest.
Ya think?
David Nabarro, the U.N. coordinator on avian and human influenza/Senior System Coordinator, when asked if a pandemic was inevitiable, recently said "we are all standing on the edge of a deep precipice and not knowing how far we are going to fall when it happens."
"Not only I am 'freaking out', to use the correspondents expression, and not mine, not only is that worry or anxiety because of the impact of a possible pandemic, but there is also that worry and anxiety because so many people when I talk to them about getting prepared seem to imply that we have months ahead to get prepared
I say to them it might not be months, it could be that we get human to human transmission tomorrow, so please act as though it is going to start tomorrow, don't keep putting off the difficult issues".
As some wag on one of the forums stated. It sounds like he's got something he want's to get off his chest.
Ya think?
Thursday, February 09, 2006
OMINOUS WORDS FROM WHO
Today, Maria Cheng, director general of the World Health Organization, released a statement on the emergence of H5N1 in Africa. Exerpts follow:
This latest outbreak confirms that no country is immune to H5N1. Every country is at risk. Every country must prepare. . .
If the H5N1 virus changes to allow it to pass easily from person to person, and it goes unchecked, this could trigger an influenza pandemic. H5N1 is spreading rapidly across the world. All countries must take measures to protect human health against avian flu, and prepare for a pandemic.
There is no time to waste.
Alarmist?
No, but alarming, nonetheless. The powers that be, the ones who are in charge of mitigating this mess, are really begining to sweat. The stakes are high, and quite frankly, time may be running out.
Have you started your preps today?
Today, Maria Cheng, director general of the World Health Organization, released a statement on the emergence of H5N1 in Africa. Exerpts follow:
This latest outbreak confirms that no country is immune to H5N1. Every country is at risk. Every country must prepare. . .
If the H5N1 virus changes to allow it to pass easily from person to person, and it goes unchecked, this could trigger an influenza pandemic. H5N1 is spreading rapidly across the world. All countries must take measures to protect human health against avian flu, and prepare for a pandemic.
There is no time to waste.
Alarmist?
No, but alarming, nonetheless. The powers that be, the ones who are in charge of mitigating this mess, are really begining to sweat. The stakes are high, and quite frankly, time may be running out.
Have you started your preps today?
The Most Important Prep of All
Okay, you’ve got your food, water, meds, and maybe even guns stockpiled. It’s a good start, but it’s not going to be enough. There’s one preparation you must make if you expect to survive a pandemic.
You have to prepare mentally.
IF a pandemic occurs, for most of us, we will be entering uncharted territory. Even if you sequester yourself inside your home, you may have to deal with illness, death, isolation and fear. News reports from the outside, while informative, will likely to serve to heighten you fears. If looting or rioting breaks out in your vicinity, or worst case, you have to deal with an attempted home invasion, your ability to react under stress will be vital.
Having started in EMS at the age of 18, I was woefully unprepared for the daily onslaught of trauma, tragedy, and yes, fear that would accompany every shift. A dozen or more times a day I would find myself in the midst of an emergency, where lives, including my own, were on the line. The first few weeks, I wasn’t at all sure I was cut out for it.
But I learned a few secrets, from those whom I worked with, that enabled me to handle the stress, the tragedies, and the unexpected. For what it’s worth, I will pass them on to you.
First, no matter what, keep your sense of humor. It will see you thru when nothing else will. Although often misunderstood by those outside of the profession, the ability to find irony in any situation, no matter how terrible, is a wonderful defense mechanism. As long as you can do that, things can’t be that bad. The wisecracks in the operating room scenes in M.A.S.H. were very representative of real life. It’s an outlet. Use it.
Second, you have to be able to detach yourself from the situation, at least for the moment, if you expect to function. No, that doesn’t mean you don’t care. But if you allow yourself to become emotionally involved, you can’t do the things you need to do. Parents are especially guilty of becoming too emotional when their child is injured, and frequently do the wrong thing. Their first inclination when a child is injured is to scoop them up into their arms to comfort them. It isn’t easy, but to be effective, you have to distance yourself from your emotions.
Third, a little bit of fatalism is a good thing. Sometimes you have to accept you’re not going to get out of this world alive. I’ve seen people freeze when they should have acted, and it cost them their lives. There is an old saying in the military; even doing nothing can get you killed. Soldiers can get killed even if they never leave their foxholes. You need to be able to react, even in the face of danger.
Fear is normal, as is the desire to preserve your own skin. But don’t let it keep you from acting when you need to. If you freeze, you no longer are able to affect the situation. You are at the mercy of whatever happens.
Fourth, don’t obsess over what might happen next. You can prepare, and you can train, but you can’t anticipate every eventuality. Running scenarios thru your head incessantly will drive you nuts. Take things as they come. Your imagination can be your worst enemy. I learned early on that the time spent in-between calls, where you anticipate what the next call may bring, was harder on me than the actual call.
Finally, you aren’t Superman. There will always be things you can’t control. Accept that. Do the best you can, but accept that it may not be enough. You should be prepared for losses. Learn from them. Then move on.
None of this is to suggest that you can go thru an emergency without being affected by it. That stoic firefighter or medic who pulls a 4-year-old out of the deep end of a pool, and spends an hour trying unsuccessfully to revive him, does so professionally, and seemingly without emotion. They have to. But don’t think for one second that later, after the call is over, they are unaffected.
You can’t eliminate fear or emotions from stressful conditions. But you can put them aside; delay them until the situation is over. The ability to do so will mean the difference between being able to act, and freezing up.
Perhaps the hardest thing for most people to accept when dealing with illness or injury, particularly of a loved one, is the concept of letting go. That sometimes, there is nothing that can be done. Heroic measures are not always appropriate, and they seldom work.
We live in a culture that fears death, and in recent decades we have tended to hide those people on the verge of death away in nursing homes or hospitals. Often it is for their own good, but many times it is just so we don’t have to watch the process. In a pandemic, this will not be possible in a lot of cases. Many people will have to face that reality.
Among medics, there is a saying. “Death is just nature’s way of telling you to slow down”
This isn’t cruel, or insensitive. It’s simply acceptance.
While I pray that none of you have to face any of the mental traumas that may come with a pandemic, I hope that each of you will take some time and think, really think, about your ability to cope with emergencies. That you will prepare yourself mentally for what you may be called upon to do. Your ability to do so, and to respond appropriately in an emergency, can spell the difference between life and death for you, or someone you love.
And remember. If I could do it at 18, you can do it now. You just have to believe in yourself.
Okay, you’ve got your food, water, meds, and maybe even guns stockpiled. It’s a good start, but it’s not going to be enough. There’s one preparation you must make if you expect to survive a pandemic.
You have to prepare mentally.
IF a pandemic occurs, for most of us, we will be entering uncharted territory. Even if you sequester yourself inside your home, you may have to deal with illness, death, isolation and fear. News reports from the outside, while informative, will likely to serve to heighten you fears. If looting or rioting breaks out in your vicinity, or worst case, you have to deal with an attempted home invasion, your ability to react under stress will be vital.
Having started in EMS at the age of 18, I was woefully unprepared for the daily onslaught of trauma, tragedy, and yes, fear that would accompany every shift. A dozen or more times a day I would find myself in the midst of an emergency, where lives, including my own, were on the line. The first few weeks, I wasn’t at all sure I was cut out for it.
But I learned a few secrets, from those whom I worked with, that enabled me to handle the stress, the tragedies, and the unexpected. For what it’s worth, I will pass them on to you.
First, no matter what, keep your sense of humor. It will see you thru when nothing else will. Although often misunderstood by those outside of the profession, the ability to find irony in any situation, no matter how terrible, is a wonderful defense mechanism. As long as you can do that, things can’t be that bad. The wisecracks in the operating room scenes in M.A.S.H. were very representative of real life. It’s an outlet. Use it.
Second, you have to be able to detach yourself from the situation, at least for the moment, if you expect to function. No, that doesn’t mean you don’t care. But if you allow yourself to become emotionally involved, you can’t do the things you need to do. Parents are especially guilty of becoming too emotional when their child is injured, and frequently do the wrong thing. Their first inclination when a child is injured is to scoop them up into their arms to comfort them. It isn’t easy, but to be effective, you have to distance yourself from your emotions.
Third, a little bit of fatalism is a good thing. Sometimes you have to accept you’re not going to get out of this world alive. I’ve seen people freeze when they should have acted, and it cost them their lives. There is an old saying in the military; even doing nothing can get you killed. Soldiers can get killed even if they never leave their foxholes. You need to be able to react, even in the face of danger.
Fear is normal, as is the desire to preserve your own skin. But don’t let it keep you from acting when you need to. If you freeze, you no longer are able to affect the situation. You are at the mercy of whatever happens.
Fourth, don’t obsess over what might happen next. You can prepare, and you can train, but you can’t anticipate every eventuality. Running scenarios thru your head incessantly will drive you nuts. Take things as they come. Your imagination can be your worst enemy. I learned early on that the time spent in-between calls, where you anticipate what the next call may bring, was harder on me than the actual call.
Finally, you aren’t Superman. There will always be things you can’t control. Accept that. Do the best you can, but accept that it may not be enough. You should be prepared for losses. Learn from them. Then move on.
None of this is to suggest that you can go thru an emergency without being affected by it. That stoic firefighter or medic who pulls a 4-year-old out of the deep end of a pool, and spends an hour trying unsuccessfully to revive him, does so professionally, and seemingly without emotion. They have to. But don’t think for one second that later, after the call is over, they are unaffected.
You can’t eliminate fear or emotions from stressful conditions. But you can put them aside; delay them until the situation is over. The ability to do so will mean the difference between being able to act, and freezing up.
Perhaps the hardest thing for most people to accept when dealing with illness or injury, particularly of a loved one, is the concept of letting go. That sometimes, there is nothing that can be done. Heroic measures are not always appropriate, and they seldom work.
We live in a culture that fears death, and in recent decades we have tended to hide those people on the verge of death away in nursing homes or hospitals. Often it is for their own good, but many times it is just so we don’t have to watch the process. In a pandemic, this will not be possible in a lot of cases. Many people will have to face that reality.
Among medics, there is a saying. “Death is just nature’s way of telling you to slow down”
This isn’t cruel, or insensitive. It’s simply acceptance.
While I pray that none of you have to face any of the mental traumas that may come with a pandemic, I hope that each of you will take some time and think, really think, about your ability to cope with emergencies. That you will prepare yourself mentally for what you may be called upon to do. Your ability to do so, and to respond appropriately in an emergency, can spell the difference between life and death for you, or someone you love.
And remember. If I could do it at 18, you can do it now. You just have to believe in yourself.
Wednesday, February 08, 2006
And this just In . . .
A `highly pathogenic' strain of H5N1 has been detected in Nigeria. This is the first confirmed incidence of Avian Flu in Africa. While this has been predicted, it is considered to be a major escalation in world's threat from avian flu.
Meanwhile, China has announced a confirmed outbreak in the northern part of the country. 15,000 fowl reportedly died over two days. Chinese officials report they have culled an additional 200,000 birds.
These outbreaks, thousands of miles apart, show the avian flu virus is rapidly spreading around the world.
A `highly pathogenic' strain of H5N1 has been detected in Nigeria. This is the first confirmed incidence of Avian Flu in Africa. While this has been predicted, it is considered to be a major escalation in world's threat from avian flu.
Meanwhile, China has announced a confirmed outbreak in the northern part of the country. 15,000 fowl reportedly died over two days. Chinese officials report they have culled an additional 200,000 birds.
These outbreaks, thousands of miles apart, show the avian flu virus is rapidly spreading around the world.
We Need More Time
The consensus of public health officials is that a pandemic is inevitable. The only question is when.
This is not a new conclusion. They’ve known it for a long time. But now, with the H5N1 virus spreading, and mutations appearing that make it more likely to become a H2H (human to human) transmissible disease, many scientists believe we are dangerously close to a global catastrophe.
In the past six months, governments and big business have started to take notice. After years of neglect, some of it bordering on criminal, they are beginning to face up to the grim reality of what would happen if another pandemic swept the globe.
In the past 30 years, we have all but destroyed our domestic ability to produce vaccines. Nearly all of it is produced overseas. The technology we use is more than 50 years old, and is slow and cumbersome. While in 1976, we had the ability to produce enough vaccine to inoculate the entire country in a little less than 8 months; today we can’t even produce enough to handle the seasonal flu.
Part of this is due to litigation in this country. Vaccines have sometimes caused side effects, and the liability costs make vaccine manufacturing a risky business. That, combined with the low price our government is willing to pay for vaccines, has driven most manufacturers to more lucrative ventures.
We are hearing these past few weeks about advancements in vaccines, and promises of a `magic bullet’ against H5N1. Happy talk, for the most part, as even the most optimistic assessment is a year for clinical trials, and if successful, our capacity for production is about 300 million doses a year. With 6 billion people on this planet, 300 million doses won’t go very far.
And of course, the avian flu virus is mutating constantly. We now know there are at least 4 distinct versions of it, and any one (or all) of them could mutate into a pandemic strain. How much immunity a vaccine made from today’s strain would confer on a mutated virus a year from now is unknown, but it is unlikely to be much.
Our hospitals are slowly admitting that they are simply unprepared to handle a pandemic. Most flu victims, they admit, will simply have to stay home. The number of respirators available is laughably small. Their supplies of anti-viral medication, masks, and gloves would be exhausted within the first few days of a pandemic. After that, hospital staff would have to choose between reporting for work and working without protection, or staying home and probably staying alive.
One estimate recently given was that a hospital with 600 beds would require 1.6 million disposal masks to handle a 6 week epidemic. And that assumes that the rules for infection control were relaxed.
Masks, of course, are not manufactured in this country. And the demand worldwide would preclude anywhere near enough being manufactured for, or shipped to, U.S. hospitals.
A large percentage of hospital staff has already expressed doubts that they would even show up for work during a pandemic. They know the protective measures will not be there for them, and without them, reporting to work would be fluicidal.
Corporate America is no better prepared. Absenteeism could run 50% or more. Some will be stricken by the flu, while others will simply feel going to work is too risky.
Non-essential businesses, such as restaurants, movie theatres, shopping malls, and any place where people can gather and spread the disease, will be closed by government mandate. Schools will close early, and stay closed for the duration.
The hit the economy will take from all of this will be dramatic. A pandemic could last months.
Insurance companies are sweating bullets. Imagine what happens if 1 million healthy young adults in this country die over a course of a couple of months.
And there is real concern over public utilities. Who will run the power plants, water treatment systems, and sewage systems during a pandemic?
It is too much to hope that a pandemic never comes. But we need to pray that it doesn’t happen this year or next. And we’d better seriously start tackling the deficits in our infrastructure now, because time and flu wait for no man.
The consensus of public health officials is that a pandemic is inevitable. The only question is when.
This is not a new conclusion. They’ve known it for a long time. But now, with the H5N1 virus spreading, and mutations appearing that make it more likely to become a H2H (human to human) transmissible disease, many scientists believe we are dangerously close to a global catastrophe.
In the past six months, governments and big business have started to take notice. After years of neglect, some of it bordering on criminal, they are beginning to face up to the grim reality of what would happen if another pandemic swept the globe.
In the past 30 years, we have all but destroyed our domestic ability to produce vaccines. Nearly all of it is produced overseas. The technology we use is more than 50 years old, and is slow and cumbersome. While in 1976, we had the ability to produce enough vaccine to inoculate the entire country in a little less than 8 months; today we can’t even produce enough to handle the seasonal flu.
Part of this is due to litigation in this country. Vaccines have sometimes caused side effects, and the liability costs make vaccine manufacturing a risky business. That, combined with the low price our government is willing to pay for vaccines, has driven most manufacturers to more lucrative ventures.
We are hearing these past few weeks about advancements in vaccines, and promises of a `magic bullet’ against H5N1. Happy talk, for the most part, as even the most optimistic assessment is a year for clinical trials, and if successful, our capacity for production is about 300 million doses a year. With 6 billion people on this planet, 300 million doses won’t go very far.
And of course, the avian flu virus is mutating constantly. We now know there are at least 4 distinct versions of it, and any one (or all) of them could mutate into a pandemic strain. How much immunity a vaccine made from today’s strain would confer on a mutated virus a year from now is unknown, but it is unlikely to be much.
Our hospitals are slowly admitting that they are simply unprepared to handle a pandemic. Most flu victims, they admit, will simply have to stay home. The number of respirators available is laughably small. Their supplies of anti-viral medication, masks, and gloves would be exhausted within the first few days of a pandemic. After that, hospital staff would have to choose between reporting for work and working without protection, or staying home and probably staying alive.
One estimate recently given was that a hospital with 600 beds would require 1.6 million disposal masks to handle a 6 week epidemic. And that assumes that the rules for infection control were relaxed.
Masks, of course, are not manufactured in this country. And the demand worldwide would preclude anywhere near enough being manufactured for, or shipped to, U.S. hospitals.
A large percentage of hospital staff has already expressed doubts that they would even show up for work during a pandemic. They know the protective measures will not be there for them, and without them, reporting to work would be fluicidal.
Corporate America is no better prepared. Absenteeism could run 50% or more. Some will be stricken by the flu, while others will simply feel going to work is too risky.
Non-essential businesses, such as restaurants, movie theatres, shopping malls, and any place where people can gather and spread the disease, will be closed by government mandate. Schools will close early, and stay closed for the duration.
The hit the economy will take from all of this will be dramatic. A pandemic could last months.
Insurance companies are sweating bullets. Imagine what happens if 1 million healthy young adults in this country die over a course of a couple of months.
And there is real concern over public utilities. Who will run the power plants, water treatment systems, and sewage systems during a pandemic?
It is too much to hope that a pandemic never comes. But we need to pray that it doesn’t happen this year or next. And we’d better seriously start tackling the deficits in our infrastructure now, because time and flu wait for no man.
Tuesday, February 07, 2006
Bits and pieces of the Puzzle
It’s been a busy couple of days for flubies. Lots of rumors, subtle hints in the media, and every once in awhile, a genuine news report.
For the first time that I’ve seen, a financial headline hinted that today’s stock market jitters were based, in part, on Bird Flu fears. Carried by ABC news, the headline screamed:
Stocks Fall After Bird Flu Strain Detection
The upshot of the story is that more dead birds, infected with H5N1, were found in Hong Kong. The authorities in Hong Kong are getting very nervous, and are enacting laws to outlaw the keeping of poultry in small family coops.
Meanwhile, in Lithuania, a sailor on a commercial freighter died, and the local doctors fear it was from avian flu. No test results back on that one, and the captain of the ship is balking at allowing an autopsy.
The Indonesian reports keep coming in, with more deaths reported, and more H5N1 positive test results. The WHO is not accepting these local tests as definitive, and will wait until they can run their own tests.
In Iraq, the uncle of the girl who died last month, who subsequently died 10 days later, was confirmed to have died of Avian Flu. Another suspected death, in the southern part of Iraq, has been linked to H5N1. Tests are pending.
As far as word from the quarantine area? There is none.
Researchers, including the noted virologist Dr. Robert Webster, have published a paper indicating that there are now FOUR distinct variants of the Avian Flu, which will make the development of a vaccine more difficult. They also concluded that the bird flu has been spread by both domestic poultry and migrating wild birds.
And this last little tidbit. The United States has announced that they will join forces with the Pasteur Institute in France to do their own Avian Flu investigations in S.E. Asia. Dissatisfaction over the performance of the UN and WHO these past few months is speculated as being behind this move, although no one is officially saying that.
As I said. It’s been a busy couple of days.
It’s been a busy couple of days for flubies. Lots of rumors, subtle hints in the media, and every once in awhile, a genuine news report.
For the first time that I’ve seen, a financial headline hinted that today’s stock market jitters were based, in part, on Bird Flu fears. Carried by ABC news, the headline screamed:
Stocks Fall After Bird Flu Strain Detection
The upshot of the story is that more dead birds, infected with H5N1, were found in Hong Kong. The authorities in Hong Kong are getting very nervous, and are enacting laws to outlaw the keeping of poultry in small family coops.
Meanwhile, in Lithuania, a sailor on a commercial freighter died, and the local doctors fear it was from avian flu. No test results back on that one, and the captain of the ship is balking at allowing an autopsy.
The Indonesian reports keep coming in, with more deaths reported, and more H5N1 positive test results. The WHO is not accepting these local tests as definitive, and will wait until they can run their own tests.
In Iraq, the uncle of the girl who died last month, who subsequently died 10 days later, was confirmed to have died of Avian Flu. Another suspected death, in the southern part of Iraq, has been linked to H5N1. Tests are pending.
As far as word from the quarantine area? There is none.
Researchers, including the noted virologist Dr. Robert Webster, have published a paper indicating that there are now FOUR distinct variants of the Avian Flu, which will make the development of a vaccine more difficult. They also concluded that the bird flu has been spread by both domestic poultry and migrating wild birds.
And this last little tidbit. The United States has announced that they will join forces with the Pasteur Institute in France to do their own Avian Flu investigations in S.E. Asia. Dissatisfaction over the performance of the UN and WHO these past few months is speculated as being behind this move, although no one is officially saying that.
As I said. It’s been a busy couple of days.
Sunday, February 05, 2006
Keep Your Eye on Indonesia
While our attention has been rivited on Turkey and Iraq these past few weeks, reports from Indonesia continue to come in, indicating that Avian Flu is alive and well in that country.
The only news we have from Iraq is more than 3 days old. Supposedly 400,000 people in 50 villages are under `quarantine'. As there are language barriers, translation difficulties, a war going on, and obvious attempts to quell any panic, exactly what they mean by this is unclear.
This lack of news from Iraq has caused a great deal of speculation on the Internet. Rumors abound. Dispatches from sources claiming to be in the infected area are unverifiable, and therefore suspect. Afterall, anybody can write something and claim they are on the scene.
Still, it's disturbing. If there was good news, you'd think the authorities would be anxious to broadcast it.
While our attention has been rivited on Turkey and Iraq these past few weeks, reports from Indonesia continue to come in, indicating that Avian Flu is alive and well in that country.
JAKARTA (AFP): Indonesia, which has already registered 16 bird flu deaths, is awaiting test results from the World Health Organization (WHO) on 11 more suspected infections, a health official said Sunday.Meanwhile, Hong Kong is preparing to outlaw all home poultry raising as more and more H5N1 positive birds are found in the city. Many residents claim they will slaughter, and eat their birds before they will turn them over to the authorities.
"The latest report we have shows that there has been a total of 23 cases of confirmed infection, 16 of them fatal, while we are still awaiting the result of WHO tests on 11 other probable cases, four of them fatal," said an official at the health ministry's bird flu information center.
The only news we have from Iraq is more than 3 days old. Supposedly 400,000 people in 50 villages are under `quarantine'. As there are language barriers, translation difficulties, a war going on, and obvious attempts to quell any panic, exactly what they mean by this is unclear.
This lack of news from Iraq has caused a great deal of speculation on the Internet. Rumors abound. Dispatches from sources claiming to be in the infected area are unverifiable, and therefore suspect. Afterall, anybody can write something and claim they are on the scene.
Still, it's disturbing. If there was good news, you'd think the authorities would be anxious to broadcast it.
Thursday, February 02, 2006
The First Casualty in an Epidemic
… is the truth.
Today, we are receiving conflicting reports from Iraq, and it is impossible right now to know what is true, and what is the result of mistranslations or deliberate deception.
Hot off the wires this morning is this report:
If true, then this is a serious turn of events. But is it true?
Seasonal flu is sweeping the world, a pesky but routine version of H3N2. With fears of Avian Flu running high, how many of these 162 suspected cases are nothing more than seasonal flu? Testing will take days. In some cases, weeks. The initial negative tests that we hear so much about in the news are often reversed a week or two later . . . after the patient has died.
I am reluctant to jump to any conclusions here. These reports are coming from a war torn area, with minimal health facilities, and more political agendas than you can count. I’ve repeatedly seen obviously flawed news accounts, where sloppy reporting has given the wrong impression.
Two days ago, the Iraqi Health Minister annouced that 5 mobile hospitals were being dispatched to Northern Iraq to help contain the virus. The next day, this was changed to 5 Ambulances.
Which version is true? Damn if I know.
However . . .if the number of H5N1 cases has really jumped from 12 yesterday, to 162 today . . . then Iraq may be the focal point of a real outbreak. One where Human to Human transmission is occurring. If this proves to be true, as Sherlock Holmes used to say, “The game is afoot”.
Time will tell.
Tick . . . Tick . . . Tick . . .
… is the truth.
Today, we are receiving conflicting reports from Iraq, and it is impossible right now to know what is true, and what is the result of mistranslations or deliberate deception.
Hot off the wires this morning is this report:
Al-Sulaimaniya, Iraq/Cairo (dpa) - A fresh bird flu scare has erupted in the Kurdish region in northern Iraq with reports of 162 suspected cases almost two weeks after a 15-year-old girl died of the deadly strain.
In the Thursday issue of pan-Arab daily al-Hayat, the head of the pre-emption committee in the Kurdistan Province Najm Eddin Mohammed announced that 162 people have been admitted to the diagnosis center on suspicion of contracting the virus.
Mohammed told al-Hayat that the virus has proliferated throughout Rania, a region southwest of al-Sulaymania on the border with Turkey, and described the influx as a “crisis.”
If true, then this is a serious turn of events. But is it true?
Seasonal flu is sweeping the world, a pesky but routine version of H3N2. With fears of Avian Flu running high, how many of these 162 suspected cases are nothing more than seasonal flu? Testing will take days. In some cases, weeks. The initial negative tests that we hear so much about in the news are often reversed a week or two later . . . after the patient has died.
I am reluctant to jump to any conclusions here. These reports are coming from a war torn area, with minimal health facilities, and more political agendas than you can count. I’ve repeatedly seen obviously flawed news accounts, where sloppy reporting has given the wrong impression.
Two days ago, the Iraqi Health Minister annouced that 5 mobile hospitals were being dispatched to Northern Iraq to help contain the virus. The next day, this was changed to 5 Ambulances.
Which version is true? Damn if I know.
However . . .if the number of H5N1 cases has really jumped from 12 yesterday, to 162 today . . . then Iraq may be the focal point of a real outbreak. One where Human to Human transmission is occurring. If this proves to be true, as Sherlock Holmes used to say, “The game is afoot”.
Time will tell.
Tick . . . Tick . . . Tick . . .
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