The Blog Curse
Just about everyone knows of the Sport's Illustrated cover curse. Any athlete who is having a good streak finds their picture on the cover, and invariably, goes into a slump.
Well, a couple of days ago I profiled the FluWiki. And you guessed it, they've had serious server problems and have been offline since then.
Obviously, this is all my fault.
The good news is, they are moving to a new server. They hope to be back up within a day or two. Bigger and better than ever.
I'll try to refrain from singing their praises. It won't be easy, because they are a class act. I just need to think of the common good.
Thursday, March 30, 2006
What's Your I.Q. ?
Readers of this blog, by now, know that I view the odds of a pandemic as being between 30% and 50% over the next 18 months. I also believe, the odds that it will be severe, greater than, or equal to the 1918 Spanish Flu Pandemic, as being about 30%.
Taken together, that puts my estimate of a nightmare scenario at about 10%.
Among avid flu watchers, that makes me a moderate.
There are many who would consider my estimates to be laughably low. So be it. I’ll take my 10% chance of doomsday with a grain of salt. But until we see a mutated virus, spreading rapidly from person to person, and leaving behind a high number of corpses, I’ll hold on to a little optimism.
But given the odds of any sort of pandemic pushing the 50/50 mark, it makes sense to prepare. Even the Federal Government is telling its citizens to be ready. Sadly, they give little guidance as to how much preparation is enough. They are caught between being prudent, and fearing that nothing will happen, and they will be accused of crying wolf.
Each individual must make their own risk assessment of the situation. Some folks are gearing up to ride out a year or longer, with enough food, medicine, and bottled water to enable them to remain isolated in their homes. Others have decided to prepare for a less dramatic event, and the average among those who are prepping seems to be supplies to last 3 to 6 months.
I would never tell someone not to prepare for a year. After all, if they can do it, and the worst case happens, they will be glad they did.
But for most of us, a year’s supply of food and medicine is not an achievable goal. For some, money is an obstacle. For others’ storage and logistics bar that possibility. And few of us can get a years supply of Rx’s ahead.
So what is prudent? What should we think of as a minimum stockpile?
I’m looking at 3 to 4 months. I understand that it may prove to be too little. But there are physical limits to what I can store. If a pandemic appears imminent, I’ll buy up some emergency supplies at the last minute. Rice and beans, if nothing else. But for now, I’m pretty comfortable with a pantry full of canned goods.
I’ve bought food I would eat, anyway. Food with a long shelf life. And I’ve spent only a couple of hundred dollars. If a pandemic doesn’t happen, I’ll consume what I’ve bought, or donate it to a food bank. The couple of hundred dollars is, for me, cheap insurance.
While no one can say for sure if a pandemic is coming, or how bad it will be, there are signs and portends.
Beginning to think this is some kind of global I.Q. test.
Those smart enough to be able to read for comprehension, and who are able to think logically, will prep.
Those lacking in fundamental cognitive skills, will simply believe the pied pipers of passivity, and will not prep.
A damn shame, as the final exam could be a real killer.
Readers of this blog, by now, know that I view the odds of a pandemic as being between 30% and 50% over the next 18 months. I also believe, the odds that it will be severe, greater than, or equal to the 1918 Spanish Flu Pandemic, as being about 30%.
Taken together, that puts my estimate of a nightmare scenario at about 10%.
Among avid flu watchers, that makes me a moderate.
There are many who would consider my estimates to be laughably low. So be it. I’ll take my 10% chance of doomsday with a grain of salt. But until we see a mutated virus, spreading rapidly from person to person, and leaving behind a high number of corpses, I’ll hold on to a little optimism.
But given the odds of any sort of pandemic pushing the 50/50 mark, it makes sense to prepare. Even the Federal Government is telling its citizens to be ready. Sadly, they give little guidance as to how much preparation is enough. They are caught between being prudent, and fearing that nothing will happen, and they will be accused of crying wolf.
Each individual must make their own risk assessment of the situation. Some folks are gearing up to ride out a year or longer, with enough food, medicine, and bottled water to enable them to remain isolated in their homes. Others have decided to prepare for a less dramatic event, and the average among those who are prepping seems to be supplies to last 3 to 6 months.
I would never tell someone not to prepare for a year. After all, if they can do it, and the worst case happens, they will be glad they did.
But for most of us, a year’s supply of food and medicine is not an achievable goal. For some, money is an obstacle. For others’ storage and logistics bar that possibility. And few of us can get a years supply of Rx’s ahead.
So what is prudent? What should we think of as a minimum stockpile?
I’m looking at 3 to 4 months. I understand that it may prove to be too little. But there are physical limits to what I can store. If a pandemic appears imminent, I’ll buy up some emergency supplies at the last minute. Rice and beans, if nothing else. But for now, I’m pretty comfortable with a pantry full of canned goods.
I’ve bought food I would eat, anyway. Food with a long shelf life. And I’ve spent only a couple of hundred dollars. If a pandemic doesn’t happen, I’ll consume what I’ve bought, or donate it to a food bank. The couple of hundred dollars is, for me, cheap insurance.
While no one can say for sure if a pandemic is coming, or how bad it will be, there are signs and portends.
Beginning to think this is some kind of global I.Q. test.
Those smart enough to be able to read for comprehension, and who are able to think logically, will prep.
Those lacking in fundamental cognitive skills, will simply believe the pied pipers of passivity, and will not prep.
A damn shame, as the final exam could be a real killer.
Wednesday, March 29, 2006
HEADLINES PROVE CONFUSING
News that the vaccine trials produced dismal results has produced a number of unusual headlines today. You'd think there'd be some consistancy. But then, you'd be wrong. The mainstream media is spinning this story a dozen different ways.
When you read something in the paper, or hear it on TV, take note. The following headlines are all on the same story.
Vaccine May Help Bird Flu - ClickOnDetroit.com
Bird Flu Vaccine Ineffective - USA TODAY
Early testing shows U.S. bird flu vaccine modestly effective - Dallas Morning News
Bird flu vaccine shows some promise, scientists say - Santa Barbara News Press
1st Bird-Flu Vaccine Only Partly Effective - WRAL.COM
Bird flu vaccine falls short - kare11.com
Well, which is it guys? Effective? Ineffective? Partly Effective? Falls short? Shows promise?
Surprisingly, USA TODAY is the only one that got it right.
If you're gonna B.S. the public, the least you could do is agree on the propaganda message!
News that the vaccine trials produced dismal results has produced a number of unusual headlines today. You'd think there'd be some consistancy. But then, you'd be wrong. The mainstream media is spinning this story a dozen different ways.
When you read something in the paper, or hear it on TV, take note. The following headlines are all on the same story.
Vaccine May Help Bird Flu - ClickOnDetroit.com
Bird Flu Vaccine Ineffective - USA TODAY
Early testing shows U.S. bird flu vaccine modestly effective - Dallas Morning News
Bird flu vaccine shows some promise, scientists say - Santa Barbara News Press
1st Bird-Flu Vaccine Only Partly Effective - WRAL.COM
Bird flu vaccine falls short - kare11.com
Well, which is it guys? Effective? Ineffective? Partly Effective? Falls short? Shows promise?
Surprisingly, USA TODAY is the only one that got it right.
If you're gonna B.S. the public, the least you could do is agree on the propaganda message!
GOOD NEWS/BAD NEWS
First the good news: The US government has bought 162 million dollars worth of vaccine for the Avian Flu. This vaccine is based on the Vietnam Strain of the virus, and has recently been tested on 400 volunteers.
And it is with a great sense of relief I can report that the vaccine appears to be safe. No major side effects were observed.
Now the bad news: The vaccine doesn't work very well. Not well at all.
Only those test subjects who received 2 shots, 1 month apart, and at the highest dose, achieved any level of immunity. And of those, only a little more than half developed protective antibodies.
The hope was that this vaccine would innoculate 20 million people. At the levels indicated by these tests, they would produce only 4 million effective doses. And of those, only half would work.
So, dissapointment reigns in the vaccine world today. We obviously have a long way to go.
BUT, news of a chinese scientist making a serum from infected horses that confered immunity to mice has made the news. Surely, this could save our collective bacon?
Not likely. Horse serum is fraught with problems, not the least of which is the high incidence of serum sickness that it can induce. It is unlikely that any western nation would approve its use, and besides, producing serum in quantity from horses would be very difficult.
Serums, by the way, only confer short-term immunity. A couple of weeks protection. They could be used for front line personnel who are directly in contact with the virus, but once again, are not a cure.
There are still avenues to persue; adjuvants, antivirals, and new vaccine techinques. By no means is a preventative out of our reach.
We just need time, money, and more time.
First the good news: The US government has bought 162 million dollars worth of vaccine for the Avian Flu. This vaccine is based on the Vietnam Strain of the virus, and has recently been tested on 400 volunteers.
And it is with a great sense of relief I can report that the vaccine appears to be safe. No major side effects were observed.
Now the bad news: The vaccine doesn't work very well. Not well at all.
Only those test subjects who received 2 shots, 1 month apart, and at the highest dose, achieved any level of immunity. And of those, only a little more than half developed protective antibodies.
The hope was that this vaccine would innoculate 20 million people. At the levels indicated by these tests, they would produce only 4 million effective doses. And of those, only half would work.
So, dissapointment reigns in the vaccine world today. We obviously have a long way to go.
BUT, news of a chinese scientist making a serum from infected horses that confered immunity to mice has made the news. Surely, this could save our collective bacon?
Not likely. Horse serum is fraught with problems, not the least of which is the high incidence of serum sickness that it can induce. It is unlikely that any western nation would approve its use, and besides, producing serum in quantity from horses would be very difficult.
Serums, by the way, only confer short-term immunity. A couple of weeks protection. They could be used for front line personnel who are directly in contact with the virus, but once again, are not a cure.
There are still avenues to persue; adjuvants, antivirals, and new vaccine techinques. By no means is a preventative out of our reach.
We just need time, money, and more time.
CANADIAN PANDEMIC PLAN UNMASKED
The Canadian government has set up a pandemic flu website for it's citizens. Here, our northern neighbors will find a sobering assessment of what can, and cannot, be done during a pandemic.
The information here describes a pandemic where 58,000 Canadians could die. They give no hope for a vaccine, or even an adequate supply of anti-virals to be available.
Health Canada concedes that citizens can't do much to fend off infection except wash their hands. They go on to say that soap, and hand sanitizers may be in short supply. They even state that the use of masks by the general public, would be of little value, once the virus is unleashed into their community.
This advice on masks, however, flies in the face of what other experts have been saying. Many doctors believe that masks are effective in reducing the risk of contracting the disease.
So why the disconnect? Why discourage the use of masks?
Here I can only speculate.
A pandemic could last 18 months, coming in multiple waves that could go on for weeks or months at a time. Masks are considered disposable, and you are lucky to get 8 hours wear out of one. To have enough masks on hand to last for a year and a half, requires a large stockpile.
With 33 Million Canadians, if each person had only 100 masks, that would require the stockpiling of 3 BILLION masks. At a dollar each, that's a pretty heavy pricetag.
Worse, if the public bought up masks in these quantities, there would be precious few available for health care workers, first responders, and essential workers. A mask shortage, already anticipated, would grow far worse.
Here in the US, with 10 times the population, we'd need 30 Billion masks, and that isn't likely to happen either.
In Canada, there may be fear that the government would be expected to supply masks to the public. Or perhaps it is just a fear that the haves and have-nots will come to blows during a pandemic.
I would imagine that the easiest solution is to dispell the idea that masks will help, except for medical personnel dealing with infectious patients. The supply of masks is finite. Those at greatest risk, should have them. The general public should not.
And all of that makes sense. It isn't practical for the entire populace to stockpile masks.
That said, I have a small cache of masks at home. Far less than 100. But enough to allow me to move about in public during a pandemic if the occasion arrives. I think it is simply prudent.
This blog doesn't reach a lot of people. Perhaps 30 or 40 people read it with any regularity. So to those I say, get some masks while they are still available. You won't make a dent in the national supply.
You want, if possible, N95 masks. Surigcal masks are cheaper, but are probably less effective. A contractor's pack of 20 can be had at most large hardware stores for under $20.00.
The Federal government has already stated that they will be unable to help much if a pandemic occurs. They say you have to be willing to help yourselves.
So, as long as masks are still available, I agree with them.
Help yourselves.
The Canadian government has set up a pandemic flu website for it's citizens. Here, our northern neighbors will find a sobering assessment of what can, and cannot, be done during a pandemic.
The information here describes a pandemic where 58,000 Canadians could die. They give no hope for a vaccine, or even an adequate supply of anti-virals to be available.
Health Canada concedes that citizens can't do much to fend off infection except wash their hands. They go on to say that soap, and hand sanitizers may be in short supply. They even state that the use of masks by the general public, would be of little value, once the virus is unleashed into their community.
This advice on masks, however, flies in the face of what other experts have been saying. Many doctors believe that masks are effective in reducing the risk of contracting the disease.
So why the disconnect? Why discourage the use of masks?
Here I can only speculate.
A pandemic could last 18 months, coming in multiple waves that could go on for weeks or months at a time. Masks are considered disposable, and you are lucky to get 8 hours wear out of one. To have enough masks on hand to last for a year and a half, requires a large stockpile.
With 33 Million Canadians, if each person had only 100 masks, that would require the stockpiling of 3 BILLION masks. At a dollar each, that's a pretty heavy pricetag.
Worse, if the public bought up masks in these quantities, there would be precious few available for health care workers, first responders, and essential workers. A mask shortage, already anticipated, would grow far worse.
Here in the US, with 10 times the population, we'd need 30 Billion masks, and that isn't likely to happen either.
In Canada, there may be fear that the government would be expected to supply masks to the public. Or perhaps it is just a fear that the haves and have-nots will come to blows during a pandemic.
I would imagine that the easiest solution is to dispell the idea that masks will help, except for medical personnel dealing with infectious patients. The supply of masks is finite. Those at greatest risk, should have them. The general public should not.
And all of that makes sense. It isn't practical for the entire populace to stockpile masks.
That said, I have a small cache of masks at home. Far less than 100. But enough to allow me to move about in public during a pandemic if the occasion arrives. I think it is simply prudent.
This blog doesn't reach a lot of people. Perhaps 30 or 40 people read it with any regularity. So to those I say, get some masks while they are still available. You won't make a dent in the national supply.
You want, if possible, N95 masks. Surigcal masks are cheaper, but are probably less effective. A contractor's pack of 20 can be had at most large hardware stores for under $20.00.
The Federal government has already stated that they will be unable to help much if a pandemic occurs. They say you have to be willing to help yourselves.
So, as long as masks are still available, I agree with them.
Help yourselves.
Tuesday, March 28, 2006
Something Wiki this Way Comes
For those readers of this blog who wish to take one step deeper into the avian flu pool, I would recommend a trip to the FluWiki.
What, exactly, is a Wiki?
A Wiki is a web resource, created by its members. Anyone can contribute. It is a think tank of sorts. In this case, a user created Encyclopedia Influenza.
From the Fluwiki website, this is how they describe themselves:
My first reaction when I heard about it was: This can't possibly work.
After all, if the members write it, and other members can come in and change it, it would be chaos. Right?
Wrong.
After 3 months on this site, I've changed my tune. It works, and most of the time damn well. Thanks to the moderators: Melanie, DemFromCt, and Pogge; the place runs like a well-oiled machine. Most of the time, anyway.
The wiki does suffer from growing pains. On occasion, their server has experienced outages. And we get a visit from the occasional troll. But these problems are transient, and are quickly remedied.
The wiki is divided into numerous sections. One side of the wiki is basically reference material. And here you will find the largest repository of influenza information on the Internet. Articles written by virologists, medical doctors, psychologists, health officials, and housewives. Very eclectic, and varying in sophistication, but full of valuable information.
The other side of the wiki are the discussion threads. Unlike many flu forums on the net, the focus here is on the science, and on how to deal with a pandemic, and less on politics or hard core (read:guns, guns, guns) survivalism.
A visit to the discussion forum will produce thousands of threads (you can search to find old topics) where people are simultaneously discussing the best way to can food, where to buy N95 masks, the science behind the polymorphism of the virus, how to build an LED lantern, and the best ways to deliver goods and services to communities during a pandemic.
The level of discussion here is, most of the time, more thoughtful and more rational than other sites that cater to flubies. When a discussion thread goes off track (and they do, occasionally), one of the mods will step in and redirect it. If that doesn't work, the thread is closed.
The purpose of the wiki is to unite people, to empower them: not divide them. It can be a difficult job for the moderators, but they do it exceedingly well.
One of the most fascinating series of discussions has been on what healthcare workers will do during a pandemic. You need to read this to really get an idea of what we are up against and how poorly prepared hospitals really are when dealing with a pandemic. HCW's are being asked to go to the front lines, and have not been assured of having even the basic protections afforded to them of masks and gloves. The debate, often, is passionate.
Featured on CNN, in Science Magazine, and in feature articles on the national news wires, the wiki is rapidly becoming the best source of flu information on the net. And we have some real heavyweights who post regularly. Many use pseudonyms, in order to talk freely. I know who some of these folks really are, and their backgrounds, and I am impressed.
We're talking doctors, scientists, public health officials, and health care workers. And while they patiently debate the intricacies of the influenza virus at a level I could only hope to understand someday, they all fit seamlessly into the less scientific threads.
You don't have to be a rocket scientist (although we have at least one on board) to enjoy, and learn from the wiki.
To Melanie, DemFromCt, and Pogge. My hat is off to you. You've created something truly unique.
And we do more than talk on the wiki. Members are working on projects that will help our communities during a pandemic. A series of videos, to be available freely off the net, are being planned on how to care for a flu victim at home. The feeling is, if the government won't do it. We will.
These projects aren't really a part of the wiki. They spring forth from our discussions, and members join with one another, to make them happen.
Behold, the power of the wiki.
For those who wish to talk politics, religion, conspiracy theories, or the stopping power of a .40 caliber vs a .45 caliber handgun, this place really isn't for you. But if you are looking for the best discussions on how to deal with a pandemic, the latest research information on pandemic flu, or just need a sane and safe place to relate to others preparing for a pandemic.
The wiki is the place you want to be.
www.fluwikie.com
For those readers of this blog who wish to take one step deeper into the avian flu pool, I would recommend a trip to the FluWiki.
What, exactly, is a Wiki?
A Wiki is a web resource, created by its members. Anyone can contribute. It is a think tank of sorts. In this case, a user created Encyclopedia Influenza.
From the Fluwiki website, this is how they describe themselves:
The purpose of the Flu Wiki is to help local communities prepare for and perhaps cope with a possible influenza pandemic. This is a task previously ceded to local, state and national governmental public health agencies. Our goal is to be:
- a reliable source of information, as neutral as possible, about important facts useful for a public health approach to pandemic influenza
- a venue for anticipating the vast range of problems that may arise if a pandemic does occur
- a venue for thinking about implementable solutions to foreseeable problems
My first reaction when I heard about it was: This can't possibly work.
After all, if the members write it, and other members can come in and change it, it would be chaos. Right?
Wrong.
After 3 months on this site, I've changed my tune. It works, and most of the time damn well. Thanks to the moderators: Melanie, DemFromCt, and Pogge; the place runs like a well-oiled machine. Most of the time, anyway.
The wiki does suffer from growing pains. On occasion, their server has experienced outages. And we get a visit from the occasional troll. But these problems are transient, and are quickly remedied.
The wiki is divided into numerous sections. One side of the wiki is basically reference material. And here you will find the largest repository of influenza information on the Internet. Articles written by virologists, medical doctors, psychologists, health officials, and housewives. Very eclectic, and varying in sophistication, but full of valuable information.
The other side of the wiki are the discussion threads. Unlike many flu forums on the net, the focus here is on the science, and on how to deal with a pandemic, and less on politics or hard core (read:guns, guns, guns) survivalism.
A visit to the discussion forum will produce thousands of threads (you can search to find old topics) where people are simultaneously discussing the best way to can food, where to buy N95 masks, the science behind the polymorphism of the virus, how to build an LED lantern, and the best ways to deliver goods and services to communities during a pandemic.
The level of discussion here is, most of the time, more thoughtful and more rational than other sites that cater to flubies. When a discussion thread goes off track (and they do, occasionally), one of the mods will step in and redirect it. If that doesn't work, the thread is closed.
The purpose of the wiki is to unite people, to empower them: not divide them. It can be a difficult job for the moderators, but they do it exceedingly well.
One of the most fascinating series of discussions has been on what healthcare workers will do during a pandemic. You need to read this to really get an idea of what we are up against and how poorly prepared hospitals really are when dealing with a pandemic. HCW's are being asked to go to the front lines, and have not been assured of having even the basic protections afforded to them of masks and gloves. The debate, often, is passionate.
Featured on CNN, in Science Magazine, and in feature articles on the national news wires, the wiki is rapidly becoming the best source of flu information on the net. And we have some real heavyweights who post regularly. Many use pseudonyms, in order to talk freely. I know who some of these folks really are, and their backgrounds, and I am impressed.
We're talking doctors, scientists, public health officials, and health care workers. And while they patiently debate the intricacies of the influenza virus at a level I could only hope to understand someday, they all fit seamlessly into the less scientific threads.
You don't have to be a rocket scientist (although we have at least one on board) to enjoy, and learn from the wiki.
To Melanie, DemFromCt, and Pogge. My hat is off to you. You've created something truly unique.
And we do more than talk on the wiki. Members are working on projects that will help our communities during a pandemic. A series of videos, to be available freely off the net, are being planned on how to care for a flu victim at home. The feeling is, if the government won't do it. We will.
These projects aren't really a part of the wiki. They spring forth from our discussions, and members join with one another, to make them happen.
Behold, the power of the wiki.
For those who wish to talk politics, religion, conspiracy theories, or the stopping power of a .40 caliber vs a .45 caliber handgun, this place really isn't for you. But if you are looking for the best discussions on how to deal with a pandemic, the latest research information on pandemic flu, or just need a sane and safe place to relate to others preparing for a pandemic.
The wiki is the place you want to be.
www.fluwikie.com
Saturday, March 25, 2006
Slow Saturday : More bird flu Limericks!
The virus Orthomyxoviridae
With birds was having its way
In fowls it’s endemic
So someday a pandemic
But when, nobody can say
It started with poultry in Hong Kong
And was spread thru out Asia before long
Migratory birds made it spread
Now more than a hundred are dead
Are Wild birds are now singing our swan song?
We live in a world of distraction
And are lulled into fatal inaction
With news for the masses
And a sling for our Asses
I fear awareness will never gain traction
It’s just a new bird influenza
So I’m counting on my powdered relenza
So the end may be near
Say the prophets of fear
As we've no vaccine to take to defendz us
Ten pills of tamiflu won’t do
When combating the avian flu
I ask for more doses
But my doc says neurosis!
What's a poor prepper to do?
It starts out with fevers and aches
And soon cytokine proteins it makes
When my lungs start to filling
The thought is so chilling
That my Internet Tamiflu’s a fake
Isolation is definitely my plan
When the bird feces encounter the fan
My beans and my rice
I pray will suffice
For me and the rest of my clan
It’s over and I’m beginning to hope
That for our leaders who weren’t able to cope
We’ll throw a big party
And laugh hale and hearty
And I'll pray that someone remembers a rope!
The virus Orthomyxoviridae
With birds was having its way
In fowls it’s endemic
So someday a pandemic
But when, nobody can say
It started with poultry in Hong Kong
And was spread thru out Asia before long
Migratory birds made it spread
Now more than a hundred are dead
Are Wild birds are now singing our swan song?
We live in a world of distraction
And are lulled into fatal inaction
With news for the masses
And a sling for our Asses
I fear awareness will never gain traction
It’s just a new bird influenza
So I’m counting on my powdered relenza
So the end may be near
Say the prophets of fear
As we've no vaccine to take to defendz us
Ten pills of tamiflu won’t do
When combating the avian flu
I ask for more doses
But my doc says neurosis!
What's a poor prepper to do?
It starts out with fevers and aches
And soon cytokine proteins it makes
When my lungs start to filling
The thought is so chilling
That my Internet Tamiflu’s a fake
Isolation is definitely my plan
When the bird feces encounter the fan
My beans and my rice
I pray will suffice
For me and the rest of my clan
It’s over and I’m beginning to hope
That for our leaders who weren’t able to cope
We’ll throw a big party
And laugh hale and hearty
And I'll pray that someone remembers a rope!
Friday, March 24, 2006
Something to Think About
Over the past several months, the US government has begun urging Americans to stockpile food and medicine. They've committed 3 Billion dollars to stockpile antivirals and work on vaccines. And HHS secretary Mike Levitt has visited half of the states in our nation to urge state and local governments to prepare for an `almost inevitable' pandemic.
Where are the nay sayers? (bloggers and book authors with an agenda don't count)
Where are the political opportunist's crying fowl? (yep, I spelled it that way on purpose).
Why aren't opposition candidates sneering at all of this time and expense, and charging that this is just a way to divert attention from Iraq?
Where are those voices who you'd expect to be demanding that our precious resources be spent on rebuilding New Orleans, or increasing Medicaid funding, or funding alternative fuel research?
While not everyone is on the bandwagon, I hear no strident voices of dissent in the halls of congress. No demands that the Bush administration stop scaring the public. Even the silence from some politicians, who have not gone on record supporting these steps, speaks volumes.
When was the last time this happened? When was the last time you saw petty politics give way to something more important?
The immediate aftermath of 9/11 comes to mind. But other than that . . .
What do the politico's know, that we aren't being told? What could possibly dissuade them from using bird flu to score political points? This is an election year, for Pete's sake!
Like I said, it's something to think about.
Over the past several months, the US government has begun urging Americans to stockpile food and medicine. They've committed 3 Billion dollars to stockpile antivirals and work on vaccines. And HHS secretary Mike Levitt has visited half of the states in our nation to urge state and local governments to prepare for an `almost inevitable' pandemic.
Where are the nay sayers? (bloggers and book authors with an agenda don't count)
Where are the political opportunist's crying fowl? (yep, I spelled it that way on purpose).
Why aren't opposition candidates sneering at all of this time and expense, and charging that this is just a way to divert attention from Iraq?
Where are those voices who you'd expect to be demanding that our precious resources be spent on rebuilding New Orleans, or increasing Medicaid funding, or funding alternative fuel research?
While not everyone is on the bandwagon, I hear no strident voices of dissent in the halls of congress. No demands that the Bush administration stop scaring the public. Even the silence from some politicians, who have not gone on record supporting these steps, speaks volumes.
When was the last time this happened? When was the last time you saw petty politics give way to something more important?
The immediate aftermath of 9/11 comes to mind. But other than that . . .
What do the politico's know, that we aren't being told? What could possibly dissuade them from using bird flu to score political points? This is an election year, for Pete's sake!
Like I said, it's something to think about.
A MUST READ
Dr. Michael Osterholm, a frequent adivsor to both the Clinton and Bush administration, probably understands the logistics of a pandemic better than anyone else in our nation. He heads up CIDRAP, the Center for Infectious Disease Reporting and Policy, and is a very smart man indeed.
He recently gave an interview, which is published here:
http://tinyurl.com/krwqv
Pour yourself a stiff drink. And go read it. Better make it a double.
Dr. Osterholm is no wild-eyed fringe lunatic. Think Patton in a lab coat.
And yes, a third drink is permissible. But only after you've read the whole thing.
Dr. Michael Osterholm, a frequent adivsor to both the Clinton and Bush administration, probably understands the logistics of a pandemic better than anyone else in our nation. He heads up CIDRAP, the Center for Infectious Disease Reporting and Policy, and is a very smart man indeed.
He recently gave an interview, which is published here:
http://tinyurl.com/krwqv
Pour yourself a stiff drink. And go read it. Better make it a double.
Dr. Osterholm is no wild-eyed fringe lunatic. Think Patton in a lab coat.
And yes, a third drink is permissible. But only after you've read the whole thing.
Thursday, March 23, 2006
Swine Flu Redux
I was a young paramedic at the time of the swine flu scare, and was loaned out to the County Health Department to assist in their innoculation program and public awareness program.
Basically, I was put on the `rubber chicken circuit’ over the summer and gave lectures at the rotary, kiwanis, Elks, etc. I was part of the civil defense planning commission, inservice instructor for our County EMS, and that fall, gave several thousand flu shots for the health department. We set up in shopping malls, schools, community centers, etc.
I can tell you that, while there was deep concern over a pandemic back then, it didn’t rise to the level we are seeing today. Of course, this was before CNN, and 24 hour cable news, and the Internet. Almost no comparisons were made to the Spanish Flu.
There were probably political considerations at the highest levels, but I believe they really did perceive a threat. The emergence of Swine flu at Fort Dix was a bit of a shock. The feeling was, we’d dodged a bullet in 1968 with the Hong Kong Flu.
While the decision to try to innoculate the nation before additional cases broke out turned out to be ill fated, I believe it was well intentioned. It was debated, and decided, that waiting until an outbreak occured would be too risky. So the decision was to innoculate the country prophylactically.
The vaccine was blamed for a lot of deaths, and cases of guillian-berre syndrome (a form of paralysis). The fear of the vaccine was exacerbated by newspaper speculation. But the truth is, we were vaccinating a lot of elderly people, and many of their deaths, while attributed to the vaccine in the press, may have been from other causes.
We learned a lot about mass innoculations, and the difficulties of pulling off that sort of thing. Lessons that to this day worry me. The glib response that we `could have a vaccine within 6 months’ of the virus going H2H is just a tad optimistic, IMHO.
Sure, we might have it in the lab. Maybe even in quantity. But getting it out to the people will be a logistical nightmare. We managed to innoculate 40 million people in 8 weeks. And this was a national priority. And it was before any pandemic had struck.
I can tell you that my level of concern this time is much higher. Mostly due to the high CFR of H5N1. This is a different critter, altogether. And frankly, my perception is we were better equiped back then to handle an outbreak. Less reliance on just-in-time inventory deliveries.
While we did not see a swine flu outbreak, the following year we did see the A VICTORIA outbreak, and back then, it killed 36,000 people in the US, and overwhelmed the hospitals. We were seeing, and transporting, flu patients every day. Hospitals were often closed due to having no beds. ER’s would shut down due to overload. A lot of nurses and docs were out with the flu, as were some medics. I guess I was lucky, as I didn’t catch it.
So all of this, for me, is a case of Deja-Flu.
I was a young paramedic at the time of the swine flu scare, and was loaned out to the County Health Department to assist in their innoculation program and public awareness program.
Basically, I was put on the `rubber chicken circuit’ over the summer and gave lectures at the rotary, kiwanis, Elks, etc. I was part of the civil defense planning commission, inservice instructor for our County EMS, and that fall, gave several thousand flu shots for the health department. We set up in shopping malls, schools, community centers, etc.
I can tell you that, while there was deep concern over a pandemic back then, it didn’t rise to the level we are seeing today. Of course, this was before CNN, and 24 hour cable news, and the Internet. Almost no comparisons were made to the Spanish Flu.
There were probably political considerations at the highest levels, but I believe they really did perceive a threat. The emergence of Swine flu at Fort Dix was a bit of a shock. The feeling was, we’d dodged a bullet in 1968 with the Hong Kong Flu.
While the decision to try to innoculate the nation before additional cases broke out turned out to be ill fated, I believe it was well intentioned. It was debated, and decided, that waiting until an outbreak occured would be too risky. So the decision was to innoculate the country prophylactically.
The vaccine was blamed for a lot of deaths, and cases of guillian-berre syndrome (a form of paralysis). The fear of the vaccine was exacerbated by newspaper speculation. But the truth is, we were vaccinating a lot of elderly people, and many of their deaths, while attributed to the vaccine in the press, may have been from other causes.
We learned a lot about mass innoculations, and the difficulties of pulling off that sort of thing. Lessons that to this day worry me. The glib response that we `could have a vaccine within 6 months’ of the virus going H2H is just a tad optimistic, IMHO.
Sure, we might have it in the lab. Maybe even in quantity. But getting it out to the people will be a logistical nightmare. We managed to innoculate 40 million people in 8 weeks. And this was a national priority. And it was before any pandemic had struck.
I can tell you that my level of concern this time is much higher. Mostly due to the high CFR of H5N1. This is a different critter, altogether. And frankly, my perception is we were better equiped back then to handle an outbreak. Less reliance on just-in-time inventory deliveries.
While we did not see a swine flu outbreak, the following year we did see the A VICTORIA outbreak, and back then, it killed 36,000 people in the US, and overwhelmed the hospitals. We were seeing, and transporting, flu patients every day. Hospitals were often closed due to having no beds. ER’s would shut down due to overload. A lot of nurses and docs were out with the flu, as were some medics. I guess I was lucky, as I didn’t catch it.
So all of this, for me, is a case of Deja-Flu.
Bad Reports All Over
Yesterday, dozens (perhaps hundreds) of newspapers ran with an article stating that scientists had discovered why the bird flu did not pass from human to human, and suggested concerns over the virus in man were overblown.
While all of this may sound great, there is nothing in this report that we didn't already know. Or at least, strongly suspect.
We've known the virus's ability to pass H2H is very limited. And that it starts deep in the lungs, not the upper respiratory tract, as with most influenzas. We've know it was attuned to avian receptors, not human receptors. And that it would have to mutate before it could go pandemic.
Absolutely nothing has changed here. The media has latched on to a story, and has blown it out of proportion.
That isn't to say this study is not without value. And that there isn't at least a little hope in it. There is.
This reports tells us, that until a crucial mutation occurs, the likelihood of catching this disease from wild birds is very small. Good news, given the expectation that avian flu will arrive in migratory birds this summer in the U.S. Unless you hunt birds, and clean them, or somehow come in close contact with our feathered flu carriers, you are pretty safe.
But we've known that. In the past 3 years, with millions of birds infected, less than 200 humans have contracted the disease. Many thousands of people have worked with infected poultry, yet few have been infected.
This report also explains why early tests for avian flu, taken with nasal and mouth swabs, have turned out negative. This despite the fact that many of these patients go on to die, and we find out later that they did, indeed, have H5N1. The virus doesn't like the cells of the mouth and nose! So it doesn't reside there.
This certainly isn't good news. It means that the quick and dirty testing going on in many parts of the world simply won't pick up the disease. But once again, we've known that, too.
The only question that is really pertinent is: Can this virus mutate to have an affinitity to human receptors?
And the only answer we have is, it hasn't yet.
This report does nothing to suggest, in anyway, how the virus may mutate in the future. What we do know is, the virus is mutating, and at an alarming rate. It is closer today to a H2H virus than it was 2 years ago. And the opportunities for it to mutate, grow each day.
Is there some natural barrier, some genetic roadblock, that can prevent this virus from obtaining the ability to pass from man to man? History tells us that other avian virus's have made this leap, so it seems a bit optimistic to believe this one can't.
But there are subtle, tho important differences between words like can't and won't. Right now, we don't know if it will happen. It may not. We may get lucky. But there is no reason to believe it can't.
And that, is worrisome indeed.
Yesterday, dozens (perhaps hundreds) of newspapers ran with an article stating that scientists had discovered why the bird flu did not pass from human to human, and suggested concerns over the virus in man were overblown.
While all of this may sound great, there is nothing in this report that we didn't already know. Or at least, strongly suspect.
We've known the virus's ability to pass H2H is very limited. And that it starts deep in the lungs, not the upper respiratory tract, as with most influenzas. We've know it was attuned to avian receptors, not human receptors. And that it would have to mutate before it could go pandemic.
Absolutely nothing has changed here. The media has latched on to a story, and has blown it out of proportion.
That isn't to say this study is not without value. And that there isn't at least a little hope in it. There is.
This reports tells us, that until a crucial mutation occurs, the likelihood of catching this disease from wild birds is very small. Good news, given the expectation that avian flu will arrive in migratory birds this summer in the U.S. Unless you hunt birds, and clean them, or somehow come in close contact with our feathered flu carriers, you are pretty safe.
But we've known that. In the past 3 years, with millions of birds infected, less than 200 humans have contracted the disease. Many thousands of people have worked with infected poultry, yet few have been infected.
This report also explains why early tests for avian flu, taken with nasal and mouth swabs, have turned out negative. This despite the fact that many of these patients go on to die, and we find out later that they did, indeed, have H5N1. The virus doesn't like the cells of the mouth and nose! So it doesn't reside there.
This certainly isn't good news. It means that the quick and dirty testing going on in many parts of the world simply won't pick up the disease. But once again, we've known that, too.
The only question that is really pertinent is: Can this virus mutate to have an affinitity to human receptors?
And the only answer we have is, it hasn't yet.
This report does nothing to suggest, in anyway, how the virus may mutate in the future. What we do know is, the virus is mutating, and at an alarming rate. It is closer today to a H2H virus than it was 2 years ago. And the opportunities for it to mutate, grow each day.
Is there some natural barrier, some genetic roadblock, that can prevent this virus from obtaining the ability to pass from man to man? History tells us that other avian virus's have made this leap, so it seems a bit optimistic to believe this one can't.
But there are subtle, tho important differences between words like can't and won't. Right now, we don't know if it will happen. It may not. We may get lucky. But there is no reason to believe it can't.
And that, is worrisome indeed.
Wednesday, March 22, 2006
ARE WE GETTING CLOSER?
Reports out of Azerbaijan and the former soviet republic of Georgia are deeply disturbing. Testing and reporting from Nigeria is non-existent. Indonesia continues to percolate, and Turkey and China are less than forthcoming with information. Egypt now has 4 human cases, and Israel is slaughtering fowl.
The WHO now reports that the virus has developed into two distinct strains. Each are mutating as they spread around the world. Each (or both) has the potential to turn into a pandemic. There are probably more strains, but countries like China and Indonesia are withholding data.
In Georgia, 3 soldiers are in intensive care with severe respiratory problems and reported hemorrhaging from the nose. Nineteen additional soldiers are reported to be ill, with lesser symptoms. Is this H5N1? We don’t know. The reports of hemorrhage, a common symptom in H5N1, are worrisome.
In Azerbaijan, 5 are dead from Avian Flu. All from the same village, all related. Early reports indicated they did not have direct contact with infected birds. Then, a report surfaced that they may have collected feathers from dead swans. Hard to know what is true here, but the time lag between the dates each fell ill indicate they all weren’t likely infected at the same time. This is a very suspicious cluster, and may indicate Human to Human transmission.
Each day brings new reports. Human cases, bird deaths, dogs, cats, and martens. And very disturbing stories of large scale die offs of pigs in India, Nepal, and Africa. Swine can carry the influenza virus, and would make the perfect mixing bowl for the virus to mutate.
On the home front, suddenly our government is talking far more seriously about the effects of a pandemic. They are telling us not to panic. Warning the press to be responsible in their reporting. And now are trying to openly discourage the use of masks for the masses and the private acquisition of Tamiflu.
And the prospects of a vaccine, often mentioned as not being available for at least six months after a pandemic begins, seems to dim with each passing day. With two strains out there, this will make vaccine production even harder. And as the virus mutates, we could be looking at multiple pandemics over a period of time.
Some health officials are talking a year, perhaps two, after a pandemic begins before enough vaccine would be available for the masses.
So, are we closer today? It certainly feels like it. But the virus must still make a crucial mutation before it comes a human pandemic. That might never happen. Or perhaps it already has, and we don’t know yet. The odds are, we won’t be aware that it has happened until a week or two has already passed.
But I can tell you that the experts are growing more concerned, not less.
Monday, March 20, 2006
The Exercise below
While I personally do not believe we are looking at a pandemic of the magnitude described in the fictional scenario below, I offer this as an example of the difficult decisions that might have to be made in the face of a pandemic.
A more likely scenario would be for a pandemic like we saw in 1918, where 30% of the country contracted the illness, and perhaps 5% of those died.
However, to date, the CFR (case fatality rate) of the Avian Flu has run over 50%. No one knows if it will decrease in its lethality if it should turn into a pandemic.
So the little exercise below is not beyond the realm of possibilities.
While I personally do not believe we are looking at a pandemic of the magnitude described in the fictional scenario below, I offer this as an example of the difficult decisions that might have to be made in the face of a pandemic.
A more likely scenario would be for a pandemic like we saw in 1918, where 30% of the country contracted the illness, and perhaps 5% of those died.
However, to date, the CFR (case fatality rate) of the Avian Flu has run over 50%. No one knows if it will decrease in its lethality if it should turn into a pandemic.
So the little exercise below is not beyond the realm of possibilities.
YOU MAKE THE CALL
The Date: Sometime in the Next 5 years.
We now take you into the very bowels of the Whitehouse’s command center, located 3 stories below ground, where an emergency meeting of the President (POTUS), his National Security Director (NSD), the Secretary of Defense (SECDEF), and two leading virologists, Dr. Payne and Dr. Goodman are meeting. The subject at hand, a potential pandemic.
NSD: Mr. President, I’ll allow Dr. Payne to go first. Please proceed.
Dr. Payne: Mr. President, I along with many of my colleagues, are convinced this virus will mutate within the next year, and spread rapidly around the globe. We have no reason to believe than mankind will have any immunity, and we fully expect the CFR to run between 50% and 80%. In our view, when this happens, somewhere in the vicinity of 3 to 5 billion people will perish from the disease, and from collateral damage.
POTUS: Good God! We need to warn our people now!
NSD: Mr. President, before we take that step, perhaps you should hear from Dr. Goodman.
Dr. Goodman: Mr. President, I represent a group of notable scientists that take serious issues with Dr. Payne’s predictions. We view the odds of this virus mutating to be very small, perhaps less than 10%. And we also feel the lethality of the virus will be greatly diminished if it does mutate.
POTUS: Wait, you’re telling me it probably won’t happen. Dr. Payne, what is your estimate on whether this will happen?
Dr. Payne: It is only a guess, of course. But I believe there is a better than 50/50 chance that it will happen.
POTUS: So, you are telling me that it could be devastating, or it might not be terrible at all?
NSD: That’s about the size of it, Mr. President. This could either be the worst disaster to befall mankind in memory, or it may not happen at all.
POTUS: Then what do we tell the people?
NSD: Nothing, Mr. President.
POTUS: Nothing?
NSD: Absolutely. This is an event we cannot prepare for. If it happens, it will have the same effect on our populations, our infrastructures, and our economies that a killer asteroid strike or a nuclear war would generate. Prepping for 3 months, or 6 months, or even a year would likely do little to mitigate its effects. In the meantime, if word of this gets out, there will be anarchy.
POTUS: But we can’t simply allow people to go blindly forth, not knowing it could happen.
NSD: Think, Mr. President. What would happen if we announced this to the world. There would be an immediate panic. Runs on every bank. Food shelves stripped bare overnight. Riots in the streets. Economic and societal collapse. By telling the world, we would visit upon our people the exact same crisis that we hope to avoid. Millions could die in a scramble for food, water, and medicines. You’d have to declare martial law, now, and keep troops in our cities for the foreseeable future.
POTUS: Is it even possible to declare martial law and control our cities if we made such an announcement?
SECDEF: Mr. President, our resources are already stretched thin. We have commitments in the mid-east, South Korea, and Europe. We’d either have to close all of our embassies overseas, or heavily fortify them. National Guard troops could be called in, but logistically speaking, the best we could field would be 50,000 to 100,000 troops, across the country. We’d have to concentrate on the 100 biggest cities, to have any impact at all. Personally, I think we’d have to devote a great deal of manpower to securing our borders.
More worrisome than our own population, are what happens overseas. This could ignite geopolitical maneuvering by North Korea, Iran might move on Iraq, India and Pakistan, Hell… China might decide to move on Taiwan. This could incite nations to begin using their nuclear options. If the world believed the end was near, no telling what would happen.
POTUS: But telling our people now would at least give some people a chance to survive.
NSD: Perhaps, a few. But the vast majority of people would not. The richest, and most powerful would perhaps be able to create safe havens, but even they are unlikely to be able to prepare for an event of this magnitude. And remember, IT MAY NOT HAPPEN. We may avoid this doomsday scenario if Dr. Goodman’s assumptions are correct.
POTUS: It’s a terrible gamble.
NSD: Yes it is, Mr. President. But one we must take. If this pandemic happens, all the preps in the world will not save us. Not enough to matter, anyway. Life as we know it, civilization, will likely cease to exist. We would enter a prolonged dark age. Very few would survive. There is no upside to warning the people. All it will do is create a panic, one that would cost lives, and wreck the world’s economy.
We need to keep quiet on this. Downplay it at every turn. Hope and pray it doesn’t happen. Even Dr. Payne admits that the odds it won’t happen are just as good as that it will. We have to accept that as our only hope.
POTUS: Dr. Goodman, what is your recommendation?
Dr. Goodman: I believe it is totally irresponsible to panic the world over an event that is unlikely to reach fruition. Your NSD is correct. The effects of this sort of announcement would elicit immediate panic. The downsides far exceed any benefits. Why, this could set off a chain of events as horrible as a pandemic. Of course, there’s nothing wrong with telling people we might see a minor event, and to prepare for a couple of weeks, but to go beyond that would be unconscionable.
POTUS: Dr. Payne, what is your assessment?
Dr. Payne: Once again, I must disagree with my esteemed colleague. While the odds of survival are slim, you have a duty to tell the American people what is to come, regardless of the fallout from such an announcement.
NSD: Mr. President . . . it’s your decision . . .
--
So I leave it to you, the good folks who are reading this, to decide what the right course of action would be. If you were the President, faced with this dilemma, what would you do?
Tell the world, and risk anarchy, perhaps even nuclear war, when even the most pessimistic prediction is of a 50/50 chance of a pandemic. Or downplay the possibility and pray it doesn’t happen.
No easy decisions here.
The Date: Sometime in the Next 5 years.
We now take you into the very bowels of the Whitehouse’s command center, located 3 stories below ground, where an emergency meeting of the President (POTUS), his National Security Director (NSD), the Secretary of Defense (SECDEF), and two leading virologists, Dr. Payne and Dr. Goodman are meeting. The subject at hand, a potential pandemic.
NSD: Mr. President, I’ll allow Dr. Payne to go first. Please proceed.
Dr. Payne: Mr. President, I along with many of my colleagues, are convinced this virus will mutate within the next year, and spread rapidly around the globe. We have no reason to believe than mankind will have any immunity, and we fully expect the CFR to run between 50% and 80%. In our view, when this happens, somewhere in the vicinity of 3 to 5 billion people will perish from the disease, and from collateral damage.
POTUS: Good God! We need to warn our people now!
NSD: Mr. President, before we take that step, perhaps you should hear from Dr. Goodman.
Dr. Goodman: Mr. President, I represent a group of notable scientists that take serious issues with Dr. Payne’s predictions. We view the odds of this virus mutating to be very small, perhaps less than 10%. And we also feel the lethality of the virus will be greatly diminished if it does mutate.
POTUS: Wait, you’re telling me it probably won’t happen. Dr. Payne, what is your estimate on whether this will happen?
Dr. Payne: It is only a guess, of course. But I believe there is a better than 50/50 chance that it will happen.
POTUS: So, you are telling me that it could be devastating, or it might not be terrible at all?
NSD: That’s about the size of it, Mr. President. This could either be the worst disaster to befall mankind in memory, or it may not happen at all.
POTUS: Then what do we tell the people?
NSD: Nothing, Mr. President.
POTUS: Nothing?
NSD: Absolutely. This is an event we cannot prepare for. If it happens, it will have the same effect on our populations, our infrastructures, and our economies that a killer asteroid strike or a nuclear war would generate. Prepping for 3 months, or 6 months, or even a year would likely do little to mitigate its effects. In the meantime, if word of this gets out, there will be anarchy.
POTUS: But we can’t simply allow people to go blindly forth, not knowing it could happen.
NSD: Think, Mr. President. What would happen if we announced this to the world. There would be an immediate panic. Runs on every bank. Food shelves stripped bare overnight. Riots in the streets. Economic and societal collapse. By telling the world, we would visit upon our people the exact same crisis that we hope to avoid. Millions could die in a scramble for food, water, and medicines. You’d have to declare martial law, now, and keep troops in our cities for the foreseeable future.
POTUS: Is it even possible to declare martial law and control our cities if we made such an announcement?
SECDEF: Mr. President, our resources are already stretched thin. We have commitments in the mid-east, South Korea, and Europe. We’d either have to close all of our embassies overseas, or heavily fortify them. National Guard troops could be called in, but logistically speaking, the best we could field would be 50,000 to 100,000 troops, across the country. We’d have to concentrate on the 100 biggest cities, to have any impact at all. Personally, I think we’d have to devote a great deal of manpower to securing our borders.
More worrisome than our own population, are what happens overseas. This could ignite geopolitical maneuvering by North Korea, Iran might move on Iraq, India and Pakistan, Hell… China might decide to move on Taiwan. This could incite nations to begin using their nuclear options. If the world believed the end was near, no telling what would happen.
POTUS: But telling our people now would at least give some people a chance to survive.
NSD: Perhaps, a few. But the vast majority of people would not. The richest, and most powerful would perhaps be able to create safe havens, but even they are unlikely to be able to prepare for an event of this magnitude. And remember, IT MAY NOT HAPPEN. We may avoid this doomsday scenario if Dr. Goodman’s assumptions are correct.
POTUS: It’s a terrible gamble.
NSD: Yes it is, Mr. President. But one we must take. If this pandemic happens, all the preps in the world will not save us. Not enough to matter, anyway. Life as we know it, civilization, will likely cease to exist. We would enter a prolonged dark age. Very few would survive. There is no upside to warning the people. All it will do is create a panic, one that would cost lives, and wreck the world’s economy.
We need to keep quiet on this. Downplay it at every turn. Hope and pray it doesn’t happen. Even Dr. Payne admits that the odds it won’t happen are just as good as that it will. We have to accept that as our only hope.
POTUS: Dr. Goodman, what is your recommendation?
Dr. Goodman: I believe it is totally irresponsible to panic the world over an event that is unlikely to reach fruition. Your NSD is correct. The effects of this sort of announcement would elicit immediate panic. The downsides far exceed any benefits. Why, this could set off a chain of events as horrible as a pandemic. Of course, there’s nothing wrong with telling people we might see a minor event, and to prepare for a couple of weeks, but to go beyond that would be unconscionable.
POTUS: Dr. Payne, what is your assessment?
Dr. Payne: Once again, I must disagree with my esteemed colleague. While the odds of survival are slim, you have a duty to tell the American people what is to come, regardless of the fallout from such an announcement.
NSD: Mr. President . . . it’s your decision . . .
--
So I leave it to you, the good folks who are reading this, to decide what the right course of action would be. If you were the President, faced with this dilemma, what would you do?
Tell the world, and risk anarchy, perhaps even nuclear war, when even the most pessimistic prediction is of a 50/50 chance of a pandemic. Or downplay the possibility and pray it doesn’t happen.
No easy decisions here.
MACRO-TRIAGE
While no one can say with any certainty when the next pandemic will arrive, there is almost universal consensus that even a moderate pandemic will break the health care system.
Our hospitals today routinely run with a 96% or greater census. There is little surge capacity built in. Nationwide, there are only a few thousand spare ventilators available on any given day. During a pandemic, it has been estimated that 700,000 patients may require one.
Large numbers of Health Care Workers (HCW’s) may not report for work during a pandemic. Many are single parents with small children at home and would fear being quarantined at work. Others will fear bringing the virus home to their families. And probably at least 1/3rd of them will come down with the virus and be unable to work.
Within days of a major outbreak, every hospital in this country will look like the Superdome 5 days after Katrina.
Masks, gloves, and gowns will be quickly consumed. IV’s, anti-virals, and antibiotics will be in desperately short supply. And flu patients will be lined up in the hallways, bringing the infection to every wing of the hospital. A hospital’s ability to care for and feed a large influx of people will be marginal. The system will break, and hundreds of thousands of non-flu patients will probably die as a result.
As harsh as it sounds, the only realistic solution is to bar flu patients from our hospitals.
There is little that a hospital will be able to do for 90% of flu patients. There will be 50 patients needing a ventilator for each one that is available. In many ways, the majority of flu patients are likely to be better off at home, than in a chaotic and short staffed medical facility. Yes, many will succumb at home. But those that do, would probably die in a hospital also. The only difference is, by staying home, they don’t take the health care system down with them.
This will require macro-triage. Triage on a national level. We need to decide now, before we break the system, that for the good of the nation as a whole, we will not accept flu patients to most hospitals.
On any given day, there are probably 900,000 patients occupying hospital beds in the US. Another 1.8 million people live in nursing homes. During a pandemic, millions more will require non-flu related care. Many of these people will die, even though most are quite salvageable, if our hospitals are wrecked by trying to care for flu patients.
It’s a cold equation. Lock out sick and dying patients, for whom there is little we can do, in order to preserve medical care for others. But it is the only option that makes sense.
Will it happen? I hope so, but I doubt it. There is little political courage in our world today. And damn little common sense. It will be easier to allow the system to crash and burn under the weight of millions of flu patients, for whom there is little that can be done, than it will be to make the hard decision to turn them away.
Triage is never pretty. But sometimes, it’s the only way to save the salvageable.
While no one can say with any certainty when the next pandemic will arrive, there is almost universal consensus that even a moderate pandemic will break the health care system.
Our hospitals today routinely run with a 96% or greater census. There is little surge capacity built in. Nationwide, there are only a few thousand spare ventilators available on any given day. During a pandemic, it has been estimated that 700,000 patients may require one.
Large numbers of Health Care Workers (HCW’s) may not report for work during a pandemic. Many are single parents with small children at home and would fear being quarantined at work. Others will fear bringing the virus home to their families. And probably at least 1/3rd of them will come down with the virus and be unable to work.
Within days of a major outbreak, every hospital in this country will look like the Superdome 5 days after Katrina.
Masks, gloves, and gowns will be quickly consumed. IV’s, anti-virals, and antibiotics will be in desperately short supply. And flu patients will be lined up in the hallways, bringing the infection to every wing of the hospital. A hospital’s ability to care for and feed a large influx of people will be marginal. The system will break, and hundreds of thousands of non-flu patients will probably die as a result.
As harsh as it sounds, the only realistic solution is to bar flu patients from our hospitals.
There is little that a hospital will be able to do for 90% of flu patients. There will be 50 patients needing a ventilator for each one that is available. In many ways, the majority of flu patients are likely to be better off at home, than in a chaotic and short staffed medical facility. Yes, many will succumb at home. But those that do, would probably die in a hospital also. The only difference is, by staying home, they don’t take the health care system down with them.
This will require macro-triage. Triage on a national level. We need to decide now, before we break the system, that for the good of the nation as a whole, we will not accept flu patients to most hospitals.
On any given day, there are probably 900,000 patients occupying hospital beds in the US. Another 1.8 million people live in nursing homes. During a pandemic, millions more will require non-flu related care. Many of these people will die, even though most are quite salvageable, if our hospitals are wrecked by trying to care for flu patients.
It’s a cold equation. Lock out sick and dying patients, for whom there is little we can do, in order to preserve medical care for others. But it is the only option that makes sense.
Will it happen? I hope so, but I doubt it. There is little political courage in our world today. And damn little common sense. It will be easier to allow the system to crash and burn under the weight of millions of flu patients, for whom there is little that can be done, than it will be to make the hard decision to turn them away.
Triage is never pretty. But sometimes, it’s the only way to save the salvageable.
Sunday, March 19, 2006
Morton's Fork
I’m not an economist, but my post paramedic career has been as a Building Contractor, software designer, and business consultant. I also hold a mortgage brokers license.
All of which does not make me an expert in macro-economics, it merely shows I can’t hold a job.
But I do have some experience in big business, particularly in residential and commercial construction. And I see a possible scenario, come a disruption from a pandemic (or other national disaster), that could greatly increase the impact of such a crisis.
Allow me to paint a scenario. Hypothetical, true. But one not out of the question.
Here in Florida, at any given time, there are scores of builders putting up spec houses (unsold). Some builders will construct 1,000 single family homes, and another 1,000 multi-family units a year. The average time of construction is about 5 months.
So let’s take a fictional construction company, Behemoth Homes Corp (BHC) , that has a half dozen subdivisions scattered across Florida. Today, PUD’s (planned unit developments) come with golf courses, retail shops, club houses, and often private water and sewer plants. They cost a lot of money to develop and maintain.
In order to create these subdivisions, the builder/developer submits a plan to a lending institution. They receive draws based on the percentage of completion of each phase of a development. Additionally, when a house is built, the builder submits (4 or 5) draws to the bank at various stages of completion to receive another chunk of money to continue the construction.
Now, for the part that most folks don’t know. Builders and lenders engage in a Kabuki dance of sorts, highly stylized and ritualistic. The builder is constantly trying to get ahead of the bank, so that they can pay their suppliers and subcontractors. The lenders are supposed to ensure that substantial work has been completed before releasing funds. But the lenders also understand that the builder has to get into their knickers a bit, else they run out of money, so they turn a blind eye. Often they will release monies for work that has not, in fact, been completed.
While all of this is going on, the subcontractors (roofers, plumbers, electricians) wait for THEIR money, and THEIR suppliers are waiting for the subcontractor to be paid. When I worked for a Fortune 500 Builder, my job was as the choreographer for this little musical comedy.
Hard to believe a mess like this works.
But it does, as long as the builder manages to sell houses at the same rate as they put them into the ground. The builder lives off of the cash flow from the bank draws, doles out the money as slowly as possible to the subs and suppliers, and prays the economy doesn’t tank. If you put 5 new houses in the ground today, you'd better hope you're selling 5 houses a day 5 months from now.
Now, let’s say a pandemic happens. Doesn’t have to be the worst case scenario, but bad enough to cause significant social isolation and worker absenteeism.
What happens?
First, the housing market will tank. People will not be going out looking at houses to buy during a pandemic.
Second, BHC will be caught will hundreds of milions of dollars worth of homes under construction, and will not have the workforce or the building materials to finish them.
Third, overhead continues for the builders. Interest on those hundreds of millions of dollars in construction loans pile up. Unpaid subcontractors (who had to borrow money to pay their workers and suppliers) will be hung out to dry. As will their suppliers and their employees.
Fourth, with work stopped, houses that are not dried in (shingled) will begin to suffer damage from the elements. Golf Courses cost hundreds of thousands of dollars a year to maintain, even if no one is using them. Fail to maintain them, and they revert to the wild. Very expensive to reclaim later.
Fifth, the lenders will find themselves suddenly out hundreds of millions in construction loans, and the builders will quickly default. Without the interest income, or the satisfaction of the construction loans when the houses sell, they are in deep trouble.
Sixth, large institutions (Insurance companies, pension funds, etc) routinely invest their money in the stock Market, and mutual funds, which supply the lenders and builders with funds to operate. Now they’re in trouble.
The ripple effect of even one large builder going down the tubes would send a chill thru the market. Multiply that times a thousand or more across the country, and this one industry would bring the stock market, the banking system, and our economy to it’s knees.
Were talking hundreds of billions of dollars, just in residential construction. By the time you follow all the ripples, we’re talking trillions.
But wait, there’s more.
Say the first wave passes after 12 weeks. The all clear is sounded. Can’t we just re-start things?
After 3 months, people may come out of isolation. Many will fear another wave (we’ve been warned) and so the mood of the public will be to hunker down, not to attempt to buy a new house or move.
Many potential buyers will have been out of work for 3 months, and are behind in their bills. They will be more concerned with stocking up and preparing for the next wave. Those who might have had good credit before the first wave, have probably lost their credit rating, and can no longer obtain a mortgage.
The CEO of the now failing BHC has to decide what to do. Assuming his lender would agree, he could begin to finish the 800 homes he has under construction, but that would only put him further in debt. He has an unsold inventory of maybe a hundred FINISHED homes. UNTIL THEY SELL, it would be madness to commit to finishing the others.
The building industry (which includes real estate, banking, material suppliers, subcontractors, insurance companies, ad nauseum) is at an impasse. A Morton’s Fork. Two options, both equally bad.
Go deeper in debt and finish the houses (tempting because it would generate cash flow), or try to wait it out until the buyers reappear. Which is worse?
But the CEO knows that it will take months before we know if another wave will come. He can’t simply increase his inventory to 900 unsold homes with no prospects of selling them.
What happens then is the builder goes under. The subcontractors go under. Their suppliers go under. And the lender goes under, taking with it the stock market, mutual fund investors, and institutional investors that have been funding the lender. It’s a cascade effect.
Now all of this is just one industry, albeit a big one. Add in retail sales. Restaurants. The staggering health care costs incurred during a pandemic. Losses due in the Insurance Industry. Infrastructure losses due to social unrest and lack of maintenence. The list goes on . . .
While the economy might handle a 3 month interruption, it is unlikely to be limted to that, even if there is only one wave. People will be waiting for the next shoe to drop. Even if it doesn’t, there will be a period of at least six months after the first wave where everyone will be expecting it.
If a second wave does occur, now we bump this `frozen’ economic outlook to extend a year or more.
Listen to TV ads for an hour, and you will undoubtedly hear a couple of ads for refinancing your home. It’s a big business. Bad credit? No problem. They’ll loan you up to 125% of the value of your home. They are playing the same game.
The average American has no savings to speak of, a big mortgage, and credit card debt of probably 10,000. These personal debts, during a time of massive work stoppages, will cause massive defaults.
The banks won’t want the properties, although existing homes will be more attractive to them than unfinished ones. They would simply be stuck with assets they can’t sell. They will, however, probably want to do paper foreclosures, in hopes they may survive long enough to liquidate these assets when things turn around.
We saw something akin to this scenario in Altanta in 1975. A large lender had 200 million dollars in construction loans out, when the market tanked. They ended up selling $150K homes for $50K, just to try to keep their cash flow alive. It didn’t work. They went under after 18 months. The only ones that make out were those with cash who bought the homes for 30 cents on the dollar.
These fire sales of homes also hurt the other builders and lenders in Altanta, because while still solvent, they couldn’t compete against prices like that.
Sorry for such a long post. I did restrain myself a bit. Could have written war and peace on this subject.
Bottom line, ANY long term interruption in the cash flow/credit system will have extreme effects on the economy, both here, and internationally. While I greatly fear the virus, and the health ramifications of a pandemic, what I truly fear are the financial ramifications they will bring.
While I’m hesitant to post this (I dislike presenting a problem without a solution), I think it is important that people understand just how fragile our economy is. How dependent everything is on things going forward without a major interruption.
While you may not grieve over the losses of the Behemoth Home Corp, or the Banks, or those heavily invested in the stock market: do not think that their misfortunes won’t affect you.
How all of this will shake out is anyone’s guess. Will the government decide to crank up the printing presses and try to hyper-inflate ourselves out of debt? Possible, and some people have suggested it, but that may just make matters worse.
Will the glut of goods (homes, real estate, consumer items) with damn few dollars chasing them drive prices and wages down after a pandemic? That’s possible too. You may well be able to buy your $250K dream home for $50K … if you have the cash.
If you wonder why we get mixed messages about a pandemic from our government, and the governments around the world, remember: This isn’t just a public health crisis.
A pandemic will affect us in ways few people have considered. But I guarantee you, those that ARE thinking about it are scared to death. While I’m not expecting a Mad-Max scenario, I can see a pandemic setting off a global depression that could last for years.
Of course, all of this is speculation. Maybe the Power That Be have it all figured out and we will have a soft landing. But right now, I don’t see one.
I’m not an economist, but my post paramedic career has been as a Building Contractor, software designer, and business consultant. I also hold a mortgage brokers license.
All of which does not make me an expert in macro-economics, it merely shows I can’t hold a job.
But I do have some experience in big business, particularly in residential and commercial construction. And I see a possible scenario, come a disruption from a pandemic (or other national disaster), that could greatly increase the impact of such a crisis.
Allow me to paint a scenario. Hypothetical, true. But one not out of the question.
Here in Florida, at any given time, there are scores of builders putting up spec houses (unsold). Some builders will construct 1,000 single family homes, and another 1,000 multi-family units a year. The average time of construction is about 5 months.
So let’s take a fictional construction company, Behemoth Homes Corp (BHC) , that has a half dozen subdivisions scattered across Florida. Today, PUD’s (planned unit developments) come with golf courses, retail shops, club houses, and often private water and sewer plants. They cost a lot of money to develop and maintain.
In order to create these subdivisions, the builder/developer submits a plan to a lending institution. They receive draws based on the percentage of completion of each phase of a development. Additionally, when a house is built, the builder submits (4 or 5) draws to the bank at various stages of completion to receive another chunk of money to continue the construction.
Now, for the part that most folks don’t know. Builders and lenders engage in a Kabuki dance of sorts, highly stylized and ritualistic. The builder is constantly trying to get ahead of the bank, so that they can pay their suppliers and subcontractors. The lenders are supposed to ensure that substantial work has been completed before releasing funds. But the lenders also understand that the builder has to get into their knickers a bit, else they run out of money, so they turn a blind eye. Often they will release monies for work that has not, in fact, been completed.
While all of this is going on, the subcontractors (roofers, plumbers, electricians) wait for THEIR money, and THEIR suppliers are waiting for the subcontractor to be paid. When I worked for a Fortune 500 Builder, my job was as the choreographer for this little musical comedy.
Hard to believe a mess like this works.
But it does, as long as the builder manages to sell houses at the same rate as they put them into the ground. The builder lives off of the cash flow from the bank draws, doles out the money as slowly as possible to the subs and suppliers, and prays the economy doesn’t tank. If you put 5 new houses in the ground today, you'd better hope you're selling 5 houses a day 5 months from now.
Now, let’s say a pandemic happens. Doesn’t have to be the worst case scenario, but bad enough to cause significant social isolation and worker absenteeism.
What happens?
First, the housing market will tank. People will not be going out looking at houses to buy during a pandemic.
Second, BHC will be caught will hundreds of milions of dollars worth of homes under construction, and will not have the workforce or the building materials to finish them.
Third, overhead continues for the builders. Interest on those hundreds of millions of dollars in construction loans pile up. Unpaid subcontractors (who had to borrow money to pay their workers and suppliers) will be hung out to dry. As will their suppliers and their employees.
Fourth, with work stopped, houses that are not dried in (shingled) will begin to suffer damage from the elements. Golf Courses cost hundreds of thousands of dollars a year to maintain, even if no one is using them. Fail to maintain them, and they revert to the wild. Very expensive to reclaim later.
Fifth, the lenders will find themselves suddenly out hundreds of millions in construction loans, and the builders will quickly default. Without the interest income, or the satisfaction of the construction loans when the houses sell, they are in deep trouble.
Sixth, large institutions (Insurance companies, pension funds, etc) routinely invest their money in the stock Market, and mutual funds, which supply the lenders and builders with funds to operate. Now they’re in trouble.
The ripple effect of even one large builder going down the tubes would send a chill thru the market. Multiply that times a thousand or more across the country, and this one industry would bring the stock market, the banking system, and our economy to it’s knees.
Were talking hundreds of billions of dollars, just in residential construction. By the time you follow all the ripples, we’re talking trillions.
But wait, there’s more.
Say the first wave passes after 12 weeks. The all clear is sounded. Can’t we just re-start things?
After 3 months, people may come out of isolation. Many will fear another wave (we’ve been warned) and so the mood of the public will be to hunker down, not to attempt to buy a new house or move.
Many potential buyers will have been out of work for 3 months, and are behind in their bills. They will be more concerned with stocking up and preparing for the next wave. Those who might have had good credit before the first wave, have probably lost their credit rating, and can no longer obtain a mortgage.
The CEO of the now failing BHC has to decide what to do. Assuming his lender would agree, he could begin to finish the 800 homes he has under construction, but that would only put him further in debt. He has an unsold inventory of maybe a hundred FINISHED homes. UNTIL THEY SELL, it would be madness to commit to finishing the others.
The building industry (which includes real estate, banking, material suppliers, subcontractors, insurance companies, ad nauseum) is at an impasse. A Morton’s Fork. Two options, both equally bad.
Go deeper in debt and finish the houses (tempting because it would generate cash flow), or try to wait it out until the buyers reappear. Which is worse?
But the CEO knows that it will take months before we know if another wave will come. He can’t simply increase his inventory to 900 unsold homes with no prospects of selling them.
What happens then is the builder goes under. The subcontractors go under. Their suppliers go under. And the lender goes under, taking with it the stock market, mutual fund investors, and institutional investors that have been funding the lender. It’s a cascade effect.
Now all of this is just one industry, albeit a big one. Add in retail sales. Restaurants. The staggering health care costs incurred during a pandemic. Losses due in the Insurance Industry. Infrastructure losses due to social unrest and lack of maintenence. The list goes on . . .
While the economy might handle a 3 month interruption, it is unlikely to be limted to that, even if there is only one wave. People will be waiting for the next shoe to drop. Even if it doesn’t, there will be a period of at least six months after the first wave where everyone will be expecting it.
If a second wave does occur, now we bump this `frozen’ economic outlook to extend a year or more.
Listen to TV ads for an hour, and you will undoubtedly hear a couple of ads for refinancing your home. It’s a big business. Bad credit? No problem. They’ll loan you up to 125% of the value of your home. They are playing the same game.
The average American has no savings to speak of, a big mortgage, and credit card debt of probably 10,000. These personal debts, during a time of massive work stoppages, will cause massive defaults.
The banks won’t want the properties, although existing homes will be more attractive to them than unfinished ones. They would simply be stuck with assets they can’t sell. They will, however, probably want to do paper foreclosures, in hopes they may survive long enough to liquidate these assets when things turn around.
We saw something akin to this scenario in Altanta in 1975. A large lender had 200 million dollars in construction loans out, when the market tanked. They ended up selling $150K homes for $50K, just to try to keep their cash flow alive. It didn’t work. They went under after 18 months. The only ones that make out were those with cash who bought the homes for 30 cents on the dollar.
These fire sales of homes also hurt the other builders and lenders in Altanta, because while still solvent, they couldn’t compete against prices like that.
Sorry for such a long post. I did restrain myself a bit. Could have written war and peace on this subject.
Bottom line, ANY long term interruption in the cash flow/credit system will have extreme effects on the economy, both here, and internationally. While I greatly fear the virus, and the health ramifications of a pandemic, what I truly fear are the financial ramifications they will bring.
While I’m hesitant to post this (I dislike presenting a problem without a solution), I think it is important that people understand just how fragile our economy is. How dependent everything is on things going forward without a major interruption.
While you may not grieve over the losses of the Behemoth Home Corp, or the Banks, or those heavily invested in the stock market: do not think that their misfortunes won’t affect you.
How all of this will shake out is anyone’s guess. Will the government decide to crank up the printing presses and try to hyper-inflate ourselves out of debt? Possible, and some people have suggested it, but that may just make matters worse.
Will the glut of goods (homes, real estate, consumer items) with damn few dollars chasing them drive prices and wages down after a pandemic? That’s possible too. You may well be able to buy your $250K dream home for $50K … if you have the cash.
If you wonder why we get mixed messages about a pandemic from our government, and the governments around the world, remember: This isn’t just a public health crisis.
A pandemic will affect us in ways few people have considered. But I guarantee you, those that ARE thinking about it are scared to death. While I’m not expecting a Mad-Max scenario, I can see a pandemic setting off a global depression that could last for years.
Of course, all of this is speculation. Maybe the Power That Be have it all figured out and we will have a soft landing. But right now, I don’t see one.
Saturday, March 18, 2006
Resilient Communities
As some of you may know, I was a part of the cruisingcommunity for more than a decade. We liveaboard boaters come in all stripes and hail from all economic stratas, but there was one constant: We looked out for each other.
If you left your boat in an anchorage, or at a marina, and were gone for a day or a week or a month, you could be pretty sure your neighbor would watch it for you. If your boat started taking on water, someone would notice and bring over a bilge pump to keep her afloat. If an anchored boat was dragging, another boater would hop aboard and reset the anchors. If a hurricane was coming, and you couldn’t get there in time, someone would have put extra lines and bumpers on your boat.
And if you had a problem, any problem, there were always volunteers ready to help. Have an engine that won’t start? You can expect a couple of diesel mechanics to row over and try to fix it. Need a lift to the grocery store? Someone at the marina, who has never laid eyes on you before, will likely hand you the keys to their car.
The law of the sea is that you never refuse to help a fellow mariner in trouble.
I never really thought about it much, just accepted that this was the way things were. I grew up aboard a boat in a marina, and this was `normal’ as far as I knew. But it begs the question: Why?
What makes this small, largely transient, stubbornly independent community so willing to look out for one another?
I come up with two reasons.
First, any boat in trouble could prove to be a hazard to other boats in the anchorage or marina. So part of it is self preservation. It is in the interest of everyone to keep a boat from dragging, burning, or sinking.
Second, we all had a common foe. The sea that we all loved so much was also a fearsome and harsh mistress. When things go badly aboard a boat, they go south in a hurry. The universal feeling, I believe, is that anything you do today for a fellow cruiser will be repaid someday when you need it most.
When I first entered that community, I foolishly tried to pay for each kindness extended to me and my wife. I quickly learned that `paying it forward’ was the accepted norm.
An offer of a cold beer, however, is rarely refused.
Pull into any liveaboard marina, or large anchorage, and you will likely find a `lending library’ near the laundry facilities. Shelves of books, CD’s, DVD’s, and spare parts. A sign will usually be seen that says “Take what you want . . .leave what you can”. A bulletin board would have hand scrawled notes of items wanted or available.
Every morning, in anchorages around the world, boaters get on the vhf or SSB and at an appointed hour, meet for a `roll call’. Anyone who needs something, can request help. Anyone who has something they don’t need, and would like to offer it to the community, simply broadcasts that fact. Boats on passages also check in, and their progress is monitored by other boaters. If someone is overdue, or misses a check-in, the alert is raised.
Bartering, instead of cash, was also the norm. But usually only for larger, more expensive items. Credit was usually arranged if you didn't have anything to trade at the time. Debts were routinely forgiven.
And in the evenings, we would gather on the bigger boats or dockside and toast the sunsets together. Trade lies, hoist a few, talk of our next jump, and vow to meet again someday. Pot luck suppers were held several times a week. When one of our own fell on hard times, we passed the hat.
We traded not only goods and services, but information, too. Local knowledge, the best anchorages, and recipes.
Sometimes you’d wander into a new marina or anchorage and only stay a day or two. Sometimes you stayed for months. It didn’t matter. You were a member of the club just by being there. And it didn’t matter if you had a 60 foot motoryacht or a 23 foot sailboat. Long haired hippies who worked under the table at the local watering hole were held in the same regard as rich corporate types. Sometimes higher.
There were no strangers aboard boats, just friends you hadn’t met yet. True, occasionally we’d run into someone who `didn’t get it’, but someone would take them aside, buy them a beer, and explain the `facts of life to them’. Most of the time, that was all it took.
There are lessons here, for every neighborhood, for every community. Life is uncertain. No man is an island. While today it might be your neighbor in trouble, tomorrow it could be you.
There are other communities where I’ve seen this mindset. Pilots, RV’rs who caravan, firefighters & Medics, and the military. It’s how things USED TO BE.
All seem bound together by a common need. They shared a common enemy. Maybe that’s what it will take for our communities at large. A common threat that binds us together. A paradigm shift away from personal isolationism and towards community involvement.
Perhaps someday, before it’s too late, people will understand, you CAN get by with a little help from your friends. That it can, and does work, if you let it.
Something to hope for, anyway.
Damn shame that it might take a pandemic to make it happen, tho.
As some of you may know, I was a part of the cruising
If you left your boat in an anchorage, or at a marina, and were gone for a day or a week or a month, you could be pretty sure your neighbor would watch it for you. If your boat started taking on water, someone would notice and bring over a bilge pump to keep her afloat. If an anchored boat was dragging, another boater would hop aboard and reset the anchors. If a hurricane was coming, and you couldn’t get there in time, someone would have put extra lines and bumpers on your boat.
And if you had a problem, any problem, there were always volunteers ready to help. Have an engine that won’t start? You can expect a couple of diesel mechanics to row over and try to fix it. Need a lift to the grocery store? Someone at the marina, who has never laid eyes on you before, will likely hand you the keys to their car.
The law of the sea is that you never refuse to help a fellow mariner in trouble.
I never really thought about it much, just accepted that this was the way things were. I grew up aboard a boat in a marina, and this was `normal’ as far as I knew. But it begs the question: Why?
What makes this small, largely transient, stubbornly independent community so willing to look out for one another?
I come up with two reasons.
First, any boat in trouble could prove to be a hazard to other boats in the anchorage or marina. So part of it is self preservation. It is in the interest of everyone to keep a boat from dragging, burning, or sinking.
Second, we all had a common foe. The sea that we all loved so much was also a fearsome and harsh mistress. When things go badly aboard a boat, they go south in a hurry. The universal feeling, I believe, is that anything you do today for a fellow cruiser will be repaid someday when you need it most.
When I first entered that community, I foolishly tried to pay for each kindness extended to me and my wife. I quickly learned that `paying it forward’ was the accepted norm.
An offer of a cold beer, however, is rarely refused.
Pull into any liveaboard marina, or large anchorage, and you will likely find a `lending library’ near the laundry facilities. Shelves of books, CD’s, DVD’s, and spare parts. A sign will usually be seen that says “Take what you want . . .leave what you can”. A bulletin board would have hand scrawled notes of items wanted or available.
Every morning, in anchorages around the world, boaters get on the vhf or SSB and at an appointed hour, meet for a `roll call’. Anyone who needs something, can request help. Anyone who has something they don’t need, and would like to offer it to the community, simply broadcasts that fact. Boats on passages also check in, and their progress is monitored by other boaters. If someone is overdue, or misses a check-in, the alert is raised.
Bartering, instead of cash, was also the norm. But usually only for larger, more expensive items. Credit was usually arranged if you didn't have anything to trade at the time. Debts were routinely forgiven.
And in the evenings, we would gather on the bigger boats or dockside and toast the sunsets together. Trade lies, hoist a few, talk of our next jump, and vow to meet again someday. Pot luck suppers were held several times a week. When one of our own fell on hard times, we passed the hat.
We traded not only goods and services, but information, too. Local knowledge, the best anchorages, and recipes.
There were no strangers aboard boats, just friends you hadn’t met yet. True, occasionally we’d run into someone who `didn’t get it’, but someone would take them aside, buy them a beer, and explain the `facts of life to them’. Most of the time, that was all it took.
There are lessons here, for every neighborhood, for every community. Life is uncertain. No man is an island. While today it might be your neighbor in trouble, tomorrow it could be you.
There are other communities where I’ve seen this mindset. Pilots, RV’rs who caravan, firefighters & Medics, and the military. It’s how things USED TO BE.
All seem bound together by a common need. They shared a common enemy. Maybe that’s what it will take for our communities at large. A common threat that binds us together. A paradigm shift away from personal isolationism and towards community involvement.
Perhaps someday, before it’s too late, people will understand, you CAN get by with a little help from your friends. That it can, and does work, if you let it.
Something to hope for, anyway.
Damn shame that it might take a pandemic to make it happen, tho.
Thursday, March 16, 2006
But it’s Only the Flu
I hear it all the time. I’ve had flu’s before. I’m still here.
True, but you’ve never had an H5N1 flu before. Only a couple hundred people in the world have. And half of them aren’t here anymore.
The Avian Flu is a new critter on the block. It isn’t like any flu you’ve ever experienced. While we hope it will become less lethal with time, there are no guarantees on that. Should it retain its current CFR (Case Fatality Rate) of 50%, then we are totally screwed.
But virus’s mutate. Particularly influenza virus’s. A mutation that makes this thing go pandemic might cause it to lose some of its lethality. Believe me, public health officials are clinging to this hope.
For reasons not entirely understood, the young seem more apt to die from this flu than those over 40. Theories abound, but the most widely accepted one is the better a person’s immune system, the more likely they are to succumb to this virus. Older people have less active immune systems, and therefore have few complications.
Regardless of a person’s age, anyone who contracts this illness will be very sick, and for quite some time. Many people who might survive this flu may die because there was no one there to care for them. Knowing the proper way to treat the flu is imperative. During a pandemic, 90% of flu victims will not see the inside of a hospital.
I recommend that everyone get a copy of Dr. Woodson’s guide to treating influenza patients. It is available as a free download in PDF format from:
Here you will find sound advice on the home treatment of flu victims. This guide is about six months old, and so the advice on Tamiflu is outdated. Current recommendations are for a much higher dose of Tamiflu than was recommended last year. A treatment course is now between 30 and 40 pills.
Get this. Print it out. Keep it handy.
It could save your life. Or the life of someone you love.
Wednesday, March 15, 2006
Dr. Robert Webster: 50/50 Chance of Pandemic
One of the most preeminent virologists in the world, Dr. Robert Webster aka “The Flu Hunter”, went on national television last night and announced that the odds of H5N1 going to a human pandemic was about even odds.
http://abcnews.go.com/WNT/print?id=1724801
Dr. Webster is a heavy hitter in the world of virology. He was the first to identify H5N1 and was responsible for the quick eradication of the first outbreak in Hong Kong 8 years ago. Since then, he has focused a good deal of his attention on this viral threat.
His prediction, that we are basically at a `coin flip’ situation is astounding. While many scientists will cry foul, I believe he sincerely believes in his prediction. He also announced that he has 3 months of food and water stockpiled.
Last October, he made the following statement:
This is the worst flu virus I have ever seen or worked with or read about. We have to prepare as if we were going to war—and the public needs to understand that clearly. This virus is playing its role as a natural bioterrorist. The politicians are going to say Chicken Little is at it again. And, if I’m wrong, then thank God. But if it does happen, and I fully expect that it will, there will be no place for any of us to hide. Not in the United States or in Europe or in a bunker somewhere. The virus is a very promiscuous and efficient killer.
While my personal take on the odds of a pandemic happening are somewhat less dire, I take his announcement seriously. He is in a better position to know than I am.
Right or wrong, this is a wakeup call. We all should be paying attention.
Sunday, March 12, 2006
THE STATE DEPARTMENT SPEAKS
The following information can be found on the US State Department's website:
http://tinyurl.com/l5omx
10 March 2006
Health Services Could Be Overwhelmed in a Pandemic, Experts Say
Communities urged to plan for meeting populations' health care needs
This fact sheet was compiled from various Internet sources as well as from presentations made at a February conference, held in Minnesota, on business planning for a pandemic.
Following information applies to pandemic influenza generally:
Folks, this is an important document. I recommend you read it. When you talk to others about pandemic flu, send them to this website, and www.pandemicflu.gov.
The following information can be found on the US State Department's website:
http://tinyurl.com/l5omx
10 March 2006
Health Services Could Be Overwhelmed in a Pandemic, Experts Say
Communities urged to plan for meeting populations' health care needs
This fact sheet was compiled from various Internet sources as well as from presentations made at a February conference, held in Minnesota, on business planning for a pandemic.
Following information applies to pandemic influenza generally:
Families should stock cupboards with enough nonperishable and prepackaged food products to last four weeks to five weeks. Supplies should include bottled water, canned meats, fruits, vegetables, soups, protein or fruit bars, dry cereal, granola and fruit bars, crackers, peanut butter or nuts, canned juices, canned or jarred baby food and formula, and pet food.
To avoid opportunities for exposure, shoppers should consolidate trips to the grocery store by purchasing larger quantities than normally and avoid dining outside the home during the initial months of a pandemic.
Other important precautions include stockpiling prescription drugs, if possible, as well as medical supplies like insulin and blood-pressure monitoring equipment, soap and water or alcohol-based hand wash, anti-diarrheal medication and fluids with electrolytes and vitamins.
Folks, this is an important document. I recommend you read it. When you talk to others about pandemic flu, send them to this website, and www.pandemicflu.gov.
Saturday, March 11, 2006
THE NEWS MEDIA WAKES UP
Wyoming, be ready for the flu
Gov. Dave Freudenthal and Michael Leavitt, U.S. secretary of health and human services, urged preparation at the Wyoming Pandemic Flu Summit.
By Jennifer Frazer
rep8@wyomingnews.com
Published in the Wyoming Tribune-Eagle
CHEYENNE - The governor of Wyoming and the U.S. secretary of Health and Human Services shared a united message at the Wyoming Pandemic Flu Summit Friday: Be prepared.
They would like this motto to be impressed on every mind and reflected in the pantries, medicine chests and supply closets of every Wyomingite. . . .
Finally . . . a state that gets it. I would urge everyone to read the entire article at:
http://tinyurl.com/p958p
This newspaper article is the most honest evaluation of what a pandemic might bring that I've seen to date. And no . . . it is not a worst case scenario.
We need more news articles like this. More awareness. And much more preparation. And yes, time.
We gonna need all we can get.
Wyoming, be ready for the flu
Gov. Dave Freudenthal and Michael Leavitt, U.S. secretary of health and human services, urged preparation at the Wyoming Pandemic Flu Summit.
By Jennifer Frazer
rep8@wyomingnews.com
Published in the Wyoming Tribune-Eagle
CHEYENNE - The governor of Wyoming and the U.S. secretary of Health and Human Services shared a united message at the Wyoming Pandemic Flu Summit Friday: Be prepared.
They would like this motto to be impressed on every mind and reflected in the pantries, medicine chests and supply closets of every Wyomingite. . . .
Finally . . . a state that gets it. I would urge everyone to read the entire article at:
http://tinyurl.com/p958p
This newspaper article is the most honest evaluation of what a pandemic might bring that I've seen to date. And no . . . it is not a worst case scenario.
We need more news articles like this. More awareness. And much more preparation. And yes, time.
We gonna need all we can get.
Friday, March 10, 2006
SPECIAL MEDIA ALERT
All next week ABC news plans to do multiple segments on the avian flu threat. Kicking off the coverage will be segments on Good Morning America (monday & tuesday), with other reports planned for the evening news and Nightline.
Promo's are already running on ABC affliates. The slogan?
`Not to Scare, but to Prepare'
Hopefully NBC & CBS will follow suit.
All next week ABC news plans to do multiple segments on the avian flu threat. Kicking off the coverage will be segments on Good Morning America (monday & tuesday), with other reports planned for the evening news and Nightline.
Promo's are already running on ABC affliates. The slogan?
`Not to Scare, but to Prepare'
Hopefully NBC & CBS will follow suit.
WHY WE WILL LOSE
This report from Feb 27th illustrates the problem:
In Antwerp, Belgium on Sunday 18 dead pigeons were found. According to the Belgian agency for the security of the food chain (FAVV), the birds were not infected with the H5N1 virus.
The H5N1 virus does not occur in pigeons. The cause of death has not been determined.
The birds were found under a bridge on the Boomssesteenweg (street). The authorities were informed and the dead birds will be picked up on Monday, according to the Antwerp police.
Sounds great. Except . . . H5N1 has been found in pigeons!
What goes on here?
Simply a government’s attempt to dismiss and cover up the truth. By saying it doesn’t occur in pigeons, they can then destroy the carcasses without testing them. A Simple solution to a nasty problem. You can’t find the virus unless you test for it. Ergo, don’t test and the problem doesn’t exist.
Now scientists have found the H5N1 in a dead stone marten, a weasel-like mammal common in Europe. Undoubtedly politicians and lawyers worldwide are worried sick over this latest news.
The newsmedia has expressed shock and concern over this one, much like Claude Raines expressing shock to find gambling going on in Rick’s Café American. Tigers, cats, dogs, and humans have already died from H5N1, proving it has an affinity to mammalian receptors. There is no reason to suspect that other mammals couldn’t be infected. Horses, cows, pigs, and rats . . . the list of potential victims, and vectors, is endless.
In Azerbaijan, 11 people are sickened with suspected bird flu. Eight members of one family. Three of the 11 have died. Local officials suspect avian flu, but are unable to properly test for it. Have they sent samples off to a lab to confirm? Well … not yet. But they’re planning to. Seems they don’t have the proper shipping containers.
Eight members of one family stretches the credulity of believing they all caught it from an infected bird. This, if it proves to be H5N1, is most likely a H2H cluster. But hey, they’ll test for it eventually.
Reports out of China and Indonesia continue to show up in the news. A death or two each day, but somehow, the WHO death toll doesn’t seem to move up. Local tests, when positive for H5N1 must be confirmed. Negative tests are, well, negative. Gotta love that logic.
We are now seeing news stories about bird-flu psychosis. People worried about the virus beyond what local authorities deem necessary. Reminiscent of the US governments campaign during the 1918 pandemic, urging people not to succumb to Spanish Flu Mania.
Obviously, governments are running scared. They still cling to the hope that a pandemic may not errupt, or that they can contain it if it does. Until then, like a cheating husband caught in bed with his mistress, they are continuing to deny the truth.
Even to the point of looking rediculous.
This report from Feb 27th illustrates the problem:
In Antwerp, Belgium on Sunday 18 dead pigeons were found. According to the Belgian agency for the security of the food chain (FAVV), the birds were not infected with the H5N1 virus.
The H5N1 virus does not occur in pigeons. The cause of death has not been determined.
The birds were found under a bridge on the Boomssesteenweg (street). The authorities were informed and the dead birds will be picked up on Monday, according to the Antwerp police.
Sounds great. Except . . . H5N1 has been found in pigeons!
What goes on here?
Simply a government’s attempt to dismiss and cover up the truth. By saying it doesn’t occur in pigeons, they can then destroy the carcasses without testing them. A Simple solution to a nasty problem. You can’t find the virus unless you test for it. Ergo, don’t test and the problem doesn’t exist.
Now scientists have found the H5N1 in a dead stone marten, a weasel-like mammal common in Europe. Undoubtedly politicians and lawyers worldwide are worried sick over this latest news.
The newsmedia has expressed shock and concern over this one, much like Claude Raines expressing shock to find gambling going on in Rick’s Café American. Tigers, cats, dogs, and humans have already died from H5N1, proving it has an affinity to mammalian receptors. There is no reason to suspect that other mammals couldn’t be infected. Horses, cows, pigs, and rats . . . the list of potential victims, and vectors, is endless.
In Azerbaijan, 11 people are sickened with suspected bird flu. Eight members of one family. Three of the 11 have died. Local officials suspect avian flu, but are unable to properly test for it. Have they sent samples off to a lab to confirm? Well … not yet. But they’re planning to. Seems they don’t have the proper shipping containers.
Eight members of one family stretches the credulity of believing they all caught it from an infected bird. This, if it proves to be H5N1, is most likely a H2H cluster. But hey, they’ll test for it eventually.
Reports out of China and Indonesia continue to show up in the news. A death or two each day, but somehow, the WHO death toll doesn’t seem to move up. Local tests, when positive for H5N1 must be confirmed. Negative tests are, well, negative. Gotta love that logic.
We are now seeing news stories about bird-flu psychosis. People worried about the virus beyond what local authorities deem necessary. Reminiscent of the US governments campaign during the 1918 pandemic, urging people not to succumb to Spanish Flu Mania.
Obviously, governments are running scared. They still cling to the hope that a pandemic may not errupt, or that they can contain it if it does. Until then, like a cheating husband caught in bed with his mistress, they are continuing to deny the truth.
Even to the point of looking rediculous.
Tuesday, March 07, 2006
The Java Jive
This morning there are disturbing reports coming out of Indonesia and China. In central Java, at least 7 new suspected bird flu patients were admitted to one hospital alone. The number of deaths keeps climbing, with one or two reported nearly every day. The true number of infected people is unknown.
China, meanwhile, reportedly is ordering anyone with a fever of 37.5 centigrade or higher to report to their local hospital. Non-infected patients are being moved about to make room for flu patients. The Chinese appear to be gearing up for an outbreak.
In Australia, they are running commercials on the TV with a toll free number to report if you have the flu. Some Aussies have expressed concerns over calling this number, apparently worried that it might invoke some sort of enforced quarantine. We'll see how effective it is.
And from Russia, this story:
No quarantine measures can stop bird flu pandemic, if it appears, stated in March 7 head of virology research institute of Russian Medical Academy of Sciences Dmitry Lvov, informs a REGNUM correspondent.
According to the expert, one third of Earth population will suffer from bird flu pandemic. He thinks that in Russia, bird flu pandemic can come from China. He reminded that nearly all Russian regions, except for Eastern Siberia and Far East are infected with bird flu in a greater or lesser extent.
The expert asked Russian authorities to be ready in short amount of time to create hundred thousands of quarantine places.
And yesterday, the WHO announced that Avian Flu is a bigger global health Challenge than AIDS.
This announcement is particularly worrisome. AIDS has been a political sacred cow for nearly two decades, and to elevate Avian Flu above AIDS was a bold statement.
As I write this, a hastily called meeting is in progress in Geneva, where the WHO is gathering to discuss pandemic planning and response.
The pot is definitely boiling.
This morning there are disturbing reports coming out of Indonesia and China. In central Java, at least 7 new suspected bird flu patients were admitted to one hospital alone. The number of deaths keeps climbing, with one or two reported nearly every day. The true number of infected people is unknown.
China, meanwhile, reportedly is ordering anyone with a fever of 37.5 centigrade or higher to report to their local hospital. Non-infected patients are being moved about to make room for flu patients. The Chinese appear to be gearing up for an outbreak.
In Australia, they are running commercials on the TV with a toll free number to report if you have the flu. Some Aussies have expressed concerns over calling this number, apparently worried that it might invoke some sort of enforced quarantine. We'll see how effective it is.
And from Russia, this story:
No quarantine measures can stop bird flu pandemic, if it appears, stated in March 7 head of virology research institute of Russian Medical Academy of Sciences Dmitry Lvov, informs a REGNUM correspondent.
According to the expert, one third of Earth population will suffer from bird flu pandemic. He thinks that in Russia, bird flu pandemic can come from China. He reminded that nearly all Russian regions, except for Eastern Siberia and Far East are infected with bird flu in a greater or lesser extent.
The expert asked Russian authorities to be ready in short amount of time to create hundred thousands of quarantine places.
And yesterday, the WHO announced that Avian Flu is a bigger global health Challenge than AIDS.
This announcement is particularly worrisome. AIDS has been a political sacred cow for nearly two decades, and to elevate Avian Flu above AIDS was a bold statement.
As I write this, a hastily called meeting is in progress in Geneva, where the WHO is gathering to discuss pandemic planning and response.
The pot is definitely boiling.
Monday, March 06, 2006
Counting Down the Top 40
As of today, 40 countries are reporting avian flu in their bird population. That's an increase of 5 countries in the last week. A number of these countries have suspected cases of human infection. Only those with confirmed cases are noted, however.
-- Austria
-- Azerbaijan
-- Bosnia and Herzegovina
-- Bulgaria
-- Cambodia
-- China (human cases confirmed)
-- Croatia
-- Cyprus
-- Egypt
-- France
-- Germany
-- Greece
-- Hungary
-- India
-- Indonesia (human cases confirmed)
-- Iran
-- Iraq (human cases confirmed)
-- Italy
-- Japan
-- Kazakhstan
-- Kuwait
-- Laos
-- Malaysia (human cases confirmed)
-- Mongolia
-- Niger
-- Nigeria
-- Poland
-- Pakistan
-- Romania
-- Russia
-- Serbia and Montenegro
-- Slovakia
-- Slovenia
-- South Korea
-- Sweden
-- Switzerland
-- Thailand (human cases confirmed)
-- Turkey (human cases confirmed)
-- Ukraine
-- Vietnam (human cases confirmed)
At the rate things are spreading, look for this number to double over the next few months. Experts expect avian flu to arrive in the United States over the next few months.
Who's next?
As of today, 40 countries are reporting avian flu in their bird population. That's an increase of 5 countries in the last week. A number of these countries have suspected cases of human infection. Only those with confirmed cases are noted, however.
-- Austria
-- Azerbaijan
-- Bosnia and Herzegovina
-- Bulgaria
-- Cambodia
-- China (human cases confirmed)
-- Croatia
-- Cyprus
-- Egypt
-- France
-- Germany
-- Greece
-- Hungary
-- India
-- Indonesia (human cases confirmed)
-- Iran
-- Iraq (human cases confirmed)
-- Italy
-- Japan
-- Kazakhstan
-- Kuwait
-- Laos
-- Malaysia (human cases confirmed)
-- Mongolia
-- Niger
-- Nigeria
-- Poland
-- Pakistan
-- Romania
-- Russia
-- Serbia and Montenegro
-- Slovakia
-- Slovenia
-- South Korea
-- Sweden
-- Switzerland
-- Thailand (human cases confirmed)
-- Turkey (human cases confirmed)
-- Ukraine
-- Vietnam (human cases confirmed)
At the rate things are spreading, look for this number to double over the next few months. Experts expect avian flu to arrive in the United States over the next few months.
Who's next?
Sunday, March 05, 2006
CARROT OR STICK?
From a Canadian Newspaper March 1st, 2006
"Pandemic Bill Raises Alarm"
By John Miner
Health Care workers could face fines of up to $100, 000 and jail if they refuse to work.
Sweeping new Ontario emergency legislation has health-care workers afraid they may be forced to choose between protection of their families and a jail sentence if a flu pandemic hits the province. Bill 56 has raised alarms with doctors, nurses and other health-care workers because it contains a clause that gives the Ontario cabinet power to "authorize" any person reasonably qualified to provide services in a declared emergency.
The penalty for violating the proposed law is a fine of up to $100,000 and a year in jail for each day the order isn't obeyed.
While this bill isn't the law yet, its proposal has enraged thousands of healthcare workers in Canada, and has those in other countries wondering how long before other governments follow suit.
Particularly disturbing is the announcement last month that Health Care Workers in Canada will not be receiving Tamiflu as a preventative anti-viral as was orginally proposed. There are, it seems, not enough pills to go around. Tamiflu will only be provided after a health care worker falls ill.
Of course, we don't really know if taking Tamiflu will protect against the Avian Flu. But it was a small bit of hope that most nurses, doctors, medics, and techs had if they were going to report to work.
Now, workers will be faced with no antiviral protections, and a government that is threatening to jail them if they don't expose themselves, and their families, willingly.
You can bet that the government will have Tamiflu for essential employees and their families. HCW's are apparently cannon fodder in the war against Avian Flu.
The decision to use a stick will surely backfire.
Better to offer a carrot to those who will volunteer to brave a pandemic. Tamiflu, masks, gloves, and adequate security for the workers and food/water/meds for their families. If needed, set up barracks for HCW's to live in, away from their families, while they work. But make sure their families are taken care of, provide for communications between workers and their families, and be prepared to pay bonus's to those who work.
The idea that you can force HCW's to work, and that they will comply, is ludicrous. Entice them to work. Make it reasonably safe. Provide incentives for their families. And many (but not all) will decide it is in their families best interests for them to report to work.
Sadly, as governments around the world begin to realize the enormity of the situation, I expect more draconian measures to be considered by our legislatures.
You may avoid the Flu, but Stupidity is endemic in government.
From a Canadian Newspaper March 1st, 2006
"Pandemic Bill Raises Alarm"
By John Miner
Health Care workers could face fines of up to $100, 000 and jail if they refuse to work.
Sweeping new Ontario emergency legislation has health-care workers afraid they may be forced to choose between protection of their families and a jail sentence if a flu pandemic hits the province. Bill 56 has raised alarms with doctors, nurses and other health-care workers because it contains a clause that gives the Ontario cabinet power to "authorize" any person reasonably qualified to provide services in a declared emergency.
The penalty for violating the proposed law is a fine of up to $100,000 and a year in jail for each day the order isn't obeyed.
While this bill isn't the law yet, its proposal has enraged thousands of healthcare workers in Canada, and has those in other countries wondering how long before other governments follow suit.
Particularly disturbing is the announcement last month that Health Care Workers in Canada will not be receiving Tamiflu as a preventative anti-viral as was orginally proposed. There are, it seems, not enough pills to go around. Tamiflu will only be provided after a health care worker falls ill.
Of course, we don't really know if taking Tamiflu will protect against the Avian Flu. But it was a small bit of hope that most nurses, doctors, medics, and techs had if they were going to report to work.
Now, workers will be faced with no antiviral protections, and a government that is threatening to jail them if they don't expose themselves, and their families, willingly.
You can bet that the government will have Tamiflu for essential employees and their families. HCW's are apparently cannon fodder in the war against Avian Flu.
The decision to use a stick will surely backfire.
Better to offer a carrot to those who will volunteer to brave a pandemic. Tamiflu, masks, gloves, and adequate security for the workers and food/water/meds for their families. If needed, set up barracks for HCW's to live in, away from their families, while they work. But make sure their families are taken care of, provide for communications between workers and their families, and be prepared to pay bonus's to those who work.
The idea that you can force HCW's to work, and that they will comply, is ludicrous. Entice them to work. Make it reasonably safe. Provide incentives for their families. And many (but not all) will decide it is in their families best interests for them to report to work.
Sadly, as governments around the world begin to realize the enormity of the situation, I expect more draconian measures to be considered by our legislatures.
You may avoid the Flu, but Stupidity is endemic in government.
No News is . . .
Well, actually there is news. It just has been pushed off the front pages by a barrage of other stories. Bush in India/Pakistan. A tit for tat civil war brewing in Iraq. The Oscars. . .
Somehow, over the past few days, Avian Flu has fallen by the wayside among the mainstream media. Perhaps it's the lack of access to the hot zones, after all, many are in remote (and dangerous) areas of the world. Iraq, Nigeria, Indonesia, China . . . none of which are exactly reporter friendly.
Still, the threat continues to grow.
International avian flu specialists gathered in Taipei yesterday to give an update on the spread of the disease.
Masato Tashiro, director of the Department of Viral Diseases and Vaccine Control at the National Institute of Infectious Diseases in Tokyo, warned that cases in which the virus transmitted from birds to humans had begun to rise recently and human-to-human virus transmissions are likely to be seen in the near future.
"Avian-human transmission happens sporadically, but the number of cases are increasing," Tashiro said, "Flu viruses are constantly undergoing mutations, which could result in human-to-human virus transmissions, which is the worst case scenario."
Comforting.
In Germany, a dead cat was found to be infected with H5N1. Not really surprising, as a couple of dozen tigers in the far east died after zoo keepers fed them infected chickens. But in France and Germany, the public is being advised to keep their cats indoors, their dogs on a leash, and not to allow cats to sleep in their beds.
Cat lovers by the hundreds are now dumping their beloved pets at shelters for `adoption or disposal'.
In Azerbaijan, a family of six is reportedly ill with `viral pneumonia'. Officials admit they are concerned this may be another cluster of Avian Flu. Awaiting test results.
Local media in Puerto Rico are reporting a family of 5 that may have avian flu, but right now, this is an unconfirmed rumor. I have doubts as to it's reliability, so just file that one away as a `maybe'.
Chinese officials continue to warn of a `massive outbreak' of bird flu, and say the the situation is `fairly grave'. Film at 11.
And my favorite hotspot, Indonesia, continues to report cases . . . and deaths. Officially, up to about 70 people now. And roughly 1 death a day in the media attributed to avian flu.
And finally, there's this. . .
The WHO has announced a meeting of the Public health experts in Geneva next week for quick action to head off a potential influenza pandemic. This three-day conference is called as a Hong Kong official reported another possible human case of H5N1 avian flu in China, involving a 32-year-old man who died yesterday.
The international body stated: "Even if the pandemic cannot be stopped, public health interventions might buy time to allow countries to further strengthen their response systems, as well as accelerating the production of pandemic vaccine."
THANK GOD WE HAVE A VACCINE!
Oh, wait. No vaccine, maybe not for another year or two.
Nevermind.
Well, actually there is news. It just has been pushed off the front pages by a barrage of other stories. Bush in India/Pakistan. A tit for tat civil war brewing in Iraq. The Oscars. . .
Somehow, over the past few days, Avian Flu has fallen by the wayside among the mainstream media. Perhaps it's the lack of access to the hot zones, after all, many are in remote (and dangerous) areas of the world. Iraq, Nigeria, Indonesia, China . . . none of which are exactly reporter friendly.
Still, the threat continues to grow.
International avian flu specialists gathered in Taipei yesterday to give an update on the spread of the disease.
Masato Tashiro, director of the Department of Viral Diseases and Vaccine Control at the National Institute of Infectious Diseases in Tokyo, warned that cases in which the virus transmitted from birds to humans had begun to rise recently and human-to-human virus transmissions are likely to be seen in the near future.
"Avian-human transmission happens sporadically, but the number of cases are increasing," Tashiro said, "Flu viruses are constantly undergoing mutations, which could result in human-to-human virus transmissions, which is the worst case scenario."
Comforting.
In Germany, a dead cat was found to be infected with H5N1. Not really surprising, as a couple of dozen tigers in the far east died after zoo keepers fed them infected chickens. But in France and Germany, the public is being advised to keep their cats indoors, their dogs on a leash, and not to allow cats to sleep in their beds.
Cat lovers by the hundreds are now dumping their beloved pets at shelters for `adoption or disposal'.
In Azerbaijan, a family of six is reportedly ill with `viral pneumonia'. Officials admit they are concerned this may be another cluster of Avian Flu. Awaiting test results.
Local media in Puerto Rico are reporting a family of 5 that may have avian flu, but right now, this is an unconfirmed rumor. I have doubts as to it's reliability, so just file that one away as a `maybe'.
Chinese officials continue to warn of a `massive outbreak' of bird flu, and say the the situation is `fairly grave'. Film at 11.
And my favorite hotspot, Indonesia, continues to report cases . . . and deaths. Officially, up to about 70 people now. And roughly 1 death a day in the media attributed to avian flu.
And finally, there's this. . .
The WHO has announced a meeting of the Public health experts in Geneva next week for quick action to head off a potential influenza pandemic. This three-day conference is called as a Hong Kong official reported another possible human case of H5N1 avian flu in China, involving a 32-year-old man who died yesterday.
The international body stated: "Even if the pandemic cannot be stopped, public health interventions might buy time to allow countries to further strengthen their response systems, as well as accelerating the production of pandemic vaccine."
THANK GOD WE HAVE A VACCINE!
Oh, wait. No vaccine, maybe not for another year or two.
Nevermind.
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