Pandemic preparedness: a pat on the back or a kick in the butt?

Another report, another story: the world is not ready for a pandemic. Before you click away (you've heard it before) I'll be saying something more about it than just reiterating the dire prognosis if we don't shape up. But first the message, from the UN and the World Bank:

The world remains unprepared to cope with a pandemic in humans arising from bird flu, a UN and World Bank report released Thursday found.

"Although a massive global effort to control highly pathogenic Avian Influenza (or severe bird flu) has led to improved responses to outbreaks in poultry in many countries during the last year, there is a continuing risk of a virus mutation which results in severe and easily transmitted influenza in humans, potentially precipitating an influenza pandemic," said the report by the UN System Influenza Coordinator, Briton David Nabarro, and the World Bank.

"The pandemic threat has led most governments to improve services to detect, contain and lessen the impact of dangerous pathogens," it said.

"However, many national pandemic plans are not sufficiently operational and the coordination of pandemic planning between countries needs greater attention," it added, ahead of an international conference set to discuss related issues December 4-6 in New Delhi. (Agence France Presse via Raw Story)

So what could anyone possibly say about this that's at all new -- or even just not boring? Probably not much, but I'll take a stab at it. We first started blogging about this three years ago. At the time we were almost alone in the blogosphere (two simultaneous exceptions were DemFromCT at DailyKos and The Next Hurrah and Melanie at Just a Bump in the Beltway; our common interest led in June 2005 to the founding of the Flu Wiki). Now we are just a small corner of FluBlogia, often overshadowed by fine blogs like Avian Flu Diary, Crof's H5N1, Sophia Zoe's blog, Coming Influenza Pandemic and many more (apologies to those left out; I am tired and it's been a long day). Of course there's Flu Wiki Forum, still the go-to source (IMO). Maybe the World Bank doesn't count these developments, but I do.

Yes, there remains a good deal to do. Most countries, cities, towns, states, agencies . . . whatever, don't have an operational plan in place. But many of them have been planning, and it's the planning not the plan that makes the difference. The Plan will go down the toilet on Day 3 of a pandemic, but the thinking ahead will last. Forethought is the major weapon and it is being wielded by many.

Most of us are tired of hearing the world's not ready. That's not a reason to stop reminding us. The fact that the progress from three years ago is substantial is also not a reason to rest. There is still a lot to do. But every once in a while it pays to remind ourselves that it isn't hopeless, that progress has been made, that we can make still more progress. No one knows when or if the other shoe will drop but until it does, slow, steady, systematic efforts will get us a bit farther down a long road.

Sometimes we need a light pat on the back. We've had plenty of kicks in the butt.

More like this

Yeah and thats it Revere. Trying to convince locals and state officials that having a 600 page plan as we do here in Tennessee is WAY too much for a pandemic. Hell, it uses words that I literally had to go look up the meaning for. But its like writing a playbook for a war. I mean they have positions, then sub supported positions. If-then-else programming. It also points out that most states and counties have things on PAPER but nothing to support that position. They are allotting a little more money but not doing what they should with it. And thats what this is all about...money.

If its 5% then we can take that hit, probably all the way to 7% if it doesnt move too terribly fast. Some governmentals will collapse somewhere between there. But if it takes off and really goes, then figure what 8% of your population is and thats the number when the gloves are going to come off at the state houses and governors are going to be declaring states of emergency.

I do disagree though...Michael P can chime in. They have a plan and they suck. Just flat suck because their big idea is that we will just go out and call the governor. The governor on the big plan sheet says urps too much and calls FEMA.... They are much better prepared now than they were but they are a direction agency. They are an agency with money but few people. They pull all other branches in and tell them what to do. Those branches though will be heavily wilted by panflu and the second you hear state of emergency from any really populated state, then you can bet the federal one will come two or three days later. There is no way even with the military that the outcome of panflu at anything past 8% could be good. We have all spoken about logistics, and planning and you aptly understand that this all goes out the window when it comes at about day three.

It will come and hit hard and then the shock will start to settle in, then the body will start to react and people will start to panic, with the panic comes the state of emergency, then the real realities start to come into play. Vaccines? The plan here establishes a drive up flu shot line and how they would do it. But not where. Not a word in it. Some would call that flexibility. I call it bullshit. You should have a place and a backup. It also assumes that there will be power, water and all the essentials to do this.

By M. Randolph Kruger (not verified) on 30 Nov 2007 #permalink

The Avian Flu Talk forum was around in 2005. It's funny how nobody ever mentions that. AFT released 20 news wires and paid for several different types of national ad campaigns to bring awareness to panflu. Did any other sites ever spend one penny of their own money to do these things? The Flu Wiki founders/doctors with all their might (and dinero) have never spent a dime, yet they take the credit for the awareness AFT brought. If it wasn't for Avian Flu Talk, not only would there be no Flublogia, but there would probably be very little awareness overall.

Same old lack of respect.

Revere, MRK, et al

I too share your frustrations,for the past 2 years + I've been trying to get my town to prepare.

Alas, it was I was not prepared: for partisanship, indifferance, sheer blantant stupidity and bureauracy at its' lowest level.

However, there are a few good decent grass-oots level folks locally who share our views and are willing to help in the planning.I take great heart in their friendship and work ethic.

Times change but people don't.

Revere, MRK, et al

I too share your frustrations,for the past 2 years + I've been trying to get my town to prepare.

Alas, it was I who was not prepared: for partisanship, indifferance, sheer blantant stupidity and bureauracy at its' lowest level.

However, there are a few good decent grass-oots level folks locally who share our views and are willing to help in the planning.I take great heart in their friendship and work ethic.

Times change but people don't.

Anonymous from Avian Flu Talk: No offense meant to the many who have toiled hard to bring us to the point we are, wherever that might be. If you read the post carefully you will see I did not credit Flu Wiki with creating Flublogia, but for the record, FW is not free to its founders. All of us have spent considerable amounts of money keeping the servers up and paying technical support. It runs into the many thousands (I don't even want to think how much). We haven't made in issue of it.

When you work hard on something it is natural to expect some credit and recognition and I thought hard about whether to mention anybody since I couldn't mention everybody. I won't argue about whether Flublogia is the creation of AFT or FW or H5N1 or CE -- or not -- since it doesn't matter much. My point was that we have made progress. I'm happy to give you the credit you deserve -- along with others.

Just to point out that the funding that paid for most of that planning (CDC Panflu and Emergency Preparedness Grants) took a fairly major hit again this year. I guess other things are more important.

By A Nonny Mouse (not verified) on 30 Nov 2007 #permalink

Hi Revere(s),

First of all I want to "Thank You" for all you do! I remember when you let us know that on a Thanksgiving Holiday 2005 you and others decided to start a blog. Of course I wasn't real savvy about blogs at the time and when I posted my inquiry to "Effect Measure" in early 2006 you were prompt to reply and calm my fears; another big "Thank You". I have been a busy little bee getting ready and boy am I glad I did (what with the price of oil and all). By the way I follow a lot of other blogs and the guys at the Avian Flu & H5N1 blogs should get a Pulitzer! Kathy from Florida, FluWiki should get her own cooking show for personal prepareness on Food TV, CanadaSue, Theresa42, AlaskaDenise, Scott MacPherson, and all the others-what can I say except terrific job!

Thanks to all that keep us informed and have a Merry Holiday

DD

PS, I glad Juan went away...and so did my headaches.

By 2 & 11 mon… (not verified) on 30 Nov 2007 #permalink

DD: Thanks. Actually we started on Thanksgiving 2004. Time flies, even when you're not having fun (but when you are old).

Some of those elite who rule us supposedly believe the biggest threat to the planets environment is the virus known as "homo sapiens" and would welcome a 80% reduction in the population. I sometimes wonder if the lack of any real effort on global warming is in anticipation of events like pandemics and possibly the coming WW III that our leader keeps harping about. If WW III is welcomed, then possibly a H5N1 pandemic is as well. After that, carbon emissions will go way down. It's a theory that explains inaction on environmental and health issues and our aggressive wars, but you have to believe in conspiracies.

About the only good thing that seemed to come out of the H5N1 hype a couple of years ago was Rumsfelds stock in Gilead went up. They receive a royalty on 10% of Tamiflu sales. Oh, and also the Flu Wiki where I spent a lot of time after checking Henry Nimans site. I even was able to stock up on some Tamiflu which has now past it's expiration. Incidentally, isn't it about time for Uncle Sam to place new orders as the drug only has a 3 year shelf life, this might explain the H5N1 warning by the UN and World Bank. Might be time to buy some of that Gilead stock.

Don't get me wrong, I take H5N1 seriously. As a possible (long story) SARS survivor who spent considerable time in Shanghai, Taipei and Hong Kong at the time, and going from one quarantine to the other, and traveling on near empty planes, and who still lives in Greater China, I do not want to see a repeat of that nonsense.

This year, in the run up to the 2008 Olympics, you can bet any pandemic like viruses in China that appear will not be reported, so let's hope this is not the year.

revere,
let me express my gratitude for your relentless efforts. I read most, if not all of your comments and with interest. Very well done. My sincere thank you.

By Anon Dr. med. (not verified) on 30 Nov 2007 #permalink

Okay Randy, I will weigh in.
While Randy and I don't agree on a lot, one thing we do agree on is that local government is ill prepared for a pandemic. I attended our county pandemic simulation as a participant. With no justification Homeland Security demanded that we simulate only a 30% infection rate and a 2% CFR. Even at that, our hospitals were done in 11 days. The hospital plan was to hire armed security guards to keep people away from food and drugs. What kind of plan is that?
Schools had no organized plan.
As you might expect, police and fire were the best prepared.
I was there as a local government representive-I almost fell out of my chair when one large city said their burial plan was to use a large oriental resturant freezer for the bodies and 18 wheeler refrigerated trailers. When I asked what they were going to do when the fuel ran out they had no response.
So much for local planning...

Can we, I mean this blog to be the mid-wife for future H5N1 vaccine companies in the world?

My concept is to form a think tank for steering the commercial vaccine production globally by providing a list of rating criteria. First, to induce the potential players to be involving with the commercial commitments. Secondly, in the future for ongoing rating their performances by top 10.

We need innovative approach to be positive re-enforcement facilitator to start.

It is a very constructive project, can we start with think tank and brainstorming?

I personally feel that the leadership of WHO, UN or World Bank are not mellow enough to take this assignment. Perhaps, they could be good followers.

What do you think, dear guys?

So Michael God love him who has a crap back is out there like me trying to get them to do SOMETHING and that something is substantial other than coming up with grade B. ideas. But the NPFP is shot full of holes and its relegated to the states to deal with. Wisely the government has said you are on your own, but we will be there as a backstop. I would put it at no more than a month before all states toss the towel in. At that point in time the 11 days of supply requests will have gone unanswered for two additional weeks. Hell, there isnt enough space to even put all of this stuff we would need. This makes it now personal responsibility.

The law is specific. Elections and disasters are all local. The Federal Government will step in when they think there is a danger to national security. My bet? The Feds will be concerned with power, fuel, security of national interests, and food if able. The latter I would say you had better crank up on.

Now except for the affection that we all feel for losing say Revere or the Reverelettes, he has said he wont prepare. On the other hand he and Ms. R. now have obligations that they took on the first time some 20 or 30 years ago when they had their first one. Those children now have children and they are all in todays prime kill zones both by age and locality. You live in a city He has said they wont prepare for personal reasons. Now IMO they have to because they because of their age will survive. Sickened but survive. Their newborns and toddlers might need them. Can anyone tell me that in the age groups we have seen that the odds are in the kids favor?

Yesterday I sent a years worth of news stories to a person who requested them in Canada. She is about 37, three kids and no dad to help. She called me back and was crying that she felt that if it came she might just go the Kool-Aid route for herself and kids. I had to calm her down and say it was a cop out to even say it. It is survivable. In fact very in Canada in the winter if you are prepared. That was her rub, she wasnt. She had done an inventory of food, availabilty of water, medicines and said, "I think I could last a month." I started laughing out loud at her. She was really upset by that.

I had to tell her that by US standards, she was now a full NIMS-800 incident responder. The average done by polling people via the phone book in Tennessee was 3-5 days for ability to survive just for food. I asked about heat. Six cords of wood she said, a fireplace and lived in the boonies. I asked her if she wanted to be in charge of her district.

She felt a lot better and just by simply doing something personally it stretches out the chances. Anyone who prepares will likely make it. Anyone in a city who prepares is likely going to have to leave to preserve themselves. I wouldnt write those others off but I can say that their chances in even a 10% event would be limited. At 30% I think its going to be a Pezzulli....

By M. Randolph Kruger (not verified) on 01 Dec 2007 #permalink

When the second commentor mentioned the start date of AFT ( Avian Flu Talk) and tied to claim credit for starting flublogia, , he forgot to tell everyone that he constantly bans people from his forum for providing good information and keeps people in the dark, neutralizing links that would provide additional information. He has banned the use of email and private messaging keeping the people there from communicating and exploring other sources of information. If he was truly concerned about raising pandemic awareness he would not be running a 'cult' type of restricted information forum. Go look at all the 'guest' members postings, they are all from people he has kicked off for trying to provide good information

By anonymous (not verified) on 01 Dec 2007 #permalink

Michael said

As you might expect, police and fire were the best prepared.

That is not what I would expect, having spent the last couple of years attending the first, second and sometimes third exercises in at least 25 local jurisdictions around here. From major metros to burgs with less 500 population, the cops and fire guys are focussed on Sept 11, anthrax, new radios and "catching the bad guys". When you try to talk to talk to them about 30% absenteeism and providing security for anybody trying to do anything, you get a blank look. If they ask questions at all, it is "where do we go for our shots?" I have to say that the small towns are going to do better than the cities. The rub will be when the cityfolk try to "evacuate" to the countryside.

Anonymous-If they want bragging rights then my lefty friend Revere gets the award for most competent website...Even if it is leftblogia, its pretty good stuff. I have my own "Gang of 13" which is 13 bug docs and an Episcopal Bishop on my email info that I send out each day. They comment from time to time if its directly in their sights. Chinese, couple of Americans, two Canucks, one I think used to be at Vektor and grad students that fill out the rest.

Got to have a thick skin here of course because Revere started it with a political bent if I recall, but its mostly medical political bent and it aint bad. As a rule though unlike all the others we try to keep it a bit more cerebral to at least the 5th grade rather than the 3rd on other sites.

I may not agree with Reveres positions but I sure as Hell respect them. Where does that one go down in the flubraggia?

.

By M. Randolph Kruger (not verified) on 01 Dec 2007 #permalink

Hi Revere(s),

First of all I want to "Thank You" for all you do! I remember when you let us know that on a Thanksgiving Holiday 2005 you and others decided to start a blog. Of course I wasn't real savvy about blogs at the time and when I posted my inquiry to "Effect Measure" in early 2006 you were prompt to reply and calm my fears; another big "Thank You". I have been a busy little bee getting ready and boy am I glad I did (what with the price of oil and all). By the way I follow a lot of other blogs and the guys at the Avian Flu & H5N1 blogs should get a Pulitzer! Kathy from Florida, FluWiki should get her own cooking show for personal prepareness on Food TV, CanadaSue, Theresa42, AlaskaDenise, Scott MacPherson, and all the others-what can I say except terrific job!

Thanks to all that keep us informed and have a Merry Holiday

DD

PS, I glad Juan went away...and so did my headaches.

By 2 & 11 mon… (not verified) on 30 Nov 2007 #permalink