Pandemic preparedness
revere | May 16, 2007The squabble about viral isolates originating within the borders of Indonesia notwithstanding, the simple fact is that if there were a pandemic there is only a fraction of the needed productive vaccine capacity necessary globally. What fraction? Good question.
The earth is home to 6 billion people, give or take a few hundred million. And a few hundred million doses is our global vaccine capacity in the event of a pandemic. The annual capacity is estimated around 300 - 400 million, possibly 500 million if pushed. That's annual production. If we had to ramp up a specific pandemic strain from…
revere | May 15, 2007Indonesia has just registered its 76th death and 95th case of bird flu, making it the country with more of each than any other nation. Not that you would know it by looking at the current WHO count of confirmed cases. That's because Indonesia hasn't sent WHO any viral isolates for confirmation since January. We've covered this too often to repeat the details (see here, here, here, here, here, here, here, here and here for some background), but the issue is now front and center in this week's World Health Assembly, the official governing body of WHO convened in Geneva:
The issue of sharing…
revere | May 14, 2007You might wonder what this video (hat tip Boingboing) has to do with bird flu. Nothing. Except this. If this guy and another 40% of his buddies are out sick, who's going to do his job if the high voltage lines go down in an ice or wind storm. I'd like to think I'd help sick people. But this? Forget it.
glumbert.com - High Power Job
revere | May 11, 2007The US military didn't plan for the aftermath of Iraq. You know, controlling the civilian population? So they've learned their lesson. You gotta plan for it:
The US military has begun to plan for a possible avian flu pandemic that could kill as many as three million people in the United States in as little as six weeks, a Pentagon planning document said.
The Defense Department's "Implementation Plan for Pandemic Influenza," which was posted Wednesday on a Pentagon website, lays out guidelines and planning assumptions for US military services and combatant commands.
Possible scenarios include…
revere | May 7, 2007Thursday CDC issued some "Interim Guidance Issued For The Use Of Facemasks And Respirators In Public Settings During An Influenza Pandemic" and of course there were many news stories. It would seem the guidance wasn't exactly clear, at least judging from what headline writers took away from exactly the same story:
CDC recommends masks in pandemic
Masks Might Not Block the Super-Flu
CDC offers tips on using masks against flu
Scientists can't mask their opinion
US Government Issues Facemask Advice For Flu Pandemic
Consider using masks if flu strikes
CDC: Masks Not Much Help In Flu Pandemic
TFAH…
revere | May 4, 2007What do you say when you really don't know the answer to the question, "Should I wear a mask to protect me against bird flu if it becomes pandemic?" Here's the CDC answer:
If a super-flu strikes, face masks may not protect you. Even so, the government says people should consider wearing them in certain situations, just in case. The consumer advice issued Thursday reflects the fact that the science behind it is unclear. Whether widespread use of masks will help, or harm, during the next worldwide flu outbreak is a question that researchers are studying furiously. (AP)
I'm not sure exactly how…
revere | May 1, 2007Last week we talked about "mash-ups," the combination of online resources from disparate sources, and pointed out that Google Maps and Google Earth were favorite substrates for this. Declan Butler, senior correspondent at Nature, is the first we know of to construct a Google Earth mashup for bird flu. Now there is a very sophisticated version from scientists at the University of Colorado and Ohio State University:
The research team has tracked the spread avian flu around the globe over time by specific host groups of birds, mammals and insects. (Credit: CU-Boulder, Ohio State University)
A…
revere | April 27, 2007It was inevitable. Roche is now planning to cut production of its antiviral Tamiflu because, they say, supply is exceeding demand:
Swiss pharmaceutical group Roche said Thursday it would trim production of the frontline bird flu drug Tamiflu unless demand picked up, but warned that the world was still not ready for a pandemic.
Manufacturing capacity for the antiviral treatment has reached 400 million treatment courses a year and is outstripping demand, William Burns, the chief executive of the group's pharmaceuticals division told journalists.
Roche has received orders for 215 million…
revere | April 25, 2007The stuff you read in the newspapers. Jeez. First a story about Des Moines, Iowa officials looking for someplace to quarantine people in the event of a bird flu outbreak. Yes, that's right. Quarantine. Lots of times when you read that they really mean, isolation, the segregation of sick people. Quarantine is the segregation of possibly exposed people who aren't sick. And in Des Moines they really mean "quarantine":
One of the toughest challenges would be to quarantine people who were exposed to the virus but weren't showing symptoms. Most would be asked to stay home for about a week. Those…
revere | April 19, 2007An excellent article on the CIDRAP site by Maryn McKenna (late of the Atlanta Journal Constitution where she had the CDC beat) won't be news to readers here, but it is news that it is news. The subject is efforts by non public health types in preparing for pandemic influenza. McKenna notes that recent reports by two different but highly regarded groups has noted that governmental planners are not making full use of grass roots groups outside of professional boundaries. In fact they aren't making use of them at all. Communication with the public is one way.
The first report, "Community…
revere | April 13, 2007I admit to being prejudiced, here, but my experience living in Sweden (a long time ago, it is true), knowing a bit of the language and seeing what goes on there makes me think of the Swedes as one of the most rational people on earth. It's true most other peoples don't give them a lot of competition on that score, and I am sure there will be Swedes reading this who will protest I've done their country an injustice. It's far worse than I'm making out, they'll tell me. Sure. Come over here and live. Don't forget to bring your Swedish health insurance. We don't provide it here.
Sweden is a small…
revere | April 7, 2007For some reason the subject of masks evokes great emotion here. I'm not sure why. The idea that masks will help in a pandemic is a strongly held belief that might even be true. We don't know. I venture into mask territory knowing that, like gun control and atheism, I'll get a reaction. But a recent paper in the CDC journal, Emerging Infectious Diseases, brings up once again the difficulties in proper mask use. The subject was N95 Full Face (FF) respirators, the kind you would need in an influenza pandemic if you were to cover your mouth, nose and eyes, the latter because you can be infected…
revere | March 26, 2007[Oh, my. Thanks to my readers at CIDRAP (tip of the hat!) I have become aware the story linked below on masks is an old one, something Crof at H5N1 calls a ghost story. The NewsNow aggregator I use has been doing this a lot lately, so I have been alert, but in this case I had it in my head there was a new mask report and I didn't check the date carefully. Everything I said in the post is still true, but it isn't new. In fact I said much the same thing when it first came out -- a year ago! Anyway, my apologies to readers. I hate to make mistakes like this.]
The National Academies os Science'…
revere | February 28, 2007Sometimes my flu obsessed readers think no one is paying attention but it isn't true. Beneath the surface of a spasmodically and superficially interested mainstream media, various institutions are worrying and grappling with the enormity of the consequences of a pandemic. Colleges and universities have the special problem of large and dense communities of mobile and active young adults, the ones in the cross-hairs of the current pandemic candidate, influenza A/H5N1. Many, probably most, colleges and universities have not done much. But a significant number have. The University of Minnesota is…
revere | February 25, 2007Table top exercises are supposed to be realistic. I've taken part in them and I can tell you they are. So it's not surprising this realism, often including simulated notices and documents, can combine with the speed of information dissemination of the internet in ways that are, well, not surprising:
UNICEF and the Maldivian government are today reassuring people that reports of a bird flu outbreak in the Maldives are untrue.
The reports were spread after documents forming part of a UNICEF simulation training exercise were doctored and leaked by a third party. A document detailing the…
revere | February 24, 2007The American Public Health Association is the organizational voice of American public health. I've been a member for almost 40 years and served on its Governing Council and on one of its top policy boards. Admittedly I've not been very active for the last number of years, especially as APHA has become neutered and politically marginalized. But I have a soft spot in my heart for it and its tens of thousands of members, mostly dedicated, hardworking and underpaid public sector professionals. So it pains me to say their just announced pandemic flu "prescription" is a prescription for an obsolete…
revere | February 21, 2007Good idea, but is it new? When I read (hat tip easyhiker) that computer scientists at the University of Maryland were suggesting logging onto a social networking site as a useful adjunct to official information in the event of a pandemic, I thought this was not a new idea. The grandaddy/mama of sites like this, The Flu Wiki, has been up since June of 2005. It regularly logs thousands of daily visitors sharing information and tips on pandemic prepping. Other sites, in bulletin board format, have also been up for a long time. Flublogia is already well-populated.
But an examination of their…
revere | February 13, 2007An influenza pandemic will have many casualties, but truthfully, it never occurred to me YouTube might be one of them:
Many companies and government agencies are counting on legions of teleworkers to keep their operations running in the event of an influenza pandemic. But those plans may quickly run aground as millions of people turn to the Internet for news and even entertainment, potentially producing a bandwidth-choking surge in online traffic.
Such a surge would almost certainly prompt calls to restrict or prioritize traffic, such as blocking video transmissions wherever possible,…
revere | February 5, 2007The big news is that the UK has its first large outbreak of H5N1 in commercial poultry, a turkey farm in Suffolk. Retailers there are already moving to reassure the public. Although this is the UK's largest turkey farm, large chains have been quick to say they do not sell its birds. The Talking Points have been ready for some time. You have nothing to fear but fear itself. It is perfectly safe to eat an infected bird if you cook it properly.
The US poultry industry is also ready, although they have assured us they are safe because they have excellent biosecurity. Just like the UK farms…
revere | February 4, 2007Friday CDC released its guidelines for communities to respond to pandemic flu. It adopts a hurricane warning analogy (Category 1 to Category 5 pandemic). The Categories are keyed to case fatality ratio, with the lowest category being roughly the experience of seasonal influenza (less then 0.1% CFR and illness rates of 5 - 20%), Cat 2 being the experience of the 1957 and 1968 pandemics (CFR of less than .5%) ratcheting up to Cat 5, the experience of the 1918 spanish Flu, whose CFR has been roughly estimated to be around 2 - 3%. By these measures, if H5N1 went pandemic at its current CFR of 60…