Public health preparedness
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 23, 2007If you travel at all, and I have to travel a fair amount, you know how brittle the air traffic system is. Last week I did an out-and-back one day affair of around 500 miles each way. Weather was good and I made it to my destination on time. The meeting went from 10 am to 1:45 pm. Then a dash to the airport for a 2:35 pm flight home. Except that higher than usual winds at my destination set in motion a cascade of air traffic delays as the number of available runways shrank and I was 3 hours late. Not terrible, but just a measure of how sensitive the system is to the slightest upset.
The…
revere | April 21, 2007If you have ever driven or lived in Boston you know that signage is not one of the city's strong points. In fact, it is almost impossible for an outsider to comprehend how bad the sign situation it is. Often you can only tell what street you are not on, because many main streets don't have street signs, although the cross streets do. And a street is likely to change it crosses over one of the invisible boundaries that mark the divisions between the state's 351 cities and towns. Each city and town borders others. There is no unincorporated land in Massachusetts, every square inch being in…
revere | April 6, 2007The RAND corporation is one of the country's foremost non-profit consulting companies. Their Reports carry weight. So I was interested to see the announcement of a new Rand panel report on key components of public health emergency preparedness. Emergency preparedness means many things to many people, and immediately after 9/11 it meant responding to a terrorist attack. These days we think more in terms of hurricanes and pandemics. I think that's progress. But I have to say the RAND report didn't seem to advance the ball much. Here are the three broad categories they believe communities should…
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 | March 13, 2007Be prepared, and be careful not to do
Your good deeds when there's no one watching you
If you're looking for adventure of a new and different kind
And you come across a Girl Scout who is similarly inclined
Don't be nervous, don't be flustered, don't be scared,
Be prepared
(Tom Lehrer, Be Prepared)
The recent stories that CDC has not been able to determine the effectiveness of tax dollars meant to improve response to bioterrorism comes as no surprise. Not because CDC has misspent the money (which they probably have) or because they have been negligent in seeing if the money is well spent. The…
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 5, 2007No vaccine, antivirals in short supply, what to do if bird flu strikes? Wash your hands, seems to be a favorite. While its efficacy is unproven, it's not a bad thing to do anyway. Dry skin is the only plausible side effect. Dry skin and hand sanitizer abuse. It's 70% ethyl alcohol:
The 49-year-old Maryland inmate seemed seriously sick after he drank from a gallon-container of hand sanitizer. Described as "loony," "red-eyed" and "combative," he was whisked by officials to a nearby Baltimore hospital for treatment.
But they quickly discovered he wasn't ill -- just very, very drunk on Purell.…
revere | February 3, 2007CDC held a full scale bird flu drill yesterday and allowed reporters to watch (h/t ch). After some reported what they saw, one wonders if they will do it again. Not that they finished the drill, which was stopped halfway because Atlanta had an ice storm. I hope this doesn't happen during a real emergency. An emergency like this one:
⢠A 22-year-old Georgetown University student who visited his family in Indonesia returned to the United States. He became seriously ill the next day and went to a Washington, D.C. hospital. Lab tests confirmed he had the bird flu that's been killing people in…
revere | February 1, 2007It's flu season. Human flu, that is. Also, it seems, flu in poultry. So if someone comes down with high fever, aches and pains and a cough in an area where there is H5N1 in poultry, is it likely to be bird flu? The answer, so far, is "No." The reason is fairly straightforward, although this is counter-intuitive for many. First, the empirical evidence (from Thailand), then the explanation.
Nearly half of the patients on the bird-flu watch list have, in fact, caught human influenza, the Medical Sciences Department (MSD) disclosed yesterday.
Since bird-flu infections among fowls were detected…
revere | January 25, 2007We spend a lot of time on bird flu here because, as I have explained, it is a useful lens through which to look at the void in public health leadership as well as preparedness issues of the system that allegedly protects us from bird flu and much else. We don't spend all this time on bird flu because we believe it is the most important public health problem in the world. It could become so, but it isn't now. Our view is that if it ever does, we should be ready for it, and it takes leadership for that to happen. But there are other gigantic problems, too, and we want to highlight one of them…
revere | December 14, 2006Last week we posted on the Canadians realizing that if a a pandemic hit, even a moderate one, their hospital system would be in deep feces. This week it's the US's turn. Not that this is news, exactly, but it bears repeating. Again. And again. And again. So here's the message. Again:
Half of all U.S. states would run out of hospital beds within the first two weeks of a moderate flu pandemic and 47 states would run out if a bad one hit, according to a report issued on Tuesday.
The report from the Trust for America's Health shows the United States is still poorly prepared for a pandemic,…
revere | November 7, 2006Nothing says more about the routinely nasty depths American politics than this story.
In Houston, the city health department got money from the Robert Wood Johnson and Amerigroup Foundations, two charities much involved in health care, to provide free flu shots near polling places in medically underserved areas. This isn't uncommon. Some twenty other cities, in several states, are said to have similar "vote and vaccinate" programs (see for example, here). The idea is to go where the people who need the services are.
Nothing is simple anymore. Not even free flu shots for the poor. The right…
revere | October 24, 2006An urgent communication from the World Health Organization (WHO) expresses concisely how far behind we are in being prepared for a global pandemic of influenza. Currently there are a number of vaccines under development, some of which might protect against an H5N1 virus that has become readily transmissible from person to person. But none are in production, and even if some were found adequate (not the case) and large scale production begun (far from the case), we, the world, would still be in a fix:
"We are presently several billion doses short of the amount of pandemic influenza vaccine we…
revere | October 7, 2006If you haven't gotten your flu vaccine yet or you don't plan to get one you are in the majority. Of course if you read this site you are in a small minority, so I'm guessing many of you plan to get a flu shot. Which is good. I'd also ask for pneumovax, too, a vaccine against pneumococcal pneumonia, a frequent secondary infection in influenza. But back to flu vaccine.
There is some evidence of cross-protection between seasonal influenza vaccination and H5N1 infection. Since one component of the seasonal vaccine, H1N1, shares a subtype N1 antigen with H5N1, this isn't implausible. More…
revere | October 6, 2006I'm still trying to figure out if the statement by Ambassador John Lange, the US State Department's special representative on avian and pandemic influenza, that this country is close to "state-of-the-art" in its preparations for a pandemic of H5N1 and its biosecurity measures is some kind of dark humor about state-of-the-art in general or just an amazingly clueless assessment of where we are. I'm aware that a sense of humor doesn't usually characterize the official prnouncements of this administration, although some of them do produce hysterical laughter. I'm pretty sure he is either clueless…
revere | September 26, 2006The City of Boston is now soliciting volunteers for a new Boston Medical Reserve Corps Program, designed to help the city prepare for disasters:
"I want everyone in Boston to consider joining the Boston Medical Reserve Corps; people in our medical, health and business communities, our residents, our college students, retirees -- anyone who wants to help," said Mayor Menino in announcing the recruitment drive. "We're looking for everyday heroes to help make Boston safer and more prepared."
Following many disasters, large numbers of people often come forward to help. Many of those well-…
revere | September 20, 2006Nick Zamiska had an interesting piece in yesterday's Wall Street Journal about the difficulty WHO is having encouraging a sense of urgency about a possible pandemic of avian influenza and the many other programs and problems with which they are daily engaged in a (literally) life and death struggle in many places in the world most of us have never heard of. The problem is made more difficult because of the roulette-wheel like nature of an emerging pandemic. We don't know when or if our number will come up or how much we should invest in the event it does. So far it hasn't happened, which is a…