Disaster/Pandemic preparedness - page 24

I was looking the the other Disaster/Pandemic thread that Florida1 started. She mentioned that after the hurricanes, that they had problems getting basic supplies and food stores were often closed... Read More

  1. by   indigo girl
    Dr David Butler-Jones, Canada's Chief Public Health Officer on Warding Off the Next One

    http://www.flutrackers.com/forum/sho...85&postcount=1

    Quote from www.flutrackers.com

    During a pandemic, aggressive decisions are sometimes made without consulting the public. Who should be held responsible for those decisions in the aftermath? It depends on the situation-that's why it's good to have things in place. When planning for these situations, you need to involve the private sector, make sure there's a connection and meet the people you need to work with. This way when you have to make decisions in an instant, you bring expertise and experience to those judgements.

    What if those actions are out of proportion to the threat? We tend to err on the side of caution. Pilots make that sort of decision all the time, when they delay a flight for instance. It's a tremendous inconvenience but most of us would prefer to be delayed than risk getting ill or have the plane go down.

  2. by   indigo girl
    The Myth of "Just in Time" (JIT) Prepping

    http://afludiary.blogspot.com/2008/0...-prepping.html

    This essay is on home prepping supplies, but consider also that
    healthcare facilities will face the same problem of running out of essential
    supplies like O2. My facility plans on being supplied by barges on the river.
    How realistic is this scenario? Where will the supplies come from when every
    other hospital, and nursing home will be asking for the same limited resources?

    Quote from afludiary.blogspot.com

    Over the past few weeks a relatively small handful of individuals and restaurant owners have stockpiled extra rice as a hedge against its rapidly escalating prices, and that has caused some large retail outlets to run short. Buyers at Sam's and Costco, two major bulk distributors, have found either empty rice shelves or rationing at many locations.


    Imagine what it would have been like if, instead of a few hundred people stocking up, it had been millions of families all racing to the store to buy a 90-day supply of food?


    The days of stores having a `stock room' filled with pallets of food waiting to be put out on the floor are gone. Stores use JIT stocking, and many get replenished every day of the week.
  3. by   indigo girl
    National Discussion Needed on Antiviral Drug Distribution During a Flu Pandemic

    http://www.flutrackers.com/forum/sho...39&postcount=1

    There is not enough antiviral for the entire population, therefore they have to
    decide who gets it. Another consideration to think about is this. At what
    point do people who are lucky enough to receive Tamiflu begin to take it?
    If waves of infection hit your city for over 4 weeks, surely you are not going
    to be taking the drug for that long even should you happen to have that much
    Tamiflu available at the currently recommended dosage. Do you only take it
    if you know you are exposed? How will you know that? Do you only take it
    if you think that you are getting sick? HCW could be exposed for weeks not
    that it is likely that all of them would be given prophylaxis. Just wondering
    because if many are sick, there is likely to be a lot of exposure and not all of
    it will not be obvious.

    Quote from www.infozine.com

    Uncertainties about the availability and effectiveness of antiviral drugs during a
    flu pandemic require federal and state officials to begin a national discussion
    about the difficult choices they may be forced to make about the drugs'
    distribution, says a new report from the Institute of Medicine.


    "We need to engage the public in a discussion about the use and distribution of
    antiviral drugs in advance of a pandemic when there will be limited time for
    deliberations because large numbers of people will be getting sick," said
    committee chair June Osborn, president emerita, Josiah Macy Foundation, Falls
    Church, Va.
  4. by   indigo girl
    IOM Report Questions Size and Intent Of US Tamiflu Stockpile

    http://afludiary.blogspot.com/2008/0...intent-of.html

    Interesting commentary on that IOM Report on the Tamiflu Stockpile.
    CIDRAP is calling the current planning documents "fuzzy." Lots of unanswered
    questions come to mind for many of us that are concerned about getting
    the country ready.

    Quote from www.cidrap.umn.edu

    An IOM committee of experts asserts that the government needs to clarify its goals concerning antiviral use in a pandemic, because current planning documents are fuzzy on prophylactic use of the drugs.

    The nation currently has about 71 million treatment courses of antivirals in federal and state stockpiles, with a goal of 81 million courses, the report says. But in a pandemic, it might take more than twice that amount to treat sick patients and offer preventive doses to people at risk for exposure on the job, it asserts.
  5. by   indigo girl
    US Orders More Pre-Pandemic Vaccine

    http://afludiary.blogspot.com/2008/0...c-vaccine.html

    Just as the viruses causing seasonal influenza change every year requiring
    the vaccines to change, bird flu changes. Here we see that the US has
    ordered another version of prepandemic vaccine. I remember reading
    that the committee that makes these decisions did not have a lot of confidence
    in their prior purchase but felt it was better to have some vaccine on hand
    rather than none at all.

    Disagreements with Indonesia where the case fatality ratio is about 80%,
    means we can not use samples of their latest version of the virus for a
    vaccine unless they agree, and they don't without major compensations.
    It would appear that the current order is based on a 2005 strain of
    Clade 2.2.

    Quote from afludiary.blogspot.com

    This antigen will be based on Clade 2.2 (A/Barheaded goose/Qinghai Lake/01/2005)of the H5N1 virus, seen in migrating birds.

    In 2007 the United States purchased 126 million dollars worth of prepandemic vaccine based on Clade 2.0 of the virus. Smaller amounts of a clade 1 vaccine were produced prior to 2007.
  6. by   indigo girl
    HHS Webcast On Wednesday April 30th - Closure of Schools During a Pandemic

    You have questions? Hopefully they have answers. School closure
    is a majorly important mitigation strategy to slow the spread of virus
    and help kids, families, and communities be safer.

    http://afludiary.blogspot.com/2008/0...pril-30th.html

    Quote from afludiary.blogspot.com

    Email your questions for the webcast panelists during the program to hhsstudio@hhs.gov.
    Please include your first name, state and town.

    This webcast will cover the impact of implementing the community
    mitigation intervention of dismissal of students/school closures. It will
    provide the opportunity for a live question-and-answer session with these
    Federal specialists:


    Francisco Averhoff, MD, MPH, Centers for Disease Control and Prevention
    Camille Welborn, U.S. Department of Education
    Barbara Bingham, U.S. Department of Labor
    Brenda Lisi, U.S. Department of Agriculture
  7. by   indigo girl
    Florida's agriculture commissioner's panflu planning guide

    http://tinyurl.com/6p4pc8

    Scott McPherson's blog is always a great read. This particular piece
    is wonderful. The emphasis in this plan is on taking care of family first,
    a concept that many nurses in the poll here at allnurses would relate to.

    http://allnurses.com/forums/f8/will-...258506-21.html

    Scott is the CIO for the Florida House of Representatives.

    Quote from www.scottmcpherson.net

    Placing families first, ahead of business concerns, is key to successful management of a pandemic. I cannot tell you how many panflu plans I have seen (or COOP/DR plans, regardless of event) that fail because they fail to take reality into account. That reality is that people's concern moves away from the business or corporation or government, and moves correctly into concern for family and the safety of the family. Once the family is secure and safe, then the consciousness moves back to the workplace.
  8. by   indigo girl
    Toronto

    Though cash-strapped, Toronto is going to purchase $1.5-million worth of
    Tamiflu to treat up to 13,000 municipal employees in the event of pandemic
    outbreak. Funny that the word HCW is not mentioned among the recipients.
    They remember SARS just not who took care of the sick, and got infected
    as a result?


    http://www.flutrackers.com/forum/sho...ount<br /> =1

    Quote from network.nationalpost.com

    Toronto is the only major Canadian city stockpiling its own supply of influenza-
    fighting drugs for its employees after learning from the SARS epidemic.

    The decision follows the recommendation of Toronto's medical officer of health,
    who said Toronto must act now given the long lag time involved in acquiring
    Tamiflu, which is not a vaccine but one of the key drugs expected to be crucial
    in the event of an outbreak.
  9. by   indigo girl
    Another Possibility for Those Who Will Have No Access to Vaccines or Antivirals

    http://www.thelancet.com/journals/la...act?iseop=true

    In countries where prepandemic vaccines are being ordered there will never be
    enough for everyone, and we do not know how effective they will be. It is hoped
    that they will give enough protection to prevent death, but it may be not enough to
    prevent illness. Still being sick is better than being dead, imo. The unfortunate
    truth is that there will be no vaccine or antivirals for most of the world's
    population in the event of a severe pandemic. That tragic reality was the
    impetus for this study. This abstract is suggesting a possible fix to what might
    otherwise be a hopeless situation for many.

    Quote from www.thelancet.com

    Statins, fibrates, and chloroquine are produced as generic medications in developing countries. They are inexpensive, could be stockpiled, and would be available on the first pandemic day. With a lack of realistic alternatives for confronting the next pandemic, research is urgently needed to determine whether these and other generic agents could mitigate the effects of what might otherwise become an unprecedented global public-health crisis.

    Australia Gives Preliminary Thumbs Up On Two Vaccines

    http://afludiary.blogspot.com/2008/0...thumbs-up.html

    Quote from news.ninemsn.com.au

    The vaccines, called Pandemrix and Panvex, have become the first to reach the final step towards registration in Australia, the pharmaceutical bulletin Pharma in Focus says.

    The Australian Drug Evaluation Committee has recommended the formulas, which both protect against the H5N1 strain of bird flu responsible for outbreaks of avian flu in Asia, the Middle East, Europe and Africa.
    Last edit by indigo girl on May 1, '08
  10. by   indigo girl
    Children, avian influenza H5N1 and preparing for the next pandemic

    http://adc.bmj.com/cgi/content/abstract/93/5/433

    Quote from adc.bmj.com

    Children will be affected at least as much as adults and may play an important role in amplifying transmission. Pharmacological and public health interventions focused on children will save lives through suggested community measures such as pre-emptive closures of schools, and need to be considered carefully, balancing benefits against negative consequences. Child health services will be hugely stressed by any pandemic but also have the potential to save many lives. The challenge will be to deliver core services in the face of major staff illnesses...
  11. by   indigo girl
    An H5N1 Virus Neutralization Strategy

    http://www.pnas.org/cgi/content/abstract/0801367105v1

    The first confirmed human cases in Turkey occurred in early January 2006,
    and gave Europe a wake up call. This abstract looks at using antibodies
    from the survivors.

    Quote from www.pnas.org

    ...we report the generation of combinatorial antibody libraries from the bone marrow of five survivors of the recent H5N1 avian influenza outbreak in Turkey.

    The large number of antibodies obtained from these survivors provide a detailed immunochemical analysis of individual human solutions to virus neutralization in the setting of an actual virulent influenza outbreak. Remarkably, three of these antibodies neutralized both H1 and H5 subtype influenza viruses.
    Last edit by indigo girl on May 3, '08
  12. by   indigo girl
    Rationing Care during a Pandemic

    http://www.flutrackers.com/forum/sho...21&postcount=1

    Quote from www.victoriaadvocate.com

    Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

    Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

    The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.
  13. by   indigo girl
    Pandemic triage recommendations overdue, necessary, welcomed

    http://tinyurl.com/4zr9pt

    Wow! This is quite the thought provoking essay by Scott McPherson, CIO
    of the Florida House of Representatives. Who gets treated in a category
    5 pandemic, and who does not? When there isn't enough, who gets the Tamiflu?
    Who gets that ventilator?

    Sadly, I would have to agree with Scott on this one, but it would be a very, very
    difficult choice. You and I are not going to be the ones who will decide this.

    How would you choose? Look at the most at risk group. Read the essay.

    Quote from www.scottmcpherson.net

    Back in late 2006, HHS floated a trial balloon: Let the governors of the states
    decide how best to distribute vaccine and antivirals during a flu pandemic, once
    the first responders were taken care of. I sent my friend, then-governor Jeb Bush,
    an email that included the balloon from HHS. I concluded in the missive,

    "Jeb, Who do you vaccinate in a pandemic? Your future or your past?" I also told
    Jeb that, blessedly, he would not have to make that decision -- but his successor
    very well might.

    The answer to my rhetorical question is very, very clear to me: It is whoever
    is at highest risk.
    If it's 1918 all over again, I would not hesitate to treat and vaccinate the most vulnerable first, based on mortality: Young adults 18 to 40...

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