Disaster/Pandemic preparedness

[indigo girl]

What Japan Is Doing

http://afludiary.blogspot.com/2008/09/japan-national-police-agency-releases.html

http://afludiary.blogspot.com/2008/09/japan-pre-pandemic-vaccination-priority.html

Over the summer 6,000 medical personnel were inoculated in Japan in the

largest test of the vaccine to date to see if unwanted side effects would

show up.

Nothing serious has been reported.

Now Japan is drawing up a list of 10 to 15 million workers who would,

during a pandemic, be at particular risk of contracting the virus and who

are considered essential.

http://afludiary.blogspot.com/2008/09/japan-mask-recommendations-for-public.html

A government health panel is recommending the use of masks in the

event a new type of influenza breaks out in Japan, suggesting that

households should store 20 to 25 masks per person.

The recommendations from the Health, Labor and Welfare Ministry

- special conference, compiled in a report Monday, are due to be

carried on the ministry's Web site in the near future, as the ministry

calls for caution among residents.

Masks are sold in packs at pharmacies and convenience stores. However,

they are not able to completely stop people from breathing in viruses, and

the ministry says it is important for people not to come within two meters

of patients and to take preventive measures such as avoiding crowded places.

[indigo girl]

And the Answer Is . . . At Least Two Weeks

It is worth noting that, in this Webcast we are hearing probably for the

first time that the Red Cross is inferring that you might actually

need 6 to 12 months of supplies. Now what emergency can you think

of that would really last 6 to 12 months other than a pandemic?

If he is saying at least 2 weeks because that is all they think most people

could afford to do but then says 6 to 12 months would be ideal,

that might give you a clue as to how long the Red Cross thinks the

situation would last.

Is it that difficult to put some canned goods away? I think most of us

could manage to put a month's worth of food by if we did some

budgeting, and put family security ahead of entertainment. But, it is

true, many folks are struggling just to get by in today's economy.

Do your best to have some kind of plan for emergencies.

http://afludiary.blogspot.com/2008/09/and-answer-is-at-least-two-weeks.html

During yesterday's HHS Webcast on personal preparedness the question was asked:

How long should American households be stocking up for?

The answer given by Dr. Richard Benjamin, Chief Medical Officer, of the American Red Cross was:

"At least two-weeks."

He went on to say, "but if you could do more, that would be a wonderful thing."

He added, "Six to 12 months would be wonderful, but that's probably not

practical for most people."

[indigo girl]

Three reasons to consider getting the pneumonia vaccine sometime soon:

As we move into flu season in the year 2008. Consider the wisdom of

trying to protect yourself from the secondary infection that caused many

of the deaths in 1918. This vaccine may not keep you from getting

pneumonia, but it might keep you from dying from it.

Sometimes people get the flu even though they are vaccinated.

Doctors will then treat them with Tamiflu, but we now live in a world in

which one of our seasonal influenzas, H1N1 has become increasingly

resistant to Tamiflu, our primary antiviral.

It is a fact that most countries are actively preparing for the next

pandemic. Has the world ever prepared in advance for a pandemic

event before? The spread of the H5N1 virus into Europe, Africa, and

Asia is great cause for concern. Most efforts to eradicate it have

been temporarily successful at best as it almost always reappears later.

It is likely to be an ongoing situation. There is no way to predict if this

will be the pandemic virus but it is true that H5N1 is adapting to mammals,

and that it is a very virulent virus killing most of those it infects.

http://www.flutrackers.com/forum/showpost.php?p=36851&postcount=17

[indigo girl]

HHS Personal Preparation Webcast Now Archived And Available Online

Personal preparedness for the next pandemic, courtesy of the US govt:

http://afludiary.blogspot.com/2008/10/hhs-personal-preparation-webcast-now.html

On September 25th, the HHS held the 6th in their series of online

Webinars designed to spread the word about pandemic preparedness.

The archived video of this 57 minute session is now online, and available

for people to watch.

[indigo girl]

CDC takes notice of Akron's flu plan

Organization hopes to use ideas as role model for other communities

to prepare for pandemic

http://www.ohio.com/news/30480434.html

Usually, communities will talk about preparing for a pandemic by

choosing a gymnasium or civic center that will serve as a make-shift

hospital ward when hospitals fill up, Levy said. But a plan requires much

more than that, including arranging for staffing, providing supplies and

setting ''triggers'' for when the plan should be set in motion.

Among the ideas in the Akron plan are:

* Creating a call-in center, which would allow people to stay home

while getting their flu questions answered.

* Moving non-flu patients, such as those recovering from heart attacks,

surgery or childbirth, to long-term-care facilities, so they're not exposed

to the flu virus.

* Opening a site that could serve as a hospital for severely ill flu patients,

to keep them from spreading the virus to other hospital patients.

* Setting up triage sites away from emergency rooms, to direct patients

toward the proper care.

* Using a mobile facility to treat patients.

* Converting outpatient offices into sites for distributing vaccines and

medications.

(hat tip PFI/pixie)

[indigo girl]

World Bank Says Flu Pandemic May Cost World Economy Up to $3 Trillion (Update2)

http://www.flutrackers.com/forum/showpost.php?p=185828&postcount=1

A slump in tourism, transportation and retail sales, as well as workplace

absenteeism and lower productivity caused by a ``severe'' outbreak, may

cut global gross domestic product by 4.8 percent, the Washington-based

bank said in a report obtained by Bloomberg News. Economic modeling by

the bank in June 2006 estimated GDP would drop by 3.1 percent, or about

$2 trillion. Measures to avoid infection would generate most of the

costs, said the report, which used simulations to underline the

importance of global preparations for a pandemic sparked by bird flu.

Human cases of the H5N1 avian-influenza strain have fallen by half this

year as controls of outbreaks in poultry improve.

``Even with such efforts, an eventual human pandemic at some unknown

point in the future is virtually inevitable,'' Andrew Burns, Dominique

van der Mensbrugghe and Hans Timmer, economists at the bank, wrote

in the report.

``The potential cost of a human pandemic is massive compared with the

quite modest sums required to ensure pandemic preparedness,'' said

David Nabarro, UN senior coordinator for avian and pandemic influenza,

in a telephone interview from Geneva today. The funds ``must be coupled

with political commitment to ensure that all parts of government, civil

society and the private sector are prepared to keep functioning in the

event of a pandemic.''

Such a contagion would start when a novel influenza A-type virus, to which

almost no one has natural immunity, emerges and begins spreading. Experts

believe that the so-called 1918 Spanish Flu pandemic, which may have killed

as many as 50 million people, began when an avian flu virus jumped to people.

[indigo girl]

Lloyds of London on the Pandemic Threat

http://tinyurl.com/6aw5jd

Everyone knows who Lloyds of London is, right?

The Emerging Risks team is part of the Franchise Performance

Directorate at Lloyd's. We define an emerging risk as an issue that is

perceived to be potentially significant but which may not be fully

understood or allowed for in insurance terms and conditions, pricing,

reserving or capital setting. Our objective is to ensure that the Lloyd's

market is aware of potentially significant emerging risks so that it can

decide on an appropriate response to them.

http://afludiary.blogspot.com/2008/10/lloyds-report-closer-look.html

EXECUTIVE SUMMARY

1. A PANDEMIC IS INEVITABLE With historic recurrence rates of 30-50

years it is prudent to assume that a pandemic will occur at some point in

the future. The severity of such events is highly variable; some estimates

suggest the most severe to date, in 1918, killed up to 100m. Many pandemics

affect the old and young; but some (including the 1918 event) can,

perversely, affect the most healthy.

2. 1918 MAY NOT BE THE WORST CASE It is certainly true that the 1918

event was extreme relative to other pandemics in history. However many

published "worst case" scenarios take 1918 as a base. There is a danger

that we over optimise to this one scenario. There are other forms of

pandemic than influenza, some have higher case mortality. Pandemic

preparedness should consider a range of scenarios to ensure plans are

appropriately flexible.

3. ECONOMIC IMPACTS MAY BE SIGNIFICANT A repeat of the 1918 event

is expected to cause a global recession with estimated impacts ranging

from 1% to 10% of global GDP. Most industries will be affected, some more

than others. In particular, industries with significant face to face contact will

be impacted significantly. Insurers investment assets may be affected

depending on the mix held. Wider economic and social effects may lead to

secondary forms of loss for insurers.

4. MANY INSURANCE LOSSES ARE POSSIBLE For some classes of

business such as, life and health it is clear that the impact will be

adverse. For other classes of business it is less clear but many forms

of liability covers including general liability, D&O, Medical Malpractice

as well as specific products offering business interruption and event

cancellation could be triggered. Inner limits for Pandemic losses

(vertical and sideways) may help to contain exposure.

5. SECONDARY IMPACTS MAY OCCUR Events causing significant global

and societal turmoil can give rise to considerable secondary impacts. It

is far from clear which of these, if any, would occur; but for resilience

planning purposes it is worth considering them. For example the

lawlessness experienced in New Orleans after Katrina could be repeated

if police services are affected. Traditional claims such as fire loss may be

exacerbated if fire emergency services have depleted efficiency and if

tradesmen are in short supply.

[indigo girl]

Video: Pandemic Prevention - Bird Flu and Emerging Diseases

Don't understand why all the concern about bird flu? Check out one of

the following. Dr. Greger does an excellent job of simplifying for a lay

audience in the 11 minute version. This is serious stuff. Hoping it

won't happen is not going to help, but preparation will.

http://afludiary.blogspot.com/2008/10/video-pandemic-prevention-bird-flu-and.html

Dr Michael Greger is is a physician, an author, and a much sought after

public speaker on a variety of public health issues. Dr. Greger has

written three books, including Bird Flu: A Virus Of Our Own Hatching -

which is available to read for free online at his website.

He is also the Director of Public Health and Animal Agriculture at The

Humane Society of the United States.

His one hour lecture:

http://videos.med.wisc.edu/videoInfo.php?videoid=241

The eleven minute version:

http://video.hsus.org/index.jsp?fr_story=cd17a1def7749aba7f9484996e4315882e5e9725&rf=rss

[indigo girl]

A history lesson from the Reveres at Effect Measure, with permission:

Bird flu reminder

With the advent of flu season the perennial question of the "next

pandemic" is again making an appearance, although I think it is more

of a cameo appearance than a substantive one. WHO, CDC and

numerous state health departments are warning citizens about

seasonal flu, still a major public health problem, and the continuing

threat of emergence of a novel flu virus to which the earth's population

has little or no immunity. There is something both plaintive and formulaic

about these warnings. Seasonal flu is with us every flu season (hence

its name) and the feared pandemic of bird flu has yet to materialize.

Meanwhile there are great many "important things" claiming our

attention, not the least of which is a global financial system in meltdown.

People have been warning of a potential financial crisis for years, but it

didn't happen. Until now.

So what about a bird flu pandemic? It is just as hard to predict as a

financial crisis. The world of public health has been trying to prepare for

the possibility of a pandemic with the most likely culprit, the H5N1

subtype of influenza A. H5N1 is endemic in poultry and avian wildlife in

many countries. It infects humans infrequently (one would have to say

rarely, given the prevalence of exposure) but when it does it is highly

virulent. Case fatality ratios are well over 50%. But so far it is not easily

transmissible between people, the last step to making this a truly

horrific pathogen. Most countries and most states in the US now have

some kind of pandemic plan but these are mainly on paper. There is an

old military adage that most battle plans don't survive the first

engagement with the enemy, and this is certain to be true with most

pandemic plans as well. The geographic spread of bird flu to poultry

and humans has stabilized, but that is small comfort for flu scientists.

There are billions upon billions of viruses replicating out there in one

kind of host or another, and each replication is an experiment in finding

a recipe for efficient replication in a new host. The number of possible

combinations is unimaginably large so it is not a given, even with all

that natural experimentation going on, that a deadly recipe is

inevitable or imminent.

Human cases of H5N1 first appeared in Hong Kong in 1997. A heroic

effort on the part of Hong Kong public health and veterinary

authorities involved culling nearly every poultry animal on the island

and the world appeared to have dodged a bullet. But out of nowhere

H5N1 reappeared in poultry in 2003 and the incidental human cases

started appearing along with it. Where it was in the 6 years prior to

that we don't know. But it wasn't gone. The relative quiet (relative to

the several years preceding) shouldn't be interpreted as a war that

as been won. We have no idea what controls the dynamics of this

disease.

Ninety years ago, just about this time, the 1918 pandemic's ferocious

second wave was reaching its peak. It seemed to come out of nowhere

(although retrospectively it was visible the previous spring) and fell like

a giant hammer. It's a reminder that things can turn on a dime in this

world. I don't expect this will get anyone's attention. There is too much

noise out there. But it doesn't hurt to remind everyone.

Now back to our regularly scheduled programming.

"The Editors of Effect Measure are senior public health scientists and

practitioners. Paul Revere was a member of the first local Board of

Health in the United States (Boston, 1799). The Editors sign their posts

"Revere" to recognize the public service of a professional forerunner

better known for other things."

[indigo girl]

Florida Testing of Wild Bird Kills

http://www.palmbeachpost.com/treasurecoast/content/local_news/epaper/2008/

Part of the national surveillance for avian influenza involves the testing of

migratory birds which we might expect in Alaska, but testing is occurring

even as far south as Florida.

As the migratory game bird season gets under way, wildlife officials announced

this week that they will begin their annual testing of bagged game birds for

the avian flu. Participation is voluntary, and biologists will test the birds'

respiratory and digestive tracks at several duck-hunting hot spots throughout

the state.

The sampling is part of an international surveillance effort to determine

whether migratory birds carry the deadly flu. Last year, more than

65,000 samples were collected nationwide, including more than 1,200

samples in Florida. None of the samples tested positive. It is "extremely

unlikely" that hunters could be infected by wild birds in Florida.

[indigo girl]

Africa: International Partners Work to Prevent Next Pandemic

http://allafrica.com/stories/200811130611.html

Most emerging infectious diseases are zoonoses-animal diseases that

can be transmitted to people-and most zoonoses arise from wildlife,

so anywhere in the world that wild animals and people interact, a new

disease can enter the human population.

Google.org, the philanthropic arm of the company behind the world's

most popular Internet search engine, is supporting efforts to identify hot

spots where such diseases are most likely to emerge and to detect

new pathogens circulating in animals and people.

An initial $14.8 million, announced October 21 as part of the Predict

and Prevent initiative, is going to six partnerships working in Africa

and Southeast Asia. Their shared goal is to help nations and global

organizations for animal and human health learn about and respond

to outbreaks before they become global crises.

The work is accomplished through a global network of partners --

collaborators and field teams, and laboratories where increasingly

advanced techniques allow researchers to understand and discover

disease agents in completely new ways.

"We think about where in the world do we believe there to be

important viruses -- what are the hot spots," Wolfe said. "Then we

charge into the hot spots and focus our energy on the interface

between humans and animals -- hunters, maybe people working

in wet markets, wildlife veterinarians -- people in close contact with

animals. Then we sample at that interface -- what's in the animals,

what's in the humans, and what's jumping from the animals into

the humans."

"We are still at the very beginnings of the science of pandemic

prevention, but that doesn't mean that we are without skills or

facilities," Wolfe said.

(hat tip pixie/PFI)

A Disaster Simulator In A Deck Of Cards

I wonder if this game comes in an English language version.

http://afludiary.blogspot.com/2008/11/disaster-simulator-in-deck-of-

cards.html

"Suppose you're a nurse. The hospital you're working for has decided

to accept avian flu patients. You are worried you could become

infected and subsequently infect your child, who goes to a daycare

center, with the flu. Do you think it's appropriate to make up an excuse

to miss work in this situation?"

This is one of the situations found in an increasingly popular card

game called "Crossroads" in which participants exchange views about

serious situations players could find themselves in.

The game was first devised for disaster prevention purposes after the

1995 Great Hanshin Earthquake. Since then, many versions of the game

have been developed, including games on subjects such as bird flu and

food safety.

Japan Donates Tamiflu And PPE's To The Philippines

It's a mystery why H5N1 has not been reported in the Philippines yet.

Japan has been very generous in helping them to prepare.

http://afludiary.blogspot.com/2008/11/japan-donates-tamiflu-and-ppe-to.html

Today, in a press release posted on the Japanese Embassy website, it

was announced that Japan would donate 75,000 courses of Tamiflu, and

35,000 sets of PPE's (Personal Protective Equipment) to the Philippines.

Japan has made a sizable commitment to the member nations of

ASEAN (Association of Southeast Asian Nations) to provide them with

Tamiflu and PPE's in anticipation of a possible pandemic.

Their donations are eventually expected to reach 1 million courses

of Tamiflu and 700,000 sets of PPEs.

[indigo girl]

Very recent videos on Pandemic Influenza

Thank you to Florida Medic of Avian Flu Diary for making us

aware of these, and to everyone involved making this information

available.

http://afludiary.blogspot.com/2008/11/october-hhs-webcast-now-available.html

Secretary Leavitt’s Discussion on Pandemic Planning and Preparedness

(October 29, 2008) – 72 minutes

Secretary Mike Leavitt

Dr. Bill Raub, Science Advisor to Secretary Leavitt

Dr. Michael Osterholm, University of Minnesota

Maggie Fox, Reuters

http://afludiary.blogspot.com/2008/11/video-threat-of-avian-influenza.html

The CSIS (Center for Strategic & International Studies) held a meeting on

November 13th, where Dr. David Nabarro and U.S. State Department

Special Representative John Lange presented the latest information on

the Pandemic threat.

We are fortunate to have the 90 minute video of this meeting available

for viewing.