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
Apr 25, '08Occupation: visiting nurse Specialty: Too many to list ; From: US ; Joined: Mar '06; Posts: 5,909; Likes: 1,741Dr David Butler-Jones, Canada's Chief Public Health Officer on Warding Off the Next One
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.
Apr 25, '08Occupation: visiting nurse Specialty: Too many to list ; From: US ; Joined: Mar '06; Posts: 5,909; Likes: 1,741The Myth of "Just in Time" (JIT) Prepping
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.
Apr 26, '08Occupation: visiting nurse Specialty: Too many to list ; From: US ; Joined: Mar '06; Posts: 5,909; Likes: 1,741National Discussion Needed on Antiviral Drug Distribution During a Flu Pandemic
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
Apr 27, '08IOM Report Questions Size and Intent Of US Tamiflu Stockpile
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.
Apr 28, '08US Orders More Pre-Pandemic Vaccine
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
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.
Apr 28, '08HHS 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.
Quote from afludiary.blogspot.com
Email your questions for the webcast panelists during the program to email@example.com.
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
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
Apr 29, '08Florida's agriculture commissioner's panflu planning guide
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.
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.
Apr 29, '08Toronto
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.
May 1, '08Another Possibility for Those Who Will Have No Access to Vaccines or Antivirals
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
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
May 3, '08Children, avian influenza H5N1 and preparing for the next pandemic
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...
May 3, '08An H5N1 Virus Neutralization Strategy
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
May 4, '08Rationing Care during a Pandemic
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.
May 5, '08Pandemic triage recommendations overdue, necessary, welcomed
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...