Pandemic Flu - Thread II - page 20

Frist calls for a Manhatten Project: We are so..., you know. He is telling it like it is. Does anyone really understand this? There is nothing that we can do but prepare, but no one is... Read More

  1. by   indigo girl
    Pandemic Planning and Not Getting It -- Commentary - Effect Measure

    Effect Measure

    A Pandemic Could Be Bad (in case you hadn't heard):
    Effect Measure

    A Pandemic Could Be Bad, part 2, US version (in case you hadn't heard):
    http://scienceblogs.com/effectmeasur...bad_part_2.php

    A series of very thoughtful articles as always from this site:
    Avian Flu Diary
    Last edit by indigo girl on Dec 15, '06
  2. by   CrunchRN
    Indigo G,

    I love your avatar. Do you think it will happen? Do you foresee even nurses being "conscripted" into working. I see you have done a lot of research and i am very interested in what you think may happen.

    I won't hold you to it!
  3. by   indigo girl
    Quote from CrunchRN
    Indigo G,

    I love your avatar. Do you think it will happen? Do you foresee even nurses being "conscripted" into working. I see you have done a lot of research and i am very interested in what you think may happen.

    I won't hold you to it!
    CrunchRN,

    I will tell you more than you asked for, and this is for my indifferent nursing colleagues more than for you. We have some major problems.
    History tells us that there will be another influenza pandemic, and that we are overdue. It does not tell us which virus will be the culprit.
    In Hong Kong in 1997, 18 people died from H5N1, and they began culling poultry in that area. In May of 2005, experts sounded the alarm when the massive die off of wild birds occurred at Qinghai Lake in China. An avian flu virus, H5N1 was identified as the cause. It was obvious that the virus was spreading via wild birds, and had become pathogenic to its natural hosts. It is a virus that humans have no immunity to, and no vaccine for. It kills young adults in the prime of life, and young children in a horrible way. We only have enough antiviral, Tamiflu to treat 20% of the world's population. The mortality rate is over 60%. Couple all of that with a just in time delivery system for food, and medicine, and an overloaded healthcare system, no prophylaxis for healthcare workers, not enough beds, not enough ventilators, not enough of the right kind of PPE, and either disbelief or indifference to the possibility of this event occurring, and what do you get?

    I am hearing from my ex husband, a physician, who works for the Red Cross, that their planning is looking at 12 weeks as the length of time that a wave of infection will occur, and that they will be telling people to prepare to shelter in place for that length of time. Again, historically, there will likely be more than one wave. There were at least three in 1918.

    Honestly, I do not know if we will be conscripted to work. Some of the language in some of the plans, does consider us as resources. Without, asking the question to TPTB, how can we know? Are any of you willing to ask them?

    Here is another problem:
    I have met nurses who thought that there was nothing that could be done about this possible event, so nothing is being done. I have met nurses who refuse to consider making any preparations for their families now while supplies are plentiful, because they will only be concerned if the pandemic actually happens. I have heard from nurses who think only people who live with their chickens in poor countries are getting sick. And, I have talked to nurses who thought that they already knew it all, and there was nothing that you could say to them to help them to see this as a possible nursing and public health problem. Thus, the patients and staff that depend upon their judgement, are left inadequately protected, and that is a damned shame.

    I have tried to communicate with nurses for the common good, who let their personal feelings get in the way so that instead of trying to help their colleagues to come to grips with this, they do nothing, despite their own belief that this event will occur.

    We will own this problem, nurses, and it will interrupt our lives. There are many intelligent, and eloquent nurses on this board. We can let this happen to us blindly, or we can get involved in doing something to help make the outcome better. There is not a person here who will not be effected by what will happen. If it does not happen this year than it will be another year, and we will have that much more time to protect and prepare our people. Even if you are not convinced that anything will happen, would it not be better to err on the side of caution especially when you consider all of those who are depending upon you? If there was ever a time that nursing leadership was desperately needed, it is now.
    Last edit by indigo girl on Dec 25, '06
  4. by   pickledpepperRN
    Please forgive me if this has already been posted. It shows that St. Jude is serious about the terrible possibility.

    Investigators at St. Jude Children's Research Hospital have completed the first large-scale study of bird flu virus genomes, thereby doubling the amount of genetic information available on the genes and proteins of these viruses. The results of the project could lead to major insights into the bird flu virus known as H5N1, the researchers said. H5N1 is the bird flu virus currently infecting humans in Asia and Eastern Europe, and flu experts fear it could mutate in a way that would allow it to cause a worldwide pandemic in humans.

    St. Jude conducts first large-scale bird flu genome study
    H5N1 vaccine could be basis for life-saving stockpile - H5N1 vaccine could be basis for life-saving stockpile
    St. Jude test of bird flu vaccine proves successful

    Memphis, Tennessee, May 2, 2006
    A commercially developed vaccine has successfully protected mice and ferrets against a highly lethal avian influenza virus, according to the investigator who led the study at St. Jude Children's Research Hospital. The vaccine was developed by Vical Incorporated in San Diego, California.

    St. Jude test of bird flu vaccine proves successful
  5. by   indigo girl
    I have permission from the author to post this here. I hope that it will help everyone to at least consider the consequences of what could happen to our healthcare systems, and to us personally, and to address these issues with our employers sooner rather than later.

    Quote from afludiary.blogspot.com/

    The HCW (Health Care Worker) Disconnect

    # 253

    Over the weekend I received a long email from a nurse who is very concerned that her colleagues and their workplaces show little or no signs of preparing for, or even accepting the a possibility of a pandemic.

    Why, she asks, is there such an institutional blind spot when it comes to avian flu? And how can we change that?

    As I’m not a psychologist, and am no longer directly connected to the health care field, the best I can do is tender a guess. And if I had to guess, I’d say the twin reasons are fear and stasis.

    Depictions of bold and maverick medical types on TV aside, in reality most medical professionals are fairly conservative. They’ve learned, due to mounting litigation concerns, to do things by the book, and not to stray far from the accepted norm. Pioneers are easy to spot in the medical world.

    They’re the one’s with arrows in their backs.

    So the medical establishment tends to be monolithic, and moves only slowly towards new ideas. And in some ways, this is a good thing. It means there is uniformity in medical care, and that patients are more likely to receive generally accepted and approved treatments wherever they may go. But it also promotes stasis in the industry, and a reluctance to embrace new ideas.

    For now, the avian flu pandemic threat is simply that, a threat. It is not guaranteed that it will ever become a pandemic strain. It is a possibility, and opinions vary as to how likely it is to happen. Many doctors are understandably reluctant to jump onboard the pandemic bandwagon, for fear of appearing to have fallen for the `hype’.

    Any doctor who does openly accept the pandemic threat opens the door to criticism from their colleagues. Public health doctors can get away with it, because they’re supposed to be alarmist. Their job is to anticipate and stop health threats. But clinicians are supposed to remain focused on their patient’s immediate problems, not worry about something that might happen someday.

    Once a doctor embraces the idea that a pandemic may be coming, they immediately are faced with a variety of ethical considerations.

    What do they tell their patients? How do they handle requests for Tamiflu and antibiotics? What do they tell their staff? How much time, effort, and money do they expend on PPE’s (Personal Protective Equipment) for their people?

    If the imminent arrival of a pandemic is uncertain, then worrying patients and their staff about one could be seen as a violation of the first tenant of medicine: Primum non nocere : First, do no harm.

    I spoke to one doctor, a closet pandemic worrier, who admits he is frightened over the avian flu threat, and asked if he was talking to his patients about it. He said `No’.

    I asked him why and he shrugged his shoulders, and said, “If it comes, there is nothing we can do to help them. The hospitals will be overrun. There aren’t enough drugs, and the ones we have may not work. What can I tell them, other than they might die?”

    While I may not agree with their conclusions, or their actions, I do understand why many doctors are very reluctant to even discuss a pandemic. They have patients dying today of heart disease, cancer, and AIDS. They can see no upside to dealing with a problem that doesn’t, as yet, pose a direct threat.

    And any doctor who does stray from the reservation, who openly discusses the need for pandemic preparation, runs the risk of drawing flack from their peers. `Rocking the boat’ isn’t often viewed with favor in any industry, but this is particularly true in the medical world.

    Preparing for a pandemic is frightfully expensive, and takes badly needed resources away from today’s needs. How does a hospital justify buying and storing hundreds of thousands of N95 masks to protect their personnel against a pandemic that may not come? Add in gowns, gloves, face shields or goggles, prophylactic Tamiflu, and everything else a facility would need to handle a pandemic, and even a small hospital could expend millions of dollars.

    Doctors who see the need to take these steps are often viewed as alarmist or radical. Luckily, they do exist, and are growing in number, but for now they are a minority.

    The level of concern in the health care industry therefore is muted by a large contingent of doctors who are unwilling, as yet, to deal with a pandemic being an imminent threat. One can either view this as being reasonable, or shortsighted, depending on your personal view of the likelihood of a pandemic.

    Lost in all of this debate, or lack of debate in too many cases, it the sobering reality that once a pandemic begins, it will be too late to prepare. The scramble for PPE’s and medicines will quickly outstrip the supply chain.

    And this will put hundreds of thousands of Health Care Worker’s lives at risk. Mostly nurses, techs, nurse’s aids and orderlies: for these are the ones that will have the closest, and most prolonged contact with infectious patients.

    The medical establishment is taking a terrible gamble in hoping a pandemic doesn’t come, and if they are wrong, there can only be two results.

    Either HCW’s will be forced to work without adequate protection, and will undoubtedly succumb to the virus in droves, or HCW’s will simply refuse to work and risk exposure.

    Either way, it is a tragedy in the making.

    My view, for what it’s worth, is that we have to accept the possibility of a pandemic coming, and do what we can to prepare, even if it means spending money today for a threat that may not materialize in the immediate future.

    But for that to happen, nurses, techs, and other HCW’s need to become vocal about the preparations of their facilities, and demand that their safety come first. Many nurses and HCW’s belong to unions or professional associations, and they need to push their representatives to make pandemic preparations, and particularly the stockpiling of PPE’s a priority in their negotiations.

    The stakes are simply too high not to do this. And we need to do it now.

    The battle against the next pandemic will be won or lost based on what we do to prepare before it arrives. Waiting for proof positive that a pandemic is coming before we begin will almost certainly guarantee failure.

    And this is a battle, quite frankly, we can’t afford to lose.
    posted by FLA_MEDIC @ 8:11 AM
    Here is the link to his essay:

    Avian Flu Diary
    Last edit by indigo girl on Dec 25, '06
  6. by   pickledpepperRN
    I think one thing we can all do is write our elected representatives.
    We should also bring it up at staff meetings and employee forums.
    Letters to the editor cand be written too.

    VHA Survey on Avian Flu Shows Some Hospitals Would Exhaust Supplies in Two Weeks

    Money and Storage Space Prevent Hospitals from Building Inventory Levels

    Irving, Texas; Mar. 16, 2006 — As fears about an avian flu pandemic rise globally, the question is: Are hospitals ready for the flood of patients this disease could generate? A February survey of U.S. hospitals indicates that while many have disaster plans in place, they may exhaust their inventory of critical supplies within a couple of weeks. Supply chain experts at VHA Inc. also believe that interruptions in Asian manufacturing centers due to avian flu could severely impact replenishment options here….

    https://www.vha.com/portal/server.pt...ses/060316.asp
  7. by   Beachnurse2b
    Indigo girl,

    Has there been any final word on the 2,500 dead ducks that were found in Oregon this past week. I know that 6 agencies were involved in testing including the cdc and homeland security. The ducks had bleeding around the heart which concerned me as symptomatic of avian flu. However, the media has reported that it is aspergillas. Has there been a final ruling on this. I do not like hearing some of the comments such as "We believe it is aspergillas". We believe and we confirm are two different birds no pun intended. I have been trying to find some confirmation on this today with no results, thought you might have the better picture. Thanks!!!!

    Holly
  8. by   indigo girl
    Quote from Beachnurse2b
    Indigo girl,

    Has there been any final word on the 2,500 dead ducks that were found in Oregon this past week. I know that 6 agencies were involved in testing including the cdc and homeland security. The ducks had bleeding around the heart which concerned me as symptomatic of avian flu. However, the media has reported that it is aspergillas. Has there been a final ruling on this. I do not like hearing some of the comments such as "We believe it is aspergillas". We believe and we confirm are two different birds no pun intended. I have been trying to find some confirmation on this today with no results, thought you might have the better picture. Thanks!!!!

    Holly
    Here is a site that has been following this:

    http://www.curevents.com/vb/showthre...8&page=1&pp=40

    There are some nurses on there who are commenting on this. You'll notice that one of the posters has actually gone to the place where the mallards are dying. Read the whole thread because he comments more than once.

    Personally the bleeding around the heart bothers me too. And, the Dx that they are giving us is usually seen in young, and stressed birds.

    Holly, for now I try to keep an open mind. Maybe they are right. They are saying it is not high path H5N1. They have not said that it is or is not low path. But, the mallards are dead, over 3000. I'll probably worry more if other birds in the area are dying or mammals eating sick birds are dying.
  9. by   indigo girl
    An example of how stories can change, first it is old age, then it is avian flu, this is makes it difficult for the people to trust that they are being told the truth, this is from Russia:

    The St. Petersburg Times - News - 2 Geese Die of Bird Flu

    This is what is happening in France:

    BBC NEWS | Health | France testing dead birds for flu

    FluTrackers - View Single Post - France investigating sudden death of 4,000 chickens
    Last edit by indigo girl on Dec 18, '06
  10. by   indigo girl
    An interview with Dr. Lam and Dr. Lee, the authors of a recent book on preparing for pandemic flu:

    http://www.theglobeandmail.com/servl...andHealth/home
  11. by   indigo girl
    FAO/OIE team going to South Korea to try to understand the relationship between avian flu in wild birds and poultry, in other words, how did that poultry get infected?
    (hat tip to Flutrackers)

    http://www.promedmail.org/pls/promed..._ID:1000,35556
    Last edit by indigo girl on Dec 19, '06
  12. by   indigo girl
    Vietnam has another outbreak of avian flu. Do you get the feeling that this is a problem that is not going away? No matter what they do to control it, it keeps coming back.

    Vietnam latest news - Thanh Nien Daily

    South Korean official pronouncement trying to calm the public about the avian flu cases in poultry found there recently, and meanwhile there are economic repercussions also:
    INSIDE JoongAng Daily
    Last edit by indigo girl on Dec 19, '06
  13. by   indigo girl
    Implementation of the National Strategy for Pandemic Influenza - Six Month Status Report

    Fact Sheet: Implementation of the National Strategy for Pandemic Influenza: Six-Month Status Report
    (hat tip to Flutrackers)

    Commentary on that national strategy report, enjoy:
    Avian Flu Diary

    -------------------------------------------------------------------------------------------------



    This is what the Russians are saying now about those dead geese at the zoo:
    (hat tip to curevents)
    Onishchenko Says No Avian Flu at Zoo

    This is what the French are saying now about their dead poultry:
    BirdfluBreakingnews.com - Article
    Last edit by indigo girl on Dec 19, '06

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