Pandemic News/Awareness.

indigo girl · Feb 6, 2007

The or more is kinda concerning. Thats with a fatality rate of 2%. H5N1 currently has a case fatality rate of 60%. Unless it moderates greatly when it goes pandemic, the number of deaths would be much, much higher.
I find that very concerning. I do not understand how the officals or anyone can loook at those projections and not encourage longer term preparations thatn 2 weeks!!

I think that they need to tell people the truth. We are adults. We can handle it. CDC is expecting a panflu to happen. They must have known what was going on in England because it was reported on Thursday. CDC press conference was on Friday. I know that CDC is aware of the current case fatality ratio in Indonesia and Egypt. Don't tell us 2% when it is not even close to that!

This is what I would tell people. Prep for your family for at least 12 weeks.

If you can do more, do it. Don't forget masks and gloves for use at home.

You may need them.

As nurses, ask your facilities about their panflu policy, and check on the PPE situation. Make up your mind about what your plan is going to be. Do not assume that they will take care of you. Be proactive. Your safety and your life that may be at stake. It certainly was during the SARS epidemic.

Did nursing learn nothing from that?

Where are our nursing leaders when we need them? We need direction and we need education. We need a place at the planning table. We will be directly involved in patient care. We will be at risk. Who is going to speak for us?

Laidback Al · Feb 6, 2007

I just looked at the numbers of human cases of H5N1. Based on WHO data, since January 1, 2006, 50% of all confirmed H5N1 human cases have occurred in Indonesia. Of those cases in Indonesia, 82% have died; a CFR of 82%. For all human cases since January 1, 2006, the CFR is 70%.

If a pandemic strikes soon, a 2% CFR would be a best case scenario, not the "worst" case scenario. Prepare for the worst, hope for the best.

indigo girl · Feb 6, 2007

H5N1 found in Pakistan. Two more Indonesians have tested positive for avian flu:

http://www.alertnet.org/thenews/newsdesk/JAK144902.htm

http://www.alertnet.org/thenews/newsdesk/JAK144902.htm]
The two new Indonesian cases came as Jakarta said it had stopped sharing human genetic samples of the most deadly strain of bird flu with foreign laboratories because it wanted to keep control of the intellectual property rights of the H5N1 strain.
"We can't share samples for free. There should be rules of the game for it," said the health ministry's spokeswoman, Lily Sulistyowati.
"Just imagine they could research, use and patent the Indonesia strain. We can't give the samples but we can share data in the gene bank."

Why does it always come down to money? This is an emergency!

indigo girl · Feb 6, 2007

Which countries are researching possible vaccines and/or treatments? How close have they come to developing either?

Here is a link giving an update on antivirals. Some of this is new to me also.

http://scienceblogs.com/effectmeasure/2007/02/the_antiviral_front.php#more

One feature of the newest antiviral is that injecting it can produce much higher levels than oral Tamiflu and tests on volunteers suggest people can tolerate these higher levels for up to ten days. However the safety profile is not yet well established. Its use would be limited to treating those already hospitalized.
All this is to the good, although it is pretty late in the game. Whether any of these developments will reach the level where they are useful and available in sufficient quantities will depend on events outside of our control, the behavior of the virus as it invades ever new ecological niches in the natural world.
Meanwhile, we must agree with the dean of flu virologists, Dr. Robert Webster: we are losing the battle against H5N1.

The link above refers to this article from an interview with Dr. Webster of St. Jude in Memphis, saying that we have failed to control the virus. We have lost the battle. But, most people never even realized that we are in a war. It would certainly never occur to them that modern science is losing this war.

http://www.bloomberg.com/apps/news?pid=20601101&sid=aZWpArtSE0aM&refer=japan

http://www.bloomberg.com/apps/news?pid=20601101&sid=aZWpArtSE0aM&refer=japan[/url]"]http://www.bloomberg.com/apps/news?pid=20601101&sid=aZWpArtSE0aM&refer=japan[/url]
Each outbreak of the flu in birds, people and animals such as cats and pigs raises the possibility that it will mutate into a form that spreads quickly in people, Webster said. A resurgence of infections in countries such as Japan, South Korea and Thailand confirms that control efforts that appeared effective still need to be strengthened, he said.
``To me it means that we've failed,'' Webster said today in an interview in Washington. ``It's a lack of knowledge and political will to get at the source of the virus.''

indigo girl · Feb 6, 2007

A nurse comments on this news article about nursings curious lack of participation in pandemic/disaster planning. This nurse (no one I know) is right on target.

(hat tip to fluwiki for posting this link)

http://thelede.blogs.nytimes.com/2007/02/05/bird-flu-fight-160000-turkeys-gassed-burned-in-britain/

The CDC released its pandemic guidelines with great fanfare. However, no one has consulted with professional nursing about its expected role and responsibilities for the planning and execution of the guidelines. Has it occurred to anyone that by continuing to devalue nurses - almost 3 million of them - and ignoring their role which will be that of the most critical healthcare provider, that the US puts itself in peril? Most nurses (almost 94%) are women who care for family members (children, parents or another relative). How likely are they to respond to mandates which require their commitment to quarantine in a healthcare institution and away from their families for weeks or months at a time?

The expectation is that most patients during a flu pandemic will have acute respiratory failure. Not all nurses practice in critical care environments. Just who is going to manage the care of all of the critically ill patients? When physician and nurse deaths occur, just who is expected to stay in place and care for the overload of patients? When hospital administrators, safe in their offices away from patients, fail to deliver needed supplies from breaks in the supply chain, just who will take up the slack and improvise? When the 40% of the workforce stays home, as predicted, just who will do all of the unmanned jobs?

This may very well be the straw that breaks the camel’s back. The US - public, politicians, government, physicians and healthcare industry - have all taken professional nurses for granted. That’s a reckless and dangerous assumption to make.

Dare I say it? Notice the total lack of inclusion of nurses by the New York Times during any reporting about health policy, health news, patient advocacy, health research - anything. If nurses merit a mention at all, it’s still in the stereotype of physician’s handmaiden or trained task assistant.

Nurses provide about 95% of ALL healthcare services in the US. They have earned, and they deserve, professional respect.

Professional nursing, empowered patients. Good health.

— Posted by N=1

No representation in planning, but the assumption is, we will be there to take care of everyone!

LMonty911 · Feb 7, 2007

good catch, Indigo girl!

Yep, the poster sure hit the nail on the head on that one...nurses who arent prepared and informed in advanec are going to have quite a shock when it hits

Laidback Al · Feb 7, 2007

It is unfortunate that nurses have not a had place at the political table for discussing how they, as a group, might be affected by a pandemic. It may very well be time for a grass roots organizing effort by nurses to insure that the Health Care Community recognizes that nurses will be at the forefront of care at beginning of a pandemic. Nurses need to know that they will be provided with PPE, and assured that their personal concerns about time off to care for their own family members will heard.

It is hard to believe that this large segment of Health Care Community has not has any input in pandemic planning. There is still time to organize and make a difference.

indigo girl · Feb 8, 2007

The following essay addresses an issue that many are not aware of, but need to know. Whenever you read about a positive avian flu test result, you almost always hear that the victim had contact with poultry. What you are unlikely to be told however, is that the viral sequences of the humans does not match the viral sequences of the poultry. What does this mean? It could mean that there is good chance that there is a hidden mammalian reservoir for H5N1.

In Indonesia, the virus in the people most closely resembled the virus in a cat. This has important ramifications for preventing disease, particularly in countries where felines are pets (not the case in Indonesia), and are allowed access to the outdoors with the possibility of catching wildbirds.

http://afludiary.blogspot.com/2007/02/fao-advisory-on-cats-and-bird-flu.html

http://crofsblogs.typepad.com/h5n1/2007/02/fao_keep_cats_a.html

indigo girl · Feb 8, 2007

Indonesia and the witholding of information on viral strains of H5N1 collected from their patients could be a tremendous problem for the rest of the world. This large, populous country, where avian flu is now endemic, could be the breeding ground for a pandemic. There are over 1600 different strains of this virus. Surprised? You can see the difficulty of developing a vaccine, and if this country considers viral strains to be intellectual property, it will put the rest of the world at risk unless we agree to their terms. The Reveres are senior public heath officials, and this essay is a thoughtful look at this issue dividing a developing nation and the richer, more industrialized countries.

http://scienceblogs.com/effectmeasure/2007/02/more_on_the_indonesian_vaccine.php#more

Dixielee, BSN, RN · Feb 8, 2007

I would like to thank you Indigo Girl for the hard work you have done in educating the nursing population regarding this issue. My husband and I have been involved in family and community disaster preparedness for decades. While I have not read all of your threads or all of this thread for that matter, I appreciate your efforts.

I have been following the bird flu situation for several years and we have a pretty good idea how we as a family are going to handle it. You can bet the farm that I won't be showing up at work either. I have a responsibility to my family first. Hospital administration is NOT taking care of their employees properly now, what makes me think they will come thru in an emergency?

We are chronically short staffed, have faulty or missing equipment, get no breaks and spend countless hours on paperwork. This is NOW...in the "good times". The public probably is planning on us working as volunteers, but they will be in for a rude awakening. How many other professions are expected to risk their lives routinely for others for little or no compensation? Police, fire fighters, paramedics and nurses come to mind.

I have tried to educate people to take personal responsibility for themselves and their destiny, but feel that I am beating my head against the wall. Everyday in the ER I see countless people come in for frivilous complaints, never even taking an Advil for their backache, or benedryl for their itch. They come to us wanting free care, advice and meds, and they demand it quickly and without regard for anyone elses needs.

Do I think we are doomed in this country if the pandemic hits. YEP!! Do we expect the truck drivers to deliver groceries to stores with hoards of sniffling, coughing, febrile people ready to storm the doors for food? Do we expect the gas pumps to work, the ATM machines to have endless money and the fast food resturants to be serving? Do we expect the pharmacists to stand at the back of the drug store handing out free meds and information to the sick and afflicted? Do we expect the schools and day care centers to stay open and babysit and feed our children?

I don't think so. People will be scared, huddled up and possible quarantined at home by the government. Will travel be restricted in a futile attempt to stop the spread? Do you want to be on an airplane with recirculated air with 150 potentially infected people? Will business travel continue?

Most people can't get into their own doctors offices for illness now, they are referred to the ER, so what happens in a pandemic?

There are thousands of unanswered questions. We need to start thinking of how this could affect us. How are we going to feed our families if the grocery stores are empty? Has anyone really looked around the grocery store to see how much actual food is there? How many aisles are filled with colas, snacks, health and beauty aids, cleaning products, books, toys and gadgets, paper products, beer and wine? Stores rely in just in time delivery for supplies. Have you ever been to a grocery store in the middle of the night? Stockers are frantically replacing goods sold during the previous day or so. What happens when those trucks stop delivering?

I have ranted enough. We are as prepared as we can be. We have not been just interested in preparing for the bird flu, but for taking responsibilty for ourselves in as many situations as possible. Other potential personal disasters could include job loss, disability, death of a bread winner, local disasters such as hurricanes, tornadoes, ice storms (power outages), and floods.

We do not know what the future brings, but we will try to be self sufficient and not be a drain on public resources. Will most of the masses feel this way? NO, many feel it is their right to have others provide for them, and will act accordingly.

For a good and easy to navigate forum on the bird flu, check out www.curevents.com

Scroll down to the section on bird flu and check it out. There is some lively discussion, and it is generally directed to the lay public, so it is easy to read and quite informative. This may have been listed before, so I apologize if it is a duplicate.

Thanks again Indigo Girl for your efforts. I hope they are not falling on deaf ears.

Dixielee the doomer girl

baumeisterfuller · Feb 8, 2007

Thank you, Indigo girl, for a fine job. I have been following pandemic flu for about a year now but generally just lurking on several forums. We, as nurses, WILL be the ones expected to provide care in impossible conditions. It is hard to convince the general public--heck, I have only convinced one of my three children that preparing to be self-sufficient for at least 90 days [and maybe forever, if the inconceivable happens] is paramount.

SmilingBluEyes · Feb 9, 2007

Dixie, eye-opening site. Thank you.