Fact-esque

This is the PanFlu Plan I Want to Read

Richard Branson, star of a failed reality television program but  chairman of a very successful Virgin Atlantic, is stockpiling Tamiflu for his staff: (emph mine)

In a sign of growing travel industry concern about a possible global flu pandemic, Virgin Atlantic Chairman Richard Branson said Wednesday he had purchased 10,000 courses of medicine for the airline’s employees to use in the event of an outbreak.

At a news conference held in conjunction with a global health summit in New York, first reported on CNBC, Branson said he bought enough of the antiviral drug Tamiflu to treat up to 10,000 airline crew members, who he said would be on the front lines of any pandemic.

I wonder if the story is right about growing concern in the airline industry and what that means exactly.  This comes a little later in the story:

He said he began assembling his company’s pandemic response plan six months ago.

That's the panflu plan I want to get my hands on.  Judging from Branson's behavior and his observation that airline travel would be shut down in the even of any pandemic, it's likely a realistic and comprehensive look at some possible scenarios we can expect when a panflu hits.  In fact, I'd love to know how any big company plans to deal with staffing concerns and supply line disturbances.  I'm guessing that the private sector is coming up with some good ideas and solutions to problems that are going to impact us but which we, outside the loop, would have a harder time imagining.

I wasn't a fan of BushCo's big "When Is a Plan Not a Plan?" announcement earlier this week so here's a piece of  good advice for the beleaguered CEO president: call some of your captain of industry pals, put them together with some government officials representing every region of the country and level of government, grab whatever public health officials you haven't downsized and hold a PanFlu summit (that's right, a summit where there aren't a hundred thousand anti-you demonstrators) to explore what the public and private sector can expect to face and what each can offer.  I'm pretty sure this kind of thinking was covered in some of those fancy bidness classes you slept it off in.

Operation Save My Agenda: Day Two - Big Pharma Will Save Us All

So the big BushCo Bird Flu plan is finally out.  Typically, like any guilty, abusive parent, he's showering us with money.  Actually, it's more promises than money since the billions he's talking about are mostly going to be funnelled into Big Pharma's pockets.  Effect Measure has the best review of the plan.  This is my favorite part because it is the flipside of today's big headline: BUSH ASKS FOR BILLIONS FOR VACCINE PRODUCTION!

Bush also wants $1.2 billion to purchase enough H5N1 vaccine, developed by NIH, to vaccinate 20 million people. But there is no vaccine yet. The experimental batch that went through clinical trials a few months ago showed itself unable to protect people unless unrealistically high doses were used. And the strain it was directed against has already changed, so the best one could hope for would be some residual cross protection. No one knows how effective that would be, but no where near as effective as a vaccine directed against the actual pandemic strain when that arrives. There is also a $2.8 billion request to develop cell culture vaccines instead of conventional egg-based ones. That is already happening (Sanofi-Pasteur) but will take time. R&D money could have been pumped into this obvious need years ago, but the Administration relied on private sector initiative and Big Pharma had no interest in the lower profit vaccine business when it could make high profit Viagra and similar drugs. So the work didn't get done and now we are playing catch up. The bottom line for Big Pharma (the only line it cares about) will be that the public will fund the R&D and the big drug companies will be allowed to privatize the profits. And they are being asked to do it in a hurry, without time for adequate safety testing. So they don't want to take the risk and want immunity from suits.

If you're reading the corporate media today thinking that everything will be okay because BushCo is making noise about stockpiling Tamiflu and creating super vaccines in record time with new technology (suddenly he's all about the miracles of modern science), my guess is that when a panflu hits the U.S., you'll be wondering how Dear Leader could have let you down.  Part of the answer is, of course, "You fool.  What ever made you think that BushCo, who, since he took office, has been dismantling the very social structures and programs that are in place to protect you, could be trusted to take care of the country?"   But part of the answer is that no president can protect the entire country from the effects of a panflu.  BushCo is simply uniquely unqualified. 

We need a leader who knows the value of community.  This is one of those dare-to-be-great moments that seem to be coming along with increasing frequency.  A great leader would be honest about the limitations of throwing billions at Big Pharma.   A great leader would demand that local governments and industry, from the smallest villages on up, submit preliminary panflu plans no latter than December 31 with final versions due by January 30 and that those plans coordinate with surrounding jurisdictions and are kept up-to-date.  Local water treatment plants, electrical plants, nuclear plants, (put your indepensible utility/industry here) need protocols on file that would allow National Guard troops (whatever we have on hand) and other volunteers to  walk in and run the joint without a break in service. 

Surveys of people in need of daily medications need to be made.  How are they going to get their meds if supply lines are down?  Volunteer lists need to be drawn up. Who's going to take insulin to shut-ins?  Or to people who are self-quarantining?   

Who's going to back up the fire department or  police department  when half the staff is down with the flu?

Protective clothing needs to be stockpiled.   

Education/information seminars need to be held.  We need to educate communities about the value of better hygeine practices.   State and local boards of health need to be built up instead of torn down.  A great leader would remember the value of public health services and fully fund them top to bottom. 

School boards need to figure out what to do about facilitating homeschooling. 

Where will we put the auxilliary morgues?  What facillities can serve as emergency hospitals to take the patient overflow? 

That's only the tip of the iceberg but I think that 90% of what a good municipal panflu plan covers is not too diffcult to do.   The most difficult part now will be dealing with the ego problems that always pop up and hobble cooperative efforts.  Basically the goal is to keep the water running and to keep people from panicking and/or dying in the streets.  Good planning now will go a long way to keeping panic at a minimum when people do start dying or when food is harder to find.   The planning  gets trickier when we start talking about stuff like the personal stockpiling of food.  But personal responsibility needs to be addressed.  Leaders who ignore it are cowards. 

Related: You can go to Pandemicflu.gov to see if your state has a Panflu plan and whether it's any good.  If you get active on this issue, be sure to check out the FluWikie for tips and general education on the topic. 

My state, PA, has a panflu plan but it's so vague, it's useless.  That's a bummer because the person I spoke to at the county level told me that the state plan is the county plan, which makes no sense at all.   As far as I know, my township has no plan.  Maybe the state plan is their plan too!  This is the kind of leadership we can count on being useless when up to two thirds of the popluation is incapacited during a pandemic.   Now is the time to help local administrators see what has to be done.  We really don't have any excuse not to at least try.

PanFlu Preparedness Plan: Step One - Protect Big Pharma

In preparataion for Day Two of Operation Save My Agenda, when the big PanFlu preparedness plan is set to steal some headlines, please take a minute to read this post at Effect Measure, which puts the lie to the whole thing:

What are we to make of these two stories? The first says Bush is going to unveil the long-awaited (and unforgiveably tardy) pandemic flu plan tomorrow. The plan includes proposals to beef up stockpiles of vaccines and antivirals and allegedly also a fund to build infrastructure (AP via Yahoo News). Sounds good, if they are serious about it.

Then there's this: "Congress Weighs Big Cuts to Medicaid and Medicare." That's the Republican Congress, folks, Bush's party. I guess they aren't in on the "plan." Or maybe they are another part of the plan, the part that won't be publicized on Tuesday:

Congressional committees have proposed substantial cutbacks in Medicaid and Medicare, the nation's largest health insurance programs, which together cover more than one-fourth of all Americans.

[snip]

The House bill would take all of its savings from Medicaid, the program for low-income people, while leaving Medicare, the program for those 65 and older and the disabled, untouched, as the Bush administration wants. By contrast, the Senate bill would squeeze savings from both programs.

The new cuts are estimated to save $4 billion for the feds and $3 billion for the states in the next five years. $7 billion dollars in five years. We will burn $7 billion in a little over a month in Iraq. The Iraq mistake is already costing almost thirty times the estimated savings from five years of painful cuts to our oldest and most vulnerable citizens. al-Qaeda must be delighted.

Not everyone will suffer, however. Big Pharma doesn't want to get hurt and it's putting on a full court press to see it doesn't happen.

We really can't be surprised.  When faced with any crisis - natural or manufactured - the Republicans' first response is to get that profiteering machine up and running.  Go see what a few million dollars in well-placed pocket lining can buy you in the good ol' U.S. of A.   

If Only Someone Would Explain How Viruses Work ...

If you've got some time, read this fantastic article from DarkSyde.  It's about viruses in general and the coming avian flu in specific.  I'm not sure about one point he makes about the avian flu not being as dangerous to healthy people with good immune systems since I have heard the opposite said to be true.  But it's a great quick course in virology and the Bird Flu.   Plus, there's writing like this:

Viruses have a unique ability to sneak past cell walls, penetrate the nuclear membrane, and locate specific sequences of DNA. There they delicately snip out an unwanted segment, and/or insert a new sequences at a precise location. That's what viruses do, although they usually work against us when they're doing it. But by recruiting them to provide a benefit, disabling an unwanted gene or activating, even creating, a desirable one, we can perform nano surgery on the cell without ever breaking the membrane, much less the skin. This application, called Gene Therapy, holds a degree of promise that is almost incomprehensible in scope. We might turn off cancer cells, eliminate genetic disease after birth, or convert blue-green algae into a factory which turns sunlight and CO2 directly into gasoline, just for dreamy starters.

We're also learning to selectively breed viruses for specific tasks, and in some cases we're now experimenting with engineering them directly. (IDC fans note the term: Selection. Evolutionary biology is absolutely critical in understanding viruses in general and flu specifically. If we relied on Intelligent Design solely to manufacture flu vaccine or anti-viral drugs, create new applications for viruses, and understand how new strains develop and spread ... we wouldn't have any of that. Instead we'd all be staring at dead and dying people and animals exclaiming "Wow! Them viruses sure do look complicated").

Giddyup!

Have a Nice Weekend!

Image via Collective Sigh

Take Control

The Philadelphia Inquirer did such a good job fronting a facts-not-fear story today about avian flu that I had to post about it.   The gist is this:  Vaccines are a long way down the road.   There aren't enough anti-virals and they aren'ta cure-all anyway.  Those two bits of information do not mean that you're a dead wo/man walking when a panflu hits.   The reporter, Marian Uhlman, focuses on what you can do (and it's a lot) to avoid getting sick even in the absense of medicines to protect you.  Good news!  Most of it you learned in the first grade:

Protecting Yourself, Others From the Flu

Here are a few things you can do to reduce your chances of getting - or spreading - the flu or other contagious respiratory illnesses.

Protecting yourself

1. Wash your hands routinely with soap and warm water for at least 20 to 30 seconds after coming into contact with others.

2. Do not touch your face before washing hands after contact with others.

3. Avoid contact with people with a respiratory illness or with items they may have touched.  (I've read that 72 hours is long enough to kill the virus but double check that.  eR)

4. Ask your health-care providers whether they are making special accommodations for sick patients or instituting other changes to prevent transmission of respiratory illness in their offices. 

Protecting others

1. Stay home from work when ill with a respiratory illness.

2. Do not send your children to school, parties or other events when they are ill.

3. Cover your nose and mouth when you sneeze or cough.

Stay home from work?   Keep your kid home and miss a day of work?   Easier said than done.   And you know that most people won't even consider those options until people start dying some pretty awful deaths.   We need leadership that supports those decisions and as of now we don't have it. 

I would add wearing a nano-mask, gloves and other protective clothing when you're out and about.  But I know that I'll be able to put the mask on correctly and I know I won't get lazy about washing my hands even if I use protective clothing.   Those are big variables in the general population so most lists like this leave protective clothing off completely.   

The key to surviving the panflu will be to avoid getting sick.   Practicing basic hygeine is your best line of defense.   Start thinking now about what you'll want to carry with you to minimize your contact with the virus on doorknobs, keyboards, telephones, faucets ...

Keeping Panic Down with Misinformation

Someone should show this diagram to the Arkansas Department of Health.

Good news!   Arkansas is safe for now from Avian Flu.   The bad news is that the person in charge of Public Health in Arkansas either doesn't know what she is talking about or doesn't care if she confuses people as long as they can go to bed with smiles on their faces.   Last week,  Arkansas Department of Health Director of Communicable Disease, Sandra Snow,  said this:

"I think everybody is confused over [the bird flu]. I'm afraid it's because they don't understand it," Snow said. "The bird flu is an influenza that can attack poultry and occasionally can be seen in the United States, but it hasn't been seen in 20 years in Arkansas."

 

According to the Centers for Disease Control, avian influenza are viruses that happen naturally within birds, carried in their intestines.  The disease is spread by contact with an infected bird's bodily excretions.

"In Asia they are having a problem with avian flu and apparently [wild birds] are passing it on to chickens,"  Snow said, adding that humans can only get avian flu by close, extended contact with infected birds.

Whew.    So if you're not in close, extended contact with an infected bird, then you're safe because you can ONLY get it that way.   Of course, that part isn't in quote so Ms. Snow may have been misquoted because she goes on to say - in quotes:

"With this we have seen cases in Asia only.  It is very difficult to get," Snow said. "There have been a few person to person.   Other than that, it is passed from bird to person."

Snow said government health officials are also watching the virus closely to see if it changes.

"If that happens there will be a problem, but right now it is a bird to human passage," Snow said.

Except when it isn't.    From Effect Measure:

Most observers believed this was a cluster of human to human (H2H) transmission. With the three children, one at least a contact with another case, the possibility becomes a probability.

Snow went on:                         

"We do not have a vaccine for it yet, but they are certainly working on it," Snow said. "We do know currently that if the avian flu should reach here it will respond to Tamiflu."

Except when it doesn't.   From Effect Measure again:

On the other hand, this drug is not likely to be much use except on the margins and for some people. It needs to be taken continuously for prophylactic effect when exposure is prevalent in the community so compliance will be an issue as will cost. The dose required for whatever virus becomes the pandemic strain is also uncertain. Its main use is likely to be in health care workers and other critical personnel and possibly in household members of those who are ill.

There's a constant and understandable struggle in government between the risk of panic and  the risk of whatever doomsday scenario about which the government is  trying to educate the public.   (NB: exceptions for Team BushCo include  politically motivated terror alerts)   So far it looks like leadership on many levels is choosing to sing lullabies instead of choosing to rise above their own fears to  trust the American people to deal with a serious situation that requires equally serious planning and sacrifice.   

If our current leaders are unable to find the talent for doing that within themselves, they must find people who are capable of doing so.  We need inspiration to build community and trust each other.  We need to trust that our governments at all levels will cooperate and at least  have basic  plans in place to get us through this with a minimum loss of life and with a minimum disturbance to necessities like power, water and medicine.   We don't need  threats of martial law and certainly not misinformation about the threat we are facing.

It Takes Two to Lie. One to Lie and One to Listen.

It's still PanFlu Awareness Week.    No panicking allowed!   

If you're one of the people wondering what's the big deal with this whole flu thing and planning to trust the corporate media to stay informed, take another look at my teaching case:  the mystery illness that ripped through a nursing home in Toronto.   This was the AP report on October 5, 2005, early in the outbreak:

Mystery illness kills 4 more seniors

 

October  5, 2005

 

 

TORONTO -- Four more residents of a nursing home for elderly people have died of an unknown respiratory illness, bringing the number fatally infected to 10, Toronto's chief medical officer said Tuesday.

 

Dr. David McKeown said the outbreak at the Seven Oaks Home for the Aged has affected 84 residents, employees and two visitors to the nursing home on the outskirts of Toronto.

 

Health officials have said they have ruled out influenza, avian flu, severe acute respiratory syndrome or SARS, and Legionnaire's disease.

Now comes news that by "ruled out," those officials meant "are considering":

A Toronto health official announced that another person has died at the Seven Oaks Nursing Home from Legionnaire's disease.  When residents started getting ill health professionals were at a loss to explain what was infecting them.

They weren't at too much of a loss to rule out the disease they're now ruling right back in.    But I'm  probably  nitpicking. 

I'm not sure what the moral of this story is beyond Don't Trust the Corporate Media as Far as You Can Sneeze.    Alls I can tell you is that I get my news and analysis  from two places:  Recombinomics   (first stop every morning)  and  Effect Measure.    Something tells me that when avian flu does start killing people in earnest,  informing the public in a safe and timely manner isn't going to be Job One of Team BushCo.    After all,  maintaining a calm, protected, well-informed and prepared public really isn't their leaderhip style.

Prince Spaghetti is a Good Choice for that Pandemic Pantry

What?  You don't have a fully-stocked Pandemic Pantry?   Have you learned nothing so far from Avian Flu Pandemic Awareness Week?   I've learned that everything I thought I knew I didn't really know.  That'll be part of what I hope to get written for the American Street today.   But no bets.   

This week has been a nightmare.   I'm starting to think that a three-month quarantine would be a nice break.   Like a snow day for grown-ups.   If only I could get rid of  the mental images of lunatics shooting anyone who came within a hundred yards of their generators, I'd be able to relax.

Promise You Won't Panic

An alleged mystery illness has shown up in a Toronto nursing home.   Just typing the words "mystery illness" makes me feel like an editor for the National Enquirer.   I actually wasn't sure if I should post anything about it since the story has a potentially high panic rating -  people dying, nobody knows why, exclusion tests are inconclusive ...  Combine that with the very recent and very  poorly managed outbreak of bird flu in Jakarta, which involves  confirmed cases of human to human transmission, and any talk of mystery illnesses showing up in another continent is scary.   

On the other hand, this is a good teaching case to show how you can keep up on news that might not show up in the corporate media (cue scary music)  until it's too late!! 

Okay, I take back the "too late" thing and will admit that the suggested  scary music was manipulative.   But my point is still a good one.   Since this mystery illness (cue scary mus - Sorry.)  is probably not Avian Flu,  it's possible to relax a little bit and pay attention  to how the story is handled in the corporate media and on the web, thereby gaining valuable experience in sorting through available  information and helping to figure out which sources you trust and which you don't. 

For instance, you can follow the  Recombinomics reporting of the outbreak.   The headlines were as follows:

 10/1:  Mystery Illness Kills Four in Toronto
10/2: H5N1 Not Ruled Out In Mystery Illness That Killed Four in Toronto
10/3: Mystery Illness Spreads to Patient Vistors in Toronto 

If you read those stories, you find out that because false negatives are common, autopsies are the best way to rule out bird flu.   But, even though  autopsies didn't begin until today,  the corporate media in Canada and the US  were  reporting as early as Saturday that the avian flu was "ruled out" as a possible cause of the outbreak.    In  a nice bit of symmetry, CNN actually featured the same quote that Pravda did to reassure viewers that "there is no threat to the greater public."   

Of course, Pravda and CNN may be right about the threat level.    But I won't believe it until I read it on Recombinomics.