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The use of good judgement during the discussion of controversial issues would be greatly appreciated.

Community Open Thread June 6 to 15, 2009 ...

by: AlohaOR

Sat Jun 06, 2009 at 01:12:44 AM EDT

Not sure where to post?  Want to communicate with the Mods?  Need some help?  Post on this thread.
Welcome, new posters! Lurkers are always welcome to register and join in the discussions.  
AlohaOR :: Community Open Thread June 6 to 15, 2009 ...
The prior Community Open Thread is here.
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Spartan - How does the table look?
(It's in the June 6 news diary, after the headlines, just below the CDC chart.)

You can post updated numbers for me here (the Community Open diary) or e-mail them to me (e-mail address is in my profile).  If you want the table updated more often than weekly, I'll do my best to do so in the evening.  The CDC updates its table on Fridays at 11a.m. Eastern time.

Pneumovax - should an 11 year old be vaccinated?
I was able to get my pneumovax done at the local health department here (no prescription necessary).  The nurse told me that my 11yo daughter would still be covered by the pneumococcal vaccine that was given to her as a baby.  Also, I've read that one should have no more than 3 (or 4?) Pneumovax vaccines in a lifetime.   What to do?

Good question-- med pros please weigh in!
I have also been wondering about Pneumovax for my kids...

DS15 has asthma-fairly well controlled-- but, when it goes out of control it goes fast.  He is also a carrier of MRSA-CA, so secondary infection is always a worry.

DD12 has non-systemic Juvenile Rheaumatoid Arthritis.  She also has superbly well controlled asthma (used an inhaler last fall for the first time in 7 years) and is an athlete (ballet 15+ hours a week).

Should they have the Pneumovax vaccine?  I am more concerned about my son, but is there any harm in getting it for someone not in a "high risk" group?


[ Parent ]
High risk categories from CDC, but does this mean they should get the pneumo-vax?
High-risk groups: A person who is at high-risk for complications of novel influenza (H1N1) virus infection is defined as the same for seasonal influenza at this time. As more epidemiologic and clinical data become available, these risk groups might be revised.

   * Children younger than 5 years old. The risk for severe complications from seasonal influenza is highest among children younger than 2 years old.
   * Adults 65 years of age and older.
   * Persons with the following conditions:
         o Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
         o Immunosuppression, including that caused by medications or by HIV;
         o Pregnant women;
         o Persons younger than 19 years of age who are receiving long-term aspirin therapy;
         o Residents of nursing homes and other chronic-care facilities.


"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
here's a recent discussion
on pneumovax  http://www.newfluwiki2.com/dia...

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
in general
prevnar given to kids works better than pneumovax does. Pneumovax is generally not considered for <5-6 years.

Also, so far bacterial infections are not a prominent part of this flu.

[ Parent ]
Do we really know for a fact that bacterial infections are not a prominent CAUSE OF DEATH for this flu?
I just saw this morning that a 9yo died testing positive for H1N1 AND a bacterial pneumonia.

I read the thread discussing pneumovax that SusanC linked above, and Dr. GW said:

"What I recommend is that everyone be vaccinated for pneumococcus regardless of age of whether or not your insurance company will pay the $40 or not for the vaccine.  My advice is to pay this fee out of pocket even if your insurance company will not cover this expense."

So, my conclusion is:  my 11yo daughter SHOULD get the pneumovax vaccine.  Can I get some reassurance that I am making the right decision?  I know the Health Dept. nurse is going to try to talk me out of it.

[ Parent ]
I had the pneumovax back in autumn with my flu jab (I get asthma so get offered it on the NHS)
I insisted my son 16, and Husband got flu jabs. The surgery was happy to do it and both were happy to have it done at my insistence(they wouldn't give my 9yr old daughter a flu jab.)
But my plan is to contact my doctors surgery and try and insist the other 3 get pneumovax.
This is my personal choice. I would rather feel I had covered my family ( I don't think there is risk with having the pneumovax), than risk secondary bacterial infection.
I am in the UK and have no idea what their stance will be, but I can be quite persuasive!

[ Parent ]
if they refuse
you can always go private.  There are private clinics that offer all sorts of vaccination.  Just in case you run out of other options.  Good luck!

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Question for Susan
Can this be arranged privately in the UK?

[ Parent ]
yes, just google for clinics that offer vaccinations
in your area.  I'd suggest that you find clinics that offer the flu shot, and then ask them if they have pneumovax.  Even if they don't have it, they can order for you.  

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Thanks ...
... do you know of any side effects with this vaccine?

[ Parent ]
check out the link I posted above n/t

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
My mother had problems with the Pneumovax
She had much the same localized reaction that Susan described, with some of the other symptoms - the difference being that her reaction was limited to about a 5 day period with no lingering effects.

My husband and I and my then 28 year old daughter all had the Pneumovax in late 2005 - none of us had any problem obtaining the vax, and none of us had any reaction to it at all.

We got it at the same time that we got that year's annual flu vaccine, and our doctors didn't try to talk us out of it.
We requested it, and got it, and it couldn't have been any simpler.

[ Parent ]
Well, turns out they wouldn't give it to my 11yo
They said they require a doctor's order to give the pneumovax to a child.  I don't know whether to try to fight the battle to pursue this any longer.  Her doctor is very conservative and I'm pretty sure she'll nix it if she's going to follow the "party line."

[ Parent ]
another doc?
Is your doctor in a practice with another doctor?  Many peds are in a group...ask around and make an appointment with one who you feel might be a bit more sympathetic.

Go in prepared with your reasons why you want it...number 1 being that she is YOUR child and YOU are ultimately responsible for her! Take notes in with you if you feel the need...a complete and reasoned presentation is more likely to get want you want.

Good luck.

[ Parent ]
are there places that you get just get the vaccine from?
I read before that people can get their flu shots from like CVS or something.  Can you do the same with pneumovax?  Of course that means paying out of pocket, but it's a fall-back option if your doc won't give it to him.

I'm also asking cos my DD needs one.  She's fresh out of college in NYC and hasn't gotten round to sorting out her insurance yet.  Plus I doubt that insurance would pay for her for pneumovax.  

I'd appreciate if someone knows where she can get vaccinated.  Thanks!!

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Have you tried your local health department?
My health department gave it to me & my husband without any hesitation.  They only refused to give it to my 11yo daughter--they required a doctor's order for her (and her doctor did not hesitate to provide it when I asked).

[ Parent ]
I'm in the UK
my DD is in NYC.  She just moved there.  I can tell her about that.  Thank you.

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
I hope she follows up...let us know how she fares! n/t

[ Parent ]
will do, thanks n/t

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Kroger pharmacy vaccinates without Rx n/t

To calm the wife buy cases of chocolate, to calm the husband buy cases of booze, and to calm the children...... heck the booze and chocolate should work.

[ Parent ]
thanks, will let her know n/t

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Dem, you've got mail
I've sent you a new updated map based upon CDC case data for June 5, 2009.  I started on it yesterday evening but ran into a snag.  I created a new field, but made a mistake.  The data looks funny when it runs out to 7 decimal places.  Lots of .0000000  Just this afternoon I got back to working on it.  Anyway, you got it now, if a little late.

That's quick
Right after I wrote this I noticed you had it posted already.  Thanks.

[ Parent ]
hey, it's great stuff

[ Parent ]
Has the new panflu virus
been shown [like, with some sort of definitive laboratory method(s)] yet to directly attack any of the cells of the GI tract?

not that I know of
althoiugh about a quarter of victims have GI symptoms.

[ Parent ]
GI infections
I've seen multiple reports, first hand accounts, and I believe the Mexico study, which reports GI ONLY symptoms. No definitive lab experiments though.

Just rolling along, making waves and causing trouble...

[ Parent ]
Any link(s)?
Mainly, to that Mexico study?

[ Parent ]
Maybe ATS Webinar - May 19?
Not sure what was being referred to, but some info is available from the presentations given at the American Thorasic Society late-breaking session on Influenza A (H1N1) which included the following:

8:15 Caring For Critically Ill Patients In Mexico City Infected With Swine Flu  G. Dominguez-Cherit, MD, Mexico City, Mexico

(The link from DemfromCt's post still works as of June 9.)
I posted the speaker's list and agenda for that day as a reply to Dem's post.

It is a large file, but once loaded you can move forward and back.

It is worth watching in any case.  

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain

[ Parent ]
National Commission on Children and Disasters Public Meeting
DATE:  Friday, June 26, 2009, from 9:30 a.m. to 3:30 p.m.

ADDRESS:  The meeting will be held at the Administration for Children and Families, 901 D Street S.W., Washington, D.C. 20024. To attend either in person or via teleconference, please register by 5:00 p.m. Eastern Time, June 23, 2009.  To register, please email jacqueline.haye@acf.hhs.gov with "Meeting Registration" in the subject line, or call (202) 205 - 9560.  Registration must include your name, affiliation, and phone number.  If you require a sign language interpreter or other special assistance, please call Jacqueline Haye at (202) 205 - 9560 as soon as possible and no later than 5:00 p.m. Eastern Time, June 12, 2009.

AGENDA:  The Commission will discuss outcomes from its workshop on children and disasters, held June 25, 2009 in partnership with the National Academy of Sciences. Additionally, as pertaining to all hazards, including man-made and natural disasters, the Commission will hear subcommittee presentations on and discuss recommendations regarding:  

  1. pediatric medical care;
  2. education and juvenile justice;
  3. evacuation, transportation and housing;
  4. human services recovery; and
  5. other matters as may reasonably come before the Commission and plans for future work of the Commission.

Written comments may be submitted electronically to roberta.lavin@acf.hhs.gov with "Public Comment" in the subject line. The Commission recommends that you include your name, mailing address and an email address or other contact information in the body of your comment. This ensures that you can be identified as the submitter of the comment, and it allows the Commission to contact you if further information on the substance of the comment is needed or if your comment cannot be read due to technical difficulties. The Commission's policy is that the Commission will not edit your comment, and any identifying or contact information provided in the body of a comment will be included as part of the comment placed in the official record.

The Commission will provide an opportunity for public comments during the public meeting on June 26. Those wishing to speak will be limited to three minutes each; speakers are encouraged to submit their remarks in writing in advance, to ensure their comment is received in case there is inadequate time for all comments to be heard on June 26.

ADDITIONAL INFORMATION:  Contact Roberta Lavin, Office of Human Services Emergency Preparedness and Response, email roberta.lavin@acf.hhs.gov or (202) 401-9306.

SUPPLEMENTARY INFORMATION:  The National Commission on Children and Disasters is an independent Commission that shall conduct a comprehensive study to examine and assess the needs of children as they relate to preparation for, response to, and recovery from all hazards, building upon the evaluations of other entities and avoiding unnecessary duplication by reviewing the findings, conclusions, and recommendations of these entities.  The Commission shall then submit a report to the President and the Congress on the Commission's independent and specific findings, conclusions, and recommendations to address the needs of children as they relate to preparation for, response to, and recovery from all hazards, including major disasters and emergencies.

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

apologies for the multiple posts
important meeting, hope more people can attend!!

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Lack of concern regarding US Stages
This is my first visit and don't know where to look for discussions about the way CDC handled the US Stages. I don't want to beat a drum that's been beat hundreds of times by many others but I do want a better understanding of why they did what they did and when they will have a new version out.

US Response Stages - What Transparency?
I have searched in vain for signs of any public announcment of the US Pandemic Response Stages.  

I do know that the system was used.

Beyond what I commented on back on May 26, I have found exactly nothing.


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain

[ Parent ]
Staying at zero
While the US Stages were up on pandemicflu.org they remained at zero as WHO changed their phases. Then the reference to the US Stages was removed from the site. No explanation. No comments regarding retooling the tool. Many organizations pandemic plans had triggers based on US Stages as did ours. They moved ahead with their responses in the absence of the triggers. So did we. Our plan rewrite will be based on a series of local events.. no longer US Stages.

[ Parent ]
here's the explanation ;-D
Then the reference to the US Stages was removed from the site. No explanation. No comments regarding retooling the tool.

for why they removed it from the website.  I think.


and here http://www.newfluwiki2.com/sho...

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
same discussions as we've had
Susan C, Thanks for the links. Those views are similar to thoughts expressed in my circles but the issue that bothers me is the lack of official explanation. As I wrote earlier, for this wave we quickly established new triggering events that served us well. Going forward we will keep our current plan's grouping of responses intact for worst case events while creating a new triggering approach that provides the maximum flexibility for decision makers. We'll liberally apply the KISS mantra to our efforts so that the result will actually be of value.

When the CDC publishes their new US Stages we will weave them into our triggering matrix. The new WHO phases will occupy a position within the back of the plan as a reference.

[ Parent ]
How Will You Know?
I agree that an explanation is order.

Otherwise, how can you reliably expect to have any better access to or timely notice of the "new improved - yet inevitably imperfect" response stages than we as members of the public had to the "old imperfect" stages?

And if local government, health care systems, critical industries and key resources or even just the aware members of the general public assume they can rely on this rough summary of the progress to 'trigger' their own responses, they may be leaning on an awful thin reed.

If we failed to sound the tornado siren because it gave too little detail of the location or intensity of the storm, I'm not sure the affected members of the public would be terribly forgiving.  

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain

[ Parent ]
But US Phases Were Used - Just Not Public
While the US Response Stages were removed from public view, it is apparent that they remained in use, at least for purposes of other governmental entities.

See here on the   http://www.hsem.state.mn.us/se...

The US and MN Response Stages (as well as the WHO Phase) were also reflected in the periodic situation reports such as this:


So they may have been disappeared insofar as public access, they were used, at least in communication to States, and I found no reference in these Situation Reports to any disavowal of the US Response Stage by the US Govt.

At the very, very least, an explanation is in order of what was done, why it was done and what the current status is of that system (both as in use today and as may be used in the future.)  

It is pretty sad if we have to resort to Freedom of Information Act requests to find out this kind of information.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain

[ Parent ]
FEMA Regions didn't receive US Stage references
I receive updates from the FEMA Region office. I've spoken to them over the course of the past couple months regarding the lack of US Stages. They were, and are, as much in the dark of the lack of that reference as were those in the public sector.

Some entities, ours included, referenced the stages as we took action and coordinated our actions but it was not as a result of some declaration by CDC that a stage was in effect. It was using a common trigger reference for comparison.

[ Parent ]
that would be my understanding
It was using a common trigger reference for comparison.

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Op Ed artcle "Readying Americans for Dangerous, Mandatory Vaccinations"
by Stephen Lendman

At least three US federal laws should concern all Americans and suggest what may be coming - mandatory vaccinations for hyped, non-existant threats, like H1N1 (Swine Flu). Vaccines and drugs like Tamiflu endanger human health but are hugely profitable to drug company manufacturers.

The Project BioShield Act of 2004 (S. 15) became law on July 21, 2004 "to provide protections and countermeasures against chemical, radiological, or nuclear agents that may be used in a terrorist attack against the United States by giving the National Institutes of Health contracting flexibility, infrastructure improvements, and expediting the scientific peer review process, and streamlining the Food and Drug Administration approval process of countermeasures."

In other words, the FDA may now recklessly approve inadequately tested, potentially dangerous vaccines and other drugs if ever the Secretaries of Health and Human Services (HHS) or Defense (DOD) declare a national emergency, whether or not one exists and regardless of whether treatments available are safe and effective. Around $6 billion or more will be spent to develop, produce, and stockpile vaccines and other drugs to counteract claimed bioterror agents.


 Not "news" but shows what may influence public perception, thoughts and feelings.  

American Red cross:Digital Transition Coming Soon
The upcoming transition from analog to digital television signals will have a real effect on the disaster preparedness plans of many people who have relied on small portable televisions with antennas for emergency communications in a disaster, and the American Red Cross urges you to update your preparedness plans and materials.

Congress has mandated June 12 as the last day for television stations to broadcast in analog format and the first day for the switch to digital broadcasting. If you don't have a television capable of receiving a digital signal or if you rely on an antenna for reception (not pay television, cable, or satellite service), you will need to act now and make the changes necessary to make sure you will be able to access local television stations. This access is especially crucial during a disaster, when many people in the past have used battery operated televisions with an antenna to get disaster news.

"The change from analog to digital television signal is set to take place at the end of this week," said Scott Conner, Senior Vice President, Preparedness and Health and Safety, "If you have used a battery-operated TV in the past to get disaster news, it is urgent that you make the necessary changes now."

The federal government has set up a web site to answer questions and help families transition to the new digital format.


Take Away
 If you use an analog TV or small portable for your emergency news or emegergency info please update your plans.  

IL Co. scraps flu exercise
Ill. county scraps flu exercise over H1N1 worries

The Associated Press

GALESBURG, Ill. -- A central Illinois county has called off a planned flu pandemic exercise for fear it might alarm the public.

The Knox County Health Department had planned an exercise on Friday to test its readiness for dealing with a flu outbreak. Knox County's county seat is Galesburg, which is about 50 miles northwest of Peoria.

County Emergency Response Coordinator Jane Danielson says now isn't the right time to have the exercise because Knox County has had several cases of the H1N1 flu virus, more commonly known as swine flu.

Illinois is among the U.S. states hardest hit by the swine flu virus, with more than 1,300 cases. The virus has killed five people in the state.

COMMENT: Incredible.

Yep, 1920 cases is more than 1300!

Agree, this is a good time to make some progress instead of ducking it.  sigh.

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
Federal paid sick days hearing is tomorrow
just got this via the MomsRising.org listserv

We're making headway in our fight for paid sick days for all!  In response to the swine flu outbreak, MomsRising members (you!) sent in nearly 50,000 letters to Congress asking them act now to address the fact that over 40% of private sector workers have no paid sick days.  In today's economy, folks without paid sick days can't afford to follow the CDC's advice to stay home when they, or their children, are sick--and that puts everyone at risk of exposure to illness, whether it's swine flu or any other communicable disease.

Well guess what?  Some of our Congressional Representatives listened!  Just last week, they introduced the Healthy Families Act, which would allow people to earn paid sick days.  It has its first big hearing this very week, one of the key hurdles the bill has to jump before it can become a law.

Now's the time to move this Act forward. Tell your Congressperson to support the Healthy Families Act today.

Paid sick days:  Just common sense. Right now there is no law that guarantees people the right to earn paid sick days to take care of themselves or their children.  In fact, the very industries where you would expect paid sick days to be required (to protect public health), like home health care providers, child care workers, and folks who work in restaurants and hotels, are the LEAST likely to have them. 1

But having the support of the Congresspeople who introduced the Healthy Families Act isn't enough to win this essential protection for working families.  We need more Congresspeople on board with us.  On Thursday, the Congressional Education and Labor Committee's Workforce Protections Subcommittee will be hosting a hearing on The Healthy Families Act. This bill would guarantee seven paid sick days per year for workers at businesses with 15 or more employees, to be used to recover from routine illness, care for a sick family member, or seek services to recover from domestic violence.

Tell your Congressperson to support the Healthy Families Act today.  Click here to send a note directly to your Congressional Representatives.


Make sure to forward this email to your friends so they can take action too.

Here's a short document summarizing the issues

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

this is a very important initiative
Sure 7 days are not enough, but it's a start.  As a UK citizen, I'm appalled at the situation with regards to sick leave in the US.  

Here's a good blog on Huffington Post

The United States lags behind developed nations in mandating paid sick leave for workers, a deficiency that makes the nation more vulnerable to contagious illnesses like swine flu, according to a study by the Center for Economic and Policy Research released Monday.

"We looked at 22 affluent countries -- the 22 that are the top 22 ranked in terms of the human development index -- except for the United States, every single other one has some form of paid sick days or paid sick leave and the majority have both," said the report's lead author, Jody Heymann of McGill University's Institute for Health and Social Policy, in an interview with the Huffington Post.

More http://www.huffingtonpost.com/...

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
and here's the report itself

and a chart showing comparisons between countries, paid sick leave for 2 scenarios - 5 days of flu, and 50 days of cancer treatment.  This chart is for median wage workers.  There's a different one for lower income workers in the report.

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Co-sponsors of House bill HR 2460, and Senate bill S 1152 in case anyone wants to write
his/her own Congresspersons separately from the MomsRising site:

There's a sponsor and 101 co-sponsors listed here, for the House bill:

For the Senate version, there's a sponsor and 20 co-sponsors:

Both houses have referred the bills to committee(s).

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
RE: possible WHO to phase 6
So today may be the day.  So what do we do?  It seems that much of what we expected as far as spread of the virus seems correct. However because at this time the severity of the virus is low, it's not quite how we expected.  We've basically been at phase 6 for a while, so what do we do today. I'm not going to do my final preps yet.  I certainly am not going to stay home, (I have way to much to do) so should I do something different if they raise the level?  It's just kind of a strange feeling to be in a pandemic and not really be changing my behavior.  However, if things change in the fall, life around here will be very different.  

well, it gives us a little time
to finish off preps.  And/or to adjust our preps and plans.  Most of us prepped for H5N1.  This is a lower order of magnitude so your assumptions may be different (or they may not).  But bear in mind it may get more severe, and that may happen sooner than the normal flu season.  In 1918, the severe second wave started late August - early September.  So at least for me, this is the time to review my plans and preps, and adjust accordingly.

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
one suggestion that may apply for some folks
If you have family members who have been skeptical, particularly in your household, now would be the time to get everybody on the same page.  Not in the "I told you so" way, but in a constructive way.  If this gets severe, you need as many people in your household to be well educated about the issues as possible.

And if you can do that for your community too, that would be even better!

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
also time to take whatever vaccinations you intended to take
like pneumovax, as many have been asking.  

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
phase 6
On a personal level the announcement won't make much difference.. I'm not sure what difference it will make on a national level either unless the UK government comes out and outlines exactly how it sees the event playing out in the back end and what it expects us as individuals to do... sadly the fact that Ronaldo has gone to Real Madrid for 80 million( and think what that could have been spent on!) is more likely to engage our PM in his attempts to be down with the people ;-)  

[ Parent ]
Yep but what if Susan Boyle came down with swine flu
Gordon would be delivering a speech from her bedside... with PPE obviously.

[ Parent ]
Lol ;-)
would the mask be big enough to cover that grin?

[ Parent ]
Yesterday, I sent a memo to my staff about the pending WHO P6 announcement and links to resources. (Flu Wiki of course)

I have an educated staff (2 PhD's, 1 PsyD, and 7 MA, LPC's) and their response to this pending announcement was predictable. Not one was following this (now pandemic) flu "story". We have contact with at-risk populations on a daily basis. Several weeks ago I established hand sanitizing stations, acquired N95 masks, put up CDC posters for hand washing, mouth etiquette, etc. The response was a polite, "there goes (me) being the conservative old man again..." My obligation is to provide information and work place safety precautions, but I can't impose common sense. :)

This morning we will have our weekly staff meeting and I anticipate that no one will raise any concerns or questions about today's announcement. I hope to at least hear disbelief, cynicism or acceptance, but silence is unacceptable.

How does the announcement change anything
for your staff?  We have been at phase 6 for weeks in all but name only.

To calm the wife buy cases of chocolate, to calm the husband buy cases of booze, and to calm the children...... heck the booze and chocolate should work.

[ Parent ]
Perhaps it won't
The issue and I wasn't clear in my post, is the lack of attentiveness or curiosity and how this announcement may/will raise the level of awareness to a meaningful response or understanding. At least this is my hope.

[ Parent ]
CFR, anyone got estimates
Has anyone worked the numbers?
Right now I get: There were 28,774 confirmed cases and 144 deaths.
or about a 0.5% CFR.  If the attack rate comes in at about 50%, then world wide that would be about billion cases and about 30 million ??????
and for the US about 1.5 million?????

I just don't get the right numbers.  Perhaps the attack rate will be much lower, but even at 5% attack rate and 0.5%CFR (on the average) that would be 3 million globally and 150,000 in the US.

Does someone out there have estimates for this swine flu?

My guess is that the CFR will be lower in the US and higher in third world countries.

Be Prepared

any estimates?
Mexico was: 6,337 cases, including 108 deaths or CFR of 1.7%
and the US is around 13,000 cases and 27 deaths or CFR of 0.2%

OK those are just reported cases and many may "below the radar".

Anyone with better numbers?

notice also: "BOSTON, June 10 PRNewswire -- An analysis of the latest peptide genomic data for the H1N1 influenza virus indicates that the current global outbreak of H1N1 is increasing in its capacity for lethality. "

Be Prepared

[ Parent ]
see the links on this comment

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
The problem with using confirmed numbers
is that they are only a fraction of the actual cases.  For each confirmed case I estimate there are 10 cases (low end estimate) untested.  Deaths get tested so I wouldn't expect the death number to be significantly off.  Ergo I estimate the CFR to be 0.05% or less.  

This most likely will change geographically and if/as it mutates.

To calm the wife buy cases of chocolate, to calm the husband buy cases of booze, and to calm the children...... heck the booze and chocolate should work.

[ Parent ]
yes, you can't really use those numbers
Check out this paper by Ferguson. It's free.
Pandemic Potential of a Strain of Influenza A(H1N1) : Early Findings, see how they do it.

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
from the abstract

Our estimates suggest that 23,000 (range 6,000-32,000) individuals had been infected in Mexico by late April, giving an estimated case fatality ratio (CFR) of 0.4% (range 0.3% to 1.5%) based on confirmed and suspect deaths reported to that time. In a community outbreak in the small community of La Gloria, Veracruz no deaths were attributed to infection, giving an upper 95% bound on CFR of 0.6% .

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
about right
notice they got: "giving an estimated case fatality ratio (CFR) of 0.4% (range 0.3% to 1.5%)"
that is in about the same ballpark as what I was estimating.
My guess is the it will be Sept or so before we have a reasonable estimate.  
However a range is still usefull for planning.  

Be Prepared

[ Parent ]
but by September the virus would have changed
that is the caveat.  CFR is really very much an after-the-fact parameter.  It's not a 'leading indicator'.  

I would just track how well the healthcare system is dealing with patients.  http://www.newfluwiki2.com/sho...

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
The question of severity...
may come down to how well we can take care of those who fall severely ill. If the quality and availability of health care take a nosedive because we have no surge capacity and if the attack rate is higher in the fall, we may see the CFR rise even without marked changes in virulence.  

Death rates from other causes will also rise as health care is spread too thin.

[ Parent ]
yes I agree n/t

All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

[ Parent ]
Dem, I never thought I'd see the
Flu Wiki birds upside down!

I must say I like them better rightside up! ;-)
How long will the birds stay that way?  

United we stand: Divided we fall

I think a better question might be...
Will WHO publicly announce a reduction in phase level at any point in the future?

My unabashed, and unrequested, opinion would be that the birds swim right-side up when the PanLevel drops to 5 or below.

With a big bold "WHEW!" at the bottom...

[ Parent ]
That was my exact thought!
I sometimes wondered if I would ever see the birds upside down!......  Just goes to show... expect  the unexpected.  Ha!

we planned ahead!

Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. ~ Margaret Mead

[ Parent ]
A reminder for those who receive US TV broadcasts...
Tomorrow night (June 12, 2009) at midnite Eastern Daylight Time, all analog television broadcasts from within the United States will cease permanently.
All televisions must then have a digital converter box attached, or be hooked to a cable television service, in order to receive any broadcast from any tv station.

What does this mean? If you purchased a small, portable television that works on batteries, and it is NOT DTV-certified, it will not work with the new system. It will become, most likely, a very expensive paper weight.
There are some portable converter boxes available for these TVs, but they are expensive, and not really all that portable.

Also, some television stations have been broadcasting their audio on local FM radio stations. By new federal law, this will also cease.

There are some portable DTV sets available, but they are, and will remain for some time, quite expensive, most beginning in the range of $300 and up.

Tvs here for $129 and $199, but whether they'll pick up a signal
is a different issue.  Other brands of portables haven't had good reviews regarding their reception.  (My normal tvs are doing badly with our rabbit ears, even with electric booster antenna, since analog ended.  fooey.)


"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
According to all the DTV reports...
You have to have a Digital converter box between your antennae and television for the best reception. And the guhvement is supposedly still offering those $40 coupons to help in the purchase of a $50 box.

The "new digital" portable TVs are supposed to be clearly marked as DTV-Compatible.

[ Parent ]
Yes they're digital, but what channels will they pick up?
I've just lost the 3 major networks and one PBS channel on the kitchen tv, for example.  I live outside Chicago, with no hills to block anything.  We were spoiled and had 15 channels coming in over the air, with rabbit ears.  (Some were snowy, but audio was good.)  :-(

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
Jane---how long have you had the TV in the kitchen?
Are you looking at the channel selector to see if it's a digital TV? That's not what counts...
The insides, the guts, the tuner, must be capable of sorting out the digital signal. That's what the converter box does. Rabbit ears or rooftop antennae alone will not do that.
If I disconnect my cable box, and simply plug in a pair of rabbit ears to my LCD TV, which is fairly new, it will not pick up a signal. Your TV is the same way...no converter, no signal. Very few televisions have been built to convert a digital signal by themselves...they need a little help, and that's what the cable companies offer and that's what the converter box from Wallie World does.

[ Parent ]
No, sorry I wasn't clear that DH has done the work.
We have the [blasted] converter box attached, and we can get maybe 5 digital channels on it.  But the other ones that we're accustomed to receiving are missing now.  That's why I'm skeptical about the portables.  If our 2 sets of rabbitears (longer than portables have) aren't adequate for the [converted] kitchen tv, I don't know how good the reception can be with a little portable.  I think we'll have to change rooms instead of changing channels, if we want to see NewsHour on PBS, for example. Thanks for the explanation, though.  

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
I don't know how well digital signals travel over distance...
...so I can't really comment heavily. It's possible that digital TV signals don't have the same range as the old analog, or the same penetrating power through walls, etc.

Or maybe...just maybe...it's a long-term government conspiracy with the cable companies to force people to get "hooked up" via cable television! LOL!!

[ Parent ]
Rabbit ears
I hooked up the box for my parents and they lost about half their channels as well.  We went out and bought a new set of bunny ears, ones designed for UHF reception and they got about half the lost channels back and picked up a few they had never received before.

I lost my Fox station Friday.  Supposedly it is still broadcasting, but I couldn't get it yesterday or today and I've been on the digital side since Janurary.  I'm hoping it's their antennea and will be fixed when they dismantle the analog unit in the coming weeks.  Until then, no NASCAR :(

[ Parent ]
Another DTV answer
This article is from February 2009, when Digital TV was supposed to take effect, and was written by a Texas television station. However, the basic facts are in the article that refer to loss of channels in the new Digital world.


After more than half a century of analog TV, we've all grown accustomed to the variety in reception patterns. There can be ghosts and snow, and sometimes you just get used to it.

Digital TV is different.

Even if you have been receiving an acceptable analog picture at your location, unless your digital signal level is above a certain threshhold, you'll either see no picture at all - or it will be "blocky" and unwatchable.

Compounding the reception problem: all local stations are sending out their digital signals on a different channel than their analog signal.


If you're currently using an indoor "rabbit ear" antenna and you're having digital reception problems, extend the cable that connects it to your TV (or your converter box) and move the antenna to a higher location in the room.


You may need to employ an extra length of cable to get the needed positional flexibility. Use a simple coaxial "barrel" connector (available at electronics stores) to link the two cables, but don't use an extension that's longer than necessary; every foot of cable diminishes the signal strength.

[ Parent ]
UBS sent "swine flu kits" to all of its employees
My stepmom is a broker for UBS, a Swiss-based company. She has her office in her home in Colorado. Yesterday she received a "swine flu kits" that was sent Fed-Ex. It contains 3 N95 respirator masks, 10 surgical masks, a digital thermometer and non-latex gloves. It also contains instructions to stay home if you are sick.

UBS has supplied every employee with one of these kits. They are mailing them around the world. It's the only company I've heard of that is providing PPE this way.

I'm not sure if this should go here in the Community thread, or in daily news.

That's super!!!
My company, which shall remain nameless at this point, has told me that they "have a plan", which of course is not published for employees, but they have no intention of distributing masks or PPE or anything else, because "everything in the stores will be gone if and when a pandemic ever occurs". Gawd, I love my company!!

What I was told when I inquired about PanFlu Plans:

"ABC Corporation" has pandemic plans in place.   At this time we are in a watch mode and normal procedures are in place.  If things escalate, the Pandemic teams will make appropriate decisions and notify employees of actions taken.

A worst case scenario would cause more impacts to society than can possibly be determined at this point. It is highly unlikely that flu supplies (masks, gloves, sanitizer, vaccines, etc.) would even be available as they are in short supply now.


[ Parent ]
Several years ago I wrote up a pandemic plan for a small non-profit I worked for at the time.  (Two years ago I left them to start a GIS mapping business.)  I gave the executive director a call about a month ago as a heads up and to see whether they had activated the plan.  They hadn't.  Hopefully they have by now.  I would not be surprised if nothing is done until employees start getting ill.  Too late by then of course.  About half of them are smokers and I'm afraid this flu will hit them very hard.  They have some PPE squirreled away if they will just dig it out and use it.  Maybe they will.

[ Parent ]
Good news!
Our doctors all came through for us - myself, my husband and my daughter.  We all three have Tamiflu prescriptions, and we all three have the pneumovax vaccine.

Can someone point me to a comment or diary that has guidelines on how to know when to start taking Tamiflu?  I don't want to take it unnecessarily, but I want to be able to recognize when it is absolutely necessary.

Places to start


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain

[ Parent ]
Thanks very much; I'm printing some of these pages for reference. n/t

[ Parent ]
I could've sworn I read something about Ibuprofen increasing viral load...
...but I can't find it now.  I did some searching and instead found that there was research from 1987 showing that ibuprofen in combination with diphenhydramine and cimetidine could be helpful in treating adult respiratory distress syndrome:
I am just wondering if I have any need to worry about ibuprofen, or can I go ahead and safely use it for flu symptoms in both children and adults?

CDC Interim Guidance - H1N1 (includes ibuprophen info)
Medications to Help Lessen Symptoms of the Flu
Check with your healthcare provider or pharmacist for correct, safe use of medications

Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye's syndrome. For more information about Reye's syndrome, visit the National Institute of Health website.

Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
Teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.  Children younger than 4 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.

The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.

Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS). Examples of these kinds of medications include:

Generic Name                   Brand Name(s)
Acetaminophen                  Tylenol®

Ibuprofen                     Advil®, Motrin®, Nuprin®

Naproxen                       Aleve

Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.
Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications-don't double dose! Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.

Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu.For more information on products for treating flu symptoms, see the FDA website.


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain

[ Parent ]
Tylenol v Motrin
Tylenol vs. Motrin
Question of the Week
By Vincent Iannelli, M.D., About.com
Updated: July 18, 2007

Flu Wiki
Symptomatic Relief


ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain

[ Parent ]
No Contest
Ibuprufen (Motrin) all the way.  Works more quickly (in my kids) and lasts a lot longer.

Unless you want the child to fall asleep.  Then I got with Tylenol.

GetPandemicReady.org - non commerical website with practical ways for families to prepare.

[ Parent ]
There's a new form that dissolves in the mouth,
but I don't remember which OTC medicine it is, Tylenol or Advil or ?  It's a small sheet to put on the tongue.  However, it contains caffeine, so is it more for headache than flu?  

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
I doubt it's ibuprofen ...
...because ibuprofen kind of stings or burns if it dissolves in your mouth.  That's why the chewable ibuprofen is not very popular.  

[ Parent ]
Motrin vs Advil
Is there a difference?  What is it?  

They're the same
Both are ibuprofen.

[ Parent ]
Alert to mods Go-Daddy ads and Sponsored Listings

When I use the bookmark that I have used for months to access this site, I get a page saying that this site is parked for free at Go Daddy with ads for Go Daddy and Go Daddy sponsored commercial links.  Same thing came up when I googled fluwikie and clicked on main site.  Could find no link from the Go Daddy page to this site and I tried a couple of the google search links before getting something that I recognized.  So I had a few minutes of paranoia this morning thinking that Fluwikie had been ingeniously removed.  A casual looker will not find it.

Thanks again to everyone who makes this site work!!

Yikes! Where is the wiki? n/t

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
Yes, me too!
I had the exact same experience, (but it happened from one minute to the next, as I jumped pages, about 8:30am PST) plus the fact that I checked with "Down For Everyone?" (a test site) and it said, "yes, that site is down"... it scared me, too... I was really glad I could find this forum site...

[ Parent ]
aware, thanks...
we'll have a post about this in a bit... we are working out renewal issues with Go Daddy.

[ Parent ]
We posted at about the same time..... n/t

[ Parent ]
It looks like the Wiki side...
...has been re-directed to a GoDaddy ad page. Mods have been notified by email...

[ Parent ]
I still get the wiki...
... through a miracle of modern science caching. News to come.

[ Parent ]
Something I'm out of right now. ;-)

[ Parent ]
MaMa, I put the
Egypt article that is in the news diary in the Egypt diary too.

Good to see on. Hope you are having great weather!

United we stand: Divided we fall

Thanks cottontop!
Good to see you too and yes we are finally having great weather, it's been a cold and wet spring.

Hope all is well with you!

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

[ Parent ]
Could we have a new community diary please? n/t

United we stand: Divided we fall


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