About
About Flu Wiki
How To Navigate
New? Start Here!
Search FW Forum
Forum Rules
Simple HTML I
Simple HTML II
Forum Shorthand
RSS Feed

Search




Advanced Search


Flu Wiki Forum
Welcome to the conversation Forum of Flu Wiki

This is an international website intended to remain accessible to as many people as possible. The opinions expressed here are those of the individual posters who remain solely responsible for the content of their messages.
The use of good judgement during the discussion of controversial issues would be greatly appreciated.

Situation in Hong Kong 1 - Outbreak and School Closure

by: SusanC

Wed Mar 12, 2008 at 20:06:49 PM EDT


( - promoted by DemFromCT)

The following is a synopsis of what has been happening with the flu outbreaks in schools, and the events leading up to school closure.  Due to the large amount of media reports, I am unable to quote each in detail, but the most important sources are referenced.  

Also, because of the length of the diary, the epidemiology and investigation of the outbreak especially the fatal cases will be written up in part 2.

SusanC :: Situation in Hong Kong 1 - Outbreak and School Closure
Rapid rise in outbreaks in schools
The following data is taken from the Centre for Health Protection website on reports of outbreaks of influenza and ILI in schools (except for 1 in a hospital and 1 in a residential home).  

DateSuspectedConfirmed
March  611
March 7121
March 1090
March 11234
March 12203
Total659

This is the official count up to March 12, a total of 74 reports of outbreaks in schools from the beginning of March and obviously rapidly rising in number.

One newspaper reports an additional 23 schools with cases yesterday.

(Edit: Final count from the CHP was 50 reports of outbreaks for March 13, 41 suspected, 9 confirmed.)

School Closure

The sequence of events leading to announcement of a general school closure has been confusing and chaotic.  Initially, only the school in Tuen Muen where one of the deceased (7-year old boy) had attended was closed for 'disinfection' and also because about 30+ students were out sick, with 7 in hospital.

As late as yesterday afternoon (2:30pm 12 March), the Health Minister York Chow was still adamant there was no need for a general school closure.

But Secretary for Food and Health York Chow Yat Ngok said there was no need to have a territory-wide closure of schools. He urged people to stay calm.

"We are closely monitoring the situation now and we do not see the need to close all schools at this stage. But if the outbreak of the flu-like disease becomes more serious, we may consider that.

Dr Chow said it was up to individual schools to make the decision whether to close or not.

 

THAT last statement may have been the proverbial straw towards the subsequent chaos.  One of the schools with rapidly rising cases first decided to close.  YL Public Middle School Alumni Association Primary School (in a different district, Yuen Long) had 32 students and teachers reported sick due to ILI on Friday, but this increased rapidly to 100 on Tuesday alone.  They announced that the school would close early for Easter.  

Coincidentally, there was apparently a meeting of heads of schools in the Tuen Muen school district.  Some of the schools became very concerned, and many parents started calling in to say their kids were sick, just so they could keep them home.  Some parents who were walking their kids to school turned around after they started hearing about school closures and as the news of the latest death spread.    One parent said "I have only one son, I don't want anything to happen to him."  

At the same time the Centre for Health Protection was holding a series of territory-wide public meetings to address the concerns of teachers and school heads, who repeatedly asked to be given better 'metrics' or criteria as guidance for school closure.  There was a lot of confusion and no consensus as to when schools should close.

U-turn on school closure appears to have been led by the Chief Executive and the highest levels of government based on the rising concerns from school heads and the general public.  In a late night (10:30pm) announcement, the Health Minister announced all primary schools, kindergartens, nurseries, and special care facilities would close tomorrow.

While this might be the correct decision from the public health point of view, it nevertheless drew sharp criticism from all sides mainly because of the hastiness and more importantly how late at night this was announced.  Read the following from the South China Morning Post

Schools prepare for chaos after order to close
Teachers and parents furious at government's late-night decision to cancel classes

Paggie Leung, Martin Wong, Mary Ann Benitez and Agnes Lam
Mar 13, 2008

Educators criticised the government's 11th-hour decision to close all primary schools and kindergartens, saying it had made it difficult for them to inform parents and pupils.

Schools were desperately scrambling last night to have teachers ready to handle the expected chaos, fear and confusion from parents and students who would be expecting to attend normal Thursday classes.

Li Kin-fai, a teacher at Aplichau Kaifong Primary School, said: "This is very sudden and a bit too urgent. If they had informed us earlier - before 6pm - we could have adopted emergency plans and maybe called parents about the suspension."

The decision to close the schools amid the flu outbreak was made by health minister York Chow Yat-ngok at 10.30pm.

Mr Li said the situation would be chaotic this morning and he had arranged for some teachers to arrive at school early.

Parents were also disappointed at the late decision. Mary Sze, a teacher and mother of a three-year-old, found out moments before she went to bed.

"I need to get up at 6am. I usually go to bed at around 10pm. Thank God my sister called me and told me, otherwise my mother-in-law would have brought my daughter to wait for the school bus early in the morning.

Peter Lam, who has a four-year-old son, was also angry.

"We don't watch television early in the morning because we have to rush to work. This is not like we're having a typhoon and we have to keep checking the news and see whether schools will be closed. How would we know that the government would issue the closure order so late?

"The government should know that teachers and children go to bed earlier. If my sister-in-law hadn't called me, I would not know about the school closure."

Tags: , (All Tags)
Print Friendly View Send As Email
also in Shenzhen
there appears to be a similarly if not worse outbreak going on, again involving children.

Here's a report on how hospitals are overcrowded with more than twice their normal attendance.  It is common practice in China to give IV treatments.  You can see from the following pics how they are giving IV in the waiting halls and even outside of the hospital.




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


Timing
The timing of the decision to close the schools (in the middle of the night) caused me to sit and ponder for a while.  Either it was ineptitude on the part of the officials or they received additional information which caused them to act at that time rather than waiting till later the next day.  I suspect ineptitude.  My wife is a teacher so I asked her to read what Susan posted up above.  She also suspects ineptitude (or maybe I should call it thoughtlessness).  The officials may have inadvertently caused more panic by this middle of the night decision than might otherwise occurred.  Let us all hope this timing of the decision was due to thoughtlessness than additional information concerning the causative agent.  If new info caused this then circumstances may be getting very interesting (in a bad way) over the next two weeks or so.

Again, I think the officials simply did not think clearly about the timing of the decision.  


[ Parent ]
if you look at this picture
http://www.takungpao.com/news/... of a meeting held with teachers and school heads, and the worried or angry looks on everyone's faces.  You can imagine what happens if the government tells the schools to decide when they should close, and then do not give clear definitions of what constitutes an 'outbreak' in a school or other guidance..

There are lessons here for lots of people...


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


[ Parent ]
to be fair
10:30pm in Hong Kong is not the middle of the night ;-D  But the point is well taken.  They will see chaos and recriminations tomorrow, I suspect.



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


[ Parent ]
Lifes lessons to learn from
 This is all my reaction to the news.

Lack of information seems to have delayed action. People had to be informed before they understood.

 If other people are kept in the dark they will have to be informed and educated at the time of the incident.

 There will be delays as plans are made, not carried out. I would be better if they where carried out.

 School closure because of holiday is planned for. School closure because of bad weather is understandable and "for the safety of the kids"

 Closing a school becuase some other kid in another school got sick is ludercris. Parents have plans and need to go to work.

 Education is important.

 Besides, I bet the parents did not have any plans for their kids being out of school.

 With the HHS, HS, DoL Webcast tomorrow this would be a great topic.

Kobie
"A smart man learns from his mistakes,
A wise man learns from someone elses"  


Playing the part of a parent
SusanC,

 In my comment "Closing a school becuase some other kid in another school got sick is ludercris. Parents have plans and need to go to work. "  - that is gut reaction to how parents will react and not my belife.

Kobie


[ Parent ]
well, I think they will get both reactions
I think most parents are only annoyed cos of the late notice, not because of the school closure.  You need to know that they have gone through SARS, and so they already have had experiences of having to deal with extended school closures.  


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


[ Parent ]
SARS - indication of things to come
SusanC,

  Yes. SARS fear put Hong Kong, China and Canada way ahed of the USA in my opinoin. They had a small taste of things to come.

  Yes, the late notice probably did tick parents off. It was unexpected to them. I like to think that if the local officials had said - "We have a SARS like virus that may present itself. School closures are possible, even if there are no cases in your school." things would be different.

  Any chance of doing a one day test closure is impossible because of contractual oblications. As March passes and we move into April it would be nice to say "Hey lets use a snow day and do a school closure test. Why? There have been bad diseases recently, MARS, and there could be something worse soon.

Kobie


[ Parent ]
AFP reports that the 7 year old had the H1N1 strain
Health secretary York Chow said the move [school closure] was a precautionary measure against the spread of influenza in schools, according to the Government Information Service (GIS).

...

GIS said laboratory tests on a seven-year-old boy who died after suffering respiratory and neurological symptoms showed positive results for influenza A (H1N1).

Initial tests on a three-year-old boy currently in a stable condition in hospital also showed positive results for the same strain.

http://afp.google.com/article/...


Hong Kong Hospital Authority pours in cash to boost staff
Hospitals in HK are overwhelmed with the recent flu outbreaks.  Pediatric admissions have risen by 60-70% compared to the same time last year.  Adult wards also see a 16% increase.

Cumulative staff overtime in the past 2 weeks has reached 15,000 hours!  The HA is allocating an extra $2M to pay for this overtime.  

However, frontline staff say they are exhausted, and would rather take time off than overtime pay.  They say that they can do with the rest, not the money, and are concerned that being overtired will make them prone to mistakes as well as reduced their resistance to disease.


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


"compared to the same time last year"
Are they comparing comparable weeks?  I mean, aligning curves so they start at the same point and can then be compared week-to-week?

Visually:
- year 2007, weekly cases since January 1st: 0-0-0-1-2-4-2-1.
- year 2008, weekly cases since January 1st: 1-2-4-2-1-0-0-0.

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.


[ Parent ]
sorry - weeks seem to be directly comparable
http://newfluwiki2.com/showDia...

because the "wave" starts in January and has roughly the same shape ... but still I don't see that much of a difference right now.

The chart in the diary is about laboratory, not about cases or severe cases.

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.


[ Parent ]
sorry, typo
should be $20M, not $2M.  In HK dollars.  To cover for the 15,000 hours of overtime pay accrued so far.


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


[ Parent ]
Watch what they do...
If they start to quarantine and/or impose travel restrictions, then we know they are dealing with a serious situation and this is not "normal" epidemic influenza.

yes watch what they do
but I don't expect it.  


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


[ Parent ]
H2H?
Could this possibly be the beginning of H2H? The 1918 flu went around the world in roughly 3 months (please correct me if I am wrong) So if one was sensitive to this possible situation, should one be resonably c6ncerned.  

h2h of what?
If you are talking about seasonal flu, of course it is h2h.



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


[ Parent ]
H2H S6RRY hav5ng 2ey b6rd *r6b32e0s


H2H bird flu
Sorry about that. I was having problems with my keyboard, operator failure. Is this a possible jump of bird flu to human to human transmission and should I be concerned? Thank you in advance for your input. Jon C

well, they are saying it is H3 and H1
Certainly the outbreaks are compatible with severe seasonal flu.  The outbreaks in Australia a few months ago were also very severe.

The HK authorities are very vigilant against avian flu, so I would imagine all those tests would have been done.

I have family in HK, and I'm not concerned.  Cos my kids are grown and abroad.  I would be if they were young, to be honest.


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


[ Parent ]
flu types
H5 has been found in wild birds in Hong Kong on March 10, 2008, according to The Agriculture, Fisheries and Conservation Department, Hong Kong. The Food and Health Bureau reports no H5 in poultry nor humans. http://www.info.gov.hk/info/fl...

The danger would be increased if H5N1 met an highly contagious H1N1, but that could happen anywhere in the world.


[ Parent ]
H5 has been found in wild birds repeatedly
over the past few years in HK.  That's almost a 'new normal' now.

As you said, a reassortment can happen anywhere in the world, with the millions and millions exposed now.


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


[ Parent ]
H1N1 not H5N1
So please forgive my slowness on the whole medical situation. The HK outbreak is the common flu, not the bird flu? Correct? If a carrier of the H1N1 catches the H5N1 than this is bad as they can combine to make bad virus? Jon C



H1N1 is the seasonal flu
It isn't the avian or bird flu H5N1.  

If a carrier of the H1N1 catches the H5N1 than this is bad as they can combine to make bad virus? Jon C

In theory yes, but in practice reassortments or swapping of genes between avian and human viruses happen only rarely.  That's not to say we shouldn't be vigilant about it, but statistically speaking, you will see many millions of seasonal flu cases before you see one of avian flu, let alone a reassortant.  

Here's another way of explaining this, with a bit of virology thrown in.


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


[ Parent ]
more information on the cases can be found in part 2
http://www.newfluwiki2.com/sho...


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


[ Parent ]
normal flu
apparantly just normal seasonal flu according to the latest
expert statements. No need to worry.

If it were serious, they would be harder trying to keep it secret...

ask experts for their subjective
panflu death expectation values
and report the replies


Thank you
I appreciate the explination. Jon C

You're welcome n/t



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


[ Parent ]
School's closed?
I love this pic. A kid arrives at school to learn that it's closed.

http://www.takungpao.com/2tkp_...


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


story link
http://www.takungpao.com/news/...


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


[ Parent ]
hooray
"Hooray, school is closed, parents are at work, I think I'll go look for my friends at the video game arcade."
-kid in the picture

[ Parent ]
from the Guardian UK
Hong Kong flu scare closes schools and kindergartens

Hong Kong closed its primary schools and kindergartens this morning, giving more than half a million students a two-week holiday, after the deaths of up to four children amid a flu outbreak.

But while the move sparked concern among parents, both the government and outside experts described it as merely a precautionary measure.

The authorities are thought to be particularly cautious because of the Severe Acute Respiratory Syndrome outbreak in 2003 that killed almost 300 people and brought ordinary life in the territory to a halt. The government was subsequently criticised for not acting quickly enough.

"When you wait until you have all the data, it's too late," York Chow, the health secretary, said today.

He told reporters he had decided to act now in light of the deaths and because a higher proportion of young children seemed to be affected this year, even though the overall level of infection was the same or only slightly higher than usual.

Only two of the children, who died at the same hospital, are known for certain to have had flu.

But Chow said: "If there are two deaths related to flu even before the peak, then we need to do something to minimise the numbers in the weeks to come.




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


H1N1 and H5N1
Would it be possible to get both H1N1 and H5N1 at the same time? Without having them combine? If so, would the more dominant strain show in tests. Would it be possible that the first tests are for current circulating strains and results can be  obtained fairly quickly. Also once those tests show H1N1 (or whatever) and IF the person has died, would further tests for H5N1 even be carried out?

Good questions, let's see if I know the answers ;-)
Would it be possible to get both H1N1 and H5N1 at the same time?

Yes

Without having them combine?

Er, yes, but not sure what the significance would be.

If so, would the more dominant strain show in tests. Would it be possible that the first tests are for current circulating strains and results can be  obtained fairly quickly.

No, the tests will show up all the different ones.  We are being told explicitly now that no human cases have tested positive for H5 (or other avian viruses) at all this flu season.

Also once those tests show H1N1 (or whatever) and IF the person has died, would further tests for H5N1 even be carried out?

Yes, I'm sure that would be the dominant concern.  Or at least one of them.  Remember they are going to sequence the isolates, so that should catch any changes in any of the genes.




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


[ Parent ]
flu-tests
niman (probably) meant the Tamiflu being used for "blankets" against H5N1 could be taken
by people who are then infected by H1N1 and develope resistance.
But this should be rare as compared with Tamiflu taken for seasonal flu.

The tests are apparantly first done for flu-A. If positive, then maybe H3 or H1 is tested,
if negative the other one is (maybe) tested.
If this is also negative, they will probably become curious and do more tests.

Now, if there is H5N1 and H1N1, and they do testing and find the H1, then
I assume they miss the H5. Until the symptoms are spectacular and they
do more testing.

You can see this by the results
for example for week 9,2008 in the USA, they have these numbers of samples
reported to WHO-flunet:

A(H1):54
A(H3):327
A(not suptyped):1280
B:740
Other:0

so, presumaly they first test for A, if negative for B,
if positive only in about 25% of cases they try to further subtype.

This is just what I assume from the numbers, I don't know how it works in practice

ask experts for their subjective
panflu death expectation values
and report the replies


[ Parent ]
Huh?

This is not rocketscience.  Most physicians use (of the 7 currently approved) the rapid influenza antigen test. That strictly determines type (A or B).  It can be done 'in house' by staff and is relatively cheap and fast (~ 30 min), compared to lengthier and more expensive culture, serology (complement fixation and hemagglutination inhibition) and immunofluorescent assays that determine influenza strain type and subtype.  These tests do NOT detect H5N1.

http://www.semp.us/publication...

Viral detection for the quick tests depend on your age, time from symptom onset, and swab sampling location.  A null result does not necessarily mean you don't have the 'flu.

http://www.pubmedcentral.nih.g...


[ Parent ]
H1N1
Didn't Dr. Niman write that the N1 part of H1N1 was adopting a resistance to tamiflu or else altering somehow as it shared the N1 portion?

Or do I just need coffee?


can't say what Niman said
but tamiflu resistance is of course related to the genetic characteristics of the N1 gene (since tamiflu is a NEURAMINIDASE inhibitor).  And there appears to be a lot of tamiflu resistant H1N1 this season.  Don't know about the exact significance for H5N1 cos these are different N1 genes.


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


[ Parent ]
more details on the day of school closure
This is from conversations with friends in HK, and is a composite of sources.  I thought they are quite interesting; the logistics of ordering school closure suddenly is something that should be included in drills.  This became very much a dress rehearsal...

Apparently, on the day in question, the Health Minister York Chow, after making his "no need to close schools" announcement at 2:30pm, was then tied up with a major meeting on healthcare reform and funding that had been scheduled for that day.  Note that this issue was also a major headline item at the time.

Anyway after that meeting was finished, he then held a meeting with a panel of scientists including Yuen kwok-yung and others, from about 6pm to 9pm.  They reviewed all the information, input from schools etc, and then consulted the Chief Executive's office.  By shortly after 9pm, the decision to close schools had been made.  An announcement for a press conference at 10:30 was made (the media needed time to prepare), but the press releases seen by the media (embargoed till the press conference) at around 9pm already included school closure.

Interestingly several attempts were made to inform parents by other media than the news.  The ones that I know about are:

1) They asked all the cellphone networks to send text messages to all subscribers.  Because of the large volume of calls, it took some hours for all the messages to go out.  But it was all happening overnight, when the networks were not as busy, so that didn't cause too many problems.

2) They asked the MTR (the city's underground/subway mass transit system) to put out posters in prominent places in all stations.

3) They asked all public housing (government-subsided flats for lower-income families.  A large proportion of the population live in these flats) estates to put up notices.  That didn't work so well since some estate offices were closed and others did not have printers to print out the notices.

By and large, most parents/students did become aware of the closure.  This was because a large proportion of children use either school buses or equivalent kind of transport, so most of them became aware of the closure when they went to the school-bus stop.

Most schools opened up their facilities so that children who arrived or whose parents could not take them home in time had a place to go.  Some schools had problems serving lunch to these students since they canceled the school lunch service.  This was solved mostly by teachers going out to buy food for these students.


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


lessons for pandemic planning
This 'dress rehearsal' carries many lessons.  One obvious question that many would raise, would be why not wait for another day?  I guess the rationale is really based on the very short serial interval of influenza.  If the incubation period is 2 days on average, with an R0 of 2, you get a doubling every 2 days.  So even on day's delay can make a HUGE difference to epidemic size.

The Health Minister apologized the next day for the hastiness, but explained that on balance they felt that if they delayed one more day, a lot more kids would get sick.  Since the situation was evolving, there was no way to tell whether other children would be just as severely afflicted and die from the illness.  He (sort of) said he would feel very bad if they delayed and some other children die later down the road.

On the whole, even though there were some complaints, most polls showed that the public supported the move.

I thought these lessons are instructive for planners all round the world.  When you are working with hypothetical mortality figures, it's easy to become complacent.  But in a real outbreak, when every child who dies is a major tragic story, the considerations become very different.  For example, the 7-year old boy was a single child of a late pregnancy.  His distraught mother is 48 years old and hopes for another child are low.  Put in that light, it's a lot harder for officials or the public to accept anything other than doing the best to save as many kids as possible.

The question is not what are the costs of school closure. The question is what price are we willing to pay to save 1 child?  what about 10?  100?  1000?

Those questions should tell us that if and when a pandemic breaks out, officials will come under intense pressures to close schools as soon as the first child deaths occur.  The fact that a city of 7 million people could not tolerate the deaths of 3 children should tell planners a lot about which way they should err...



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


[ Parent ]
otoh
the recent CDC exercise also suggested that there'd be significant push-back from states about closing schools, and likely regional and local closures rather than state closures in states that allow that, at least at first.

School closure is a state and not a federal issue in the US. The bottom line is that some states will handle this better than others, and not all states have equal reporting and data collection skills.

Hong Kong, I suspect, is rather better at it than many states, and can act quicker.

All CDC can do is suggest guidance as to when to close. that guidance is in the state ops planning document now featured in today's news reports, as seen in this picture.

click for bigger picture:

The idea is for schools to close early in the acceleration phase. You need data to know that's where you are.


[ Parent ]
a word about estimates of how much push-back there will be
Any estimates based on current non-pandemic mind-set and values will severely under-estimate the public's demand for (they wish) absolute safety for their children.

What drives people on a normal day is very different from what drives them in a crisis situation.  There are certain issues that are not operational on a normal day, but will act as 'threshold values' to cause people to abandon every other value that they held before, to demand something entirely different from what they normally consider important.  

Here's a short explanation of threshold values and how they work.


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


[ Parent ]
ah, but in the early stages
with 9 or 31 cases per state you won't reach those threshold values, or at least the people making the decisions won't.

If you have a kid die, the public MAY push the decision makers locally, but likely not the state level decision makers until it gets worse. So, if you are trying for early closure, and you are talking state wide, the CDC exercise may be more real than HK. If you are talking city-wide, then HK may be a better model. And if there are no pediatric deaths, things may be delayed.

All the different ways this might develop need to be considered.


[ Parent ]
yeah, it's very complicated
and I wasn't even thinking quantitatively or geographically.  Just as a general caveat.

OTOH, take the situation that I wrote about here.  Not the sitting-inside-an-office with plans kind of environment, but standing in front of the microphone as an outbreak is developing trying to explain to the media (and the public) the rationale behind closing schools in one district and not another.

It's going to be mighty difficult, is all I'm saying.  I'm warning against complacency not just about timing of school closure, but the expectation that such 'rational' decision making may be possible in a pandemic.

The most important test prepandemic really is to take it out to the public, to give them these scenarios and ask them what they think.  Of course, it is easier said than done.  It takes a lot more courage than many have, to open up such difficult questions to the REAL general public, not just the flubies here.

BTW the flubies here mostly have no hesitation about their preference.  Those who believe we are not representative of the general public will do well to think again.  The commonality lies again in the parenting angle.  All parents think alike, more-or-less, irrespective of education, income, ethnicity, or even in different countries.  It's one of the most universal of experiences.  Ask yourself how most parents make decisions in different societies.  You will find that parents in India or Nigeria or Spain will have more or less the same concerns and drivers as American parents.


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


[ Parent ]
we make much of parents for good reasons
but not every decision will be made by a parent, or on an emotional basis.

Just as they would do well to heed what you are saying, we need to understand that some decisions WILL be made by the numbers and not by the emotional overlay, especially early on.


[ Parent ]
PS
that won't make them the right decisions ;-(

[ Parent ]
true, and true
I agree.  My perspectives about parents are driven by 2 issues:

1.  In any discussion about schools and kids, parents are (or should be) key players.  

2.  I look around and they are not at the table, at this point in time.


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


[ Parent ]
"not every decision will be made by a parent, or on an emotional basis."
That's a good point.That's why parents need to decide well in advance of a pandemic/severe seasonal flu outbreak what 'markers' need to be reached in order to implement a pre-determined decision on pulling their kids out of school.

A fellow fluwikier taught me this-avoid poor decisions made on an emotional basis by pre-deciding what limits need to be reached before a preset reaction occurs ie bug out of city to country SIP site. That way reactions are rational, well thought out and planned beforehand.

It is better to look ahead and prepare than to look back and regret.


[ Parent ]
to do that
every single parent needs to be informed sufficiently ahead of time in order to be able to work through their adjustment reactions.

They will NOT be as rational as you would like if a crisis takes them by surprise and catches them unprepared.


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


[ Parent ]
neither will officials ;-)
but my point was to not 'depend' on parents closing the schools early enough. They will close but not before deaths, and perhaps not in time to be effective.

[ Parent ]
you are very pessimistic, aren't you? ;-)
perhaps not in time to be effective.

Or perhaps I'm naive and stubborn.

Probably both.  LOL!


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


[ Parent ]
in a country this big
and dependent on local decisions, closures will be uneven at first. that's all I'm saying.

look at how Seattle learned from Philadelphia and St L. in 1918. It took both.


[ Parent ]
I was actually thinking that yesterday
I thought it really depends on where the virus first lands.  The states affected earlier will likely have a harder time making good decisions, whereas the later states are likely to have some chance to learn from others' experiences.

And, chances are, once stories of child fatalities are in the media, officials will come under severe public pressure to take more drastic actions sooner rather than later.


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


[ Parent ]
and it is fascinating
comparing the reality in Hong Kong with the exercise in Atlanta.

[ Parent ]
yes, that is what I meant
if you are doing a drill, it's easy to think of people in figures.  And not differentiate between kids and adults.

But in real-life, every child is significant.  An influenza outbreak with doubling time of 2 days leaves no room for foot-dragging.  Planners who brush aside these issues in their preparedness phase will be caught out in an outbreak,  


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


[ Parent ]
also, note that even though the 3 kids died in HK
(and we only knew of 2 till the very last day) the story was attracting worldwide interest.  The same thing happened in Australia.  

When it comes to child deaths, there is ALWAYS a story for the media.  The effect of media reports should also be taken into account.

Like I said, mortality figures are never just numbers on plans.  They tend to pick up a life of their own...


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


[ Parent ]
not just traditional media reports
Even if traditional news sources somehow could be encouraged NOT to cover the story of child deaths, the parent list-servs would be all over the news of child deaths in their own city or state from the flu or any other disease, of course.

This isn't spreading rumors, it is sharing vital initial information of enormous importance to parents.  Parents wait to hear confirmation from official sources, but if what they heard doesn't square with what is being reported from trusted members of their listservs, and if officials don't get out there IMMEDIATELY with accurate information, it's "game over" as far as trusting officials for anything else.

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


[ Parent ]
yes, you're right
that is a really good point.


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


[ Parent ]
Thanks for the explanation
Susan, thanks for giving a summary of events.  It goes a long way toward helping understand the circumstances.  Yes, there are lessons here if the powers that be (where ever) pay attention.

In retrospect, one must admire the health minister for stepping up and making a decision surely knowing it would cause considerable consternation and confusion.  So...instead of ineptitude or thoughtlessness, the decision was made with the ultimate health of the children in mind, regardless of what it could/would do to his own career or reputation.  

There is a good public official.


[ Parent ]
yes, it's not easy for officials
to face the media and do a U-turn in less than 12 hours.  It takes a bit of courage to do that.  I'm sure he was planning for lots of recriminations.  In the end, I guess it wasn't too bad.


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


[ Parent ]
Menu

Make a New Account

Username:

Password:



Forget your username or password?



Active Users
Currently 0 user(s) logged on.

Contact
  DemFromCT
  pogge
  Bronco Bill
  SusanC (emeritus)
  Melanie (In Memoriam)

  Flu Wiki (active wiki resource)
  How To Add To Flu Wiki
  Get Pandemic Ready (How To Start Prepping)
  Citizen's Guide v 2.0
  Effect Measure
  Dude's FTP

Home
Powered by: SoapBlox