Jan 28th, '09 HHS Webcast #9 - over. Next webcast Feb 18th

Where are we today? China, Egypt, Nepal and others

Plan of the day : Think about where we are, where we thought we would be, where we want to be and how to get there

Webcast - where we are

What Kobie thinks:
 Five infections in different parts of China,
 WHO reporting almost daily on case list and situations,
 Nepal culling birds and fearing out break
 H5N1 endemic in Egypt
 H5N1 in Viet Nam
 Tiawan on the defensive for H5N1 now recognized by WHO
 H5N1 in India causing economic ripples
 Scouts and young kids helping with culling
 Nigeria with H5N1

 Tamiflu resistance growing throut the EU, Russia and shown up in America.

 Very little in the news about H5N1 bringing comments of "its nuts" to "do not talk about it" for could hurt tourism from America to Asia.

 So much going on that Indonesia not sharing samples with the world has drifted from memory.

 ON the good side pandemic blogs continue, a few have dropped off. Some are getting down to the "day to day" effects.

 Citizens, laymen, who get emails on pandemic want them. They may not respond but they notice when they stop.

 Oracle corporation did a four min video to highlight how their product can integrate different groups during a flu outbreak in Chicago. A friend emailed the link to me and I was as impressed with the writing ("no bad news during re-election, dealing with the public is tricky") as the products. I hope they post it publicly.

 We have a new administration that will bring 'Change" and is promoting infrastructure rebuild.

 "If you do not know where you are going then any road will tak you there"

 Where are we now and what do we want?

 January's pandemic report shows most states are not fully prepared. IMO its not just a matter of how well the state is prepared it is how well we, the people, are prepared.

  Given the state can not whareshouse everything the people in that state will need for two months and that help will not arrive during a pandemic - shouldn't the people stockpile and be ready?

 Note: "Little strokes fell big oaks" Ben Franklin  Small steps or actions can bring down big problems. Small steps by the many over a large area may be better than alot of work by few in a single building as it us, the many, who will do most of the suffering and dying during a pandemic.

KObie
 

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by: Kobie @ Wed Jan 28, 2009 at 12:07:31 PM UTC

do you have a working link?

I do not currently see anything on www.pandemicflu.gov's home page about this webinar, and the link you posted doesn't work.

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

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by: Average Concerned Mom @ Wed Jan 28, 2009 at 14:23:52 PM UTC

nevermind, I found it! n/t

http://www.pandemicflu.gov/new...

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

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by: Average Concerned Mom @ Wed Jan 28, 2009 at 14:27:33 PM UTC

[ Parent ]

Bad Link on purpose

AverageConcernedMom,

 Hi. I broke out the 'http:' part so people can cut and past the link in eamils to others.

 I forgot to say remove the space just after http:

Kobie
"if you expect the un-expected is it still unexpected?"

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by: Kobie @ Wed Jan 28, 2009 at 14:33:39 PM UTC

[ Parent ]

Questions!

Send them questions!

Ask if the new administration is going to advise the public about the panflu threat. You all know it is a CHOICE of our local leaders and most of those local leaders are NOT making a positive choice.

NOW is the time to poise that question (again). -k

www.EmergencyHomePreparation.org -- A 'card-catalog' style of prepping information.   -

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by: Readymom @ Wed Jan 28, 2009 at 16:26:09 PM UTC

I asked a question about their plans to tell all people, not just business or other govt. officials.

Now that it's a new government, it could make a difference if we say what we think is their clear duty.  Even if our questions didn't make much difference before, this is a new era.  Our president said that he'd be honest with us; he wasn't afraid to review serious challenges when he gave his inaugural address, so I think we should nudge this issue up his priority list.  :-)

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

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by: Jane @ Wed Jan 28, 2009 at 17:13:40 PM UTC

[ Parent ]

Jane - great

Jane,

 Me too! RADM Vanderwagen kept saying "discuss this with your local people".  I guess since he is an Rear Admiral people will listen to him. Me - I have to watch upsetting folks and ruining friendships.

 So far the EOC, EMT, Schools and such will not talk to me other than to say "We have a plan"

Kobie

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by: Kobie @ Wed Jan 28, 2009 at 20:16:15 PM UTC

[ Parent ]

Twitter - post HHS webcast comments

Please see
http://twitter.com/home?status...

 for a list of comments made during the Jan. 28th HHS webcast.

Kobie

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by: Kobie @ Wed Jan 28, 2009 at 20:19:00 PM UTC

Ventilators where discussed

RADM Vanderwagon metioned ventilators several times.

 Stock piling, use and development of low cost vent.

 Personaly I do not see their use. H5N1 damage exceeds bodies ability to repair from what has been discussed here.

Kobie

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by: Kobie @ Wed Jan 28, 2009 at 20:26:30 PM UTC

Fears of swine flu revisited

  It is not known how people will tolerate H5N1 so adding it to the seasonal flu mix has to be thought out.

 Dr Robinson mentioned how the mass public did not tolerate swine flu vaccine as well as expected. They do not want to any added H5N1 to turn people off to season flu shot.

Kobie  

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by: Kobie @ Wed Jan 28, 2009 at 20:30:50 PM UTC

Dr Cox: collateral benifit

Collateral damage is well known term for "oops we destroyed more than the target'

 Collateral benifit. Preparation for A prepares one for B, C, D, etc. It is part of why the 5 billion spent for pan flu has been so good.

 NASA called it "Spin off" where doing something for A also helped B, C, D, ...  if only NASA could reap the economic benifits.

Kobie

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by: Kobie @ Wed Jan 28, 2009 at 20:33:27 PM UTC

Surprising how much emphasis there was on vents.

Sure, they'll be needed but will they be that useful, considering the medical needs of the less-severely ill, who will probably have to be cared for at home?  Robin Robinson said there's a gap of 72,000 vents now (or did I hear it wrong?).  

At least they said that HHS could help only in the early days, because later on, everyone will be dealing with problems in their own communities.  Why is that still not known by all??  Was it 1000 Katrinas or 5000 Katrinas that Sec. Leavitt said we'd be facing?  

Adm. Vanderwagen said that more cross-sectorial [training? planning?] is needed: like law and order and energy and _?_.

Question (from the moderator, I think): has bird flu fatigue set in?   [sigh]  Don't people have to hear about it first, before they're tired of it?  

Adm. Vanderwagen said there are still gaps, despite the $5 billion (or did I hear it wrong?) spent already.  Gaps are tools, medicines, people, supplies, and space.  So we can't relax yet.  :-/

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

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by: Jane @ Wed Jan 28, 2009 at 20:41:04 PM UTC

I'd like that verified ...

.... if possible Jane. I've got someone I know who works in this area of medicine, that I'd like to email regarding that statement.

Was there anyone else who listened who may have taken notes on that? (Sorry, I was multi-tasking at the time). -k

www.EmergencyHomePreparation.org -- A 'card-catalog' style of prepping information.   -

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by: Readymom @ Wed Jan 28, 2009 at 22:02:45 PM UTC

[ Parent ]

Emphasis on vents - twice

ReadyMom,

  RADM Vanderwagon said it twice and the other two guests did not disagree, make corrections nor make any stipulations.

  The webcast will be archived in five days - which is next month - Feb 6th or so.

  There is a link to twitter notes above but you need to log in to see them.

 Clawdia should have some input on this

Kobie

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by: Kobie @ Thu Jan 29, 2009 at 00:39:35 AM UTC

[ Parent ]

thanks Kobie!

I was listening and noticed that, as well. Just wish I had taken some notes. Some days it's just not a good idea to multi-task. :(   -k

www.EmergencyHomePreparation.org -- A 'card-catalog' style of prepping information.   -

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by: Readymom @ Thu Jan 29, 2009 at 00:54:35 AM UTC

[ Parent ]

Since you asked . . .

Clawdia still thinks that talk of vents and other non-starters are just distractions to keep us otherwise occupied from dealing with reality.

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by: Clawdia @ Thu Jan 29, 2009 at 05:43:32 AM UTC

[ Parent ]

Its the Why that is important

Clawdia,

 IMO - its the why - they don't help.

 Its not a matter of technology, funding, people, or technology.

 Correct me if I'm wrong - it is that they do not help and only prolong the envitable.

 1) H5N1 does more damage than the body can repair - like ebola. Hence, once infected the body never catches up with the damage and shuts down - hard. Vital organ failure(s).

 2) No reports where a vent has saved a life

 Now this could all change when H5N1 goes H2H, hmm already has in limited cases. Ok I could change when H5N1 is easilly transmitted H2H.  

Kobie

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by: Kobie @ Thu Jan 29, 2009 at 12:34:02 PM UTC

[ Parent ]

About vents, I just found random bits, nothing to back up what I thought I heard.

60% of ventilators in average daily
use during 2004-2005 flu season

http://74.125.47.132/search?q=...

The above is about New York City.
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Last week, so many ventilators were in use in Minnesota hospital intensive care units that many hospitals rented extras and several hospitals shifted patients with respiratory problems elsewhere for care.

"Was it a crisis? No, but it got a little too close for comfort," said Dr. John Hick of Hennepin County Medical Center and medical director for an emergency-preparedness compact among the 29 metro hospitals.

"The thing is, availability of ventilators is kind of a bellwether for our capacity to deal with a crisis," Hick said...

...At the Mayo Clinic in Rochester, "we were close enough to capacity that we rented four ventilators ... to make sure we had enough capacity in case we had a rush of admissions," said Curt Buck, director of respiratory care services. "We were told by the rental companies that we took the last four they had."

It was the first time in more than a year that Mayo's more than 100 ventilators were not adequate, Buck said. "And this is not usually our busy season. Not as many people from outside the region come here for surgery in the winter."...

March 14, 2008
http://www.startribune.com/lif...

...We understand that the U.S. Centers for Disease Control and Prevention's Strategic
National Stockpile (SNS) program owns and maintains approximately 6,000 mechanical
ventilators for distribution to states affected by mass casualty events. However, a
serious influenza pandemic is likely to overwhelm even the SNS inventory...

...Addendum
June 5, 2006
We have been notified by the CDC that there are actually about 4,000 ventilators in the
CDC's Strategic National Stockpile. These include 2,000 IMPACT 754 and 2,100 LP10
ventilators. An additional 486 ventilators are on order but have not yet been received.

http://74.125.47.132/search?q=...

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

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by: Jane @ Thu Jan 29, 2009 at 02:25:33 AM UTC

[ Parent ]

4,000 vents - 3 million people

Jane,

 If just 1% of the US population needed a vent that is about 3 million folks or 800 people per vent in the national stockpile.

 I figure the rich, powerful and movie stars will get theirs so that takes a few million folks off the list.  

Kobie

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by: Kobie @ Thu Jan 29, 2009 at 12:40:20 PM UTC

[ Parent ]

Border closuer

  One upcomming topic is border closure.

 China and Russia are dealing with this for smuggled poultry.

 Afghanistan - good example of a porus border. Few people with mountains.

 With thirty tons of drugs comming into America, its hard to imagine how they could close a border.

 What happens if Americans find out their hospitals are overwhelmed but Canda's are not?

 England is an island but with so much coast line can things be closed down.

 How does one board an incomming ship and turn them around using less than deadly force?

Kobie

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by: Kobie @ Thu Jan 29, 2009 at 14:56:40 PM UTC

Deadly force

Might well be the order of the day, if people won't do as they are told.  I have no desire to be a sacrificial lamb on the alter of "but I bought a ticket to ride . . . "

If deadly force is what it takes to enforce border closure, then that is what would be necessary.

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by: Clawdia @ Thu Jan 29, 2009 at 16:32:03 PM UTC

[ Parent ]

Not by boarding it, I don't think. Too risky.

How does one board an incomming ship and turn them around using less than deadly force?

The problem is that turning away all ships turns away goods that we need.  How mechanized are our ports?  Can ships be off-loaded without our dock workers physically contacting the ships' crews?   But then there are the pilots that have to board every ship before it comes into port, if I understand the process.  He could wear full PPE, if he could see well enough.  Then the cargo would have to sit somewhere for a while.  The waterfront warehouses would fill up soon, if commerce is still functioning.  Then what?

How long are voyages from Chile, say?  If the crew hadn't stopped anywhere, they might have passed the incubation period before they got to NY.  ??
 

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

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by: Jane @ Thu Jan 29, 2009 at 16:45:50 PM UTC

[ Parent ]

Boat lift

Jane,

  Good point about mechanized ports, hope the dock workers and harbor piloits are covered with transportaion folks.

  As for turning away ships - I was thinking boat lift. America gets people in rafts and boats from Cuba every few weeks. They can be turned away untill the people are on US soil - then they can ask for sactuary. I'm not up on the details of when customs can stop and not stop a ship.

  Boarders are an interesting thought.

Kobie

 

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by: Kobie @ Thu Jan 29, 2009 at 19:56:50 PM UTC

[ Parent ]

too early in the transition n/t

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

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by: SusanC @ Fri Jan 30, 2009 at 02:47:42 AM UTC