News Reports for June 8, 2009

Swine flu renegades risk prosecution

after walkout from medical center

Hong Kong - Patients displaying symptoms of pandemic disease who refuse to accept medical treatment face prosecution, the department of health said. The warning came as a 48-year-old man with flu symptoms left Caritas Medical Centre in Cheung Sha Wan yesterday morning without authorization. He was later returned to the center for treatment. Though initial test results proved negative for human swine flu (H1N1), the man remains under observation.

Meanwhile, there were five more confirmed cases of imported swine flu yesterday, bringing the total to 38.

One, a 32-year-old man, became Hong Kong's first Asia imported case when he returned from Manila on Saturday. The others were:

A 14-year-old boy who returned from San Francisco yesterday, also displaying flu symptoms.

A 20-year-old man who returned from London to Hong Kong on Thursday, on flight BA27. He had a fever and cough on Friday, and was admitted to Queen Mary Hospital the following day.

A 21-year-old woman who returned from the United States via Seoul on Friday, on flight KE603, was admitted for treatment on Saturday.

A 23-year-old woman who had been in Manila since February, and developed a cough and fever on May 31. She arrived on Cebu Pacific flight 5J108 yesterday and was taken to Princess Margaret Hospital.

The health department is now trying to trace passengers who sat in rows rows 45-51 of Friday's KE603 flight, rows 22-27 of Saturday's KA912 flight, rows 56-62 of yesterday's CX873 flight, and rows 17-23 of yesterday's 5J108 flight. Also being sought are flight attendants who served the affected sections of the cabins concerned, as well as others who may have had close contact with the five patients.

Head of emergency response and information branch Thomas Chung Wai- hung said the risk of a community outbreak is getting higher, and that the territory is seeing cases imported from other places.

The man who left the Caritas Medical Centre developed flu symptoms on June 3. (Snip) With fever and a frequent travel record, the man was required to undergo observation and a virus test. But he left without authorization at 1.15am and returned to his Wong Tai Sin home. The hospital called police and he was brought back at 3.55pm. The center said it will review the hospitalization arrangement.

Although Chung said patients who fail to accept hospital treatment may be prosecuted, the health department has not decided whether it will prosecute the man.(Snip) "In general, patients have the right to choose what treatment they receive. But for pandemics, the director can exercise his authority to send a patient to the designed treatment center." But she said it is too early to say if patients who do not cooperate will be prosecuted. http://www.thestandard.com.hk/...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Mon Jun 08, 2009 at 04:30:34 AM UTC

Refusing med treatment, did not expect this with H1N1

  I could see this with H1N5 as some refuse cancer and AIDS treatments either out of denile, stupidity or lack of positive outcome.
 One lawyer with drug resistant TB even refused isolation.

 H1N1 is a bit more of an eye opener.

Thanks
Kobie

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by: Kobie @ Mon Jun 08, 2009 at 10:42:53 AM UTC

[ Parent ]

The Chinese Have An "Atttude" Thing.

The Chinese have a way of not complying with Government regulations if it suits them and they think they can get away with it.

We had a girl from Hong Kong studying in one of our schools here during the SARS outbreak. During vacation, she told her friends she was going to a beach resort in Queensland, then hopped on a plane to Hong Kong to stay with her boyfriend for a week.

This was most definitely against the school rules as well as risking the lives of her schoolmates. She bragged about it soon after returning and was quarantined and then expelled.

I expect that the Chinese will have very little luck tracing and quarantining H1N1 contacts however draconian their regulations might be.

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by: Walrus @ Mon Jun 08, 2009 at 17:27:29 PM UTC

[ Parent ]

I don't agree with their measures

in HK or China.  It's not going to work, but results in both unnecessary aggravation and complacency at the same time.

I do, however, think characterizing a particular ethnic group as being irresponsible is not a helpful attitude. I personally know of Westerners who were doing irresponsible things during SARS.  Stupidity and lack of social responsibility is not restricted to any race.  I took care of a houseful of students at my house in the UK, students from HK who had to be quarantined before they returned to school.  In fact, I personally made the recommendation to the schools that students should be quarantined before they returned. The vast majority of students and their parents agreed it was a good idea even though it caused lots of difficulties for some.

Not all Chinese are the same, just as not all Americans, Brits, blacks, whites, Arabs, etc are the same.  In any society, you'll have a continumm of responsible and irresponsible people.

Just MHO...



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

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by: SusanC @ Mon Jun 08, 2009 at 22:16:27 PM UTC

[ Parent ]

China Quarantines New Orleans Mayor Nagin on Swine Flu Concerns

By Bloomberg News

June 8 (Bloomberg) -- "New Orleans Mayor Ray Nagin was quarantined in Shanghai yesterday after another passenger on his flight was suspected by Chinese authorities of having swine flu...Nagin is also scheduled to travel to Sydney..."
http://www.bloomberg.com/apps/...

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by: phytosleuth @ Mon Jun 08, 2009 at 07:59:57 AM UTC

What are people thinking?

Flying around the world during a pandemic. Hmm.

A question. Does going to Phase 6 increase the likelihood of this scenario in other countries than just China?

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by: phytosleuth @ Mon Jun 08, 2009 at 08:02:12 AM UTC

[ Parent ]

Absolutely, although if it remains "mild"...

I doubt many will.  Chances are if WHO declares Phase 6 they will jump through hoops to couch it with "but it's mild so don't worry."  Anecdotal evidence has shown measures such as China's are ineffective - it just makes TPTB feel better and look good to the public.  China has cases already - probably more than they will admit.  

Now if it turns more deadly, then things will definitely get interesting.  I'd think more will try such measures, only to again find that they don't work.  It seems fitting that a draconian gov't would try it now, although really an country could.  What will happen when more "democratic" govt's try it?

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by: LauraB @ Mon Jun 08, 2009 at 10:31:38 AM UTC

[ Parent ]

Phytosleuth - its only a pandemic

  IMO, in an effort not to cause panic, not to hurt airline sales the full set of outcomes has not been discussed.

 I am glad some 50 schools in NY where closed when needed. The information is good but IMO this has not changed the way most people act and think.

 People are told "Diet and excersize will improve their lives" but few follow it. Instead they go with the crowed.

 Hopefuly during a deadly outbreak, like H1N5, things will be different.

Kobie

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by: Kobie @ Mon Jun 08, 2009 at 10:48:27 AM UTC

[ Parent ]

WMD panel criticizes vaccine funding plan

[Click linked title below for entire article.]

Bipartisan WMD Panel Criticizes Obama Plan To Fund Flu Vaccine

By Spencer S. Hsu
Washington Post Staff Writer
Monday, June 8, 2009

President Obama's contingency plan to help finance production of a swine flu vaccine with funds set aside to develop defenses against biological attacks would weaken the nation's preparedness for terrorism, the leaders of a bipartisan commission on weapons of mass destruction said yesterday.

The White House asked Congress on Tuesday for authority to spend up to $9 billion more for an H1N1 flu vaccine and other preparations against the novel flu strain that first appeared in April.

Of the total, the administration asked Congress to provide $2 billion in "contingent" funding. Another $3 billion could come from the Project BioShield Special Reserve Fund, created in 2004 to field countermeasures against nuclear, biological or chemical threats; $3.1 billion from stimulus funds appropriated to spur economic recovery; and $800 million from the Department of Health and Human Services.

"Using BioShield funds for flu preparedness will severely diminish the nation's efforts to prepare for WMD events and will leave the nation less, not more, prepared," the commission's chairman, former senator Bob Graham (D-Fla.), and vice chairman, former senator James M. Talent (R-Mo.), wrote to Obama in a letter sent yesterday and in another dated Wednesday to his budget director, Peter Orszag.  

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by: InKy @ Mon Jun 08, 2009 at 09:53:10 AM UTC

Personally I'd prefer to take

my chances with WMD.  I'm thinking to odds of a deadly pandemic are much greater than WMD.  That threat is here now.  

rant off...  

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by: LauraB @ Mon Jun 08, 2009 at 10:34:52 AM UTC

[ Parent ]

WMD or Pandemic - both require isolation, prep and resiliance

InKy,

 Perhaps I have this wrong but in both cases
  1) large area affected for long periods of time measured in months
  2) Outside help will not arrive as all could be affected
  3) Medical supplies need to be dispensed to whole cities
  4) People need to be prepared to go it on their own for months
  5) Alternate forms of communication and evac plans need to be in place. They also need to work, not just look good.
  6) People have to know they can survive so they show up wiht hope, not defete, in hand.
  7) People have to be ready for power outages and break down of basic services.
  8) Hospitals will be overwhelmed, HCW may not want to come to work, supply lines interrupted for weeks to monts, etc

 To me there is a great deal of overlap. Learning to make and distribute H1N1 in mass quantities may help with biological or radiological WMD.

 BTW - New non nuclear EMP devices are under development. EMP kills iPods, cell phones, TCs, Radios, computers, ATMs, hospital equip, refridgerator controls, thumb drives, generators, and car electronics that run the engine.

Source: http://www.electronics-related...

  No word on pace makers and implanted medical devices.

 Yea some WMD are more localized in effects with fewer health problems but they are still so bad. Hopefuly people are prepared for both for they, not the leaders nor perpatraitors, will do most of the suffering, dying and recovery.

KObie

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by: Kobie @ Mon Jun 08, 2009 at 11:02:02 AM UTC

[ Parent ]

yeah, this is business/politics as usual

I don't mean partisan politics.  I mean the politics of "who gets what, and who says". that preoccupies Washington DC.

Let's see, the US has experienced one bioterror attack, which btw was home-grown, and 5 people died.  This H1N1 virus is now only in a 'mild' wave, and like 20 people have died.  And the virus is already spread around.  In bioterror terms, every city is already 'contaminated'.

So, worry about a hypothetical threat (ie WMD from foreign terrorists) and fund it to the hilt.  Or improve our capacity to respond to what is already upon us.

Again, another group of people who don't live in the real world.  



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

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by: SusanC @ Tue Jun 09, 2009 at 07:39:23 AM UTC

[ Parent ]

Moody's: Pandemic would raise Japan insurers' ratings

A severe pandemic would pressure the ratings of many Japanese life insurers, Moody's Investors Service said Monday.

Japanese insurers' core businesses could face greater risk stemming from the impact of the pandemic itself and also the likely drop in equity markets that could accompany a severe outbreak, the credit-rating company said in a report

Source: http://www.menafn.com/qn_news_...

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by: Kobie @ Mon Jun 08, 2009 at 11:04:26 AM UTC

Canada: ONTARIO NURSES DISCUSS WORKPLACE VIOLENCE, PANDEMIC

June 8 - June 12
   EVENT: PREPAREDNESS AND MORE AT NATIONAL NURSES' UNION CONFERENCE
   CITY:      VANCOUVER
   LOCATION:  Hyatt Regency Hotel in Vancouver
   CONTACT:   Ontario Nurses' Association, Sheree Bond, (416) 964-8833, ext. 2430, Cellular: (416) 986-8240; Melanie Levenson, (416)964-8833, ext. 2369
   URL: http://www.newswire.ca/en/rele...

this is just a snippet :-)

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by: Kobie @ Mon Jun 08, 2009 at 11:15:58 AM UTC

Ooops! News source for Canada-Vancover

Source http://www.newswire.ca/en/rele...

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by: Kobie @ Mon Jun 08, 2009 at 11:16:54 AM UTC

[ Parent ]

Officials Worry About Swine Flu Preparedness

Amid Budget Cuts

In light of two reports released this week, public health officials examine preparation plans for a second strain of swine flu amid troubling budget cuts. According to Reuters, "a report by the non-profit group Trust for America's Health released on Thursday found that while the investment in pandemic planning and stockpiling of antiviral medications have paid off, recent cuts in public health departments have meant many did not have adequate resources to carry out flu plans." "The group specifically urged a halt to planned layoffs at state and local health departments, and recommended hospitals improve strategies for handling a large influx of patients."

The report also detailed problems with sick-leave policies as well as plans for school closures and limiting mass gatherings. It described strains on the health care delivery system and recommended that officials stockpile antiviral medications and other supplies, improve vaccine development capabilities and plan for rapid vaccination of all Americans. Reuters also noted that a "report by the U.S. Government Accountability Office this week also said much more needs to be done to close gaps in the U.S. flu preparedness plan, including improving coordination between federal, state and local governments and the private sector." Reuters also reported the Centers for Disease Control and Prevention's latest case tally: "There are now 11,468 probable and confirmed cases of the new H1N1 swine flu in the United States" (Steenhuysen, 6/4).

CNN described policy recommendations including "that the federal government provide guidance on hospital capacities and sustain the public health work force, despite tough economic times." http://www.medilexicon.com/med...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Mon Jun 08, 2009 at 11:21:02 AM UTC

I wonder what they mean by "second strain"?

as in

In light of two reports released this week, public health officials examine preparation plans for a second strain of swine flu amid troubling budget cuts.

Are they referring to just the possible second wave expected in late summer/fall? Did the reports they are referring to give any indication of evidence of a new "strain" appearing?  IMWTK.  

Always have a plan B.

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by: maryinhawaii @ Mon Jun 08, 2009 at 15:38:59 PM UTC

[ Parent ]

25,288 cases of A H1N1 reported by 73 countries

GENEVA, June 8 (KUNA) -- The World Health Organization (Snip) 73 countries have officially reported 25,288 cases of influenza A (H1N1) infection, including 139 deaths.

(Snip) Gregory Hartl said that the meeting of the WHO emergency committee is not related to higher the pandemic level to phase 6. He added that the meeting was in the context of the International Health Regulations and the reviewing of the current severity of the situation of the flu A H1N1. Hartl noted that the decision to move to pandemic level 6 could be taken by the WHO Director-General without going back to the emergency committee, but that we are not yet there. http://www.kuna.net.kw/NewsAge...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Mon Jun 08, 2009 at 11:29:05 AM UTC

perceived CFR = 0.55%

Perceived Case Fatality Rate is 0.55% = 139 lab-certified deaths among 22,288 lab-certified ill.

We now know the practical limits to such an indicator.  It's good to know it's not currently in the range of 5%, and maybe we don't need more precision.

What would be some ways to make "perceived CFR" more like "real CFR"?  Or do we drop the indicator just like the reveres suggest we drop WHO stages?  If so, what would be a better replacement?

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

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by: lugon @ Mon Jun 08, 2009 at 12:21:36 PM UTC

[ Parent ]

0.55 makes it cat 2 or cat 3

and that means:

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by: DemFromCT @ Mon Jun 08, 2009 at 13:01:55 PM UTC

[ Parent ]

however, because the actual cases are many more

the real CFR is lower, and likely cat 1.

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by: DemFromCT @ Mon Jun 08, 2009 at 13:03:05 PM UTC

[ Parent ]

no proof

but I feel it is more like a tropical storm.  Of course, tropical storms can strengthen to hurricanes, and hurricanes strengthen into more severe hurricanes.  H5N1 pandemic would be like the great red spot on Jupiter.

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.

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by: Oremus @ Mon Jun 08, 2009 at 13:38:25 PM UTC

[ Parent ]

Yeah, and with swine flu cases spreading rapidly in Egypt

amongst their ongoing H5N1 outbreak in humans, I am holding my breath.

Always have a plan B.

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by: maryinhawaii @ Mon Jun 08, 2009 at 15:43:16 PM UTC

[ Parent ]

yes, i agree the real CFR is lower

and after a certain point it doesn't really matter how much lower, cos it's simply "low enough to treat it as a cat 1".  If actions are no different, we don't need a higher resolution.

Now, I'm really intrigued how they come up with "likely so many times more frequent that it appears to be".

I mean, "many more" is "5 times, 50 times or 500 times"?  Even if we may never get to know real reality, it helps to learn how their minds work.  If you know.

Thanks!

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

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by: lugon @ Mon Jun 08, 2009 at 16:17:59 PM UTC

[ Parent ]

CDC guesstimted a factor of 25x

in one of their press interviews, but I guess it's more.

I think that was based on a 7-10% attack rate for seasonal flu.

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by: DemFromCT @ Mon Jun 08, 2009 at 19:53:24 PM UTC

[ Parent ]

India - Govt ups measures to combat swine flu

Sprucing up measures to contain swine flu, the government on Monday said it would activate 16 more laboratories across the country and set up state-level rapid action forces of medical personnel to deal with the viral ailment, PTI reported.

After a high-level meeting with senior officials, health minister Ghulam Nabi Azad told reporters, "Lot of arrangements have already been made. Passengers, especially from the US, Mexico, Dubai and Canada, are being checked at all the 21 international airports."

Source
http://timesofindia.indiatimes...

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by: Kobie @ Mon Jun 08, 2009 at 11:41:07 AM UTC

Funding For Research

On The H1N1 Flu Virus Announced By Government Of Canada

The Honourable Leona Aglukkaq, Minister of Health, is pleased to announce another measure to address the H1N1 flu virus. The Government of Canada will fund a national influenza research network focused on pandemic vaccine evaluation. The network will strengthen Canada's capacity to evaluate the safety and effectiveness of a pandemic influenza vaccine and vaccination programs.

The network was created through a partnership between the Canadian Institutes of Health Research (CIHR) and the Public Health Agency of Canada (PHAC). It will be led by Dr. Scott Halperin, Director of the Canadian Centre for Vaccinology in Halifax. It will link over 80 scientists from 30 research and public health institutions across Canada. "The development and delivery of an effective influenza vaccine are critical to addressing the H1N1 flu virus, said Minister Aglukkaq. This research network will help ensure that Canadians have a safe vaccine that can be provided quickly." Continued: http://www.medicalnewstoday.co...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Mon Jun 08, 2009 at 11:48:13 AM UTC

Officials don't track all possible swine flu cases

Only a third of 266 samples submitted here were tested

Ohio - Just because someone has swine flu doesn't mean that public-health workers monitoring the outbreak will track the case.

Recently, a test at Nationwide Children's Hospital showed that an 11-year-old girl from suburban Columbus had influenza A, raising the probability that she had swine flu. Dr. Dennis Doody, a pediatrician, said the girl first came to his Far North Side office on May 26 and he sent the test to the hospital. He thought the initial positive result would prompt the Ohio Department of Health to perform a test to confirm whether she had the H1N1 virus. But the state didn't run the test. Health officials say it fell outside guidelines set by the Centers for Disease Control and Prevention. Those guidelines have been in flux since the beginning of the outbreak and call for testing only in certain cases.

Specifically, tests to confirm swine flu currently are called for when a person has been or should be hospitalized, has been in contact with an infected person and might be a part of a cluster of cases. The narrow parameters are designed to best monitor changes in an outbreak that has been relatively mild so far, public-health leaders say.

Possible cases are routinely rejected for subsequent state testing. In Franklin County, health officials have collected 266 screening forms indicating possible cases, but only about one-third of those have met testing criteria, (Snip)

In the case of the 11-year-old girl, her parents wanted an answer and on May 28 paid a private California lab about $300 to perform the test, which confirmed swine flu. The girl is recovering at her home.

Ohio health officials on Wednesday added her case to the state tally, which now stands at 35 confirmed cases, including two new cases in Franklin County. A 35-year-old woman was confirmed as having swine flu yesterday and the other case involves a 13-year-old girl, said Robert Jennings, a spokesman for the state Department of Health. Continued: http://www.dispatch.com/live/c...


Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Mon Jun 08, 2009 at 11:57:16 AM UTC

wasted $300

and we want to know why health care is so expensive in this country?

If it's flu, it's swine flu. Send a check to my office.

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by: DemFromCT @ Mon Jun 08, 2009 at 12:51:22 PM UTC

[ Parent ]

multiply 300 by even the (underestimated) 100,000 cases

30 million dollars just for testing.

CDC's weekly chart says 24% of tests are positive, so multiply the 30 million by 4 to guesstimate the number of tests one has to do to get all the cases, and now we are up to 1.2 billion dollars in testing fees (forget about lab time, personnel, etc.)

Who is going to pay for that? That's money taken away from every other health and public health program.

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by: DemFromCT @ Mon Jun 08, 2009 at 12:55:45 PM UTC

[ Parent ]

pointing out obvious

I find it hard to believe that $300 is not inflated as a "personalized medicine" "surcharge" (as in price gouging for concerned parents) and that the costs for the gov and state to run the test is considerably less.

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by: nika @ Mon Jun 08, 2009 at 13:02:34 PM UTC

[ Parent ]

not when you add in personnel costs

the rapid flu test is cheap, but running the typing in is very labor intensive.

Divide it by a third, if you want to guess. Still not cost effective, since it won't tell us anything we don't already know.

She had a positive test for flu antigen with a rapid test. And virologic surveillance is showing virtually all of laboratory confirmed influenza A in the CDC NREVSS surveillance system is swine flu.

http://scienceblogs.com/effect...

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by: DemFromCT @ Mon Jun 08, 2009 at 13:43:26 PM UTC

[ Parent ]

got it, agree n/t

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by: nika @ Mon Jun 08, 2009 at 14:19:16 PM UTC

[ Parent ]

So what they really should be doing is PSA's that tell everyone who is experiencing flu symptoms

(with of course the criteria that the fever be over a certain amount, and at least 2 other symptoms) to fill out an online form from the CDC which checks off all their symptoms, duration of illness, location etc.  This could be done by private individuals as well as by Doctors and clinics for each such patient they see.

The CDC can then figure based on their baseline data what percent of those are probable swine flu cases without doing any expensive testing. This would give a more accurate picture of the spread, number of cases and cfr without costing very much at all.

Always have a plan B.

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by: maryinhawaii @ Mon Jun 08, 2009 at 15:51:59 PM UTC

[ Parent ]

http://gripenet.pt/

http://gripenet.pt/

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

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by: lugon @ Mon Jun 08, 2009 at 16:18:51 PM UTC

[ Parent ]

Haven't there been confirmed cases without fever? n/t

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

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by: Jane @ Mon Jun 08, 2009 at 16:37:07 PM UTC

[ Parent ]

Only 87% of the EU samples cases had fever n/t

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by: UK - Bird @ Mon Jun 08, 2009 at 16:55:38 PM UTC

[ Parent ]

But . . .

I understand that if it's flu, it's swine flu.  It's always been the case, I believe, that if the type of flu currently circulating in a community has been established, then it is felt there's no need to test additional cases who present with the same constellation of symptoms.  I was unaware until this incident that pattern would apply to novel, probable pandemic strains, however.

But without a diagnosis of swine flu, do most people understand that they should isolate themselves for the duration of the illness?   Are doctors making their patients understand that they should help prevent the spread of the virus by staying home?  And people who are sick are now less likely to present for medical care because they know they won't be tested and believe they won't be treated appropriately.  These people also continue to be out and about and spreading the virus.

Doesn't this scenario encourage the spread of the virus?  I know it was decided early on that it was already too late for containment, but is that the same as spreading humanity out on a buffet table and telling the virus to enjoy its meal?

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by: Clawdia @ Mon Jun 08, 2009 at 16:00:08 PM UTC

[ Parent ]

well

But without a diagnosis of swine flu, do most people understand that they should isolate themselves for the duration of the illness?  Not most people. You can't make most people keep their kids home from school with fever. You can teach a good many, maybe a plurality. But as long as school = day care, kids go to school sick.

Are doctors making their patients understand that they should help prevent the spread of the virus by staying home? Sure, if a doc's advice is sought, and if people listen. Two big assumptiuons. The info is out there locally (newspaper, doc offices, etc).

And people who are sick are now less likely to present for medical care because they know they won't be tested and believe they won't be treated appropriately.  These people also continue to be out and about and spreading the virus. Yes, won't be tested, but 'treated appropriately' means no treatment at all in most cases.

Doesn't this scenario encourage the spread of the virus?  I know it was decided early on that it was already too late for containment, but is that the same as spreading humanity out on a buffet table and telling the virus to enjoy its meal? The alternative is what, exactly? Schools are not going to close in a cat 1 pandemic, and with that said, the rest folows... what's the alternative?

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by: DemFromCT @ Mon Jun 08, 2009 at 19:58:18 PM UTC

[ Parent ]

Appropriate treatment

Why does 'appropriate treatment' not include an antiviral?

Since so many people seem to have a pre-existing condition and therefore are at higher risk than otherwise with this strain of flu, it seems that to withhold antiviral treatment has and will continue to result in the deaths of some patients.  That seems very inappropriate, when medicines exist that might help prevent those deaths.

If you don't treat the patient in what I would consider an appropriate fashion, then of course you're also not treating household contacts in that same appropriate fashion, which I think should include prophylactic antiviral treatment.

You seem to be advocating withholding antiviral treatment from flu patients - I don't understand when that became accepted medical practice.  In the past, antivirals have been prescribed for influenza patients, and that was for influenza strains that weren't killing children and young adults.  This strain seems more likely to cause fatalities, some of which might be avoided with treatment.

I understand that the predominant circulating flu from this last season was resistant to the antivirals and therefore they were not prescribed because they wouldn't help.  H1N1 has not demonstrated resistance to Tamiflu or Relenza.  I think it's become accepted that pretty much the only strain now in circulation, at least in the US, is the H1N1 strain.  The use of those medicines might prevent morbidity and/or mortality.  

In view of that, why shouldn't antivirals be considered 'appropriate treatment'?  Why is no treatment considered appropriate in this situation?

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by: Clawdia @ Tue Jun 09, 2009 at 16:59:12 PM UTC

[ Parent ]

statement doesn't apply to high risk

and yes, there are a lot in that category, but unless one is very ill (and most flu patients including H1N1 patients aee not), tamiflu is not standard therapy (that's not new). It is an adjunct medicine, but is not mandatory, the way an antibiotic would be for pneumonia or a urinary tract infection.

The idea that "everyone with flu gets tamiflu" (i.e that's the norm) has never been true. It is in the "can be considered" category, and is encouraged for high risk patients, such as pregnancy, or young children, or children with special needs.  

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by: DemFromCT @ Tue Jun 09, 2009 at 17:16:41 PM UTC

[ Parent ]

hey you just said what I said LOL n/t

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

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by: SusanC @ Tue Jun 09, 2009 at 17:19:30 PM UTC

[ Parent ]

not all flu patients need antivirals

You seem to be advocating withholding antiviral treatment from flu patients - I don't understand when that became accepted medical practice.  In the past, antivirals have been prescribed for influenza patients, and that was for influenza strains that weren't killing children and young adults.  This strain seems more likely to cause fatalities, some of which might be avoided with treatment.

many recover on their own.  In fact, tamiflu has only been studied in seasonal flu and shown to do no more than reduce symptoms for a day or so, if taken early.  There are no studies to 'prove' that it can reduce severe complications or death.  Therefore, strictly speaking, the prescribing indications for tamiflu do not include anything beyond reduction of symptoms for a day or so.  So, in the past, antivirals have only been prescribed to a very small minority of flu patients.

That's not saying they shouldn't be prescribed, just clarifying where science stands.

The other, more pragmatic considerations include the fact that the US does not have enough of a stockpile to treat ALL patients who have flu.  A 25% stockpile is sufficient only if you assume 100% correct diagnosis, no distribution mismatch (eg if all states are given the meds according to population size, but not all states are equally affected), no hoarding, no misuse, etc.  So there really isn't enough to treat everyone, nor is it desirable from the POV of preventing antiviral resistance.



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

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by: SusanC @ Tue Jun 09, 2009 at 17:18:33 PM UTC

[ Parent ]

LOL

I just posted the rest of what you said. ;-P

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by: DemFromCT @ Tue Jun 09, 2009 at 17:23:00 PM UTC

[ Parent ]

PS

Why does 'appropriate treatment' not include an antiviral?
Since so many people seem to have a pre-existing condition and therefore are at higher risk than otherwise with this strain of flu, it seems that to withhold antiviral treatment has and will continue to result in the deaths of some patients.  That seems very inappropriate, when medicines exist that might help prevent those deaths. I think you are exagerrating the lethality, and whereas it is true for high risk grouops that medication shoud be considered, it is not true of everyone.

If you don't treat the patient in what I would consider an appropriate fashion, then of course you're also not treating household contacts in that same appropriate fashion, which I think should include prophylactic antiviral treatment.
there is not enough tamiflu to treat everyone and their contacts with prophylactic medication. That is sometimes tried early on (like the Brits did) to slow spread, but once you move from case-based small numbers to community based treatment, prophylaxis is not an option any more.

---

by: DemFromCT @ Tue Jun 09, 2009 at 17:21:31 PM UTC

[ Parent ]

The benefits of Tamiflu?

Tamiflu has a lot going against it. It's expensive ($20 x 5 days = $100); using it widely might encourage resistance; it works best at the beginning of an infection; and it reduces symptoms by only a day.

Does it save lives? How many? Do we know?

It seems like people grasp onto Tamiflu because that is the only treatment out there which the public has access to (with a prescription). Outside of hospitalization and ventilation, that is.

Is Tamiflu just a distraction? Instead, shouldn't people be learning how to treat the flu at home? Learning early signs and symptoms? Making sure family member rests, eats well, sleeps well and stays home?  

---

by: phytosleuth @ Tue Jun 09, 2009 at 21:01:50 PM UTC

[ Parent ]

About those benefits . . .

If Tamiflu weren't effective in some circumstances and against some strains of flu, then it seems a bit odd that Tamiflu blankets continue to be laid in a lot of countries when they have an H5N1 outbreak.  Tamiflu use seems to have been what has made the difference in Indonesia between life and death.

Actually, I've seen quite a bit of speculation that when the Tamiflu blankets stop being effective in slowing the spread of H5N1, that's when we will be more likely to face a pandemic threat from that strain of flu.

And as far as not having enough - that's another serious mistake made by many governments, including our own.  Roche was running at full capacity as long as the orders for quantities of the drug were being placed, but they cut back production when the orders weren't sufficient to warrant full scale manufacturing.

If governments had bought enough, if the states had bought all that they could have bought, if more large companies had purchased Tamiflu for their employees like Richard Branson supposedly purchased for his companies, well - then that argument wouldn't be quite as persuasive.

But I can take being outvoted . . . it won't change my mind that I think Tamiflu and Relenza can save lives.

$100 for a life saved?  That's pretty much dirt cheap.  

I also think that anyone who has ever suffered thru a case of influenza would think it was cheap if it meant that experience was shortened by even a day.  One day with full blown flu can seem like an eternity - I've had it three times in my life, and each time didn't know whether to be afraid it was going to kill me, or to hope it would go ahead and do it quickly to end the pain.

---

by: Clawdia @ Tue Jun 09, 2009 at 21:17:42 PM UTC

[ Parent ]

in a perfect world, with unlimited resoruces

I'd agree with you.

it's not as perfect world, and resources are not unlimited.

---

by: DemFromCT @ Wed Jun 10, 2009 at 02:18:29 AM UTC

[ Parent ]

Unlimited resources...

$100 for a course of Tamiflu is alot cheaper than not treating an uninsured patient with flu who develops complications that require hospitalization, perhaps even ventilation support. That first $100 would be spent in the first five seconds of an ER visit.

IMHO, it's a penny-wise, dollar-foolish policy.

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

---

by: Grace RN @ Wed Jun 10, 2009 at 03:16:33 AM UTC

[ Parent ]

that assumes tamiflu keeps you out the the ER,

or that not using tamiflu puts you there, and either way that's a big assumption that in most caees simply is not true (if it were, I'd agree with you).  

---

by: DemFromCT @ Wed Jun 10, 2009 at 04:01:11 AM UTC

[ Parent ]

True..

Hindsight for tragic cases is always what? 20/20? What if the patient was young, previously healthy but uninsured?

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

---

by: Grace RN @ Wed Jun 10, 2009 at 15:45:40 PM UTC

[ Parent ]

IMO they are not mutually exclusive

This problem is so big that we need everything we can get our hands on.  And that includes tamiflu, NPI, vaccines, homecare, personal prep, surge capacity, vents, antibiotics, whatever.




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

---

by: SusanC @ Tue Jun 09, 2009 at 22:40:40 PM UTC

[ Parent ]

2 swine flu cases at American University in Cairo

The Associated Press
Published: Monday, June 8, 2009 at 3:00 a.m.
Last Modified: Monday, June 8, 2009 at 12:59 a.m.

CAIRO - The American University in Cairo says a dorm building housing foreigners is being quarantined for 24 hours after two American students were diagnosed with swine flu.

Rehab Saad from the university's public relations office said Monday the two cases were discovered Sunday night along with a third suspected case. All three have been hospitalized.

The dorm in the Zamalek area of Cairo houses about 100 students.
It was not known where the students contracted the disease.
Egypt announced its first confirmed swine flu case June 2 after an Egyptian-American girl arriving in the country tested positive.

Egypt's government has come under criticism for its decision to slaughter the nation's pigs in response to the swine flu problem.

http://www1.pressdemocrat.com/...

United we stand: Divided we fall
www.flunewsnetwork.com

---

by: cottontop @ Mon Jun 08, 2009 at 12:34:01 PM UTC

Egypt quarantines dorm after new flu cases

Jun 08, 2009 at 09:44

Two U.S. students at the American University in Cairo have been diagnosed with swine flu, the university said on Monday, with their dormitory under quarantine after a third suspected case was discovered.

"There are two American students who came here on May 28 and the ministry of health has confirmed that they are sick with the A(H1N1) virus," university spokeswoman Rehab Saad told news agency AFP.

The two students are being treated in hospital along with a third suspected infected American, Saad said, adding that their dormitory on the central Cairo island of Zamalek had been placed under quarantine.

"The dorm of around 140 has been quarantined for 24 hours, the ministry of health is taking samples and the results are expected soon," Saad said.
A 12-year-old girl who had travelled from the United States last week became Egypt and Africa's first case of swine flu.

Egypt, the most populous Arab country, began a controversial cull of the country's estimated 250,000 pigs after initial reports of swine flu outbreaks in other countries.

The World Health Organisation has said the drastic measure is not scientifically justified.
Egyptian media have reported that more than 150,000 pigs have been culled so far, with many of them later buried in hazardous waste disposal sites.

The authorities have stepped up measures to check travellers at airports for the virus, quarantining suspected cases in makeshift centres.
Egypt is already battling bird flu, which has killed 27 people since it was first reported in 2006.
In rural areas poultry are traditionally raised on rooftops, often in close proximity to young children, many of whom have become victims of the deadly H5N1 strain of avian influenza.

http://business.maktoob.com/20...

United we stand: Divided we fall
www.flunewsnetwork.com

---

by: cottontop @ Mon Jun 08, 2009 at 12:49:49 PM UTC

UK - Update on confirmed swine flu cases 8 June 2009

http://www.hpa.org.uk/webw/HPA...

29 further patients under investigation in England have today been confirmed with swine flu. Together with the 35 cases in Scotland announced yesterday (June 7 2009) by the Scottish Government this brings the current total number of confirmed UK cases to 621.

523 cases are currently under laboratory investigation in the UK.

---

by: UK - Bird @ Mon Jun 08, 2009 at 14:12:31 PM UTC

how many are no homegrown

and deemed from community spread, not travel and Yank exposure?

---

by: DemFromCT @ Mon Jun 08, 2009 at 20:00:12 PM UTC

[ Parent ]

Most if not all are UK sourced cases but I don't know for sure

They're testing a lot more people now but releasing a lot less info :-(

There are a lot more unsourced cases in Scotland than the UK but London has to be out of control by now. YOu just can't keep a lid on a city that big.

I think that WHO must announce phase 6 tomorrow. Their announcements are usually Tuesday?

The UK graphs released on Wednesday will give a better picture of where the cases are coming from.

---

by: UK - Bird @ Mon Jun 08, 2009 at 20:14:53 PM UTC

[ Parent ]

Phase 6

what exactly will that mean to the average person who thinks this is mild?

---

by: Katie Bird @ Mon Jun 08, 2009 at 23:08:01 PM UTC

[ Parent ]

RE: most won't care

Nothing, if they even see it on the news and don't tune it out.  Most don't even know that we are in phase 5.  The swine flu thing is over as far as they are concerned.

---

by: Ruth @ Mon Jun 08, 2009 at 23:18:20 PM UTC

[ Parent ]

France : 70 confirmed cases

http://www.invs.sante.fr/actua...

France

    * 70 confirmed cases (including 1 in French Polynesia in Martinique and 1), 62 imported (11 from Mexico, 41 from United States, Canada 4 and 7 of the Dominican Republic) and 8 cases related to imported cases.
    * 27 cases under investigation.
    * No severe form was observed.

---

by: anne66 @ Mon Jun 08, 2009 at 15:58:01 PM UTC

Chart Update

PA increase 1 (Philadelphia) total PA 2

Cumulative US total = 39

---

by: spartan @ Mon Jun 08, 2009 at 16:14:43 PM UTC

Chart Update Correction = Cumulative US 38

---

by: spartan @ Mon Jun 08, 2009 at 16:18:40 PM UTC

[ Parent ]

Confused

I thought 422 is total count for Pennsylvania or is PA something else?

http://www.health.state.pa.us/...
and
http://pandemicwatchcentralpa....

---

by: phytosleuth @ Mon Jun 08, 2009 at 17:29:24 PM UTC

[ Parent ]

Number of Deaths in PA = 2

as of this morning.

---

by: spartan @ Mon Jun 08, 2009 at 17:36:06 PM UTC

[ Parent ]

UK - New cases bring Scots swine flu total to 232

http://news.stv.tv/scotland/10...

Health Secretary Nicola Sturgeon has confirmed 43 fresh cases of the H1N1 virus in Scotland.

There are 43 new confirmed cases of swine flu in Scotland, bringing the total to 232.

The fresh cases are spread across Scotland. Thirty-six are in NHS Greater Glasgow and Clyde, three are in Highland, two are in Lanarkshire, one is in Ayrshire and Arran, and one is in Fife.

Authorities have confirmed that they new cases were non-travel related.

Ten of those confirmed as suffering from the contagion are in hospital. Three people are still being treated in intensive care - a 45-year-old man from Paisley and a 38-year-old Glasgow woman are both described as critical but stable.

Comment brings the UK total to 664

---

by: UK - Bird @ Mon Jun 08, 2009 at 17:03:25 PM UTC

Nepal - Viral Fever / Flu

Viral fever grips two Tanahun schools

Himalayan New Service

TANAHU: Students of Janajyoti Higher Secondary School and Dharma Primary school of Bhimad VDC have been suffering from viral fever for the past few days.
According to Khimakanta Parajuli, principal of Janajyoti Higher Secondary School, 40 students of the school had been suffering from high fever. "Students mostly from Grade VI to X have been affected by the disease," said Parajuli.
Bhimad Primary Health Centre confirmed the disease as viral fever and said that unhygienic  water was the reason behind the disease, said Principal Parajuli. The school administration has urged the students to drink boiled water and pay attention to their sanitation. Parajuli said, "We might also shut the school if other students show signs of the disease." Some students of Dharma Primary School have also been affected with the same disease.
Health Inspector of the District Health Office Mukti Pandit said that 40 students of Janajyoti Higher Secondary School and 12 students of Dharma Primary School had received treatment in Bhimad Primary Health Centre.
He said that condition of the sick students was returning to normal. He also informed that they had a Rapid Response Team on standby with full supply of medicines.
District Health Office Tanahun informed that the RRT was in high alert to prevent the disease spreading into other parts of the district. A week ago, about four hundred students of Chhandi Secondary School and Saradi Primary School of  Dhorphirdi VDC were affected with the same disease.

http://www.thehimalayantimes.c...

Map:
http://ncthakur.itgo.com/map04...

Comment:  Tanahu is just to the south and contiguous with Gorkha District.

--------------

Viral flu claims 13 in Humla  

RSS
HUMLA, June 8: Thirteen persons have died of fever and common cold spread at Limi, the rural part of Humla district, since the first week of Jestha.

The disease has claimed 13 people so far, said VDC secretary Dharma Raj Rokaya. Of the dead, seven are woman and six are man and all are over 50, he added.

It is said that the disease was spread due to the severe cold caused by snowfall. The village lies along the border of China.

Some 200 people have been affected from the disease. A health team from the District Public Health Office has been sent to the disease-spread village.

http://www.myrepublica.com/por...

Map:

http://ncthakur.itgo.com/map04...

---

by: Okieman @ Mon Jun 08, 2009 at 18:20:18 PM UTC

US - First Oklahoma Swine Flu Death Reported

http://www.kjrh.com/content/ne...

The Oklahoma State Department of Health announced today that a 43-year-old male from Kay County is the state's first swine flu death in the state.

The patient had sought medical care for his flu symptoms but had not been hospitalized. He did have underlying chronic medical conditions, including asthma.

State health officials report the virus continues to circulate in Oklahoma. Currently, 109 cases have been confirmed in the state, while one Oklahoman living out of state has also been confirmed with the disease.

cont.

---

by: UK - Bird @ Mon Jun 08, 2009 at 19:37:24 PM UTC

Northern Oklahoma

Kay County is in north-central Oklahoma along the border with Kansas.

Thanks for the article UK-Bird.  This was the first I had heard of it.  I reckon it will be a significant news item in the evening news.

---

by: Okieman @ Mon Jun 08, 2009 at 20:07:04 PM UTC

[ Parent ]

Chart Update H1N1 Deaths US - Addition = OK 1

OK =1

Cumulative US 39

---

by: spartan @ Mon Jun 08, 2009 at 19:44:20 PM UTC

Manitoba aboriginals hit hard by flu

http://www.winnipegfreepress.c...

Manitoba has been hit with a surge in the number of people requiring intensive care for influenza-like illnesses, Manitoba Health reported this afternoon.

The majority of cases are people of aboriginal descent, an official said.

The federal Public Health Agency of Canada has provided epidemiologists to Manitoba to assist in assessing Manitoba's cases of flu-like illnesses, the official said.

At one Manitoba First Nation, St. Theresa Point, dozens of people are experiencing severe flu symtoms and 20 people from that community has been hospitalized in Winnipeg with influenza. Several of them have been confirmed as H1N1.

---

by: UK - Bird @ Mon Jun 08, 2009 at 20:06:32 PM UTC

Questions...

Could it be that folks of Native American/Aboriginal descent are at greater risk?  Could this be the reason for the deaths in Mexico City?  Closer to home for me, could this be a factor in the recent death in Kay County, Oklahoma?  Speculation only.  I know the 1918 Spanish Flu hit some native tribes in Canada and Alaska very very hard.  

As most folks know, Oklahoma has a very large Native American/Indian population.  I hope the answers to my questions above are all "no".

---

by: Okieman @ Mon Jun 08, 2009 at 20:18:57 PM UTC

[ Parent ]

Native Americans are at risk

I've spent some time on the reservations. Americans would be shocked at conditions that rival those in any poor country. Families live close together in houses they can't afford to keep up. MRSA is epidemic on one reservation I know. Poor diet (vegetables are poor quality in the grocery store I visited once). Harsh winter and summer conditions. Mining near a lot of them. Water quality? Lots of type II diabetes. High rates of cancer on some reservations. Alcohol and drugs. Pick your "underlying condition."

What about other impoverished neighborhoods or counties in the US? In the South? In parts of large cities? Along the Smoky Mountains?

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:40:33 PM UTC

[ Parent ]

Native Americans have one of the highest rates

of diabetes in the country.  This occurred when they made the transition from a native diet to one provided by the government consisting of flour, sugar, and potatoes.  

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

---

by: History Lover @ Tue Jun 09, 2009 at 01:07:31 AM UTC

[ Parent ]

Alaska, 1918

I can't help but remember how hard H1N1 hit some Alaskan villages in 1918.

"The virus arrived at even the most improbable places, like isolated Alaskan villages. In one such village, Wales, 178 of its 396 residents died during one week in November, after a mailman arrived by dog sled, bringing the virus along with the mail."

Link to NY Times article

---

by: InKy @ Tue Jun 09, 2009 at 02:10:04 AM UTC

[ Parent ]

From the American Lung Association

Native Americans/Alaska Natives and Lung Disease Fact Sheet

August 2007

   * In California, Native Americans were more likely to have been diagnosed with asthma than all racial/ethnic groups. Approximately 21.7 Native American Indian children and 18.7 percent American Indian adults had been diagnosed with asthma in their lifetime, compared to 22.8 percent African American children and 16.4 percent African American adults, 14.2 percent White children and adults, 11.2 percent Asian children and 9.7 percent Asian adults and 12.6 percent Hispanic children and 8.7 percent Hispanic adults.1
   * Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, is the sixth leading cause of death from chronic disease for Native American men and the seventh leading cause of death for women.2
   * Native Americans have the second highest rates of cystic fibrosis following whites.  One in 10,500 Native Americans have cystic fibrosis compared with one in 3,200 whites.3
   * Infection with the HIV/AIDS is uncommon among Native Americans as compared with whites, blacks and Hispanics.  Native Americans account for less than one percent of all AIDS cases in the United States. At the end of 2005, close to 1,581 American Indians/Alaska Natives were living with AIDS.4
   * Lung cancer is the leading cause of cancer death among American Indians and Alaska Natives, yet of the 217 Native American languages spoken today most, if not all, do not include a word for "cancer."5
   * Lung cancer is more common in Alaska Natives and Northern Plains tribes than among Southwestern tribes.  Lung cancer death rates range from 7.3 and 13.3 per 100,000 women and men (respectively) in the Southwest region to 43.2 and 77.1 per 100,000 women and men (respectively) in the Northern tribes.6  An exception to this is the Navajo Indians in New Mexico who have much higher death rates due to employment in uranium mining, which is known to contribute to lung cancer.7
   * American Indians and Alaskan Natives have been documented to have high rates of Respiratory Syncytial Virus (RSV) infection.  One study found that the age-adjusted RSV hospitalization rates among Navajo and White Mountain Apache children less than 1 year old were three times higher than the rates reported for children of the same age group in the general U.S. population (91.3 per 1,000  vs. 31.2 per 1,000).8
   * American Indian/Alaska Native infants have SIDS rates 2.5 times higher than white infants and 2 times higher than the United States as a whole. In 2003, 53 American Indian/Alaska Native infants died from SIDS in the U.S., a mortality rate of 124.0 per 100,000.9
   * In 2005, 32 percent of Native American adults smoked; more than any other ethnic group.10  American Indian/Alaska Native youth had the greatest cigarette smoking prevalence (23.1%) of all ethnic/racial groups between 2002 and 2004.11  However, this data may be difficult to interpret since surveys typically do not separate ceremonial tobacco use from habitual actual misuse.12
   * Smoking rates among American Indian/Alaska Natives vary by region and state. They are highest in Alaska (45.1 percent) and North Plains (44.2 percent) and lowest in the Southwest (17.0 percent).13
   * Between 1993 and 2005, the tuberculosis case rate decreased the greatest among American Indians/Alaska Natives by 50.4 percent.14

http://www.lungusa.org/site/ap...

---

by: Okieman @ Tue Jun 09, 2009 at 02:48:30 AM UTC

[ Parent ]

Massachusetts Case Update 940

http://www.mass.gov/?pageID=eo...

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:48:41 PM UTC

Checking state health department websites for new cases

Since every state records differently (or not at all), I thought I'd check for new numbers since the last count was the CDC on Friday and that's old anyway. If this isn't useful, I won't do it again. Just let me know. Thanks.

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:55:32 PM UTC

[ Parent ]

I think Mass has a ton of cases

considering how small it is. Nh only has 85 but the hospitializations appear to be running around the same (5% or so) and the ages seem to be in the same groups.

---

by: Katie Bird @ Mon Jun 08, 2009 at 23:10:40 PM UTC

[ Parent ]

Nh link

http://www.dhhs.state.nh.us/DH...

click on NH H1N1 Case Count

---

by: Katie Bird @ Mon Jun 08, 2009 at 23:12:49 PM UTC

[ Parent ]

Thanks Katie, that's a better link than I had

---

by: phytosleuth @ Mon Jun 08, 2009 at 23:22:28 PM UTC

[ Parent ]

Mississippi cases 58

http://www.msdh.state.ms.us/ms...

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:50:40 PM UTC

New Jersey cases 189

http://www.state.nj.us/health/...

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:52:09 PM UTC

New York cases 1007

http://www.health.state.ny.us/...

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:54:11 PM UTC

North Carolina 39 cases total

http://www.epi.state.nc.us/epi...

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:56:29 PM UTC

Pennsylvania 494 cases total

http://www.health.state.pa.us/...

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:58:45 PM UTC

Rhode Island 33 total

http://www.health.state.ri.us/...

---

by: phytosleuth @ Mon Jun 08, 2009 at 20:59:35 PM UTC

Wyoming cases 28 total

http://wdh.state.wy.us/phsd/ep...

---

by: phytosleuth @ Mon Jun 08, 2009 at 21:03:56 PM UTC

APHA Get Ready Day will be Tuesday, Sept. 15, 2009.

Mark your calendars: Get Ready Day 2009 will be celebrated Tuesday, Sept. 15, and it will be time to celebrate! Help Americans prepare themselves, their families and their communities for all hazards they may face, including pandemic flu and other emerging infectious diseases. APHA's Get Ready campaign can help you plan your Get Ready Day activities. Here are some ideas on what you can do:

   * Hold an after-school community preparedness fair and invite students, parents and families.
   * Sponsor a preparedness talk at your local senior center or hold a town hall.
   * Set up a booth on campus, or pass out materials at your health department.
   * Insert preparedness planning materials into your church bulletin, or post information on a bulletin board.
   * Work with a local grocery store to promote preparedness and stockpiling to shoppers through displays or fliers....

http://www.getreadyforflu.org/...

Fact sheets and games are available at links on the page above.  (I'm not clear about whether the APHA would welcome flubie volunteers doing their own exhibits or what local public health people would say if we offered to help.  It may vary from place to place.)

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

---

by: Jane @ Mon Jun 08, 2009 at 21:36:40 PM UTC

Quebec woman dies after contracting swine flu

http://www.cbc.ca/canada/montr...

A Quebec woman has become the fourth Canadian to die after getting swine flu, health officials said Monday.

Dr. Alain Poirier, Quebec's national director of public health, said the woman - who was from the Quebec City area - died on Friday, three days after she began showing symptoms.

Poirier said she was older than 65, but he did not know her exact age.

He said she had not travelled recently to Mexico, where the recent strain of H1N1 influenza A virus first appeared in April.

This is the first reported swine flu death in Quebec.

Two Toronto men who had the H1N1 virus died in May while a 39-year-old northern Alberta woman died in late April.  

---

by: blackkitty @ Mon Jun 08, 2009 at 22:22:31 PM UTC

Orange County man dies of swine flu

http://latimesblogs.latimes.co...

An Orange County man has died of swine flu, making him the fourth swine-flu related death in California.

The man, whose age and city of residence were not immediately available, suffered from other preexisting health conditions, Orange County public health officials said.

Last week, state health officials announced the death of a 9-year-old girl in Contra Costa County. The girl did not have an underlying medical problem but had a secondary bacterial infection that may have contributed to the death.

State health officials said today that results of the autopsy are pending. Statewide, there are more than 1,000 confirmed or probable cases of the novel H1N1 virus, with about 62 hospitalizations.

Orange County has 86 confirmed and probable cases.

---

by: blackkitty @ Mon Jun 08, 2009 at 22:23:36 PM UTC

Underlying bacterial infection? Was there any more detail?

If she had an infection and then got the flu, that's one thing, but if the infection was pneumonia and followed her getting flu, that's completely different.

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

---

by: Jane @ Mon Jun 08, 2009 at 23:23:34 PM UTC

[ Parent ]

First Swine Flu death in Oregon

http://www.kgw.com/news-local/...

SALEM, Ore. - The first Oregonian has died from H1N1 Swine Flu.  More:  Swine Flu

Officials said Monday a Marion County woman died on Sunday after being hospitalized for eight days. The unidentified woman also suffered from underlying health conditions and complications, doctors said.

"We are saddened by this death, and our hearts go out to the family," health officer for Marion County Dr. Karen Landers said. "It's an unfortunate reminder of the seriousness of flu."

It was the first death of a person with novel H1N1 flu in Oregon and the 28th in the nation.

Officials said there were no indications the strain was more dangerous than other strains of flu.  

---

by: blackkitty @ Mon Jun 08, 2009 at 22:52:59 PM UTC

Not More Dangerous...

"Officials said there were no indications the strain was more dangerous than other strains of flu."

--- I'm beginning to get irritated by the MSM adding that kind of snippet to these death reports. Okay -- not worse, but... remember last Fall - all the PSAs and posters saying, "Get Your Flu Shot! Don't Fool Around" etc.? Now that there is no flu shot, suddenly they are downplaying the whole seriousness? Sorry - they can't have it both ways... if seasonal flu is bad enough to pressure folks into getting flu shots, then when we don't have that safeguard, they should be pressing harder for folks to be alert and avoid spreading it!

--- sorry, I'm grumpy because I just got back from a 3 hour meeting at a woman's house, and she told us at the end of the meeting that one of our regular members was sick with a "flu-like thing" and that she herself had been "under the weather" the day before but was feeling "better"... I am amazed at how blase my friends and acquaintences are! At least the woman hosting our Wednesday meeting just emailed to say she had a "strange cough" but didn't feel too bad, but wanted to warn us... I appreciated that! But I think it has spread widely in Oregon... and we may see more serious reports soon...
Cathy

---

by: Cathy M @ Tue Jun 09, 2009 at 03:06:36 AM UTC

[ Parent ]

I agree, Cathy M. It is way too early in the pandemic for tptb to be so smug and blase.

We have no idea how many deaths there will be...it seems every day the numbers are increasing bit by bit as this thing takes hold. The thing to remember is "takes hold and ADAPTS to its new host" which is...us!

Dem from CT keeps asking "what would you have them say?"

I would have them say is "don't get cocky, don't get careless, don't presume it's going to stay mild or just go away. We don't know where this is going or how bad it may get, so just keep alert, start putting away supplies, get yourself educated and hope for the best while preparing for the worst."

Always have a plan B.

---

by: maryinhawaii @ Tue Jun 09, 2009 at 06:09:05 AM UTC

[ Parent ]

NYC records 9th swine flu death

http://www.newsday.com/news/lo...

NEW YORK - New York City has recorded its ninth death from swine flu.

The city health department said on its Web site Monday that the victim was over age 50 and had an underlying health condition that made the flu more dangerous.

Health spokeswoman Erin Brady declined to say when the victim died or release any details about the death, citing patient privacy policies.

Many thousands of New Yorkers are believed to have had swine flu. City health officials say most suffered only mild symptoms.

About 428 people have been hospitalized and there have been 694 confirmed swine flu cases reported citywide. Elderly people are usually among those most at risk in a flu outbreak, but researchers say this particular strain has hit relatively few people over age 65.

---

by: blackkitty @ Mon Jun 08, 2009 at 22:53:44 PM UTC

Flu cases requiring intensive care spike in Manitoba, first death in Quebec

http://www.capebretonpost.com/...

WINNIPEG (CP) - Manitoba health officials were investigating a sudden spike in the number of people requiring intensive care for flu-like illnesses Monday, while Quebec reported its first death related to swine flu.

There were 26 Manitobans on ventilators due to flu as of Monday, and that's in addition to the 30 or so people who are on ventilators on an average day for a wide variety of illnesses. The spike prompted the Winnipeg Regional Health Authority to order 15 additional machines.

"We're seeing a number of severe cases of influenza-like illness," said Dr. Joel Kettner, Manitoba's chief public health officer.

"What we've observed is really more severe than what we would expect to see or have seen with typical seasonal influenza in the past."

While the vast majority of people who have contracted the flu have not required hospitalization, the new swine flu seems to be hitting certain groups hard - aboriginals and people between 20 and 60, Kettner said.

Manitoba did not confirm any new cases of swine flu Monday. The provincial total remains at 40, none of which has been fatal. But Kettner said he expects most, if not all, of the recent serious cases will test positive for swine flu.

More than half of those on ventilators as of Monday were aboriginal. Native leaders have warned that poor housing conditions make it hard to prevent a contagious disease from spreading. One of the hardest-hit communities is St. Theresa Point - a fly-in reserve 500 kilometres northeast of Winnipeg where some two-bedroom homes house 10 or more people.

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by: blackkitty @ Mon Jun 08, 2009 at 23:03:59 PM UTC

RE: illinois

Illinois H1N1 Flu Case Summary
Counties Confirmed and Probable Cases Deaths
22                       1,828           5

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by: Ruth @ Mon Jun 08, 2009 at 23:52:49 PM UTC

Whoa that's 462 cases in 3 days

June 5 count was 1357

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by: phytosleuth @ Tue Jun 09, 2009 at 15:35:47 PM UTC

[ Parent ]

Chile reports 3rd death of A/H1N1 flu

http://news.xinhuanet.com/engl...

SANTIAGO, June 8 (Xinhua) -- Chilean Health Ministry reported on Monday the third death in the country due to the influenza A/H1N1 virus.

   The patient, a 37-year-old man, arrived on very bad health condition to the Central Hospital of Santiago where he died short after being hospitalized, authorities said.

   This case is added to the deaths of Fernando Vera Maldonado and Juan Humberto Pozas both from Los Lagos region, which has the largest number of confirmed cases in the country.

   According to the last report of the Health Ministry till Friday there were 890 confirmed cases of H1N1 flu in the country.

   Chile was the fifth country in the world, after the United States, Mexico, Canada and Costa Rica, to have reported a death due to H1N1 flu.  

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by: blackkitty @ Tue Jun 09, 2009 at 00:32:15 AM UTC

RE: local paper- chicago suburb

Swine flu cases jump by 30 percent
By Robert McCoppin | Daily Herald Staff

Published: 6/8/2009 4:55 PM

The number of swine flu cases in Illinois jumped by 35 percent over the weekend - but health officials maintain it's nothing to be alarmed about.

Total cases of the H1N1 virus, probable and confirmed, rose from 1,357 on Friday to 1,828 on Monday, an increase of 471 cases.
http://www.dailyherald.com/sto...

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by: Ruth @ Tue Jun 09, 2009 at 00:40:09 AM UTC

Ireland - Getting ready for flu

It is difficult to predict whether flu outbreaks will turn into pandemics but we still need to be prepared, writes CLAIRE O'CONNELL

'Flu pandemic set to strike in autumn," rang headlines in the British press last week after a virologist forecast a surge of influenza type A (H1N1) infections there after the summer break.

"Problems at the moment are fairly low, with schoolchildren and the odd sporadic case in the community," Prof John Oxford from the University of London was reported as saying. "But when children go back to school in September the virus has an opportunity, and normally it takes it."

Source
http://www.irishtimes.com/news...

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by: Kobie @ Tue Jun 09, 2009 at 00:40:37 AM UTC

USA - FL - Air passengers could be rerouted to Miami if pandemic strikes

As the swine flu scare fades, America's major airports are bracing for how to handle any future pandemic that could require them to quarantine international flights.

The Centers for Disease Control and Prevention has set up stand-by quarantine/screening facilities at 19 airports to which all flights from affected countries would be diverted.

While Miami International Airport is among the 19, Fort Lauderdale-Hollywood International Airport, which handles about 3 million international passengers a year, is not.

That means that in the event of the highest-level alert, all flights to Fort Lauderdale from pandemic-affected countries could be rerouted to Miami, Atlanta, Houston or somewhere else.

Source
http://tinyurl.com/ma8qbf

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by: Kobie @ Tue Jun 09, 2009 at 00:45:26 AM UTC

that is the funniest bit of 'spin' I've read for a while!!

That means that in the event of the highest-level alert, all flights to Fort Lauderdale from pandemic-affected countries could be rerouted to Miami, Atlanta, Houston or somewhere else.

Pandemic-affected countries???  How about the US?

Also, yeah, divert all flights to other cities.  And then what?  You screen them - how?  There's not even enough facilities to test SICK people.  You think you can 'screen' planeloads of people?  

Jeez.  Some people need to wake up!

btw I'd like to find out how much they spent on setting up these quarantine facilities.  I'm not saying they are useless, just trying to discover how small a fraction of that money could have funded a great public education campaign



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

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by: SusanC @ Tue Jun 09, 2009 at 07:23:45 AM UTC

[ Parent ]

The Orlando paper

raised the same concerns in an article today.
some snips

Will OIA help out feds in the event of a pandemic?
snip
But OIA, which handles more than 1million arriving passengers per year from foreign airports, is not one of the 19. That means that in the event of a Phase 6 pandemic, all flights to Orlando from pandemic-affected countries could be rerouted to Miami, Atlanta, Houston or elsewhere.

Nationally, airline and airport lobbyists predict chaos, saying there is no way the air-traffic system can handle such extensive rerouting. Now, new proposals are emerging in Washington, including a "Plus 6" plan that would designate Orlando, Fort Lauderdale-Hollywood International and four other major airports as potential second-tier quarantine sites.
snip

Local officials say they understand the CDC will approve the Plus 6 designations only if Orlando and the other airports pay for the quarantine facilities themselves.

The facilities aren't cheap. A 2008 study by the Federal Aviation Administration concluded that setting aside space for health screenings and a quarantine of up to 200 people could cost $15,000 per month, with costs of an actual quarantine running into the hundreds of thousands.

snip
No one has determined where the center might be set up - or where the money and public-health resources might come from. Quarantined passengers might have to remain for days to show they are not infectious.

"The airport is not a shelter. The airport is not an isolation facility. The airport is not a quarantine facility," said Tom Draper, GOAA's assistant director of operations for emergency response. "Our job is to move passengers."

snip
They argued that funneling all international air traffic to just 19 airports could be chaotic. Besides needing to set up screenings for potentially tens of thousands of passengers, the airports would then have to put cleared passengers onto flights to their intended destinations. Flights would back up and delays would spread everywhere, predicted Katherine Andrus, assistant general counsel for the trade group.

"It would be like a very, very bad snowstorm hitting all airports with international arrivals at the same time," she said.
http://www.orlandosentinel.com...

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

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by: mojo @ Tue Jun 09, 2009 at 12:36:46 PM UTC

[ Parent ]

Houston Texas - Girl, 12, dies from swine flu

http://abclocal.go.com/ktrk/st...

HOUSTON (KTRK) -- We are learning more about the latest swine flu death in our area.

A 12-year-old girl from Fort Bend County died May 26 at Texas Children's Hospital. Officials say in addition to the flu, the ginn=had severe underlying health problems.

The victim attended school in Fort Bend County, but since school is already out, no special measures will be taken.

Fort Bend County now has 36 confirmed cases of swine flu. Five people with the disease have died in Texas, including a boy from Mexico City who died in a Houston hospital. There are 1,800 cases being reported in Texas.  

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by: blackkitty @ Tue Jun 09, 2009 at 01:54:43 AM UTC

is this the third pediatric death in the US? n/t

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

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by: SusanC @ Tue Jun 09, 2009 at 07:19:20 AM UTC

[ Parent ]

Canada: Quebec woman dies after contracting swine flu

"A Quebec woman has become the fourth Canadian to die after getting swine flu, health officials said Monday.

Dr. Alain Poirier, Quebec's national director of public health, said the woman - who was from the Quebec City area - died on Friday, three days after she began showing symptoms.

Poirier said she was older than 65, but he did not know her exact age..."

http://www.cbc.ca/canada/montr...

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

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by: MaMa @ Tue Jun 09, 2009 at 01:59:04 AM UTC

New Zealand: advice from government (and many comments)

in story about Pacific Sun cruise ship quarantine (June 4, 2009).

...Health authorities yesterday urged everyone to stock up on food and essential medicines to prepare for the disruption of normal life when swine flu hits New Zealand hard....

http://www.nzherald.co.nz/nz/n...

In the same paper, there are 36 pages of comments in answer to the question: Are you concerned about the dangers of swine flu?, starting April 27.  Interesting reading.
http://blogs.nzherald.co.nz/bl...
Opinions range from "It's all a crock!" to "We must stay alert because it's a dangerous situation."

s b (Kamo)  The concern is very warranted in my opinion. This h1n1 has the potential to become very deadly very quickly. This is a virus never seen before therefore none of us know what it's going to do. Awareness is crutial, contingency plans are essential.

Maree (Hokitika)  No I don't think you can downplay any potential pandemic. I would like to see a policy in school and childcase centres where children returning from overseas trips must stay away for another week to ensure they haven't come back with the disease before returning to school/childcase and putting other people at risk.

bantamus (Waikato/King Country)  Damned if you do and damned if you don't. Good planning and response is so far stopping this virus taking the leap to the killer virus it could be. If public health didn't take the stance it has, this could and still has the potential to become, a 2nd wave mutated killer virus.

We will be headed for a bad flu season but not a deadly one yet. Thanks to the CNN effect, we can watch blow by blow updates as this events unfolds. Not like in days of old where we waited days, weeks or even months and had to be reactive not proactive.

Snort and snuffle and be cynical. For once, however, be grateful, that those who can understand these threats, really do try to stop it becoming as bad as it could potentially be. If they didn't they would still be damned, but because they are issuing warnings and trying to stop it, they are damned equally. Ungrateful sods a lot of the public are !

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

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by: Jane @ Tue Jun 09, 2009 at 02:12:26 AM UTC

Canada: Severe flu cases surge in Manitoba aboriginal community

"The Manitoba government is reporting a surge in the number of people requiring intensive care for influenza-like illnesses, particularly among a relatively young aboriginal population.

The vast majority of people reporting flu-like illnesses this spring are experiencing relatively mild cases and have not required hospitalization, Manitoba's chief medical officer of health, Dr. Joel Kettner, said at a press conference Monday afternoon.

However, there has been "an increased concentration of severe respiratory illness admitted to the intensive care units, which is higher in number than previous influenza outbreaks," officials with Manitoba Health and Healthy Living stated at the press conference.

As of Sunday night, 26 people were in the intensive care units on ventilators for flu-related reasons. It is expected many of them will be confirmed as cases of swine flu, or the H1N1 influenza A virus, officials said, noting more than half of the people are of aboriginal descent with an average age of 35, said Kettner.

The Winnipeg Regional Health Authority is taking steps to provide enough support to intensive-care units and prioritizing patients for personal-care home beds. The WRHA has also acquired 15 additional ventilators that will be put to use as needed, officials said.

Normally at this time of year, there are 30-35 patients using hospital ventilators for various reasons. The 26 people requiring the devices due to flu-like illnesses are in addition to those patients.

Typically, at this time of year, there are very few - if any - cases of severe flu.

"It's important to recognize that what we have observed is really more severe than what we would expect to see or what we have seen with typical seasonal influenza in the past," said Kettner.

The WRHA authority may also defer non-urgent surgical procedures that would normally require ICU care, said health officials.

As well, the Public Health Agency of Canada has provided three epidemiologists to Manitoba to assist in assessing cases of influenza-like illness.

There are 40 people in Manitoba with confirmed cases of swine flu. There were no new cases announced Monday..."

http://www.cbc.ca/canada/manit...

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

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by: MaMa @ Tue Jun 09, 2009 at 02:24:45 AM UTC

I'm wondering if the virus might be

changing to cause more serious illness or if there are just a high proportion of people particularly vulnerable getting infected all at once.

I also wonder if my kids and I've got it. DD has been pretty sick 4 days,other DD+DS have only mild symptoms and tires achy thing going on. I've been pretty sick for a couple days now and can't/wouldn't anyway go to the local hospital and potentiallt infect some seriously ill people just to be told to go home, rest and drink lots of fluids- I kinda already know to do that! Hubby seems to be made of stainless steel so that's good:-)

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

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by: MaMa @ Tue Jun 09, 2009 at 02:50:12 AM UTC

[ Parent ]

hospitalization tends to lag behind onset

by several days.  Add a couple of days incubation period, and for some, add a few days before they got bad enough to be in ICU.  Let's say 8-10 days in total.  In that time, for an R0 of 2, right now as we speak, you would already have a 10-fold increase in cases waiting to get to that severe point.  Which means in 10 days they will have 260 instead of 26.  Of course, right now the R0 is <2 so it will be less, but the principle of exponential growth applies.  

It sounds like a cluster of severe cases, maybe more than pure coincidence.  If true, if previous pandemics like 1918 is any guide, they will see a LOT worse hospitals being overwhelmed in the next couple of weeks.

I hope of course that my speculations are totally off-track, and it's all a coincidence.  Somehow I don't tend to believe in coincidences, that is the problem.

Fingers crossed.



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

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by: SusanC @ Tue Jun 09, 2009 at 07:17:57 AM UTC

[ Parent ]

Anecdotal experience from Utah

I have a friend, was here in Chicago last week, went home to Salt Lake City on Friday, and tried camping that weekend only to head back home with a high fever.

Flu.

But doesn't know for sure if he has the novel type because...

So get this... My doctor told me that he got new guidelines for testing the flu strain for AH1N1. The State will only test influenza strains if the patient is in the HIGH RISK target group. This means there are so many confimed cases in utah that they are no longer interested in tracking it in the general population. So I'll never know if it was the swine or not. Wife and daughter are sick too

I told him, if you have the flu, odds are now that you have h1n1 and gave him the link to the cdc chart...  Alas, he went in to work that Sunday night to help out with an over-night install.  sigh

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by: Quartzman @ Tue Jun 09, 2009 at 02:40:02 AM UTC

Thanks for all the news snips

My office has a website filter that doesn't allow me to post during the day any more (not that I frequently do so anyway), and I rarely get on the computer at home, what with the kids' activities, etc.  I read this website throughout the day at work to keep informed, and use it to keep my flubies informed, and there is no better website out there.  I appreciate all that you do -- you help me do my job better.

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by: VirginiaMom @ Tue Jun 09, 2009 at 02:43:05 AM UTC

maine

Cumberland County Sheriff Mark Dion confirms the jail is currently housing three inmates infected with N1H1 Swine Flu and three other inmates showing symptoms.

That brings the total number of cases at the jail to 7. One of those inmates has been tranfered out of state. The six still in the jail have been isolated from the other inmates and their contact with jail staff is being limited.

http://www.wcsh6.com/news/loca...

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by: DemFromCT @ Tue Jun 09, 2009 at 03:09:27 AM UTC

China reports 9 more cases of swine flu

The Associated Press , Beijing
Tue, 06/09/2009 9:56 AM |http://www.thejakartapost.com/news/2009/06/09/china-reports-9-more-cases-swine-flu.html

Chinese authorities have reported nine more cases of swine flu, including six cases of domestic transmission, bringing the total number on the mainland to 89.

Four Chinese women and two men caught the virus in southwest Sichuan province, the Health Ministry said late Monday on its Web site.

In Shanghai, a 47-year-old Chinese-American woman tested positive for swine flu, while a 12-year-old American boy was confirmed infected in the southeastern city of Fuzhou, in Fujian province.

A new case was also confirmed in southern Guangdong province, next to Hong Kong, in an 11-year-old American-Chinese boy who arrived from San Francisco with his mother, the ministry said.

Out of China's 89 cases, 39 are still being treated, according to the official Xinhua News Agency.

The World Health Organization says that as of Monday 73 countries have officially reported more than 25,000 have been infected, including 139 deaths.

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by: Pixie @ Tue Jun 09, 2009 at 03:39:01 AM UTC

Please post new news stories to...

News Reports for June 9, 2009

Thank you!

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Tue Jun 09, 2009 at 04:12:12 AM UTC

So much good information....

from such dedicated and caring people....

PRICELESS!!!

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Tue Jun 09, 2009 at 04:20:04 AM UTC

[ Parent ]

just a thought

about the many officiaal reassurances that I've just read on this thread.  I've been re-reading Alfred Crosby's book America's Forgotten Pandemic.  The case of San Francisco was particularly striking.  While Philadelphia got hit early and had to learn the hard way, cities on the west coast had plenty of prior warning about how bad things got.  And yet the health department and city officials vacillated in response.  Even after the first 600 cases were hospitalized, they still said gave all sorts of reasons why it was going to be ok in SFO, including stuff like they had vaccines (which of course didn't work, and even then the vaccines were not ready till the peak was over, and in any case they barely had enough for essential workers  Sound familiar?)

Even after cases were crowding hospitals, the news was full of Liberty bond fundraising rallies, concerts, speeches.  People were out in force in parades.  

As many people started to die, and doctors were 'treating' as many as several hundred people a day, San Franciscans gave themselves many reasons to think this was going to pass them by, and that the fear of the Spanish flu was nothing more than German propaganda.

These are very thought provoking anecdotes.  It tells me, probably, that people prefer to show unwarranted bravado in the face of an illness, as if they needed to prove, what?  I had no idea.  It also seems to me that human beings have an infinite capacity to misjudge threats - either over estimation, eg in the case of fear of child abduction, or underestimation, in the case of San Francisco in 1918, when they had PLENTY of warnings from people on the east coast about stocking up on coffins, and digging graves in anticipation of the dead.  

Which they did.  It didn't stop the rest of the foolishness, though.

For some reason, it reminds me of the UK government - don't worry, we got it under control, and, yes, we have excess mortuary facility in case you die.  That may be the ONE thing we don't have to worry about.  Or maybe not.  Can't tell how far incompetence goes...

Let's see, they got tamiflu for those who got sick and don't need to go to hospital, and they have mortuary space who die.  What happens in between, for those who got tamiflu too late (or not at all) or got very sick anyway?

YOu have ONE chance - get the tamiflu, hope that you got it at the right time, ie while you actually HAVE the flu and not have it wasted on something else.  Basically there are 2 lines - get in line for tamiflu, and get in line for the mortuary.  ARGH!!!

Sorry, rant over!



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

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by: SusanC @ Tue Jun 09, 2009 at 06:36:10 AM UTC