Newsweek story...

[Guest Guest]

I find this telling... these are really serious words to tell the "general public":

~~Almost all cases have involved people who came into close contact with chicken blood or droppings... it could be the trigger for a global pandemic that... could kill 150 million people... in a matter of months... Governments —indeed, civilizations — have collapsed from less; even if you survive, Osterholm asks, "what happens to you when the global economy shuts down?"~~ (fourth paragraph)

 

Also ~~"All states have pandemic plans that are insufficient," he says.~~ (Health and Human Services Secretary Mike Leavitt)

 

I know it's long, but try to read it carefully.

 

***********************

 

The Fight Against the Flu

 

The lethal H5N1 virus was found last week in birds in Europe. So far it has spread between humans in only a few suspected cases, but with no cure in sight, global health officials are nervously watching their borders and preparing for the worst.

 

By Jerry Adler

Newsweek

 

 

Oct. 31, 2005 issue - One parrot, imported from South America and held in quarantine in Britain, along with a shipment of birds from Taiwan.

 

One swan, in the Romanian village of C.A. Rosetti, near the border with Ukraine.

 

One man, Bangorn Benpad, 48, a sometime driver and gardener in the Thai province of Kanchanaburi, who had helped himself on a couple of occasions to chickens from a neighbor's flock. The flock had been dying off, and the chickens he took were close to death anyway. Days after he killed, plucked, grilled and ate the birds, he developed a cough and a fever and visited a local clinic, where they took an X-ray of his lungs and suggested he check himself into a hospital. Instead, he went home, but last Monday his condition worsened, and a new X-ray showed a rapid deterioration in his lungs. By Wednesday he was dead.

 

In ordinary times these deaths last week would have gone unnoticed by the world at large, but this is not an ordinary time: the world is on edge, stalked by a virus that travels the great migratory flyways and kills where it lands. After incubating for eight years in East Asia, where it was responsible for the death of 140 million birds (including those intentionally destroyed to stop its spread) and 68 people, the H5N1 variant of avian flu suddenly and mysteriously expanded its range this year, north to Mongolia and Siberia, then west into Ukraine, Croatia and Turkey. Through innumerable generations and hundreds of mutations, it maintained its extraordinary lethality, without yet evolving the ability to be transmitted directly between people. Almost all cases have involved people who came into close contact with chicken blood or droppings; when and if that changes, it could be the trigger for a global pandemic that, in a worst-case extrapolation from the toll of the 1918 Spanish flu, could kill 150 million people — 2.5 percent of the world's population — in a matter of months. Epidemiologist Michael Osterholm of the University of Minnesota calls that scenario "the single greatest risk to our world today." Governments — indeed, civilizations — have collapsed from less; even if you survive, Osterholm asks, "what happens to you when the global economy shuts down?" Thus the fate of the world hung in the balance between the invisible forces of mutation and natural selection, and the preparations undertaken by governments with far more visible problems close at hand. All over the world people were asking two things: Is the government doing everything it can? and What can I do to protect my family? And the answers were: not yet and only so much. "There have been many who foresaw this and urged the country to begin preparations sooner," Health and Human Services Secretary Mike Leavitt said last week in a remarkably frank interview with NEWSWEEK, "— and it would have been better if we had done so."

 

There is flu every year, of course, and it typically kills about 36,000 Americans, mostly the elderly. But for that very reason, most people have been exposed to it and have acquired at least partial immunity to the common varieties, which typically are hybrids of human and animal viruses. But H5N1 — like the 1918 virus, which has just been reconstructed by researchers — crossed the species barrier from chickens almost intact. Almost no one on Earth has any immunity at all, and ordinary vaccines are useless against it. It is, moreover, devastatingly lethal, for reasons not fully understood, killing nearly half the people known to have contracted it (although some researchers think mild cases might have gone unreported, making the mortality rate seem higher).

 

And, also like the 1918 variety, H5N1 has the ability to kill directly. Most ordinary flu viruses destroy the cells that line the upper respiratory tract, the body's first line of defense against airborne germs; the patient usually dies of bacterial pneumonia. That's why the elderly and immune-compromised are particularly at risk. But Spanish flu attacked deep within the lung, destroying tissue and also provoking a furious immune response that literally drowns the lungs in hemorrhage; if H5N1 follows the same pattern, as it appears to do, it would kill quickly and take a disproportionate number of healthy young adults.

 

No one knows why the virus suddenly spread into Europe this year or what it portends, although epidemiologists consider it an ominous development. "Something has happened to the relationship between the virus and wild birds that hadn't happened before," Osterholm said. Nevertheless, the only immediately obvious threat was to Europe's waterfowl and poultry farms. The likely ground zero for a pandemic is still the vast rural expanses and teeming urban markets of China and Southeast Asia. But the virus is now squarely in the path of birds migrating to Africa, where people also live in close proximity to animals and public - health facilities are often primitive — and millions are already infected with HIV, which raises the risk of serious complications.

 

Of course, medicine has made great strides since 1918. On the other hand, in those years it took weeks, not hours, to travel from Hong Kong to New York. Dr. Margaret Chan, head of pandemic-flu preparedness for the World Health Organization, notes that "in history no human intervention has managed to stop a pandemic once it starts." But, she adds, "this is the first time we've been able to see a pandemic unfold before our very eyes." There is a window of "20 to 21 days" in which a local outbreak could be controlled before it gets loose, Chan believes. The key factors that will determine success are surveillance, the authority to impose and enforce a quarantine, the availability of vaccines and antiviral drugs, and the state of readiness in hospitals — and in almost all of these, the world has a long way to go.

 

Take surveillance, the ability to detect an outbreak at the source. "Right now, [the world's] surveillance is not adequate to protect us," Leavitt said last week, at the end of a trip to seven Asian countries. "We have to work with countries all over the world and instill a sense that if it happens anywhere, it's a risk everywhere." But, as he acknowledged, that's a hard case to make in countries where the annual income might be $600 — and a family's entire wealth is tied up in livestock. At a briefing last Friday he described visiting a family in Vietnam whose flock was ordered destroyed when it showed signs of avian flu — so they frugally slaughtered and ate the birds that didn't seem sick. Within a week they were violently ill. (They survived.)

 

At the first sign of human-to-human transmission, the WHO plan calls for an immediate quarantine, freezing all traffic in and out of an area that could be as large as an entire city. Schools and businesses would be closed and public gatherings banned. Of course, these measures could be implemented only by the national government (or the states, in the United States), and would require the active cooperation of the population. To see how that could work in practice, you could have gone two weeks ago to the village of Ceamurlia de Jos, on the Danube Delta, where Romanian authorities imposed a strict quarantine after discovering avian flu in ducks, geese and chickens. Roads were blockaded by police and fire trucks, and anyone walking out of the village had to slosh through a shallow pit filled with disinfectant — including one elderly man who, compliantly stamping his feet in the tray, accidentally let loose a live chicken he'd been hiding under his jacket. Even in the United States, public-health officials have reason to worry that just as some people couldn't bear to leave their houses in the face of a hurricane, some will find it imperative to visit their relatives in another city at the start of an epidemic. States have laws to enforce quarantines, of course, but CDC officials admit that some are inadequate or have expired, and they're working urgently, if quietly, to bring them into compliance with the agency's model code. Other countries' situations are even more worrisome; in Indonesia, another country where H5N1 has been found, the Army is by far the only institution capable of enforcing a quarantine, but a military spokesman told NEWSWEEK last week that "bird flu is not within the purview of the armed forces. Talk to the Ministry of Health."

 

Antiviral drugs are an important part of the WHO's plan to combat avian flu. There are only two, Tamiflu and Relenza, and they both work the same way, by interrupting the virus's ability to replicate within the body. (Tamiflu, which is taken orally, is in wider use than Relenza, which is usually given by inhalation.) If taken at the very onset of symptoms, they are believed capable of reducing the severity and length of the disease. But their real value in public health, says Dr. Anne Moscona, an influenza expert at New York-Presbyterian Hospital/Weill Cornell Medical Center, would be to help contain an outbreak by treating healthy people in a "ring of prophylaxis" around it. Although reports suggest that some strains of H5N1 may be developing resistance to Tamiflu, Moscona still considers the drugs a useful tool, and the WHO recommends that nations stockpile enough to cover 10 percent of their population.

 

Public-health officials, though, worry that there's too much emphasis in the media on the size of the Tamiflu stockpile. "I think it's a complete misdirection of energy to be so focused on the issue of stockpiling," CDC director Julie Gerberding said in an interview Friday. "There is no evidence that it will make a difference if we are hit with a pandemic." Leavitt agrees that antivirals are only a part of the answer. But at the same time, he increased his estimate of a desirable stockpile of Tamiflu from 20 million doses earlier in the month to a range of 20 to 30 percent of the population—or upwards of 60 million. (CDC is a branch of Leavitt's department.) In any case, we're a long way from getting there: as of two weeks ago Leavitt told reporters that the United States had stockpiled 2.3 million courses, and that 2 million more would be on hand within two days. His spokesman now says the secretary misspoke, and the additional doses are not expected until the end of November. France, with a population of 60 million, claimed to have 13 million doses on hand last week.

 

Meanwhile, many people were trying to build their own stockpiles of the drug — an activity better described as hoarding. The Washington Post reported that 1.7 million prescriptions were filled in the United States in the first eight months of 2005, three times the rate last year. (A full course of Tamiflu — 10 pills over five days — costs $80 to $90; they were being sold on British eBay for as much as double that, until the company pulled the listings last Tuesday.) Although not illegal, personal stockpiling is "a really bad idea," says Moscona, who worries both about competing with the government for the limited supplies of the drug and about people taking it indiscriminately, which could foster the growth of resistant strains of the virus. Late last week the Swiss drug company Roche, the sole supplier of Tamiflu, said it would begin negotiating with four other companies to license its production. But that didn't head off an announcement by Taiwanese health officials that they would manufacture their own generic version of Tamiflu, which they said was "99 percent" identical to the patented drug — a clear indication that if a pandemic struck, it would be every man or nation for itself.

 

The best weapon against H5N1 would be a vaccine; at least two have been developed — one in the United States and one in Hungary — and are reportedly showing promise in tests. But there's a Catch-22 in vaccine production: the virus now in circulation, which infects humans only by way of birds, is not the one we have to worry about. It will have to mutate to cause a human pandemic, and the existing vaccine may or may not be completely effective against the new strain. (It presumably would offer at least some protection, but the standard vaccine now being given for this year's "seasonal" flu variety offers no protection at all against H5 viruses.) "We don't have the capacity to manufacture the vaccine necessary to combat a pandemic," Leavitt acknowledged. "We need the ability to isolate a virus and convert it to a vaccine and produce enough vaccine for 300 million people — and we need to do that in six months. That capacity doesn't exist today." Flu-vaccine production is still in the horse-and-buggy stage of inoculating chicken eggs by hand. New technologies can speed the process, either by growing vaccines in cell cultures, or manufacturing them directly from DNA — but progress on those, says Leavitt, "will be measured in years, not months."

 

The final line of defense against a pandemic is the hospital, where more than 2 million Americans, according to a study by Trust for America's Health, might need treatment. Their points of entry in many cases will be emergency rooms that would have trouble coping with even a bad regular flu season, warns Dr. Rick Blum, president of the American College of Emergency Physicians. "We've pumped billions of dollars into preparedness since 9/11, but virtually none of that has gone to the one place where we know 80 percent of patients go first," Blum says. Many of them will probably be extremely sick, with respiratory and multiple-organ failure and in need of intensive care. They would need ventilators to help them breathe, but there are only 105,000 in the country, according to Osterholm, and three quarters of them are in use already on any given day. Leavitt fears that most localities simply haven't planned for the "surge" in medical admissions resulting from a pandemic; he compares the situation to a great hurricane, with the difference that a pandemic can strike all over the country at the same time, so Philadelphia, say, couldn't count on help from Chicago or Atlanta. "All states have pandemic plans that are insufficient," he says.

 

So Leavitt's department will work to improve their plans. There is no question that the administration is taking the threat of avian flu seriously, even though it's still hypothetical at this point; epidemiologists agree that a flu pandemic is inevitable sooner or later, although there's no way to predict if H5N1 will be the germ to cause it. White House aides say President George W. Bush himself raised the question of preparedness, after reading historian John Barry's definitive account of the 1918 pandemic, "The Great Influenza." Barry believes the country is sadly unprepared for an epidemic, a situation he blames on Congress — "they cut every [budget] request in half." If the past year has shown us anything, it's how startlingly ill-equipped modern bureaucracies can be to cope with a fast-moving natural disaster. As Barry noted, Bush read his flu book because he liked the historian's earlier work. It was an account of the great 1927 flood along the Mississippi River.

 

With Pat Wingert in Washington, Rod Nordland in London, Alexandra A. Seno in Hong Kong, Joe Cochrane in Jakarta, Karen Springen in Chicago, Claudia Kalb in New York, Mary Carmichael in Boston and Melinda Liu in Beijing

 

http://www.msnbc.msn.com/id/9787849/site/newsweek/

[shadypines]

Epidemiologist Michael Osterholm also said that we could

expect three years of hell. He suggested in a speech (which

I can't find) that we have three years worth of preps.

 

Does anyone have three years worth of preps?

 

Sad thing some people consider the bird flu to be a hoax.

[Guest Guest]

thinking out loud...

 

" But H5N1 — like the 1918 virus, which has just been reconstructed by researchers — crossed the species barrier from chickens almost intact. Almost no one on Earth has any immunity at all, and ordinary vaccines are useless against it. "

 

 

now if my grandparents survived this 1918 flu, then it would go without saying that they had some sort of immunity to it. Now if their genetics were such as to surive... then wouldn't that then be passed on to their offspring?

 

Well no matter... I guess I need to get my hole dug now incase I die. Better to be prepared then not!

[Guest Guest]

 

http://www.cbc.ca/story/science/national/2...rugs050624.html

 

Ethics of stockpiling flu drugs for doctors' relatives questioned

Last Updated Fri, 24 Jun 2005 21:33:06 EDT

CBC News

Some Canadian doctors are quietly building personal stockpiles of an antiviral flu drug for their families in case of a pandemic, but the practice may be viewed as unethical.

The antiviral drug Tamiflu, or oseltamivir, is currently considered the best way to prevent and treat bird flu.

 

Tamiflu can prevent infection if used early enough.

"In the first wave of a pandemic, there will probably not be enough vaccine available to treat everyone," said Paul Brown of Roche Pharmaceuticals in Mississauga, Ont., the company that licenses the drug in Canada. "Antivirals like Tamiflu are going to be critically important."

Physicians realize the potential value of stockpiling the drug before a pandemic hits. Doctors and other health-care workers will be among the first to receive antivirals from the federal government's stockpiles during a pandemic, but their families won't be eligible for the drugs.

CBC-TV's Maureen Taylor found 12 doctors who wouldn't openly admit it, but acknowledged writing prescriptions for Tamiflu for personal stockpiling purposes.

As a public health practitioner, Michael Osterholm of the Centre for Infectious Disease Research and Policy in Winnipeg thinks it's best to let the government decide who should get the drugs during a pandemic.

But, "as a husband, a father and a friend, do I think the idea of personally stockpiling is something you should be considering? Absolutely," Osterholm said.

 FROM AUG. 28, 2004: Resistance study doesn't deter WHO from anti-flu drug

Since pandemics usually come in two or three waves, stockpiles of Tamiflu are expected to be quickly depleted. Only one company in Switzerland makes the drug.

Infectious disease specialist Dr. Allison McGeer of Toronto's Mount Sinai said she understands why some of her colleagues are acquiring a personal stockpile of Tamiflu. Ethically, though, she said the federal government should be protecting everyone.

 

Michael Osterholm

"The best protection if we don't have vaccine is one dose of prophylactic for every Canadian for every day for two waves of the pandemic," McGeer said.

The idea of personal stockpiles of Tamiflu worries most public health officials like McGeer, and some are advising doctors against writing the prescriptions.

The reasons against stockpiling are:

 The resistance hypothesis – Widespread use of Tamiflu among patients with influenza could lead to resistant strains of flu, potentially making the drug useless.

 Shelf-life: Tamiflu is only guaranteed for five years, yet no one knows when a pandemic will hit.

 Equity: At $5 per pill, not everyone will be able to afford a personal stockpile.

The federal government's pandemic plan calls for patients to get the drugs first, followed by health-care workers. There is no way to predict how long the stockpile will last.

During a flu pandemic, the government's advice to the general population will remain the same as always: wash your hands, stay home when sick, and cover coughs to reduce the spread of the virus, said Dr. David Butler-Jones of the Public Health Agency of Canada.

 

 

 

 

[Guest Guest]

http://www.newstarget.com/z009629.html

 

NewsTarget.com printable article

 

World food supply in danger if flu pandemic strikes, say experts CTA.com has interviews with a few experts about how a flu pandemic could cause worldwide food shortages for up to three years. If you enjoy this article, you may also be interested in an article entitled 'Why the world isn't ready for the coming influenza pandemic, World Health Organization warns.'

 

 

Overview:

 

An influenza pandemic would dramatically disrupt the processing and distribution of food supplies across the world, emptying grocery store shelves and creating crippling shortages for months, an expert warned Thursday.

Dr. Michael Osterholm suggested policy makers must start intensive planning to figure out how to ensure food supplies for their populations during a time when international travel may be grounded or severely cut back, when workers are too sick to process or deliver food and when people will be too fearful of disease to gather in restaurants.

"We're pretty much screwed right now if it happens tonight," said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Osterholm said the "just-in-time" delivery model by which modern corporations operate means food distribution networks don't have warehouses brimming with months worth of inventory.

 

Most grocery store chains have only several days worth of their most popular commodities in warehouses, he explained, with perhaps 30 days worth of stock for less popular items.

He pointed to the short-term shortages that occur when winter storms threaten communities, then suggested people envisage the possibility of those shortages dragging on for somewhere between 18 months and three years as the expected successive waves of pandemic flu buffet the world.

The lingering outbreak of the H5N1 avian flu strain that has decimated poultry stocks in wide swathes of Southeast Asia has influenza experts the world over losing sleep over the possibility the highly virulent virus will mutate or evolve to the point where it can spread to and among humans, starting a pandemic.

According to the official World Health Organization tally, at least 103 people have been infected with H5N1 influenza since December 2003 in Thailand, Vietnam, Cambodia.

 

Source: http://www.ctv.ca/servlet/ArticleNews/stor..._47/?hub=Health

 

Pandemic could cause food shortages, expert warns

 

Canadian Press

 

An influenza pandemic would dramatically disrupt the processing and distribution of food supplies across the world, emptying grocery store shelves and creating crippling shortages for months, an expert warned Thursday.

 

Dr. Michael Osterholm suggested policy makers must start intensive planning to figure out how to ensure food supplies for their populations during a time when international travel may be grounded or severely cut back, when workers are too sick to process or deliver food and when people will be too fearful of disease to gather in restaurants.

 

Food and other essential goods like drugs and surgical masks will be available at best in limited supplies, Osterholm cautioned in the July/August issue of Foreign Affairs, which devoted a number of articles to the threat of pandemic influenza.

 

He saved his most flatly worded warning, however, for a news conference organized by the Council on Foreign Relations, which publishes the respected journal. In an interview from Washington following the briefing, he repeated his blunt message of how dire things would be if a pandemic starts in the short term.

 

"We're pretty much screwed right now if it happens tonight," said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

 

Osterholm said the "just-in-time" delivery model by which modern corporations operate means food distribution networks don't have warehouses brimming with months worth of inventory.

 

Most grocery store chains have only several days worth of their most popular commodities in warehouses, he explained, with perhaps 30 days worth of stock for less popular items.

 

He pointed to the short-term shortages that occur when winter storms threaten communities, then suggested people envisage the possibility of those shortages dragging on for somewhere between 18 months and three years as the expected successive waves of pandemic flu buffet the world.

 

"I think we'll have a very limited food supply," he said in the interview.

 

"As soon as you shut down both the global travel and trade . . . and (add to it) the very real potential to shut down over-land travel within a country, there are very few areas that will be hit as quickly as will be food, given the perishable nature of it."

 

Osterholm has been one of the most vocal proponents of the urgent need to prepare for a flu pandemic that could sicken at least a third of the world's population and kill many millions. However, he is not alone in fearing the world may be facing a pandemic, widely viewed as the single most disruptive and deadly infectious disease event known to humankind.

 

The lingering outbreak of the H5N1 avian flu strain that has decimated poultry stocks in wide swathes of Southeast Asia has influenza experts the world over losing sleep over the possibility the highly virulent virus will mutate or evolve to the point where it can spread to and among humans, starting a pandemic.

 

According to the official World Health Organization tally, at least 103 people have been infected with H5N1 influenza since December 2003 in Thailand, Vietnam, Cambodia. That count doesn't include a farm worker in Indonesia who was recently confirmed to have been infected with - and recovered from - H5N1.

 

It also doesn't include six new cases which came to light this week in media reports from Vietnam. While Vietnamese authorities haven't notified WHO of the cases, the agency said in a statement Thursday the reports "appear to be accurate."

 

Official and unofficial tallies put the human death toll at 54 since December 2003.

 

Laurie Garrett, a fellow at the council, noted the unprecedented potential of a pandemic to wreak economic and political havoc.

 

"Frankly no models of social response to such a pandemic have managed to factor in fully the potential effect on human productivity," Garrett, a Pulitzer-prize winning former journalist and author of The Coming Plague, said in an article in the journal.

 

"It is therefore impossible to reckon accurately the potential global economic impact."

 

Osterholm said it is incumbent on governments to start identifying essential basic commodities and figuring out supply and delivery for a time when long-distance truckers may balk at travelling to affected communities and armed forces personnel may be too sick to fill in the gaps.

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[Guest Guest]

Thanks for the articles! I'm forwarding the Canadian ones to my DH. Maybe he'll listen better to CTV and CBC than to me. If the flu hit now, we have no resources with which to survive. All I have is head knowledge, and 3 gallons of water.

~Jo

[grace]

Quote:

Does anyone have three years worth of preps?

No I don't have 3 years . Depending on what we could eat I'd say a few months tops. A lot of that would be the potatoes, carrots, squash I have stored in the cellar. But I'm working on it bit by bit as I can.
Kim

[Linda]

jo that is a begaining... just build from that.

[Guest Guest]

Great article. Anyone who's not listening when it's coming straight from the Secretary of Health and Human Services is really going to be hurting. I'm still trying to catch, as Westie or Goatherder say's "what they are not saying". I think we're in deep do do with what they are telling us.

[shadypines]

Quote:

jo that is a begaining... just build from that.

The important things is that there is still time to build.
For instance, COSTCO sells a 50 pound bag of rice for
$10.

[Guest Guest]

I hope there's still time. I have a hard time getting my head around the things I need to do, even though I know that everything I need to know is right here at MrsS. I need to dive in and make a list, then maybe get one or two things a week (that way DH won't notice!) Today, I bought extra canned tomatos.

~Jo

[shadypines]

Quote:

I hope there's still time. I have a hard time getting my head around the things I need to do, even though I know that everything I need to know is right here at MrsS. I need to dive in and make a list, then maybe get one or two things a week (that way DH won't notice!) Today, I bought extra canned tomatos.
~Jo