crossposted at The Next Hurrah
Avian flu (aka bird flu and H5N1) is in the news again. There are sobering reports that bird flu has now spread to poultry in Russia and more parts of Indonesia, where 3 members of a family are confirmed to have died raising the possibility of human to human (H2H ) transmission. For a good FAQ on this topic if you are new to it, go here or try Flu Wiki. we are not in the midst of a pandemic, but the possiblility exists that we could be some time in the next few years. Even if it does not happen, pre-planning is an absolute must.
On the other hand, the CDC is finally finishing its pandemic preparedness plan. Can you spell rationing?
The plan lays out just who will get the vaccine, in descending order of priority:
- Group 1. The highest-priority group includes 9 million healthcare workers involved in direct patient care; 40,000 people who are making the vaccine and antiflu medicines; and some 37 million people who are at greatest risk if they get the flu, namely those over age 64 with a medical illness, younger people with two serious underlying medical conditions, pregnant women, and all household contacts of children under 6 months of age. Also in this top group are key government officials and specialized pandemic flu responders.
- Group 2. In the next tier are healthy seniors; younger people with one risky health condition; young children between 6 to 23 months old (the vaccine is not recommended for infants under 6 months); and workers in critical fields like public safety, utilities, emergency response, transportation, and telecommunication. This group is 68 million strong.
- Group 3. The third priority is 500,000 people, including key government healthcare decision makers and those working in mortuary services.
- Group 4. At the bottom are the remaining 179 million healthy people, 2 to 64 years old, not included in any other category.
Rationing is going to be part of the mix of how we respond, and will be subject to change as more data becomes available. It almost has to be as there’s not enough antiflu medicine to go around, and a proper vaccine will likely take 6 months or more to show up in any quantity. Quarantine and shutting down certain services such as schools, entertainment, etc might in certain circumstances be necessary as well.
Given that that’s the case, best to discuss it beforehand, early rather than late. There’s enough mistrust of this government without a natural disaster making things even worse then they already are. We need our public health officials out in front explaining things as they go along. We need to get used to who they are and what their role is. And they need to be trained in how to communicate risk to the population honestly and fairly. It’s the only way we’ll ever begin to be prepared.
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~ Posted in earlier diary ~
Being watched closely for years by CDC, European experts and World Organizations.
The human to human form can launch a world epidemic similar to the Spanish flu of 1918 … or worse.
Three people have died of suspected avian influenza in Indonesia, health authorities said yesterday.
If confirmed, they would be the first human fatalities in the country from the H5N1 bird flu virus, which experts fear could cause millions of deaths worldwide if it mutates into a form that can be easily transmitted between people.
The victims, a 38-year-old man from a suburb of Jakarta and his two daughters aged nine and one, died within 10 days of each other.
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This doesn’t surprise me, with all the unsanitary conditions that I see in the pictures.
Think of how much less of a risk we would be running of this if all the aid currently going towards the war were to be spent on economic development abroad.
I wonder if Bush will use this pandemic as an excuse to curtail civil liberties even more.
For those who may be wondering why health care workers, government officials, emergency personnel, morticians, etc. are in groups 1-3 and “the rest of us” are in group 4, the answer is not “because they can” although some might think that. These folks are going to be the ones trying to prevent not only infection but also mass hysteria and bedlam from breaking out, and you can hardly expect them to put themselves on the front lines without proper defense. In fact, it is not uncommon for the immediate families of these personnel to also be offered early vaccinations, so that (1) the family member on the front line can concentrate on protecting the public and not worry about their family, which would distract from their duties mightily and (2) as an incentive to keep these essential personnel from heading for the hills – literally – when the outbreak hits. They’re the ones who are going to know first when things are heading south, and again, if they are torn between protecting their families and the wider community, it is anticipated that a “significant number” (just what that means I’ll leave to each person’s sense of the good in their neighbors) would opt to put their families first. Human nature hasn’t changed since the middle ages, folks, and a mass exodus from the cities was a common occurrence when the plague was headed their way. Little known but true fact: Newton was out in the countryside sitting under the legendary apple tree because he had left London due to an epidemic.
I’ve seen some preparation planning scenarios for either a bioterrorist event or a natural pandemic, and mass quarantine of cities or states (a “cordon sanitaire” in public health parlance) with armed officers blocking the highways is not at all out of the question. Not to scare anybody, but this is the real world. We’ve been living with a false sense of security since the 1918 pandemic… 🙁
Full disclosure: My great-grandfather died in the 1918 flu pandemic, shortly after emigrating to Philadelphia from Italy.