Osterholm warns about pandemic

[Marcie]

Re: Osterholm warns about pandemic

A hearty high-5 and hats-off-to-you, Florida1! I'm LMAO!

I said "I personally think it is possible", therefore, based on my personal judgement, 8 weeks of essentials in the home that can be used for any emergency situation, is reasonable.

You can not argue with my personal opinion. It is subjective and my evaluation of the situation.

I know that I am only a female and not capable of understanding probabilities, but I think it is a high probability that you have too much time on your hands.

[Sally Furniss]

Re: Osterholm warns about pandemic

>4) The U.S. government has recommended that all citizens
> obtain a supply of food and water for their homes,

However other countries haven't done this. Why do you think the
US-government is more credible than the governments of other
countries with similar conditions ?

gsgs "Other countries havn't done this!" How sure of this are you?

[Niko]

Re: Osterholm warns about pandemic

Somehow I feel that still no one here agrees that the most
important thing ATM is to get the experts give us their estimates.
Same in other forums.

People don't want it to be elaborated, how big the threat is.
Weird.

People in forums don't become meditative when experts and normal
people have completely different estimates than they have.
Weird.

Weird and disappointing. And unlogical. And prevalent, even among
experts.

"Expert" bolded by Niko

Words are important, IMO. gsgs seems to refer to "experts" frequently. Many of us use the term expert quite loosely. I went in search of a definition of expert. This is what I found on Wiktionary...

Expert

Noun
A person with extensive knowledge of a given subject.
"We called in several experts on the subject, but they couldn't reach an agreement."

Extensive
Adjective

in the nature of an extent, wide, widespread

Extent
Noun

Range of values or locations.
A boundary, limit, border or edge

Knowledge (uncountable)
Noun

1.Relevant information that one is able to recall from memory.
2.The product of assumption.
3.Recognition of cause and effect (which is NOT wisdom).
4.Knowledge comprises all cognitive expectances that an individual or organisation actor uses to interpret situations and to generate activities.
5.Awareness.

"He completed it entirely without my knowledge."

Based upon the above definitions, I am declaring that I am an EXPERT!!!

[Goju]

Re: Osterholm warns about pandemic

after the NYC Conference, i can confidently say that I am an expert.

[gsgs]

Re: Osterholm warns about pandemic

I'm referring to the ,well, maybe 1000-10000 top-experts worldwide.

AnneZ, I'm pretty sure for Germany and most other EU-countries.
I'd be surprised if any EU-country would recommend stockpiling food
because of the pandemic threat.
Also some people from Canada,UK,Australia,NZ here and I can't
remember that I ever heard this from them.
And I think, these are the 1st world countries
with the largest pandemic-awareness.


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

seems that I was wrong with New Zealand,
found this with google :


noniman
Administrator
Joined: Tue Oct 18th, 2005
Location: Auckland, New Zealand
Posts: 64
Posted: Tue Nov 29th, 2005 09:01 pm
Quote
Reply

The New Zealand government announced their plan a few weeks ago.
In case of an outbreak, all airports and harbours will be shut down. Being an Island, this means no one will get into the country or out. Public places like supermarkets, petrol stations and so on will be shut down as well. The government recommends stocking up on dinking water, food and candles since facilities like power plants might have to be shut down due to no workers. It was even recommended to buy a chemical toilet since even water supply might be shut down.

[Sally Furniss]

Re: Osterholm warns about pandemic

gsgs many other countries have pandemic plans.

A list of some of them can be found here.

http://www.flutrackers.com/forum/forumdisplay.php?f=5

I don't know what proportion of those pandemic plans contain recommendations to stock food and water.

[gsgs]

Re: Osterholm warns about pandemic

here in Europe, you won't hear much about pandemic plans.
And I never heard about recommendations to store food or water.
People just won't believe it, when you tell them that the
US-government recommends storing food for a possible pandemic.

The first time ever in US-history, AFAIK. (?)

[sharon sanders]

Re: Osterholm warns about pandemic

This is one citation from the National Strategy for Pandemic Influenza published November 2005. Since then there have been more recommendations from the United States government that every citizen stockpile essential items for a period of time.

"Keeping supplies of materials at home, as recommended by authorities, to support essential needs of the household for several days if necessary."


http://www.flutrackers.com/forum/showthread.php?t=674


I am 50 years old and this is the first time that I can remember the U.S. government recommending such action, nationwide, for any reason.

[sharon sanders]

Re: Osterholm warns about pandemic

bump this

[gsgs]

Re: Osterholm warns about pandemic

thread 674 seems to be non-existant.
But it did happen in 2003, you must have missed it since
it only lasted 20 days:

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

On February 7, 2003, concerns about terrorist threats associated with an Islamic holiday caused a raise of the threat level to orange. Ridge encouraged Americans to stock up on food and water, as well as plastic sheeting and duct tape for sealing doors and windows. Ridge was criticized for what some observers described as scare mongering. On February 27, the threat level indicator again returned to yellow. When Ridge hiked it to orange again on March 18, 2003, at the beginning of the war with Iraq, such specific recommendations were not included with the warning; instead it was simply noted for Americans to be vigilant for multiple attempted attacks.

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

Ridge was the chief of HHS at that time.
Later it had been argue that the terrorist danger had been overblown
to influence the 2004 presidential elections.
Anticipating that Republicans would be considered more competent
in fighting terrorism.

Now the danger is, that the same might happen with panflu.
HHS just started its panflu-blogs. The timing is almost the same,
1 year before elections national stockpiling of food and water
is being propagated.


There had been a "pandemic"- movie yesterday BTW...

Now, we can expect some H5N1-outbreak in USA before the
next elections and it will be interesting, how the press and
the politicians will react...

[Jonesie]

Re: Osterholm warns about pandemic

Quote: gsgs: I'm referring to the ,well, maybe 1000-10000 top-experts worldwide.

gsgs: I think I found that one expert that will answer all your questions on the Pandemic. And he states in one of his articles that it is a mathematical certainty that the pandemic will arrive. Plus he states you cannot prepare for an 18 month pandemic, so maybe now you have no need to prepare at all. You can't get any better than that. So I don't see any need to question those 1000-10000 top-experts of yours. Maurice seems to have all the issues regarding this pandemic down in a nutshell.

Maurice is good with numbers, just like you, and he is so kind to give out his email address on his website also, so now you can inundate him with all your queries:

Maurice A. Ramirez, DO, CNS, CMRO
The Blog of Disaster Planning, Preparation, Education, Response & Recovery by the Founding Chair of the American Board of Disaster Medicine.

Here are two of his articles:

Pandemic / Avian Flu
March 18, 2007

I Will Watch My Friends Die

The most ominous words ever uttered by a disaster preparedness expert were voiced during a deep background interview. This expert stated simply that given the current state of hospital preparedness and the current rate at which facilities are becoming disaster ready, there will be no meaningful level of preparedness in this decade unless someone blows up a hospital. This may seem a bit extreme, but declassified documents show that Al Qaeda seeks to steal an ambulance and blow it up at a major American trauma center.

Unfortunately, this scenario is based on the lesser of the threats currently facing healthcare. History over the last three centuries has taught us that novel avian pandemic flu occurs every 91 years (plus or minus 3.5 years for antigenic drift). Given that the last major pandemic was the 1917/1918 Spanish flu this means that we can expect a pandemic flu outbreak between 2006 and 2013.

It is a mathematical certainty.

Dr. Richard Garden and others have begun to discuss the impact on the healthcare workforce in accurate terms. These pundits are absolutely correct that up to 50 percent of the workforce may not report to duty. The reasons are well demonstrated in the history of pandemics.

The true impact of this disease lies in the numbers. In 1918 100 percent of the entire world was exposed to what would later be called the Spanish Flu. This new strain of avian flu had never been encountered before by a human population, and as a result, there was no immunity to this particular strain. Of that world population, one third would ultimately fall ill, in fact, 50 to 80 percent of the youngest, healthiest, and strongest would fall ill when future generations would divide out the victims.

When these ominous numbers were scrutinized further, a far more dire picture evolved. Research into the 1918 pandemic, as well as pandemics before and since 1918, have shown that the majority of illness and death occurred not in the very old or the very young, not in the sick and infirm, but in those who are in the "prime of life"; those age 18 to 40.

But there is a bigger problem.

Because of the way that novel avian viruses (pandemics) attack the lungs and cause "immune system storms", the ultimate irony of a pandemic is that the younger and stronger you are the more likely you are to die. In 1918 fully two-thirds of all those who became ill were in the age range of 18 to 40. More distressing is the fact that 98 percent of all of those who died were age 18 to 40 years. In fact, those over age 55 had no greater rate of illness or death during the pandemic of 1918 than they did in any other flu season in the years immediately before or after that great pandemic. Similarly, those less than 18 years of age suffered no increase in death rate.

The implications for America's hospitals and healthcare institutions are inescapable. Fully two-thirds of the active workforce will fall ill during the 16 to 18 months of the disease throughout the pandemic. Twenty-five percent of the young workforce (the 18 to 40 years) will die in that 18 months. Who will replace them?

Dr. Garden is also correct that correctional institutions as well as the disabled and children have not been considered in local, regional or state pandemic planning. In fact they are barely mentioned even in federal planning. In June of 2006 the Institute of Medicine published reports on the state of preparedness but pointed out that even emergency services had been left out of much planning.

It is imperative that healthcare professionals of all stripes become expert not only in pandemic planning but in the "All Hazards" approach to disaster and catastrophic event planning. Whether it is a pandemic, a hurricane, an earthquake, a forest fire, or a terrorist event that threatens the community, bitter experience has taught us that concentrations of individuals living in institutional settings whether in prisons, military barracks or university dormitories become the "cave canaries" of society.

In 1918 Spanish flu outbreaks, which actually began in Kansas, were first seen in epidemic form in U.S. military barracks. The outbreaks of measles in the 1980s were first seen in university dormitories across the United States. And the largest concentrations of the recurrence of tuberculosis, as we all know, is seen in correctional institutions.

The 2003 SARS outbreak also provided us a small scale example of the effects for a pandemic on healthcare. Following the outbreak of SARS in Canada, healthcare workers in 4 Toronto area hospitals began to fall ill. Soon nurses and doctors were looking through protective equipment at colleagues and friends. The disease had changed the normal ?us and them? relationship to ?us and me.? These professionals watched their friends die. The result of SARS on the healthcare professionals who worked in these 4 Toronto hospitals was that 50% left healthcare entirely.

What does all this mean for the healthcare industry?

During the outbreak, up to 50% healthcare workforce absenteeism
During the outbreak, up to 25% healthcare professionals death rate
Following the outbreak, 75% of healthcare professionals still alive
Following the outbreak, 50% of remaining healthcare workforce quits
The final outcome for healthcare:

25% will die
37.5% will resign
37.5% will remain

Lest healthcare embrace the lessons for preparedness this is the fate of us all.

Posted at 11:50 AM in Pandemic / Avian Flu | Permalink | Comments (0) | TrackBack (0)

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

gsgs: I think this article will ease your mind on the need to prepare:
Quote: And you cannot stock 18 months of food and water to safeguard yourself and your family during that event.
So what can you do?

Bring pressure to bear on the healthcare community to better prepare for surge capacity.....

December 17, 2006

Setting The Record Straight on Pandemic Preparedness

The November/December 2006 issue of the AARP magazine carried an interesting story on pandemic flu. The expert virologist who authored the article painted a grim picture of the future of the coming pandemic and gave one view of how to prepare.

Let's set the record straight.

Almost all of our predictive models for pandemic flu are based on 1917/1918 Spanish flu (which actually originated in Kansas); the 1957/1958 pandemic and the 1968/1969 pandemic. The 1918 Spanish flu is known in virology circles as H1:N1. Genetic reconstruction has allowed us to isolate this virus from pathologic specimens collected in 1917 and 1918 and stored by the U.S. military and other organizations. This means that we can now study the actual virus H1:N1 aka the Spanish flu and compare it to the current pandemic risk H5:N1 aka Avian flu. What makes avian flu more likely to be a pandemic?

As we all know now from the media, influenza virus mutates over time. Small mutations are known as antigenic drift while large mutations are known and antigenic shift. These drifts and shifts slowly change the virus from something that the human immune system can recognize and therefore protect against to something that is novel or new to the human population ? a pandemic. In short it is something that the human immune system has never seen before.

In 1918 the H1:N1 strain was seen. Like all of pandemics before, it struck with a predictable infection rate (attack rate); approximately 1 in 3. Of these 1 in 3 on average in the population half would become seriously ill. Half of those would develop severe lung disease and half of those with the severe lung disease would ultimately die.

The picture changes significantly, however when you look at the infection by age group. H1:N1 caused virtually no more deaths in those over age 65 than the average flu. In fact in 1918 you were no more likely to die of the pandemic if you were over age 65 than you had been in 1915 or than you would be in 1920.

So what does that mean for the coming Avian flu (H5:N1)? Pandemics are very consistent. They act virtually the same every time they occur as long as they are a novel avian virus. H5:N1 has not been different to date. It is expected to cause no greater number of deaths in those greater than age 65 than the flu did last year in 2005 or the year before in 2004.

Yes, there will be an increase in the number of people who become ill across the age spectrum from birth to those over 100.

Yes, there will be a total increase in the number of people who die. Unfortunately the vast majority of those will be between the ages and 15 and 40. This was the age group that showed the greatest increase in death rate in 1918, in 1958 and 1969.

AARP magazine is to be tremendously complimented in their January/February edition they published an exquisite interview with Anthony Fause, a noted expert in infectious disease and pandemic preparedness. That interview asked insightful questions and gave good, logical answers. Unfortunately the same cannot be said of the recommendations made in the November/December edition.

The article in the November/December edition recommended stockpiling food and other supplies in anticipation of infrastructure collapse and supply chain failure. This advice ignores the lessons learned from history. In 1918, as with all other pandemics, 100 percent of the population was exposed despite social isolation efforts. In 1918, one third of the working population was out of work and yet food was still delivered. Farms still produced. Society did not collapse. There is no reason for panic.

Stockpiling medication is also a formula for disaster and disappointment. The current strain of H5:N1 is already showing resistance to Tamaflu, requiring far higher than usual and longer than usual doses to be effective. Tamaflu's shelf life is also far shorter than the window of likely infection from the pandemic (as late as 2012). This means that you may purchase Tamaflu and have it expire before the disease attacks.

Finally, previous pandemics have come in multiple waves over an 18 month period. In most cases the disease appears first as a low level infection in the population, followed by a large flood of influenza and then an aftershock of disease. You simply cannot stock enough Tamaflu for all three events. You cannot prevent yourself from being exposed during those three events. And you cannot stock 18 months of food and water to safeguard yourself and your family during that event.

So what can you do?

Bring pressure to bear on the healthcare community to better prepare for surge capacity.

There are fewer than 1,000,000 hospital beds in the United States and in an average cold and flu season fewer than 40,000 hospital beds are empty. The federal government recommends between 150,000 and 190,000 available hospital beds even during the peak of an average cold and flu season. The United States is woefully short of hopsital beds and it falls to private hospital corporations to provide that surge capacity.

The New England Journal of Medicine in 2004 an article by Dr. Michael Osterholm they found there are 105,000 ventilators in the United States. Eighteen percent of those are either broken, in repair or in cleaning at any given moment. Sixty-seven of those are in chronic use for ventilator dependent patients outside of the hospital. This leaves 16,000 ventilators available nationwide.

If we break down the expected number of illnesses just in those over age 65, those 16,000 ventilators will all be in use. What happens to those between age 15 and 40, the children and grandchildren of those who read the AARP magazine?

The healthcare community must step up to the plate rather than pedaling panic in the pages of the AARP magazine. The juxtaposition of the Avian flu article in the November/December issue and the far more insightful and useful interview in the January/February issue show the division within the house of medicine. The AARP magazine has the largest circulation and readership in the English-speaking world. Which side of that division will its members come down upon - Panic or preparedness?

It was once said of the generation that now reads the AARP magazine that they are the "Great Generation".

The Great Generation earned this title because of their self-sacrifice during World War II. They guided a great nation through an industrial revolution and a technological revolution that became an economic revolution that swept the planet. Many have tried to discount the Great Generation because they are now the "Geriatric Generation." I believe the Great Generation will lead us again not into panic but into a new era of preparedness.

http://www.disaster-blog.com/pandemic_avian_flu/index.html

I'm sure Maurice truly believes in his approach, but I think I will still go out and buy more beans and rice today.

"Worries go down better with soup than without."
- Jewish Proverb -

[gsgs]

Re: Osterholm warns about pandemic

doesn't look like he is one of these 1000-10000 top experts ?!
no expertise in virology AFAICT. No publication at pubmed.

> History over the last three centuries has taught us that novel
> avian pandemic flu occurs every 91 years (plus or minus 3.5 years
> for antigenic drift). Given that the last major pandemic was the
> 1917/1918 Spanish flu this means that we can expect a pandemic
> flu outbreak between 2006 and 2013.
>
>It is a mathematical certainty.


this is silly.

[Anne]

Re: Osterholm warns about pandemic

doesn't looke like is an expert, nor a virologist, nor...

[Jonesie]

Re: Osterholm warns about pandemic

doesn't look like he is one of these 1000-10000 top experts ?!
no expertise in virology AFAICT. No publication at pubmed.


this is silly.

Now, don't give up just yet. He just might be on the verge of being a top-expert with a lot of expertise in virology. All that doesn't come overnight, you know. And getting something published on pubmed in the future could be highly likely..
Time will tell.
But while you are waiting ... in the meantime, I suppose you will just have to be patient, take a little time off, and sift through all the 10,000 top-experts who do have something published on pubmed.
Good luck!

The microbe is so very small
You cannot make him out at all.
But many sanguine people hope
To see him down a microscope.
His jointed tongue that lies beneath
A hundred curious rows of teeth;
His seven tufted tail with lots
Of lovely pink and purple spots
On each of which a pattern stands,
Composed of forty seperate bands;
His eyebrows of a tender green;
All these have never yet been seen -
But Scientists, who ought to know,
Assure us they must be so ...
Oh! let us never, never doubt
What nobody is sure about!

-- Hilaire Belloc -- (1897) --

[gsgs]

Re: Osterholm warns about pandemic

pingback from

http://everything2.com/title/Alexander%2527s+question

==========================================

google hits about "Alexander's Question"

http://online.wsj.com/article/SB124199708570604829.html#

http://iom.edu/~/media/Files/Activity%20Files/PublicHealth/ImmunizationSafety/StotoPrecautionaryprinciple.pdf

http://www.docstoc.com/docs/9632393/Fineberg-Swine-Flu

http://research.unl.edu/events/docs/Intelligence%20Analysis%20Behavioral%20and%20Social%20Scientific%20Foundations%20NRC%202011.pdf