The National Pandemic Preparedness Blog Summit of the United States

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

I agree with Secretary Levitt. We must prepare for all disasters. Epidemics and pandemics are only part of the mosaic of infectious diseases and other disasters that are now upon us. According to Dr. Greger, director of Public Health for the Humane Society of the <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comffice:smarttags" /><st1:country-region><st1lace>United States</st1lace></st1:country-region>, we are now in a period of ?emerging diseases?. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-comfficeffice" /><o></o>
<o> </o>
Many diseases present a threat to humanity, not pandemic influenza alone. We need a multi-facted approach that considers this mosaic of emerging disease. On FluTrackers we investigate many different disease threats in our Emerging Disease forum.<o></o>
<o> </o>
Just for the month of May FluTrackers received over 30,000 unique visits from 134 different countries. Most of the members are public health officers, researchers, and experts who share data and updates. This validates the interest and importance of planning and preparing for emerging diseases and all kinds of disasters.<o></o>
<o> </o>
As President of FluTrackers I am in regular contact internationally with many public health entities and it is my concern that we provide security for those who serve. It is imperative to assist those individuals and institutions who support and maintain society?s safety net. Individual and family imperatives, psychological support, financial considerations, physical safety, and legal ramifications must be implemented for each person and institution who serves during an emergency situation.<o></o>
<o> </o>
The requirements of a civil society demand that we protect those who protect us: Nurses, Doctors, Police, Firepersons, EMTs, Military, Public Health Care Workers, and all others who sacrifice must have the tools and support necessary to be efficient and safe. <o></o>
<o> </o>
"Where your talents and the needs of the world cross, lies your calling." <o></o>
Aristotle

?In a gentle way, you can shake the world.?
Mohandas Ghandi<o></o>
<o> </o>

<o> http://blog.pandemicflu.gov/?p=33#comments</o>
<o> </o>

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Stockpiling: No Single Approach

In reviewing the blog postings I note there are many questions about personal and family stockpiles. These questions include: Should I stockpile food, water, medications? How long should a stockpile be designed to last? What are the Government’s recommendations for personal and family stockpiles?

There can be no single approach to family and personal stockpiling that is perfect for everyone.
Each family and individual must analyze their unique situation and needs and design a stockpile that works for them.

Below I offer some simple advice that should help strengthen your family and individual pandemic preparedness plan with regards to stockpiling, but before I begin let me lay out some important overarching preparedness principles not specific to a pandemic:

1. Preparedness should not be aimed exclusively at one hazard or the other.

A stockpile should be able to support its owner through a pandemic, a hurricane, a blizzard, an earthquake….or any other circumstance that might require the owner to be self sufficient for a period of time until outside support can be reestablished. A good preparedness plan is one designed to be useful in all sorts of emergencies.

2. For a family or individual to be prepared, they must have planned and practiced the ability to be self sufficient for the period of time it might take to get outside assistance in an emergency.

3. One should be aware that the resources of a stockpile may need to be used at home, in a shelter or on the road during an evacuation.

4. Given that the main purpose of a stockpile is really to allow the owner the time needed to reconnect to support from the outside world, it does not need to be aimed at assuring self sufficiency for prolonged periods of time.

Even in the most extreme emergency circumstances the need for prolonged periods of self-sufficiency is very unlikely. This is because in most emergencies, help is likely to arrive within days not weeks even if delayed. In rare situations where help cannot be expected immediately, evacuation to more supportive settings or the identification of alternative sources of support locally can usually be achieved within days of an emergency event.

Pandemics offer a unique challenge because they ultimately affect every community. Additionally, at the height of a severe pandemic there may well be nationwide disruptions in the production and distribution of certain services and goods.

Fortunately, unlike an earthquake that strikes suddenly or a blizzard that whips up over the course of 48 hours, in a pandemic there will likely be some advanced warning. Even in the most severe pandemics we can expect at least a month or two between the identification of initial pandemic cases (and warning of the public) before the numbers of cases begin to result in disruptions to services and supplies.

In mild pandemics there may well be no disruptions. It is also important to note that even where there are disruptions in services and supplies, they are likely to be temporary and sporadic. They will not occur in every community simultaneously, nor will they affect all goods or services at the same time or to the same extent.

Home quarantines for those exposed and home isolation for the sick are situations in which a person might need to avoid any contact with the outside world requiring a period of self sufficiency.

Rarely will these periods extend beyond 10 to 14 days. After that period of time most people will be non-infectious because they have either recovered fully or have been shown not to have been infected by an exposure.

Every family should conduct an inventory of their needs and dependencies. The stockpile for a family with a bottle fed infant will be very different from the stockpile needed to support an elderly couple with chronic illness.

It is important to list those services, goods and medications for which your family is particularly reliant on outside sources.

Home oxygen supplies, medications and special diets might all experience disruptions in availability during a severe pandemic. Stockpiles can be accumulated in small increments over time. As the stockpiles ages the oldest items in the home stockpile can be used and replaced with newer items before they expire.

The American Public Health Association advises that every family should have at least a three day home stockpile of food water and medication. This basic stockpile would likely be able to support a family through the most commonly seen emergencies.

The US Department of Health and Human Services has advised that during a pandemic, families might need as much as two weeks worth of supplies in their stockpile.

This size stockpile would be sufficient to support a family through a home quarantine and through the peak of an outbreak in their community during which sporadic temporary disruptions in availability of some products and services may occur.

It is important to note that the size of any given home stockpile might need to be larger for families that live in more rural areas served by relatively fewer sources of those essential needs identified for a family’s stockpile.

For example: A family with only one source of prescription medication within a 100 mile radius should probably maintain on hand a longer supply of that medication than an individual with four different sources within one mile of their home.

For individuals living abroad, stockpiles designed to last months may be necessary.

Depending on where exactly around the world you live, disruptions in availability of supplies might be more severe than in the US due to inherent weaknesses in distribution systems and relatively poor preparedness systems. Access to outside support and aide might be more delayed than it will be for individuals living in the US and the ability to return home may be temporarily disrupted as a result of a pandemic or other emergency.

Posted June 6, 2007 at 3:48 pm in [URL="http://blog.pandemicflu.gov/?cat=5"]Week 3: Getting the Job Done

Emphasis are from me Snowy[/URL]

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

SusanC Says: Mr Secretary,
I have applauded your efforts in initiating this blog, and I continue to think that it is an improvement from when there was no direct communication between the government and the public. Over the last few days, particularly over the last 24 hours, I have sadly come to the conclusion that I can no longer participate in this process in its current form.

Just over a year ago, it was my honor to be invited to join the team of visionaries who started the Flu Wiki. Since the beginning of its conception, we’ve had 2.7 million unique visits and 13 million page views in all our servers combined. I’ve met a large number of talented, innovative, concerned, and dedicated people from around the world, but particularly ordinary American citizens, who have participated tirelessly in this effort and contributed to the vast resource now available to anyone who has internet access. It is not perfect; I am absolutely certain there are many mistakes to be rectified and improvements to be made. But many, including officials from national and international bodies, have told us how much they have benefited from the contributions of this wonderful group of selfless and dedicated individuals.

In the course of the last 18 months, I have also participated in numerous scientific and policy forums in different countries all over the world. I have personally invested an enormous amount of time and energy and expense to keep myself informed in as many ways as possible and to the deepest level of complexity that my intellect and resources allow, about all the ramifications of influenza science and pandemic mitigation policy. I have a good track record of advocating moderation and working with official institutions. I have defended, sometimes at great personal cost, the actions of governments and public bodies such as the WHO. I do that because I understand that it is easy to point fingers when you are not in the hot seat. I make allowances as best I can for policymakers who have many complex constraints of which we can have no more than the occasional glimpse.

I believed, and I still believe, that, compared to other countries, the US government is open, proactive, and embodies excellence and leadership in many aspects of science and policymaking in the context of pandemic planning. I am forever grateful to those who did not think my being a foreign national or not holding any official affiliations was a barrier to participation and contribution in this universal humanitarian endeavor of trying to save as many lives as we possibly can in the next pandemic.

In October of 2006, I had the honor of being invited to make a presentation at your National Academies on the subject of Citizen Engagement in Emergency Planning for a Flu Pandemic. The title that I chose for my presentation was “Who Will Tell the People?”, because I saw a huge gap between the knowledge that is available and the ignorance of the public.

In the Paris Anti-Avian Influenza 2007 Conference last week, Professor Albert Osterhaus of Erasmus University in the Netherlands and a member of the WHO Pandemic Task Force, spoke movingly from the podium of the need to make sure what knowledge there is is disseminated and used to save lives. He spoke of the tragedy of the Indian Ocean tsunami, when the technology was in place and the information was available which, if there had been a mechanism and the political will to disseminate it in time, would have saved untold numbers of lives.

In my National Academies talk, one of the slides I made, and which I posted recently on our forum, points out the importance of true two-way communication, where both sides give and receive information on an equal basis. I respect that communications between officials and the public can never be truly equal to the extent that there are severe constraints as to what officials can speak about in public. I do believe, however, that one can speak as equals in spirit without divulging information inappropriately. I know it is possible because I have personally done that with officials from different agencies and from different countries in a variety of contexts.
That is not what is happening on this blog.

Mr Secretary, with all respect, I believe your experiment is in danger of descending into a farce, if it hasn’t done so already. I am sure you initiated this with the best of intentions. Many, including myself, have been participating with all the goodwill we can muster. We have received nothing in return that tells us the government is truly listening and carrying out a respectful dialogue with the public.

I am, therefore, signifying my objection to the spirit with which this has been conducted by refraining from posting here. This decision is entirely my own, and does not reflect on any other contributor directly or indirectly connected with Flu Wiki. My comments will, as always, be posted at the Flu Wiki forum, at which you and your colleagues at the HHS, are heartily welcome, along with every member of the public. We have no hierarchy there; we respect neither rank nor name nor credentials, only open and sincere discourse backed by credible and verifiable sources of information.

Finally, I apologize most sincerely to other contributors of this blog. There have been many great contributions for which I wish to make a belated effort at expressing my appreciation. I will continue to read and learn from all of you. I have no doubt that much will be achieved by this endeavor.
I continue to support and applaud everyone who wishes to make this country and the world more informed and more prepared, including the many tireless colleagues at the HHS, and I wish you every success in your work.

Yours sincerely,

Susan Chu MD
Editor
Flu Wiki

Posted June 7th, 2007 at 9:26 am
http://blog.pandemicflu.gov/?p=33#comments

 

[JohnW]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Dr. Chu makes reference to the recent conference in Paris and a presentation by Dr. Osterhaus. (14:20 - Haemagglutinin mutations and binding of H5N1 to human-types receptors: one more step to the pandemic?
Pr Albert Osterhaus, National Influenza Centre and Department of Virology Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands) Is this presentation available for review.

 

[Theresa42]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Dr. Chu makes reference to the recent conference in Paris and a presentation by Dr. Osterhaus. (14:20 - Haemagglutinin mutations and binding of H5N1 to human-types receptors: one more step to the pandemic?
Pr Albert Osterhaus, National Influenza Centre and Department of Virology Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands) Is this presentation available for review.

Not that I have seen, unfortunately.

Here's the website for the conference:
http://www.isanh.com/avian-influenza/index.php

And, here is a list of the presentations:
http://www.isanh.com/avian-influenza/abstracts.php

It does say somewhere on the site that a book of the abstracts is (was) to be published. I don't know if that has happened already and/or what the availability of that book is/will be.

 

[Gert van der Hoek]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Dr. Chu makes reference to the recent conference in Paris and a presentation by Dr. Osterhaus. (14:20 - Haemagglutinin mutations and binding of H5N1 to human-types receptors: one more step to the pandemic?
Pr Albert Osterhaus, National Influenza Centre and Department of Virology Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands) Is this presentation available for review.

I send an email to his office.

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Thanks Dutchy.

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Osterhous links:

"Albert Osterhaus, of Erasmus University in Rotterdam in the Netherlands, also warned that as well as passing H5N1 to other species, cats may help the virus to adapt into a more highly infectious strain in humans which could spark a pandemic.

"We have to take a number of precautionary measures," said Osterhaus, a virologist and veterinarian.

"We need to keep in mind that mammals can be infected and that they can spread the disease, in principle."

http://www.flutrackers.com/forum/showthread.php?t=3757



"With our current limited knowledge on highly pathogenic avian influenza in wild birds, there is no solid basis for including wild birds in control strategies beyond the physical separation of poultry from wild birds," Ron Fouchier and Albert Osterhaus of Erasmus Medical Center in Rotterdam and a team of colleagues wrote in a report published in the journal Science.


http://www.flutrackers.com/forum/showthread.php?t=4575



Albert Osterhaus of the Erasmus medical centre in Rotterdam, The Netherlands, said: "We think the most likely explanation is that it came by migratory birds, but we can't exclude the other possibilities."

http://www.flutrackers.com/forum/showthread.php?t=7780


also:

Influenza Virus Type A Serosurvey in Cats

Recent reports of cats positive for H5N1 type A influenza virus (1) raised the hypothesis that cats might have an epidemiologic role in this disease. Experimental findings seem to support this hypothesis. Experimentally infected cats might act as aberrant hosts (as do humans and other mammals), with symptoms and lesions developing and the virus subsequently spreading to other cats (2,3). The experimental conditions under which this occurs, however, can rarely be observed for domestic or wild cats. No spontaneous cases of transmission from cat to cat or cat to mammal have been reported, and scientifically validated reports about spontaneous disease in cats are rare (4–6). Reports about cats with circulating influenza virus antibodies are even more rare and occur in unusual epidemiologic situations (7). The true susceptibility of cats to type A influenza viruses in field conditions thus remains to be elucidated.

http://www.flutrackers.com/forum/showthread.php?t=19707

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Nature 444, 378-382 (16 November 2006) | <abbr title="Digital Object Identifier" minmax_bound="true">doi</abbr>:10.1038/nature05264; Received 20 August 2006; Accepted 21 September 2006
Haemagglutinin mutations responsible for the binding of H5N1 influenza A viruses to human-type receptors

Shinya Yamada<sup minmax_bound="true">1,</sup><sup minmax_bound="true">3</sup>, Yasuo Suzuki<sup minmax_bound="true">3,</sup><sup minmax_bound="true">4</sup>, Takashi Suzuki<sup minmax_bound="true">3,</sup><sup minmax_bound="true">5</sup>, Mai Q. Le<sup minmax_bound="true">6</sup>, Chairul A. Nidom<sup minmax_bound="true">7</sup>, Yuko Sakai-Tagawa<sup minmax_bound="true">1,</sup><sup minmax_bound="true">3</sup>, Yukiko Muramoto<sup minmax_bound="true">1,</sup><sup minmax_bound="true">3</sup>, Mutsumi Ito<sup minmax_bound="true">1,</sup><sup minmax_bound="true">3</sup>, Maki Kiso<sup minmax_bound="true">1,</sup><sup minmax_bound="true">3</sup>, Taisuke Horimoto<sup minmax_bound="true">1,</sup><sup minmax_bound="true">3</sup>, Kyoko Shinya<sup minmax_bound="true">8</sup>, Toshihiko Sawada<sup minmax_bound="true">9</sup>, Makoto Kiso<sup minmax_bound="true">9</sup>, Taiichi Usui<sup minmax_bound="true">10</sup>, Takeomi Murata<sup minmax_bound="true">10</sup>, Yipu Lin<sup minmax_bound="true">11</sup>, Alan Hay<sup minmax_bound="true">11</sup>, Lesley F. Haire<sup minmax_bound="true">11</sup>, David J. Stevens<sup minmax_bound="true">11</sup>, Rupert J. Russell<sup minmax_bound="true">11,</sup><sup minmax_bound="true">13</sup>, Steven J. Gamblin<sup minmax_bound="true">11</sup>, John J. Skehel<sup minmax_bound="true">11</sup> and Yoshihiro Kawaoka<sup minmax_bound="true">1,</sup><sup minmax_bound="true">2,</sup><sup minmax_bound="true">3,</sup><sup minmax_bound="true">12</sup>
Top of page Abstract

H5N1 influenza A viruses have spread to numerous countries in Asia, Europe and Africa, infecting not only large numbers of poultry, but also an increasing number of humans, often with lethal effects<sup minmax_bound="true">1, </sup><sup minmax_bound="true">2</sup>. Human and avian influenza A viruses differ in their recognition of host cell receptors: the former preferentially recognize receptors with saccharides terminating in sialic acid-

2,6-galactose (SA

2,6Gal), whereas the latter prefer those ending in SA

2,3Gal (refs 3–6). A conversion from SA

2,3Gal to SA

2,6Gal recognition is thought to be one of the changes that must occur before avian influenza viruses can replicate efficiently in humans and acquire the potential to cause a pandemic. By identifying mutations in the receptor-binding haemagglutinin (HA) molecule that would enable avian H5N1 viruses to recognize human-type host cell receptors, it may be possible to predict (and thus to increase preparedness for) the emergence of pandemic viruses. Here we show that some H5N1 viruses isolated from humans can bind to both human and avian receptors, in contrast to those isolated from chickens and ducks, which recognize the avian receptors exclusively. Mutations at positions 182 and 192 independently convert the HAs of H5N1 viruses known to recognize the avian receptor to ones that recognize the human receptor. Analysis of the crystal structure of the HA from an H5N1 virus used in our genetic experiments shows that the locations of these amino acids in the HA molecule are compatible with an effect on receptor binding. The amino acid changes that we identify might serve as molecular markers for assessing the pandemic potential of H5N1 field isolates.....

Continued here:

http://www.flutrackers.com/forum/showthread.php?t=12923

 

[sharon sanders]

Sad Tide

Sad Tide

I am saddened to see that several other "flubies" are now following the lead of Susan Chu (SusanC) M.D., Editor of Flu Wiki, and are abandoning the HHS blog project.

While it is certainly not a perfect internet forum, which amongst is?

Isn't it our collective effort throughout the "bird flu" forums and blogs to help lessen morbidity and mortality in a pandemic?

Isn't it worth our time and effort to help any institution that would like to join this internet experiment in mass public health delivery?

What if only one family logs onto that forum, and for the first time, sees the issues from our experienced points of view? This one family is worth educating. They will spread the information exponentially.

It is very interesting to view the different forums and blogs. Each has its own personality. This is a very rich and fertile plain upon which a platform of pandemic issues are expressed.

The HHS blog increases the awareness of the issues. We need to teach by our example, our patience, and by our nobleness.

What if this experiment by the HHS results in a better blog effort next time? Maybe one for TB? AIDS? SIDS?

Do we not want to change our government to be more responsive, more approachable, and more compassionate?

Let us show them the way to effective participatory mass communication. They do not know how.

We do.

:yinyang:

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

This post has generated some controversy. I would like to see the constructive comments that can be generated here.

Posted by
Admiral John O. Agwunobi
MD, MBA, MPH; Assistant Secretary for Health, U.S. Department of Health and Human Services



Stockpiling: No Single Approach

In reviewing the blog postings I note there are many questions about personal and family stockpiles. These questions include: Should I stockpile food, water, medications? How long should a stockpile be designed to last? What are the Government’s recommendations for personal and family stockpiles?
There can be no single approach to family and personal stockpiling that is perfect for everyone. Each family and individual must analyze their unique situation and needs and design a stockpile that works for them.

Below I offer some simple advice that should help strengthen your family and individual pandemic preparedness plan with regards to stockpiling, but before I begin let me lay out some important overarching preparedness principles not specific to a pandemic:

1. Preparedness should not be aimed exclusively at one hazard or the other. A stockpile should be able to support its owner through a pandemic, a hurricane, a blizzard, an earthquake….or any other circumstance that might require the owner to be self sufficient for a period of time until outside support can be reestablished. A good preparedness plan is one designed to be useful in all sorts of emergencies.
2. For a family or individual to be prepared, they must have planned and practiced the ability to be self sufficient for the period of time it might take to get outside assistance in an emergency.
3. One should be aware that the resources of a stockpile may need to be used at home, in a shelter or on the road during an evacuation.
4. Given that the main purpose of a stockpile is really to allow the owner the time needed to reconnect to support from the outside world, it does not need to be aimed at assuring self sufficiency for prolonged periods of time. Even in the most extreme emergency circumstances the need for prolonged periods of self-sufficiency is very unlikely. This is because in most emergencies, help is likely to arrive within days not weeks even if delayed. In rare situations where help cannot be expected immediately, evacuation to more supportive settings or the identification of alternative sources of support locally can usually be achieved within days of an emergency event.
Pandemics offer a unique challenge because they ultimately affect every community. Additionally, at the height of a severe pandemic there may well be nationwide disruptions in the production and distribution of certain services and goods.
Fortunately, unlike an earthquake that strikes suddenly or a blizzard that whips up over the course of 48 hours, in a pandemic there will likely be some advanced warning. Even in the most severe pandemics we can expect at least a month or two between the identification of initial pandemic cases (and warning of the public) before the numbers of cases begin to result in disruptions to services and supplies. In mild pandemics there may well be no disruptions. It is also important to note that even where there are disruptions in services and supplies, they are likely to be temporary and sporadic. They will not occur in every community simultaneously, nor will they affect all goods or services at the same time or to the same extent.

Home quarantines for those exposed and home isolation for the sick are situations in which a person might need to avoid any contact with the outside world requiring a period of self sufficiency. Rarely will these periods extend beyond 10 to 14 days. After that period of time most people will be non-infectious because they have either recovered fully or have been shown not to have been infected by an exposure.

Every family should conduct an inventory of their needs and dependencies. The stockpile for a family with a bottle fed infant will be very different from the stockpile needed to support an elderly couple with chronic illness. It is important to list those services, goods and medications for which your family is particularly reliant on outside sources. Home oxygen supplies, medications and special diets might all experience disruptions in availability during a severe pandemic. Stockpiles can be accumulated in small increments over time.

As the stockpiles ages the oldest items in the home stockpile can be used and replaced with newer items before they expire.

The American Public Health Association advises that every family should have at least a three day home stockpile of food water and medication. This basic stockpile would likely be able to support a family through the most commonly seen emergencies. The US Department of Health and Human Services has advised that during a pandemic, families might need as much as two weeks worth of supplies in their stockpile. This size stockpile would be sufficient to support a family through a home quarantine and through the peak of an outbreak in their community during which sporadic temporary disruptions in availability of some products and services may occur.

It is important to note that the size of any given home stockpile might need to be larger for families that live in more rural areas served by relatively fewer sources of those essential needs identified for a family’s stockpile. For example: A family with only one source of prescription medication within a 100 mile radius should probably maintain on hand a longer supply of that medication than an individual with four different sources within one mile of their home.

For individuals living abroad, stockpiles designed to last months may be necessary. Depending on where exactly around the world you live, disruptions in availability of supplies might be more severe than in the US due to inherent weaknesses in distribution systems and relatively poor preparedness systems. Access to outside support and aide might be more delayed than it will be for individuals living in the US and the ability to return home may be temporarily disrupted as a result of a pandemic or other emergency.



http://blog.pandemicflu.gov/?p=37

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Posted by Fla Medic-

1. <cite>Michael Coston</cite> Says: Admiral, obviously your comments have caused a bit of a stir. How are we, the public, to decide which government `voice? to listen to on the subject of stockpiling food, water, and medicine? There have been many conflicting pieces of advice offered.
   I call your attention to the following from last year.
   U.S. Department of State
   Bureau of International Information Programs
   Washington, D.C.
   March 9, 2006
   PUBLIC HEALTH AND HEALTH CARE DELIVERY: PLANNING FOR A PANDEMIC
   ?Families should stock cupboards with enough nonperishable and prepackaged food products to last four weeks to five weeks. Supplies should include bottled water, canned meats, fruits, vegetables, soups, protein or fruit bars, dry cereal, granola and fruit bars, crackers, peanut butter or nuts, canned juices, canned or jarred baby food and formula, and pet food.?
   tinyurl.com/l5omx
   On June 1st,2006 the AP carried this report.
   Little Rock (AP) - Arkansas public health officials say it?s a good idea to stockpile two months of food, water and medicines in case of an outbreak of pandemic flu or any other emergency that could lead to shortages.
   And on the same date, this appeared in Vermont.
   ?State and local police, emergency medical services, firefighters, selectmen, trustees, state officials, and health care and hospital officials gathered for the first time in one room to learn what they needed to know in the event of a pandemic. . . . ?We need to prepare and have some goods in our homes ? be prepared for six or 12 weeks.?
   These are just a few examples. In my own state, one county advised 40 days worth of supplies. I wouldn?t want you to think that those who have commented thus far on the 2-week debate are alone in their views.
   The truth is, we?ve heard everything from 3 days to 12 weeks from `official? sources. As you can understand, this makes a 2-week recommendation difficult to reconcile.
   <small class="commentmetadata">Posted June 7th, 2007 at 8:30 am</small>

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Posted by
Admiral John O. Agwunobi
MD, MBA, MPH; Assistant Secretary for Health, U.S. Department of Health and Human Services



Taking those First Few Steps

The thoughts I posted Wednesday on stockpiling mark my first entry into the world of blogging, and, I must say, I had no idea that it would spark such a strong response.
I have been working through all of your comments, and if you can bear with me as I learn more about blogging, I promise you that I will try to address the questions that have been raised.
To begin, I would like to return to the issue of stockpiling, as one component of pandemic preparedness. I believe that every family should have some sort of stockpile in order to be as self-sufficient as possible during emergencies, including a pandemic. Right now, however, many Americans have prepared very limited stockpiles, at best. Our goal with the blog is to encourage everyone to take a few steps now to begin preparing for a pandemic, including building a stockpile. Each family should customize their stockpile size and contents to meet their unique circumstances and needs. Naturally, the more time and effort that you put into preparing a stockpile, the more self-reliant you will be. We at HHS believe that two weeks is an effective compromise that can get all American families thinking about their own needs.
I am looking forward to reading your reactions and within the next few days will write about how individuals can minimize their risk of exposure to an influenza virus during a pandemic.
Please stay tuned.

 

[sharon sanders]

Dear Members of FluTrackers -

The Department of Health and Human Services of the United States is operating a blog in an attempt to reach out, not only to all Americans, but to all citizens of the world.

This blog is for the discussion of pertinent pandemic issues.

It is an experiment in internet communication for the purposes of public health education and interaction.

It is not perfect - but rather an effort by an institution of the government to involve "regular" citizens in the discourse.

Please post at this site to encourage the government to participate in our discussions.

This is our government. Our tax dollars. Our choice. Make your voice heard. The record will stand.

Make it permanent.


Fondly,

S.


http://blog.pandemicflu.gov/

 

[sharon sanders]

1. <cite>Peter</cite> Says: Well, now that my head is spinning from the Snowy Story, I have some other thoughts.
   I am afraid HHS is between a rock and a hard place. There are no ?baby steps?.
   It is one of those ?ALL or NOTHING? situations, I am afraid.
   Either you want the public to prepare?or you don?t.
   To date?it appears?for whatever reason??HHS does NOT want the public to prepare.
   When HHS DOES want the public to prepare, HHS must make their message CONGRUENT with other agencies, TRUTHFUL, with CLEAR and EASY TO FOLLOW DIRECTIONS.
   If the public heard the recent messages posted by Dr. Agwunobi, they would be baffled. The public currently does not even know what a ?stockpile? means, or why it is even necessary.
   QUOTE: ?We at HHS believe that two weeks is an effective compromise that can get all American families thinking about their own needs.?
   WHO is HHS compromising WITH?
   WHY is HHS compromising?
   If HHS delivers a message of ?TWO WEEK STOCKPILE??HHS, is in fact, recommending that NO ONE should be ready!
   If everyone stockpiles for two weeks, everyone is going to run out of food long before the pandemic wave is over. It is far better that many prepare for 8 weeks?-AT A MINUMUM?and then help the others who cannot be prepared.
   No one can be hurt by having extra food in the house! However, they could possibly die of starvation if they don?t stockpile. Cliche time:
   BETTER SAFE THAN SORRY!
   It will be a far better strategy to be truthful.
   I recommend a message as follows:
   We at HHS believe all Americans will be affected by a pandemic flu in the future. We do not know exactly when, but we are very concerned that the public should get ready and prepared.
   We can take steps NOW to make sure we are as ready as possible.
   At the very LEAST, all Americans should stock 8 weeks worth of canned goods for each person, and a manual can opener.
   At the very LEAST, all Americans should be ready and able to quickly store a Gallon of water per person per day for 2 weeks.
   (Further details could be made on how to store water rapidly and easily and how to disinfect it with drops of bleach.
   For example?take 2 kitchen garbage bags?one inside the other. Put them inside a pillowcase and fill the inner garbage bag from the tap. Purchase a kiddie pool. Purchase a water barrel.
   (Make sure to note how heavy water is.)
   Some system of charity must be set up at the grocery checkout lane. Marketing professionals know how to do this.
   A Pandemic food storage system needs to be set up in every community for those who have no means to prepare. ?Pandemic? Food banks need to fill up with donations.
   An essential medicines storage facility needs to be set up, with procedures for distribution. Someone needs to determine what medicines ARE essential to live.
   HHS cannot say: ?Run out to your doctor and get 3 months worth of your prescriptions!? It cannot be done with our health system.
   COMMUNICATION IS VITAL!
   Local phone numbers, websites, TV news, magazines, and newspapers,need to be ready to ANSWER calls for more information.
   A VIDEO needs to be made that can be viewed online. This VIDEO needs to show clearly and calmly how to care for very sick people at home. It must also show how to protect others in the home from infection.
   (For instance, a cloth tied to the face like a bandana with vaseline on it can be a pretty good barrier against
   airborne particles.)
   The wealthy need to GIVE for the common good. There is enough money in this country for everyone to be prepared?-but the wealthy MUST share.
   Encourage HEROIC actions by the wealthy!
   NOTHING you say can be PERFECT. Americans are in the habit of jumping to criticize. BUT?If they know that you are thinking and concerned about them FIRST and foremost, they will be grateful and cooperate.
   If the public feels lied to, manipulated, and ignored, we are ALL going to be living in fear and chaos.
   PLEASE do the right thing for the public. Make the people number ONE!
   Thank you for the opportunity to share my thoughts.
   <small class="commentmetadata">Posted June 9th, 2007 at 5:18 am</small>

http://blog.pandemicflu.gov/?p=43#comment-1313

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

AnneZSays:

Mr. Secretary,

Thank you for this blog.

It’s great to see this important dialogue between the American public and government on pandemic issues. Flublogia have called for this for a long time.

Here in New Zealand earthquakes, volcanic eruption, tsunamis, storms and of course pandemics are the types of disasters New Zealanders should all be prepared for.

NZ invites comments on it’s pandemic plan www.moh.govt.nz/moh….

AnneZ, Sr. Administrator
[http://www.moh.govt.nz/moh.nsf/indexmh/nz-influenza-pandemic-action-plan-2006[/URL]

Posted June 9th, 2007 at 7:52 am

http://blog.pandemicflu.gov/?p=33#comment-1318

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Florida1Says:

Buenas tardes.

Una vez más, gracias secretaria Levitt por proveiendo este foro.

Pienso es importante que los ciudadanos seban que la información pandemic está disponible en el sitio del gobierno en español.
En Flutrackers tenemos foros grandes en las idiomas siguientes:

Español

www.flutrackers.com/…

Francés
www.flutrackers.com/…

Alemán
www.flutrackers.com/…

Árabe
www.flutrackers.com/…

Indonesio
www.flutrackers.com/…

Noruego
www.flutrackers.com/…

Ruso
www.flutrackers.com/…

Pandemicflu.gov en Espanol:

espanol.pandemicflu….

Posted June 9th, 2007 at 11:18 amhttp://blog.pandemicflu.gov/?p=33#comment-1326



As usual something happened to 3 links in the transfer of information. I will correct on the HHS site in about an hour.

 

[sharon sanders]

Interesting post by Dr. Woodson

Interesting post by Dr. Woodson

Grattan Woodson, MDSays:

Dear Mr. Secretary,

I would like to discuss the wisdom of keeping the WHO Pandemic Influenza Alert Phase at 3 when there is considerable evidence that limited but inefficient human-to-human spread of H5N1 has occurred. It serves no purpose for me to waste time supporting the contention that the predefined WHO criteria for Phase 4 has already been fulfilled as this fact has been clearly documented in Turkey, Indonesia, and Egypt in the press and peer reviewed medical journals.

It is my view that H5N1 will become pandemic and that the resulting strain will have a high transmission rate, CAR, and CFR. A pandemic of this nature will have a grave impact on every aspect of human life world over and it is for this reason that I have taken the time to write to you about this issue today.

The WHO’s Pandemic Alert Phase concept as initially proposed had the potential to be one of the most useful and innovative public health tools ever deployed. Imagine, for the first time ever humankind, relying on advances in science and technology would be afforded the opportunity for to see the approaching pandemic storm well in advance of its arrival. This foreknowledge is the key to proper and appropriate preparation for the pandemic, a luxury never before realized. As those of us who have been engaged in pandemic preparedness have learned considerable time, effort, and resources are required to properly accomplish this goal.

The Pandemic Alert Phase system was designed around predetermined scientifically assessed developments in the candidate virus’s adaptation to humankind. As the Phase level increases, the prudent would be well advised to make appropriate preparations for pandemic. The coming pandemic would have constituted the system’s validation as a public health tool. Up until recently, the system was performing well by effectively identifying a likely candidate for pandemic, H5N1 among the many thousands of strains of avian influenza circulating within the avian and mammalian world after it first emerged in 1997. The Alert Phase was appropriately advanced from 1 to 2 to 3 as H5N1 began to exhibit the behavior that virologists and other scientists had predefined years ago as indicating a strain with pandemic potential. Something however happened on the way to Phase 4 that has caused many now doubt the veracity of the system.

Since the science is clear that limited but inefficient human-to-human transmission of H5N1 has occurred sufficient to fulfill the predetermine criteria for Phase 4, the only reasonable explanation for the WHO to maintain the level a 3 must be political. The WHO is a creature of the UN and I suspect that the likely the source of the political interference is located within that organization. Obviously this is a complex issue that has many facets. While I am aware of some of these and understand few of the reasons for keeping the Alert Phase at 3, the danger of doing so in my opinion far out way the benefits.

Specifically, it is my view that H5N1’s human adaptation will accelerate as it becomes more widespread within the mammalian and most particularly human population. Therefore the time the virus spends at each Alert Phase is likely to become progressively shorter as it moves toward pandemic status. Admittedly, this is pure speculation on my part but I think there are good scientifically based support for this concept. If this notion proves to be the case, since H5N1 has been at scientific Alert Phase 4 if not political Alert Phase 4 for at least 18 months if not longer, Alert Phase 5 must not be too far away. The loss of credibility the WHO has already suffered within the scientific community over this issue is substantial but not irreparable. If however the political manipulation of the pandemic early warning system becomes common knowledge among the people of the world due the obvious advent of Alert Phase 5 before Phase 4 has been declared, the credibility and effectiveness of the WHO will suffer great harm at precisely the time that the people of the world will need reliable and authoritative health guidance.

Your agency has addressed this issue by breaking with the WHO to sponsor your own pandemic alert system. It is my guess that one of the reasons you decided to take this action was because of the political corruption of the WHO’s system meant that it was no longer a reliable tool for planning when to trigger certain actions by the US DHHS and the US DHS. The US has considerable influence within the UN and can help the WHO return its system to a reliable scientifically based one that world governments and people can have confidence in before it is too late. I urge you to take this action and soon.

Sincerely,
Grattan Woodson, MD
Posted June 9th, 2007 at 11:32 am

http://blog.pandemicflu.gov/?p=33#comment-1326

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Blue, RN, Senior Moderator, Flutrackers

Dear Mr. Secretary,

Thank you for taking this on. It is no easy task to address the members of the flu community, sir.
As you can see, we all have many concerns, and it is our great hope that this dialogue will help in a positive way to lead to solutions to the many problems that our nation will face should pandemic occur as a Category 5 event. I am so grateful that
you have opened this space to address you. In my heart, I have to believe that some good must come of this.
I wanted to point out specifically post 89 from Florida1, President of Flutrackers.com

[snip]
It is imperative to assist those individuals and institutions who support and maintain society’s safety net. Individual and family imperatives, psychological support, financial considerations, physical safety, and legal ramifications must be implemented for each person and institution who serves during an emergency situation.

The requirements of a civil society demand that we protect those who protect us: Nurses, Doctors, Police, Firepersons, EMTs, Military, Public Health Care Workers, and all others who sacrifice must have the tools and support necessary to be efficient and safe.

[snip]

I am an older nurse with 25 years experience. My concern is about my younger colleagues with children. I worry about families where both parents are part of that group of people mentioned in Florida1’s post. You know, nurses married to firefighters, EMTs, or cops.

So many of us are in that category. We have mortgages like everyone else, and other financial obligations. We will be putting ourselves at risk in the line of fire in order for the public to be safe or to have someone to care for them if they are too sick to remain at home. Many of us will come in and do what we are able to do. But it will be harder for some of us.

I hope that as FlaMedic has suggested that someone out there will adopt our families. I hope that as Florida1 suggests that there will be some provision made to help such as moratoriums on
mortagage payments, that these people who serve will be paid, that there will be loan forgiveness for the student loans of the new nurse graduates that volunteer to serve etc.

Our society needs these people to be there for all of us. What else can we do to assist them to serve?

I hope that you will find a way to continue to communicate with the public. It is important for them to hear you. We need you, Mr. Secretary, and you need us also.

Blue, RN, Senior Moderator, Flutrackers.com

Posted June 9th, 2007 at 4:06 pm

http://blog.pandemicflu.gov/?p=33#comments

 

[sharon sanders]

Re: The National Pandemic Preparedness Blog Summit

Re: The National Pandemic Preparedness Blog Summit

Shrill is Overkill -

Apparently some posters at the HHS blog prefer the communication style of "rant and rave" to gentle persuasion.

A few of the comments on the blog of Admiral Agwunobi are so emotional as to dilute the message.

The message is a good one. More than 2 weeks of essential supplies has been recommended by FluTrackers since May 27, 2006 http://www.flutrackers.com/forum/showthread.php?t=6536here.

In fact, we have been recommending a 90 supply since that date.

Apparently the HHS is recommending 2 weeks. Well, I simply do not agree. We will not change our policy here to match what the government is recommending.

There are many reasons to gather a 90 day supply. There is only one reason to recommend a two week supply. The reason is that it is a start.

By now most of us know that convincing our neighbors, friends, families and others that "bird flu" is a real threat can be a challenge - even with all the scientific and historical evidence to support such a possibility.

A two week recommendation is a sound one if it is recommended as a start which I believe is in the admiral's message:

"...can get all American families thinking about their own needs."

It is intended, I believe, to get Americans to begin to accumulate a disaster stockpile when they do not have any kind of disaster preparedness mindset at this time.

What is the most effective method to reach the officials in the United States government? Ranting? Emotional outbursts?

No. Thoughtful discussion is.

They want to listen to us. Let's give them a message as effectively as we can.

Speak in clear, unambiguous, concise, and compassionate words.

This is our chance to influence policy.

To demand humanity is to show it.


:yinyang: