Osterholm Changes Pandemic Flu Emphasis -

sharon sanders · Sep 16, 2008

Hat tip Senior Moderator Fla Medic -

Here is an excerpt from an essay by Michael Osterholm, MPH, PhD written for business clients but applicable to families as well:

"Bottom line for business

In short, I am no longer counting on any substantial or meaningful pandemic preparedness efforts that require major national leadership or significant financial investment. :applause: I believe that's far more than we can expect among our get-elected-at-any-cost "leaders." Though I've hit the "wall," I'm not stopping my efforts to prepare or giving up my belief that we'll get through this catastrophe. After all, my efforts, your efforts, are about our kids, all kids, and their future. For that alone I could never give up.....

So here's my plan. I will address the following topics in upcoming columns:

Electricity. What must we do to ensure that our communities don't lose electricity during the next pandemic, and if they do, what should our plan be?
Critical life-saving drugs. To be sure, we will run out of drugs that have nothing to do with preventing or treating pandemic influenza. So, what can your organization do now to prepare for the 5% or more of your workers or their families who won't be able to get their life-saving insulin?
Food. Finally, I'll address why we'll see major food shortages within hours of the official declaration that the pandemic has begun. What can you do now to be better prepared?..."

http://www.cidrapsource.com/content/do/view/marketing/mart/freecolumn.html

Avian Flu Diary Comments:

Tuesday, September 16, 2008

 Osterholm: The Reality Of Pandemic Planning

http://afludiary.blogspot.com/

# 2305

Michael Osterholm PhD, MPH, Director of CIDRAP (Center For Infectious Disease Research & Policy), is widely regarded as one of the leading voices urging action to prepare for an influenza pandemic.

His credentials are impeccable, and he is both a charismatic and knowledgeable public speaker. He is also the Editor-in-Chief of the CIDRAP Business Source.

Normally access is through a paid subscription.

Last week Dr. Osterholm wrote a remarkable article for the CIDRAP Business Source called The reality of pandemic planning: I've hit the wall but I'm not giving up.

Friends and colleagues of Dr. Osterholm felt this article was too important not to be widely available, and urged him to make it publicly accessible.

Dr. Osterholm has graciously done so.

I've only printed the opening paragraphs. Please follow the link to read this article in its entirety.

You will find it well worth the effort.

The reality of pandemic planning: I've hit the 'wall' but I'm not giving up

Special feature alert: Welcome to CIDRAP Business Source, a subscription service from the University of Minnesota designed to help businesses prepare for public health threats. This commentary by infectious disease and preparedness expert Michael T. Osterholm, MPH, PhD, Editor-in-Chief, appeared in the Sep 11 Osterholm Briefing. In view of the importance of Dr. Osterholm's message to all organizations and individuals, we're making this column available to the general public. We encourage you to explore our content-rich site for additional context and commentary.

Michael T. Osterholm

September 11, 2008 (CIDRAP Business Source Osterholm Briefing) – Like marathon runners or long-distance swimmers, I hit the "wall" this week when it comes to pandemic preparedness planning—big time. It wasn't pretty. And while I am not giving up, recent events certainly gave me pause. So, I'm changing my strategy—and sharing it with you.

What brought me to this place

Yesterday, our presidential campaign devolved into "lipstick and pigs" nonsense, and it became so clear to me that no politician can get elected today by telling the electorate the painful truth: We're not prepared for our future, and we're not going to do much to get prepared. True preparedness requires sacrifice, and, frankly, as a nation we're mostly too "in the moment" to consider sacrificing for the future.

(Continue reading . . . .)

posted by FLA_MEDIC @ 2:11 PM

kent nickell · Sep 17, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

I like Dr. Osterholm's shift in strategy although I would argue that preparedness and mitigating the consequences can have things in common. Prepandemic vaccine use and increased emphasis on nonpharmaceutical interventions can accomplish both. I definitely agree that national and international authorities could be more proactive in informing a distracted public and helping forge political will for these efforts... (I thought some of his comments were similar to excerpts from "The Black Swan: The Impact of the Highly Improbable" by Nassim Taleb....)

Michael Osterholm:

"""What I am doing is changing my approach. In upcoming columns, I will focus on what we can do to better prepare for the collateral damage of the next pandemic, rather than on preparing for the pandemic itself.

This approach may sound like a subtle difference, but in the public health world, such a shift is like knowing when it's not possible anymore to prevent a disease outbreak, so we choose to focus our energy and resources on limiting the impact of the outbreak."""

Nassim Taleb:

"""All these recommendations have one point in common: asymmetry. Put yourself in situations where favorable consequences are much larger than unfavorable ones.

Indeed, the notion of asymmetic outcomes as the central idea of this book: I will never get to know the unknown since, by definition, it is unknown. However, I can guess how it might affect me, and I should base my decisions around that.

We can have a clear idea of the consequences of an event, even if we do not know how likey it is to occur. I don't know the odds of an earthquake, but I can imagine how San Francisco might be affected by one. This idea that in order to make a decision you need to focus on the consequences (which you can know) rather than the probability (which you can't know) is the central idea of uncertainty.

You can build an overall theory of decision making on this idea. All you have to do is mitigate the consequences."""

tropical · Sep 17, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

From 1#:

"it became so clear to me that no politician can get elected today by telling the electorate the painful truth: We're not prepared for our future, and we're not going to do much to get prepared. True preparedness requires sacrifice ..."

requires money.

"The reality of pandemic planning: I've hit the 'wall' ..."

sharon sanders · Sep 17, 2008

But didn't we know this?.....really.....

But didn't we know this?.....really.....

We can not depend on the federal or state governments to "save" us.

From my experience with hurricanes in Florida, I expect to be "on my own" in any large emergency. The state of Florida does an excellent job of preparing for these kinds of emergencies. They liaision with the federal government and before these storms arrive in Florida many resources are in place to help the victims. But....

There is never enough ice.

There is never enough food.

There are never enough blue tarps.

There is never enough money.

And the lines for assistance are very long.

The bottom line is that no matter how well the state and federal governments respond - it is not enough.

And this is with all the political will necessary to accomplish this task.

We are on our own.

We have to help ourselves.

Family to family.

House to house.

Neighborhood to neighborhood.

Community to community.

Find a few friends and organize a mutual help committee. Something we have called Disaster Partners.

There are many resources to help you:

Get Pandemic Ready,

30 Day Prep List,

FluTrackers Scientific Library,

Pandemic Preparedness Tools,

Personal, Family, & Professional Preparations,

Traditional & Alternative Influenza Interventions,

Francophones des FluTrackers,

Foro de Espanol de FluTrackers,

Forum Italiano de FluTrackers,

Other languages including: Arabic, Chinese, German & Africa

We need to get back to basics. Materialism is out. Help your family and friends. Less is more.

We have been lost.

"Every man has to learn the points of compass again as often as he awakes, whether from sleep or any abstraction. Not till we are lost, in other words not till we have lost the world, do we begin to find ourselves, and realize where we are and the infinite extent of our relations."

Thoreau "Walden"

Reconnect with your near ones. Discover the light that surrounds you.

sharon sanders · Sep 17, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Family structure and health, how companionship acts as a buffer against ill health
Amelia R Turagabeci,<sup>1</sup> Keiko Nakamura,<sup>

</sup><sup>1</sup> Masashi Kizuki,<sup>2</sup> and Takehito Takano<sup>2</sup><sup>1</sup>International Health Section, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo 113-8519, Japan
<sup>2</sup>Health Promotion Section, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo 113-8519, Japan

<sup>

</sup>Corresponding author.
Amelia R Turagabeci: art.ith@tmd.ac.jp<script type="text/javascript" language="JavaScript"></script>; Keiko Nakamura: nakamura.ith@tmd.ac.jp<script type="text/javascript" language="JavaScript"></script>; Masashi Kizuki: kizuki.hlth@tmd.ac.jp<script type="text/javascript" language="JavaScript"></script>; Takehito Takano: takano.hlth@tmd.ac.jp<script type="text/javascript" language="JavaScript"></script>
Received September 6, 2007; Accepted November 23, 2007.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background

Health and well-being are the result of synergistic interactions among a variety of determinants. Family structure and composition are social determinants that may also affect health behaviours and outcomes. This study was performed to examine the associations between family structure and health and to determine the protective effects of support mechanisms to improve quality of health outcome.

Methods

Six hundred people, selected by multistage sampling to obtain a representative population of men and women aged 20?60 living in communities in Japan, were included in this study. Data regarding subjective views of one's own health, family structure, lifestyle and social support were collected through structured face-to-face interviews on home visits. Systolic and diastolic blood pressures, height and weight were measured by trained examiners. The associations between family structure and health after controlling for demographics, lifestyle and social support were examined using logistic and linear regression analyses.

Results

Subjects living alone were significantly more likely to be in ill health, as determined using the General Health Questionnaire, in comparison to those in extended families (OR = 3.14). Subjects living alone or as couples were significantly more likely to suffer from severe hypertension in comparison to those living in extended families (OR = 8.25, OR = 4.90). These associations remained after controlling for the influence of lifestyle. Subjects living only with spouse or in nuclear family had higher probabilities of mental ill health in the absence than in the presence of people showing concern for their well-being.

Conclusion

The results of this study infers that a support mechanism consisting of companionship and the presence of family or other people concerned for one's well being acts as a buffer against deleterious influence of living in small family that will lead to improved quality of health outcome.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2234394

tropical · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Post 4#:

"We need to get back to basics. Materialism is out. Help your family and friends.
There is never enough money."

Looking the recent markets/funds/banks one day blowings of bilions, seems that there are enaugh money to blow it.
The quantity of money for an item is dependent on the named item money allocation decision.

"And the lines for assistance are very long.
The bottom line is that no matter how well the state and federal governments respond - it is not enough.
And this is with all the political will necessary to accomplish this task.
We are on our own.
We have to help ourselves.
Family to family.
House to house.
Neighborhood to neighborhood.
Community to community.
Find a few friends and organize a mutual help committee. Something we have called Disaster Partners."

I agreed with the above except for the obviousity of be on our own if we pay regulary all necessary taxes.
From that taxes it must be extracted an enaugh amount of money to not expose us to a live danger without an individual enaugh effective shielding. If the actual taxes aren't enaugh, it must be inserted a special health dedicated one.

Presuming to receiving no help from conteal/state/federal sources meant an global weakening of the pandemic counter responce.
Thinking that it would be possible in a first pandemic pandemonium months receive an enaugh life saving medical care from the neighborhood/community in our 21 century world as maybe seen in some previous epoques is IMO wishfull thinkings, especialy in the megapolis towns.

If we must create our safety, nothing change in the money formulation - it's still more money to invest for every food/energy/safety item.
The only diference is that it is our individual money to be spent.
Only "a good will, and a cabin" would not be enaugh, as isn't for a normal daily living.

Science Teacher · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Dr. Osterholm and Dr. Gratton Woodson have both begun the process of accepting the financial reality of the current situation in terms of pandemic planning at a governmental level among other things.

It's encouraging to hear that Dr. O. will focus on ways to strengthen our community resources. The grid is so tremendously important to saving lives.

Dr. Grattan Woodson's newest book, Coming Pandemic Catastrophe,
reflects his concern that we need to include long term sustainability components in our preparations.

One of my kids just began an MPH program at a major University. In the orientation lecture, an influenza pandemic was identified as one of the major public health threats we are facing. The next comment was that public health work would be focusing on this before the pandemic happens and that once it began, the public health part was over.

I think we are looking at a major paradigm shift here and it is of great concern.

sharon sanders · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Welcome Science Teacher!

cartski · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Science Teacher said:
One of my kids just began an MPH program at a major University. In the orientation lecture, an influenza pandemic was identified as one of the major public health threats we are facing. The next comment was that public health work would be focusing on this before the pandemic happens and that once it began, the public health part was over.

I think we are looking at a major paradigm shift here and it is of great concern.

I don't get this. How can public health work stop once the outbreak, epidemic or pandemic sets in? Surely public health is not just limited to prevention activities.

J.

Science Teacher · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Thanks for the welcome. I've read your site for a long time. Finally got brave enough to de-lurk.

AlaskaDenise · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

....once it began, the public health part was over

Surely this is not what it appears.

Welcome Science Teacher - love to see lurkers converted......especially after lurking for 2 1/2 years.

.

Science Teacher · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Cartski, I don't 'get it' either. Neither did my kid who emailed me about it right away. I consider him a totally reliable source of info.

I guess I've always expected to be pretty much on my own at the community level since I've been studying the possible pandemic issues for several years now.

cartski · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

With respect to F1, I'm not sure I would applaud Dr. O's statement:

"I am no longer counting on any substantial or meaningful pandemic preparedness efforts that require major national leadership or significant financial investment."

It may be very worthwhile to emphasize limiting the "collateral damage" from the impending war, yet surely it's still worthwhile to continue to raise the issue with political leaders in the hopes of preventing the war.

Churchill limited the collateral damage and fought back; but his efforts would not have been required had Chamberlain succeeded - and the current knowledge at the time supported trying to head off the war before it started.

Dr. O shift sound more like a jaded, disillusioned leader of an environmental group. I would rather see him strategically hand off the leadership of the prevention/lobbying efforts to someone else that to dramatically declare that political lobbying is a worthless endeavour.

J.

sharon sanders · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

What I am applauding is the acknowledgment that we need to take charge of our own destiny and not wait for a state or federal government to determine our fate.

AlaskaDenise · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Florida1 said:
What I am applauding is the acknowledgment that we need to take charge of our own destiny and not wait for a state or federal government to determine our fate.

That messge should be driven home to anyone with average intelligence and a TV - courtesy of various hurricanes.

How many red flags must be run up the flagpole to motivate people toward preparation?

.

Farmer · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

"How many red flags must be run up the flagpole to motivate people toward preparation?"

My efforts to communicate/educate about pandemic preparedness among family and friends continue to frustrate me no matter how many big hurricanes seem to land.

I really think: people are in denial; people are too busy with daily activities; people do not feel a sense of urgency to deal with it; people are overwhelmed by the potential scope of a severe pandemic, they cannot imagine it; and / or people do not like to spend time thinking about things that make them feel sad or fearful.

Sally Furniss · Sep 18, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Welcome Science Teacher

tropical · Sep 19, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Florida1 said:
What I am applauding is the acknowledgment that we need to take charge of our own destiny and not wait for a state or federal government to determine our fate.

Even if I share your thinking also, it seems quite dificult to accomplish it, and thus it's not enaugh to survive an hypothetic serious deadly pandemic agent.
I understand that it represent a position that we must fight individualy and by a near community for ourself, but for that kind of danger which is something else than hurricanes, it is only one part of the equation.
The other part must be accomplished by the public organized forms of the society. Cartski and Farmer texts are on that trail.

States/govs DO determine the overall state of most questions.
You can't provide prepand/pand. vaccines your own.
You can't provide antivirals/antibiotics/medicines your own.
You can't provide food on the shelfs and enaugh clean water your own in a town, etc.

With the our own thinking we automaticaly pose ourself in an position as were the populace prior the scientific revolution of the society (which enable us with tools to counterfeit illnesses), instead of pushing the legal dedicated institutions to more invest in an overall shielding.

sharon sanders · Sep 19, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

I agree Tropical. The various governments provide essential and valuable services.

In a perfect world, each government would have a thorough and well thought out: pandemic plan, vaccine program, anti-viral plan, education plan, and training exercises - and would have funded these 100%. This is a worthy goal and I hope that many governments strive to accomplish this.

But.......while we are waiting........

We need to wake up and take charge of our own lives.

This starts with priorities. Family. Emphasis on the human spirit.

Forget about the acquisition of material objects. These things will be meaningless in a pandemic. No one will care what car you drive or where you live. We will be judged by how we treat others, not by what we own.

Get back to basics.

Hard and fruitful work. Closeness to family and friends.

These are the things that will save us in a real crisis.

The question we ask ourselves each day should not be - How can I make my government serve me better?

We should ask ourselves each day - How can I serve better?

How can I make a meaningful difference in the lives of my near ones today?

How can I make a difference in my community today?

We all leave this earth eventually.

What have we left behind?

tropical · Sep 19, 2008

Re: Osterholm Changes Pandemic Flu Emphasis -

Thanks Florida for your answer.

I can share your emotional, compassional, and community efforts, also.
And without unnecessary goods.

But I think that for the question:
"We should ask ourselves each day - How can I serve better?"
we enaugh good serve, mainly.

In plain words, the fact is that 3-5 years after this presumpted possibility of biological danger, after all world pandemic plans, we will must rely mainly on some very basic individual sentiments of mutual family/neighb. help, and without health sector care.

If we are there, that means an global factual preparedness failure, maybe.
The Wall of Dr. Osterholm (or P.F.?)

For the near community we can always try to do better if we are able, but the results would be not enaugh important to change the pandemic ravage, as Farmer stated:

""How many red flags must be run up the flagpole to motivate people toward preparation?"
My efforts to communicate/educate about pandemic preparedness among family and friends continue to frustrate me no matter how many big hurricanes seem to land.
I really think: people are in denial; people are too busy with daily activities; people do not feel a sense of urgency to deal with it; people are overwhelmed by the potential scope of a severe pandemic, they cannot imagine it; and / or people do not like to spend time thinking about things that make them feel sad or fearful."

Osterholm Changes Pandemic Flu Emphasis -

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