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What do you think is going on in Egypt?

Shannon Bennett

Well-known member
I believe at this time we should start a dialogue of what each of us is thinking. Up to now we have relied on importing news over openly discussing a situation. This is the perfect opportunity to air our thoughts, rebut arguments, and discuss our concerns.
 
Re: What do you think is going on in Egypt?

When the number of suspect cases go up, but the official numbers of cases goes down, suspicions are raised.
 
Re: What do you think is going on in Egypt?

What is the suspected tally now and what is the cluster status? I am interested in clusters.
 
Re: What do you think is going on in Egypt?

I suppose we are now waiting for reports of fatalities or health care workers being suspect for H5N1. If that doesn't develop, could it be that the virus is being transmitted more easily from bird to human?
 
Re: What do you think is going on in Egypt?

I am most concerned because of the clamp down on updates. We have seen this phenomenon before. If governments have nothing to hide then information flows, if they are covering up something then information ceases. At least this is the perception. I for one would like to see some statistics that are verifiable. How many are actually sick? How many are confirmed? How many were taking an antiviral or antiviral cocktail prior to being tested? How many have died? And perhaps most importantly, what were the relationships of those who are sick with H5N1? Are we seeing familial clusters, medical professionals sick, bird handlers and their immediate families ill, or are we seeing persons with only casual contact becoming ill?

The news blackout has me on tenterhooks. Time is running out for news. Eventually speculations are going to override good sense. If this is a grave situation, and I am not saying it is, then the world needs as much time as possible to prepare. If it isn't bad news then why are we still in the dark?
 
Re: What do you think is going on in Egypt?

Regarding the news....I was reading an old Jordanian story about BF. They came down hard on the news media for not adhering to their "responsibilty" to deter public fears and panic. Different cultures and their different views on press freedoms may be partly to blame.

,
 
Re: What do you think is going on in Egypt?

Good point AD. I recall reading something like this myself during the run up to the Iraq war. The quote was something like it is better to live under a tyrant then suffer without a strong leader. Civil unrest is anathema in the Muslim world was my take on the situation.

Regarding the news....I was reading an old Jordanian story about BF. They came down hard on the news media for not adhering to their "responsibilty" to deter public fears and panic. Different cultures and their different views on press freedoms may be partly to blame.

,
 
Re: What do you think is going on in Egypt?

What is the suspected tally now and what is the cluster status? I am interested in clusters.
Names aren't coming out for released cases, and so far none of the hospitalized patients in the past week have been confirmed.
 
Re: What do you think is going on in Egypt?

As we are being asked for opinions, here goes:-

Prior to events in December, the population had been lulled into a false sense of security. People had reverted to keeping chickens at home to supplement both diet and income, and with no positive cases, people thought the problem had largely gone away. Then we had the five confirmed cases in a week with four deaths. This caused alarm at every level.

Reporting was open and free initially to get the public communication message across - they have achieved this now, and the country is widely alerted to the fact that H5N1 is alive and well and a serious threat to everyone.

What is there for the government to gain by publicising further cases? There is a fine line between motivation to action and co-operation, and all out panic. Panic is a state of affairs that governments fear as control of the population can rapidly fall away. Additionally, in a panic situation, it can be harder for the authorities to get their job done - so I think that they are treading the fine line between mobilisation and a panic reaction. There needs to be enough fear for the populace to accept widespread culling and enforcement of preventative measures, but not so much that the political stability of the region is affected.

As such, I doubt we will hear of any positive confirmations until the situation has settled somewhat - there have been occasions where many weeks have passed before a positive case confirmation has been announced. Perhpas that is the case this time, and we will hear, eventually.
 
Re: What do you think is going on in Egypt?

As we are being asked for opinions, here goes:-

Prior to events in December, the population had been lulled into a false sense of security. People had reverted to keeping chickens at home to supplement both diet and income, and with no positive cases, people thought the problem had largely gone away. Then we had the five confirmed cases in a week with four deaths. This caused alarm at every level.

Reporting was open and free initially to get the public communication message across - they have achieved this now, and the country is widely alerted to the fact that H5N1 is alive and well and a serious threat to everyone.

What is there for the government to gain by publicising further cases? There is a fine line between motivation to action and co-operation, and all out panic. Panic is a state of affairs that governments fear as control of the population can rapidly fall away. Additionally, in a panic situation, it can be harder for the authorities to get their job done - so I think that they are treading the fine line between mobilisation and a panic reaction. There needs to be enough fear for the populace to accept widespread culling and enforcement of preventative measures, but not so much that the political stability of the region is affected.

As such, I doubt we will hear of any positive confirmations until the situation has settled somewhat - there have been occasions where many weeks have passed before a positive case confirmation has been announced. Perhpas that is the case this time, and we will hear, eventually.
That hasn't he case in the past in Egypt. Confirmed cases have been announced promptly.

The issue is whether things have changed.
 
Re: What do you think is going on in Egypt?

It is hard to know what is really going on. However I have been impressed by the timely and open flow of information to the media to date.

Compare this situation to other countries we closely follow! At least we are receiving almost real-time news of suspected cases.

I would expect communication challenges between medical personnel within hospitals and governorates and the national government in numbers of suspected cases in this rapidly evolving situation. It takes time to get the numbers the same and that is done usually retrospectively once suspected cases have stopped.

As far as knowing the disposition of cases, I have been frustrated in the past by 'losing track' of suspected cases. No official announcements of negative results were made in many cases.

Given that, I have no reason to suspect that there are positive cases that are being hidden.
 
Re: What do you think is going on in Egypt?

That hasn't he case in the past in Egypt. Confirmed cases have been announced promptly.

The issue is whether things have changed.

Dr. Niman,

Are you in contact with your colleagues in Egypt? Are they actively involved in testing and research of current cases? Is there heightened concern among the "experts" with "boots on the ground"?

Of course, you may not be free to share, but I'm curious about any light you can shed at this time.

Personally, I'm more jittery than usual since life has caused me to be uncharacteristically absent from FT and other forums lately. The known, no matter how bad the news, is better than the unknown, I suppose.
 
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Re: What do you think is going on in Egypt?

It has been almost impossible to track these outbreaks.

There are no towns mentioned, for example, for all these people:
Qena Governorate
Jan 07 - Mohammed Khairi (4) - brother to Ahmed below
Jan 07 - Ahmed (3) - brother to MK (4) above
Jan 07 - Mayada Abdel Fattah Abdel Hearings (13 months)
Jan 07 - Fatima Yusuf Ahmed Abu Hassan (student AZHAR)
Jan 07 - Hanan Ahmed Mohmoud (housewife)
Jan 07 - Sadli Sayed Abdel Karim Younis (11)
Jan 07 - Kenya Abulhasan (10)
Jan 07 - arrows (3)
Jan 07 - Mohammed Faris Abdul (12)
Jan 07 - Kawther Mohammed Ahmed Mustapha

And then you tack this on for today's news:
Jan 08 - 5 cases in Hospital Dietetic Qena

This is what I have in todays news for Sohang Governorate:

Jan 08 - 11 reported suspected cases
Jan 08 - Mr. Abir/Jishim (29) - from Aldnaklh

11 new cases? Or from the beginning of the outbreak?

And this. I don't think Zagazig is a Governorate, and I have no clue where the others should go?

Zagazig
Jan 08 - 4 cases suspected -3 below.
Mohammed Saeed (30) - from Zagazig
Mr. Suad (31) - from Abrahamic
Fatima Mitwalli (38)

Jan 08 -
11 suspected cases in hospital in salt Mahala
7 cases Hospital Dietetic Tanta (2 al-Azhar; 1 case & 4 new cases)

So, I can't help anyone out.
 
Re: What do you think is going on in Egypt?

What timely flow of data to the media? The WHO is present and certainly capable of cataloguing patients, especially since those who are infected are being taken to a very limited number of hospitals. In the past Theresa and others have been able to name those who are infected, that kind of news stopped last week. Others have been able to map the cases. We can no longer make a current map.

If you have information that we lack this is the time to share.

It is hard to know what is really going on. However I have been impressed by the timely and open flow of information to the media to date.

Compare this situation to other countries we closely follow! At least we are receiving almost real-time news of suspected cases.

I would expect communication challenges between medical personnel within hospitals and governorates and the national government in numbers of suspected cases in this rapidly evolving situation. It takes time to get the numbers the same and that is done usually retrospectively once suspected cases have stopped.

As far as knowing the disposition of cases, I have been frustrated in the past by 'losing track' of suspected cases. No official announcements of negative results were made in many cases.

Given that, I have no reason to suspect that there are positive cases that are being hidden.
 
Re: What do you think is going on in Egypt?

Remember that the NAMRU Cairo facility has now been designated a WHO testing site. That may be the change that has created the new situation. Also, at least one of their highly qualified senior personnel is working elsewhere.

.
 
Re: What do you think is going on in Egypt?

Dr. Niman,

Are you in contact with your colleagues in Egypt? Are they actively involved in testing and research of current cases? Is there heightened concern among the "experts" with "boots on the ground"?

Of course, you may not be free to share, but I'm curious about any light you can shed at this time.

Personally, I'm more jittery than usual since life has caused me to be uncharacteristically absent from FT and other forums lately. The known, no matter how bad the news, is better than the unknown, I suppose.
NAMRU-3 isn't saying anything.

PS Sequences are coming out of Nigeria (from 2007) and they are a MAJOR distaster zone with all kinds of mixing and matching).
 
Re: What do you think is going on in Egypt?

I think they are reporting any cases of people who have severe flu symptoms. Since they are hypersensitive to the possibility of a pandemic, everyone suspected is probably getting Tamiflu. How will we ever know the
H5N1 status if patients receive Tamiflu before they are tested?

What is the protocol for testing for H5N1? Would they test before or after giving Tamiflu? If there is a Tamiflu blanket, would anyone test positive for
H5N1 even if they had it?
 
Re: What do you think is going on in Egypt?

Good question Angie, I don't think I have ever read the WHO protocol for testing. I do know that if you start antivirals the test results are flawed.
 
Re: What do you think is going on in Egypt?

If the people counts are off, how about keeping track any health care workers who get sick? This should be a barometer.
 
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