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WHO considers raising global pandemic alert level

Re: WHO considers raising global pandemic alert level

As far as I know, all meeting today are confidential. I've not seen any references to public attendance/web-casts
 
Re: WHO considers raising global pandemic alert level

Lack of information is what causes panic.


I wouldn't mind some information about the New York 'flu'. I imagine if those kids have the swine flu, it will be one heck of a conference call.
 
Re: WHO considers raising global pandemic alert level

I wouldn't mind some information about the New York 'flu'. I imagine if those kids have the swine flu, it will be one heck of a conference call.

Yes, would imagine they will know more by later today.

There is always a human tendency to not want to believe everything we are being told. Does the government tell us everything? Do we want to know everything?

The carefully chosen words that CDC and WHO use is what I normally pay attention to. I am concerned when they tell us that they are "very very" concerned. You don't have that often.

The internet is making it easier to spread rumors and half-truths. Everything is instantly known by millions of people. Secrets are hard to keep. What took days in the past for people to find out about occurs within hours today.

We will see what they say this afternoon. If they raise the alert level then I suppose we have a serious situation.
 
Re: WHO considers raising global pandemic alert level

From another site - WHO has met and taken no action. According to Reuters - via another site.
 
Re: WHO considers raising global pandemic alert level

<table border="0" cellpadding="0" cellspacing="0" width="100%"><tbody><tr><td class="NewsDetailsTitle">WHO chief says can''t say whether Swine Flu will cause pandemic </td> </tr> <tr> <td>
</td> </tr> <tr> <td class="NewsDetailsCategory">Health 4/25/2009 8:27:00 PM</td> </tr> <tr> <td> </td> </tr> <tr> <td class="ArticleDetails"> <table class="ImageFloat" align="left" cellpadding="0" cellspacing="0"> <tbody><tr> <td>
</td> </tr> <tr> <td id="tdCaption" class="pictureCaption" align="center" width="180">
</td> </tr> </tbody></table> GENEVA, April 25 (KUNA) -- The World Health Organization (WHO) urged health authorities in all countries Saturday to be on high alert for unusual patterns of disease and any rise in severe flu or pneumonia cases.

WHO Director-General Margaret Chan said that there is clearly an animal strain of the H1N1 virus and it has pandemic potential because it is infecting people.
In a teleconference, Chan added that however, "we cannot say on the basis of currently available laboratory, epidemiological, and clinical evidence whether or not it will indeed cause a pandemic.

Chan said that the new H1N1 flu strain -- a mixture of swine, human and avian flu viruses which has killed up to 68 people among 1,004 suspected cases in Mexico and infected eight in the United States -- is still poorly understood and the situation is evolving quickly.
She added that there were currently no indications of similar outbreaks elsewhere in the world.

"It would be prudent for health officials within countries to be alert to outbreaks of influenza-like illness or pneumonia, especially if these occur outside in months outside the usual peak influenza season," added Chan.

Chan said that health officials worldwide should also be alert to large incidences of severe or fatal flu-like illness in groups other than young children and the elderly, the ages usually at highest risk from normal seasonal flu.

"Influenza viruses are notoriously unpredictable and full of surprises, as we are seeing right now," Chan said.

WHO Director-General said that they "need to know how the virus is spread, what is the transmission pattern and whether or not it is going to cause severe disease and in what age group".

"We do not yet have a complete picture of the epidemiology or the risk, including possible spread beyond the currently affected areas. Nonetheless, in the assessment of WHO, this is a serious situation which must be watched very closely," said Chan. (end) hn.bs KUNA 252027 Apr 09NNNN</td></tr></tbody></table>

http://www.kuna.net.kw/NewsAgenciesPublicSite/ArticleDetails.aspx?id=1993192&Language=en
 
Re: WHO considers raising global pandemic alert level

Who has changed their pandemic alert page. With the new proviso's it makes me wonder if a change in level is imminent.



Current WHO phase of pandemic alert

Current phase of alert in the WHO global influenza preparedness plan

Pandemic preparedness
In the 2009 revision of the phase descriptions, WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1–3 correlate with preparedness, including capacity development and response planning activities, while Phases 4–6 clearly signal the need for response and mitigation efforts. Furthermore, periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities.
The current WHO phase of pandemic alert is 3.

<TABLE border=0 cellSpacing=0 cellPadding=1 width=750><TBODY><TR><TD>
phases1-3.gif
</TD></TR></TBODY></TABLE>


In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region (Figure 4). While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.
Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.
In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.

http://www.who.int/csr/disease/avian_influenza/phase/en/index.html
 
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Re: WHO considers raising global pandemic alert level

Thanks Solitaire.
Note the figure on the phases emphasizes the difference in phase 3 to 4 is the spread of animal to human versus human to human. This model between the phases may not have anticipated the current situation. I have not seen reports of any outbreak of swine flu in swine in the region, but it appears we are seeing only human to human transmission of a novel swine flu. I imagine that authorities are trying some type of trace back to the source. Maybe the genetic sequences will provide the answers.
 
Experts to advise WHO on pandemic alert phase

Experts to advise WHO on pandemic alert phase

GENEVA, April 26 (Reuters) - International experts will convene on Tuesday to advise the World Health Organisation (WHO) whether to raise the current pandemic alert level due to the new flu virus in Mexico and the United States, a WHO spokesman said.

"We need more epidemiological evidence from Mexico before the experts would be in a position to advise on a pandemic change," WHO spokesman Gregory Hartl told Reuters on Sunday.

"An advisory body will recommend whether or not the director-general should up (raise) the phase. They are meeting again on Tuesday," he said.

A new type of swine flu has killed up to 81 people in Mexico and infected around a dozen in the United States. The current pandemic alert level is 3 on a scale of 1 (low risk of human cases) to 6 (efficient, sustained transmission between humans). (Reporting by Stephanie Nebehay)


http://www.reuters.com/article/usDollarRpt/idUSLQ52912820090426
 
Re: WHO considers raising global pandemic alert level

"... tuesday ..."

looking at the phases definition texts, everybody can figure that Mexico is already at the stage 4

by looking at the definition text needed for be at phase 5, we can see that with the addition of the USA, it comes out to be now at phase 5.

Could it be that the WHO teams don't see the same: no way.

That's buying a little more time to see if maybe estinguish itself now when it gain out in the "open new horizons".

And our hope is that it would burn out, without making an second entrance more powerful after.

But by lefting the (especialy) distant plane travelings from Mexico out during this time, was precisely what were must be avoided, because that now driven us to have carriers worldwide, so we can speculate we are into phase 6 (as Dr. Niman pointed in Recombinomics).

So such frantic sticking onto the definition phase 3, and delaying, at the same time when the CDC/... declares that it can't be securely stopped now, is buying time.

It is not bad to buying time anyway, but to nailing the phase to 3 when it is obviously higher, would produce an sense of unbeleavings to the official institutions (as some countries tryings of linking the virus to an pig farm spread, and the vets, as used for bird flu).

It would be much better that the WHO declare a phase 4 now, with suggesting the possibility of an rapid further raising of the number.
,
At the same time it can be pointed that maybe, if we are lucky, from the actual outbreak the outcome would slow and weaken itself.

P.S. Now I'm looking an CNN correspondent from Mexico who freely breath and speak onto the camera without any mask, probably to calm down the masses.
Why we must every time see such downplaying efforts on the field, as was the eating of raw egs, etc. Giv'us a break.

As we debated here at FT, the need of make in time enaugh production facility of cell made vaccs, if they did that from the 2005, we would now have an firm decision to make vacc. of this actual virus.

But as we know, until now, and I'm now listened the Dr. S. Gupta CNN interview about, he said it is not maked any decision IF to start the vaccine production, because of the above cited reasons of small productions capacities, and long few month period with egg production, (until they can decide if that it is indeed a pandemic virus) ...
and that we can aspect poping some cases worldwide, linked to travelers maybe infected at Mexico.
 
Re: WHO considers raising global pandemic alert level

This is the problem. Plans everywhere have action lists aligned to the phase announcement. I thnk that the delays are just for govt to get their houses in order and activate their plans. It takes time to do this.

Containment measures that were originally planned are frankly, useless at this stage of the game - hence the standpoint IMHO. We will probably go straight to 5 on tuesday.
 
Re: WHO considers raising global pandemic alert level

does it have anything to do with no deaths yet in countries other than Mexico?

a worldwide case of the sniffles wouldn't raise the level...

but deaths in multiple communities in Mexico does make this at least level 4

do they take blood from patients that had it and knocked it out to design vaccines?
 
Re: WHO considers raising global pandemic alert level

does it have anything to do with no deaths yet in countries other than Mexico?

a worldwide case of the sniffles wouldn't raise the level...

but deaths in multiple communities in Mexico does make this at least level 4

do they take blood from patients that had it and knocked it out to design vaccines?

The for now slowing openly appearance of deadly cases elsewhere (and who knows there), could be another reason for such "nail it to 3" WHO tactics, but, as Vibrant post in #36, they take probably more time to give time the estabs to prepare the "inner country measures" (and to postpone an eventualy logistic crash, especialy if this virus would slow down after),
but the meaning of this phase web system was to prepare the masses also.

So maybe they do skip to 5 tuesday, but also maybe, they can decide to fogg. further.

IMO, rising the phase higher must means not try to be pardoned for that if finaly it remains low intensity.
It means, at the contrary, that we are capable to make the true neccessary steps for the majority also.
Droping down the number after the phase is the same as when a hurricane could come and go.

About the vaccines from the blood, as remarked previously, the WHO even not take the decision to start producing it widely for various reasons.
I'm shure that the VIP part would gain theirs (prototipes at least). ;)

So if the WHO don't give the signal, maybe the national worldwide states would (or already are) start to produce it (if they received the strain).;)

The others would wait the private production lines SCHEDULING ...
 
Re: WHO considers raising global pandemic alert level

I think the delay in vaccine production may be more down to the fact they want to see how stable this virus is.

Producing lots of vaccine and using limited egg and other resources, (if the virus changes significantly), would only waste time in getting a vaccine that could actually work.
 
Re: WHO considers raising global pandemic alert level

Being lazy I've copied a couple of posts I made earlier on CE. It's unlike me to go into rant mode but I think WHO are handling this all wrong :(

Sky News is reporting that WHO will meet on Tuesday to decide whether to raise the alert level. (no link yet)

I have never been overly critical of WHO but that has now changed. They redefine the Phase Alert criteria giving them the mechanism to raise the level and still don't do it even though we are clearly at Level 4 now.

I'm rapidly losing faith in them. In my opinion, from what I've seen over the years, there is no chance they will be able to contain a pandemic at source, they always seem too late to the party, and don't have the courage to pre-empt a potential global health crisis. They are nothing better than a global health surveillance group, telling us what we already know and I fear for us all.

I understand that we wouldn't want an organisation that is always crying wolf, but this is a clear and present danger that is smacking them in the face.

I can only think that they want to wait till the media has had time to widely advertise the new phase 4 criteria - Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion - so people can digest that little nugget and won't panic when the level is raised.

What will it take for them to raise it now? The final squeeze on the trigger? i.e when confirmed cases are found outside of Mexico and USA, well it'll just be way too late then won't it.

Perhaps they're keeping their fingers crossed that it will have all gone away by Tuesday.

and

Yes, by the time they give a Phase 5 or 6 alert it will all be over.

In the UK our internal alert levels don't kick in until level 6 is declared by WHO. If I remember rightly our stocks of Tamiflu are deployed around the country when we get to WHO level 4. It just seems to me that WHO faffing about like they do could seriously put us at risk with little time to get our stocks to where they need to be.

I'm not panicking, I'm just a bit concerned about this swine flu. Certainly not at a level were it H5N1 in Mexico, because I feel at this time, it's like comparing apples and oranges, but it's all fruit isn't it?

What worries me is that the cascade of actions triggered at WHO level 4 could descend into a shambles because of time pressures, after all we may already have swine flu cases walking around shedding virus, with us at a UK level 3 by tomorrow. If this does become pandemic it will all be too late.

United Kingdom
When the international situation reaches WHO Phase 6 there will be 4 alert levels in the UK:

UK alert level 1 No cases in the UK
UK alert level 2 Virus isolated in the UK
UK alert level 3 Outbreak(s) in the UK
UK alert level 4 Widespread activity across the UK
 
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