WHO Declares Phase 6 - Full Pandemic Due to Novel H1N1 Spread

HenryN · May 4, 2009

Re: Spokesman: WHO may raise alert to highest level

Re: Spokesman: WHO may raise alert to highest level

gsgs said:
I'm confused. Sometimes they indicate phase 6 would come soon,(Ryan,Chan,)
then (others) say no, we're not there yet. (Chan,BanKiMoon)

unfortunately noone gives probability estimates...so we must try to "interpret"
the "may"s and "maybe"s , trying to assign our individual probabilities to it.
I'm at 40%, that there will be a pandemic (starting) in 2009

Please. The pandemic began several weeks ago.

pablomorgan · May 4, 2009

Swine flu update: WHO considering alert level 6

Swine flu update: WHO considering alert level 6

The World Health Organization (WHO) may raise the pandemic alert level to 6, meaning a pandemic is in progress. The H1N1 swine flu strain is turning out to be mercifully mild, but WHO maintains that their job is to alert the world of a global influenza of any type. Scientists for the Centers for Disease Control (CDC) are cautiously optimistic that this strain of H1N1 will remain mild, though they stress that influenza evolution is unpredictable and could prove serious once again come autumn. Reuters reports:

WHO chief Margaret Chan warned against over-confidence following a stabilization in the number of new cases of the H1N1 strain that has proved deadly in Mexico. "Level 6 does not mean, in any way, that we are facing the end of the world. It is important to make this clear because (otherwise) when we announce level 6 it will cause an unnecessary panic," she told Spanish newspaper El Pais. "Flu viruses are very unpredictable, very deceptive ... We should not be over-confident. One must not give H1N1 the opportunity to mix with other viruses. That is why we are on alert."

The WHO Alert Phase 6 simply means that a pathogen, in this case the H1N1 virus, is infectious enough to spread worldwide. It does not mean massive death or global chaos. Phase 6 can be reached even if the pathogen is relatively benign, but indicates that national and local agencies should report all cases and remain prepared to initiate a widespread response should it become necessary.
http://www.examiner.com/x-9404-Menl...update-WHO-to-raise-pandemic-alert-to-level-6

phio · May 4, 2009

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Florida1 said:
She did not say anything new.

It is common knowledge that WHO is considering moving to Phase 6.

We need to prepare but we need to live our lives.

We need to watch for the possible genetic changes in both H1N1 and H5N1.

It's really their call on this, if they decide to do it, they will. I'm watching carefully what's happening in the US.

sharon sanders · May 4, 2009

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Discussion thread here:

http://www.flutrackers.com/forum/showthread.php?t=102689

Please post factual articles on this thread.

Siegfried X · Jun 3, 2009

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

WHO Tweaks Pandemic Label to Avoid Swine Flu Panic

June 3 (Bloomberg) -- Swine flu, becoming entrenched in Australia and Chile, will prompt the World Health Organization to declare the first influenza pandemic in 41 years, said three people familiar with the agency?s plans.

Margaret Chan, the WHO?s director-general, will make the announcement sometime in the next 10 days, said the people, who spoke on condition of anonymity because the deliberations are private. The agency, having spent the past five years alerting the world to the dangers of a pandemic, is now looking for a way to declare one without causing panic.

Chan has to navigate a delicate path between raising alarm about a virus that in most cases causes little more than a fever and a cough, and underestimating a bug that could kill millions. Moving to the top of WHO?s six-step pandemic scale may spur some countries to restrict travel, ban public events and adopt other measures that aren?t needed for mild flu, worsening the deepest economic slump since the Great Depression.

?The formalization of an influenza pandemic does have cascading consequences,? said Michael Leavitt, former U.S. health and human services secretary. ?The decision ought not to be taken lightly,? Leavitt said in an interview. ?The system of evaluating and triggering different levels of alert is still being refined at the WHO.?

Chan and colleagues spent 7 hours on June 1 consulting experts and public health officials from 23 countries on how to explain that swine flu is global, but not severe.

Following the discussion, the WHO is considering a three- point scale to denote different levels of severity once phase 6 has been declared, Keiji Fukuda, the agency?s assistant director-general of health security and environment, said on a conference call with reporters yesterday.

WHO Tweaks Pandemic Label

Sally Furniss · Jun 4, 2009

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Manila cautions WHO on pandemic declaration

By Dona Pazzibugan
Philippine Daily Inquirer
06/04/2009

MANILA, Philippines -- Health Secretary Francisco Duque III urged the World Health Organization (WHO) on Thursday to be ?most careful and prudent? before declaring a pandemic alert in view of the spread of the Influenza A(H1N1) virus to 66 countries, including the Philippines.

Duque reiterated the position of the health ministers of the Association of Southeast Asian Nations (ASEAN) and three partner countries that the WHO should also consider the severity of the virus and not just its geographic spread.

?We do not want a disproportionately destructive global scare from a virus that has thus far only shown mild symptoms in most of the cases that we are seeing in affected countries,? he said at a news briefing.

?We do not need this at a time of great economic crisis and uncertainty. But at the same time we should not also underestimate the potential of the virus to become more severe in the future,? he added.

The Department of Health has so far confirmed 29 cases and recommended the 10-day suspension of classes at the De La Salle University on Taft Ave., Manila, after two foreign exchange students there tested positive for the virus.

Duque said health authorities anticipate that more cases would be confirmed in the coming days since the DoH was tracing the contacts of the confirmed cases and since there was no restriction to international travel.

http://newsinfo.inquirer.net/topsto...6/Manila-cautions-WHO-on-pandemic-declaration

FrenchieGirl · Jun 5, 2009

WHO Calls Emergency Meeting

WHO Calls Emergency Meeting

WHO call emergency meeting on H1N1 flu

GENEVA, June 5 ? World Health Organisation (WHO) Director-General Margaret Chan is holding an emergency meeting today to discuss the severity of H1N1 flu outbreaks, but no decision is expected on moving to the top level of pandemic alert, a WHO spokeswoman said.

?The agenda is not to decide on phase 6, I would like to stress this,? WHO spokeswoman Fadela Chaib told a news briefing in Geneva. The teleconference is set to begin at 1200 GMT (8.00pm Malaysia) and last about an hour, she added.

?There is no timetable for WHO to go into phase 6, as you know we need to see community transmission in another WHO region and secondly to assess the severity,? she said.

The experts will discuss new findings about the virus as well as international public health measures, Chaib said.

The new strain, commonly known as swine flu, has infected 21,940 people in 69 countries, killing 125 of them, according to the United Nations agency?s latest tally. Mexico, the United States and Canada have borne the brunt of the illness and a case was confirmed in Saudi Arabia for the first time.

Keiji Fukuda, the WHO?s acting assistant director-general, said earlier this week that the spread of H1N1 flu in Spain, Britain, Japan, Australia and Chile had nudged the world closer to a pandemic.

For now, WHO?s pandemic scale remains at the second-highest level, phase 5 on a scale of 1 to 6. ? Reuters

gsgs · Jun 7, 2009

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

May 20, 2009

Allison McGeer:
I think it is a pandemic already

Peter Palese:
In the past we talked about a 1918 pandemic, a 1957 and a 1968. And if you use it in that sense,
in the classical sense of serious pandemic, then obviously (with) the swine H1N1, the name is not justified.

Michael Osterholm:
The novel H1N1 virus is causing a pandemic.

Edwin Kilbourne:
My prediction would be that it's going to be further transmitted and will become pandemic in the sense of global in distribution
But it's not going to be a very important disease in terms of mortality
And perhaps not even in terms of total morbidity."

Ian Gust
this virus is unlikely to match most people's mental picture of a pandemic.
The term pandemic as it's used in a popular sense relates to those occasions when there's
an abnormal level of influenza activity around the world associated with significant additional
illness and significant additional deaths and representing a major strain change
I think that this is likely to be somewhat less than that. That it's likely to be pretty much
like a regular flu season. More like (the mild pandemic of) '68 than anything else.

Malik Peiris:
Influenza continues to confound us even in semantics
When the (swine) H1N1 is confirmed to have spread globally, it is a pandemic.
Severity is immaterial in that definition . though, that for the public, a pandemic without severity
may seen like a "why bother?" kind of event.
I think this is really one for the communication experts,
we are redefining the meaning of the word pandemic."
To me, a novel virus that spreads globally is a pandemic, irrespective of mortality.

Albert Osterhaus:
A pandemic doesn't have to mean that people die like flies. So even if you have a limited number
of fatal cases, but still a virus causing disease and spreading around the world, you have a pandemic
by definition

Alan Hampson:
...This current one actually sits somewhere between normal seasonal and normal pandemic -
if there's any such thing as a normal pandemic.

Lance Jennings:
Should it be called a pandemic? I believe it probably should be, if not now, in the very near future
if there's continued spread. Because it is a novel virus and it is spreading.

John Oxford:
to me a pandemic is a global outbreak and this is not yet a global outbreak. It's an outbreak
in the Northern Hemisphere. And my personal view is to wait and see what happens.

David Sencer:
If we go by the dictionary definition, we are in a pandemic now. The question is the sustainability
of human-to-human transmission and case severity. I think we have to assume in our planning
that it will continue. Whether the severity of disease will increase is unknown.

Ian Gust:
A new strain which spreads to all but one continent is by definition pandemic.
But it's qualitatively different from what people have been thinking of as a pandemic.

Giuseppe · Jun 7, 2009

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Re: WHO Will Probably Go to Phase 6 Because of Outbreak of 2009 H1N1

Pandemics are often associated with ''panic'' in media outlets.

When a novel pathogen emerges and starts to spread around the globe and no countries or regions are spared, we are facing a pandemic situation: the contemporary presence in at least the entire world of epidemics sustained by a single pathogen.

Cholera pandemics recurred historically and one it is currently ongoing.

Plague pandemics are the most known and the most recent is ongoing, even whit sporadic cases in humans. The clue is the worldwide dispersion of the pathogen and its link to human illness.

HIV/AIDS pandemic started at early '80 of the past century and it is currently ongoing.

So, this new H1N1 lineage is definitely a pandemic pathogen, since at the moment it is spreading in a number of regions in various continents.

Cholera, plague, HIV/AIDS have different causative agents, transmission patterns, clinical courses but all have in common the fact of being simultaneously present in almost all the planet, irrespective of the actual case-fatality rate or overall morbidity in the general population.

Unfortunately, the ''word'' pandemic was associated with apocalyptic scenarios for decades and was employed for several purposes, extraneous at the scientific world: for ''cold-war-like'' propaganda, for terrifying people, for commercial purposes...

We are facing a relatively new pathogen (the H1N1-swl) and we cannot know its actual impact on human populations until the epidemic waves will be passed.

The most important thing I think it is the level of un-preparedness demonstrated by the most affluent nations, armed only of a small amount of drugs of uncertain effectiveness, without a comprehensive influenza treatment protocol, and of course, without a vaccine manufacturing system able to respond of a sudden need.

The delerict condition of world's health care system, nearly on collapse in at least third quarters of the world's nations after decaded of ultra-liberist politics, puts at risk thousands of millions of people, left without basic resources, and by this perspective, WHO uncertainty moves about the pandemic level may be understood.

FrenchieGirl · Jun 9, 2009

WHO getting close to declaring H1N1 pandemic

WHO getting close to declaring H1N1 pandemic

WHO getting close to declaring H1N1 pandemic
9 mins ago

GENEVA (Reuters) ? The World Health Organization said on Tuesday it was getting close to declaring a full-blown pandemic caused by the H1N1 virus, which has infected more than 26,500 people in 73 countries.

Keiji Fukuda, acting WHO assistant director-general, voiced concern at the sustained spread of the new strain in countries including Australia following major outbreaks in North America. Confirmed community spread in a second region would trigger moving to phase 6 from phase 5 on its 6-level pandemic alert scale.

Fukuda, asked whether there was any doubt that a pandemic was under way, told a weekly teleconference: "We are really getting very close to that."
(Reporting by Stephanie Nebehay, editing by Andrew Dobbie)

theforeigner · Jun 9, 2009

Re: WHO getting close to declaring H1N1 pandemic

Re: WHO getting close to declaring H1N1 pandemic

UPDATE 1-WHO getting close to declaring H1N1 pandemic

Tue Jun 9, 2009 12:17pm EDT

* WHO "very close" to declaring full pandemic
* Important to avoid panic, says Fukuda

(Combines stories, adds quotes and background)

GENEVA, June 9 (Reuters) - The World Health Organisation is getting close to declaring a full H1N1 influenza pandemic but wants to make sure countries are well prepared for such a move to prevent a panic, its top flu expert said on Tuesday.

Keiji Fukuda, acting WHO assistant director-general, voiced concern at the sustained spread of the new strain in countries including more than 1,000 cases in Australia following major outbreaks in North America where it was first detected.

The disease, widely known as swine flu, which has infected over 26,500 people in 73 countries, with 140 deaths, has also spread widely in Britain, Spain and Japan.

Confirmed community spread in a second region beyond North America would trigger moving to phase 6 from the current phase 5 on the WHO's 6-level pandemic alert scale.

Asked whether there was any doubt that a pandemic was under way, Fukuda told a weekly teleconference: "We are really getting very close to that."

Fukuda said a decision to declare a pandemic involved more than simply making an announcement. The United Nations agency had to ensure that countries were able to deal with the new situation and also handle any public reaction.

"One of the critical issues is that we do not want people to 'over-panic' if they hear that we are in a pandemic situation," Fukuda said.

A very real danger was that hospitals could be overwhelmed by people seeking help when they did not really need it.

Since the new flu strain first appeared, many people have stopped eating pork, pigs have been culled in some countries, trade bans on meat imposed, travellers quarantined and some countries have discussed closing borders.

"These are the kinds of potential adverse effects that you can have if you go out without making sure people understand the situation as well as possible," Fukuda said. (For a WHO note on its pandemic alert scale go to: here ) (Reporting by Jonathan Lynn and Stephanie Nebehay; Editing by Richard Balmforth)

Gert van der Hoek · Jun 9, 2009

Re: WHO getting close to declaring H1N1 pandemic

Re: WHO getting close to declaring H1N1 pandemic

WHO Needs to Prepare Before Declaring Flu Pandemic, Fukuda Says

By Phil Serafino

June 9 (Bloomberg) -- The World Health Organization is holding off on declaring a flu pandemic while it prepares governments and the public for the announcement, said Keiji Fukuda, the agency?s assistant director-general of health security and environment.

The Geneva-based United Nations health agency wants to educate countries further about the meaning of a pandemic to prevent overreaction, Fukuda said on a conference call with journalists today. Raising the WHO?s six-step pandemic scale to its highest level might cause people who are healthy to flock to hospitals, preventing the sick from getting care, he said.

?We are really working pretty hard to get these messages out to people,? said Fukuda. ?We know that we are getting closer probably to a pandemic situation.?

The swine flu virus, also known as H1N1, is spreading in Australia, Chile and the U.K. The number of confirmed swine flu cases in Australia reached 1,211, the government said today, the highest number outside North America. The southeastern state of Victoria has 1,011 confirmed cases, the federal health department said on its Web site.

The WHO also is continuing to lay the groundwork for development of a vaccine, ensuring a supply of antiviral medicines and providing clinical guidelines on the flu, Fukuda said.

?We very clearly see what is going on in Australia, but what we?re doing is working very hard to make sure that everyone is in the best position as we get closer to a phase six declaration,? Fukuda said.

The agency has noticed a disproportionate number of serious cases among Canada?s Inuit population, and it?s not clear why, he said.

The WHO says 26,563 cases, including 140 deaths, have been reported in 73 countries. In most cases, the illness causes symptoms no more serious than seasonal flu.

http://www.bloomberg.com/apps/news?pid=20601081&sid=aA4ZtujVg7E4

sharon sanders · Jun 10, 2009

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

hat tip FT Resident Revere -

Swine flu: are we there, yet?

Category: Infectious disease ? Influenza treatment ? Pandemic preparedness ? Swine flu ? WHO

Posted on: June 10, 2009 6:56 AM, by revere

Listening to yesterday's press briefing with WHO's Dr. Keiji Fukuda (audio file here), several things seemed clear to me. The first is that everyone, WHO included, thinks a pandemic is well underway. Second, WHO's efforts to explain why they are not making it "official" by going to phase 6 are becoming increasingly awkward and the explanations manifestly tortured. Essentially what Fukuda said was that WHO was waiting for its member nations to signal they knew it was a pandemic and then WHO would say it was a pandemic. It was reminiscent of the cries of one of the principals of the revolution of 1848 as he chased the mob into Paris's Jardin du Luxembourg: "I'm their leader! I must follow them!" Third, despite Fukuda's calm and measured tone, there was an undercurrent of worry. The severity of the not-yet-called-a-pandemic pandemic is now being termed "moderate" (which seems accurate to me). Fukuda explicitly declined to characterize it as "mild." He also called attention to reports of "disproportionate numbers of serious cases occurring? in Canada's First Nation (indigenous) community. From the Winnipeg Free Press:

There has been a "surge" in the number of people requiring intensive care in Manitoba hospitals with flu-like illnesses, the province said Monday. As of Sunday night, there were 26 such people in hospital -- more than half of them aboriginal. All were or had been on ventilators due to influenza or of an influenza-like illness. Eight persons with severe cases required hospitalization in the past week alone.
Joel Kettner, chief provincial public health officer, said Monday "most if not all" of the cases are expected to be confirmed as the new H1N1 influenza.
[snip]
Kettner said the 26 people on ventilators in hospital are "very ill."
"Some of them have been on ventilators for several weeks... The pattern has been so far that many of these patients have required several weeks of intensive care before they have recovered."
He said that in the first week of June, the rate at which people became severely ill with what is suspected as H1N1 was far higher than it was in April or May.
More than half of those in intensive care are First Nations people -- status or non-status as well as Inuit.
[snip]
Jan Currie, vice-president of the Winnipeg Regional Health Authority, said there are normally 30 to 35 people on ventilators in Winnipeg hospitals at any one time for a variety of reasons.
The 26 listed by Kettner are in addition to that, she said. The WRHA has acquired 15 extra ventilators and may defer non-urgent procedures that would normally require ICU care. It is also taking steps to provide enough support in intensive-care units and prioritizing patients for personal care home beds.(Larry Kusch, Winnipeg Free Press)

As Fukuda points out, influenza took a heavy toll in isolated and disadvantaged communities in earlier pandemics. This is part of a picture of a well transmitted novel influenza virus, circulating out of season and hitting younger age groups differentially, just what one expects from a pandemic strain based on past experience.

The on-again-now-off-again inclusion of severity as a criterion for a pandemic is currently being spun as a descriptor to give member nation's the best information on the nature of the pandemic they are dealing with. I think that's a sensible attitude, and I don't fault WHO. The politics of any intergovernmental agency, especially in the UN system, produce a difficult and treacherous landscape to negotiate. If you've never seen it close up, it's hard to appreciate the labyrinthine and counter-to-common sense ways of the international community. This is not the UN's fault and certainly not WHO's. It is the system they (and we) are forced to work within, as mandated by the nations of the world. If the space program becomes robust enough, someday you may be able to opt out for another planet. Until then, it's no use complaining.

Meanwhile we now have the long predicted influenza pandemic. It's neither so scary nor so benign that we can afford to either hide under the bed or ignore it. What we must do is roll up our sleeves and manage the consequences.

sharon sanders · Jun 10, 2009

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

"..The on-again-now-off-again inclusion of severity as a criterion for a pandemic is currently being spun as a descriptor to give member nation's the best information on the nature of the pandemic they are dealing with. I think that's a sensible attitude,.."

I agree.

The Mountains Voice · Jun 10, 2009