LINKS - Gov. Policy & Quarantine - merged threads

[Coldwater]

U.S. Center for Disease Control: Worldwide Preparedness
http://www.cdc.gov/flu/pandemic/

U.S. Health & Human Services: Pandemic - What Can Be Done Now?
http://www.pandemicflu.gov/

Center for Infectious Disease Research & Policy -- University of Minnesota
http://www.cidrap.umn.edu/cidrap/con...flu/index.html

UN World Health Organization
http://www.who.int/csr/disease/avian.../en/index.html

New research from scientists at the Harvard School of Public Health in Boston and the University of Washington in Seattle suggests that containment can buy time to prepare, but containment alone is not enough to stop a flu pandemic from occurring.

Through mathematical modeling, the researchers show that flu outbreaks are likely to emerge in multiple locations and that containment of all outbreaks is improbable. Based on the results, the scientists predict that containment efforts could likely double the time before a pandemic appears. The researchers conclude that containment should be just one element of a multi-pronged preparedness strategy.

http://www.medicalnewstoday.com/medi...p?newsid=38105

Federal officials on a nationwide awareness tour urged communities to prepare in advance for worst-case scenarios, including a possible six-week quarantine, if avian flu becomes a virus transmitted from person to person.

“You need to do this now. You need a plan and a strategy for preparedness,” said Alfonso Martinez-Fonts Jr., special assistant to the secretary for the private sector of the U.S. Department of Homeland Security.

Small communities and even neighborhoods need to organize, officials said, because if a pandemic strikes, many people will be confined to their homes. Under quarantine, people will have no way to get to hospitals, grocery stores or town centers, officials said at the Feb. 21 meeting in Dover.

Pandemic planning requires addressing the role of schools, businesses, public agencies, faith-based organizations and others, said U.S. Department of Health and Human Service Deputy Secretary Alex Azar.

“This is an ever-present threat,” U.S. Surgeon General Richard H. Carmona said.

http://www.capegazette.com/storiescu...eat022406.html

The CDC has put together a slide presentation on quarantine practice and law which is quite interesting.


http://www.chems.alaska.gov/phtn/fly...onHandouts.pdf

[Hotwater]

Bank and Thrift Agencies Issue Advisory on Influenza Pandemic Preparedness

The federal bank and thrift regulatory agencies today issued an interagency advisory to financial institutions and their technology service providers that is intended to raise awareness of the threat of a pandemic influenza outbreak and its potential impact on the delivery of critical financial services. The advisory discusses the National Strategy for Pandemic Influenza and the roles and responsibilities this strategy outlines for financial institutions and advises financial institutions and their service providers to consider this and similar threats in their event response and contingency strategies.

The advisory, which is being issued by the Board of Governors of the Federal Reserve System, the Federal Deposit Insurance Corporation, the Office of the Comptroller of the
Currency, and Office of Thrift Supervision, is attached.

Bank and Thrift Agencies Issue Advisory on Influenza Pandemic Preparedness

[bikerduck]

Miami International Airport plays a role in the county health department's plan to prevent a bird flu outbreak in South Florida.
Part of that policy: airport officials can keep a plane from taxiing to a terminal if they think an affected passenger is aboard.

Lauren Stover, assistant MIA director, said, "We are aggressively working with our federal partners here at MIA to identify certain areas and put processes in place to address this concern."

Stover said, "We have identified an area on the airfield where we can block an aircraft and then work with the authorities to transfer the passengers to an area where they can be quarantined for whatever period of time we need to keep them."

MIA has already set aside a room that would be used as a sort of containment area for a passenger suspected of being infected. The room is in a restricted area of the airport so the passenger would never make it into the main terminal.

Some humans have been infected, but almost all after contact with birds.

The virus has shown-up in Asia, Europe and Africa but has not reached the United States.

Some international passengers say it is something they worry about, while others don't give it much thought.

Passenger Beatriz Beraud said, "Well yes, of course, mostly with children I worry. But we have to travel, so we keep on doing it... but it would be good if there was more safety."

Passenger Ken Jackson said, "It's just... I don't know. It seems too far away."

Jackson said the threat just doesn't seem real yet.

http://news.yahoo.com/s/wplg/20060330/lo_wplg/3366410

[bikerduck]

WASHINGTON (Reuters) - Travel restrictions and school closures will do little to stop a pandemic of bird flu from marching across the United States, but they may slow it enough to distribute drugs and vaccines, according to a new study published on Monday.
"It's probably not going to be practical to contain a potential pandemic by merely trying to limit contact between people such as by travel restrictions, quarantine or even closing schools," said Timothy Germann of Los Alamos National Laboratory in New Mexico, who worked on the report.

"But we find that these measures are useful in buying time to produce and distribute sufficient quantities of vaccine and antiviral drugs."

Their study, published in the Proceedings of the National Academy of Sciences, supports the approach being pursued by the U.S. government and recommended by the World Health Organization for preparing for a possible influenza pandemic.

"Our model suggests that the rapid production and distribution of vaccines, even if poorly matched to circulating strains, could significantly slow disease spread and limit the number ill to less than 10 percent of the population, particularly if children are preferentially vaccinated," the team at the U.S. Department of Energy's Los Alamos National Laboratory and the University of Washington wrote.

Catherine Macken of Los Alamos said the computer model used in the study provided a surprising finding -- using a weak vaccine in many people would be better than trying to vaccinate a smaller number of people with a more effective dose.

"If you reduce somewhat the length of time that someone is infective ... you end up getting a significant impact," Macken said in a telephone interview.

"You might be better off vaccinating twice as many people, getting a lower level of protection, but still getting an improvement in susceptibility."

No flu vaccine is perfect and experts have been uncertain which approach would work better.

DRUGS CAN HELP TOO

Using several million doses of drugs like Roche AG's Tamiflu and GlaxoSmithKline's Relenza that can help prevent influenza infection could also help, the researchers said.

The H5N1 strain of avian influenza is spreading rapidly in birds around the world and experts believe it will soon be found everywhere. It rarely infects people, but has sickened 190 people and killed 107 of them, according to WHO.

If the virus mutates slightly and gains the ability to pass from person to person easily, it is likely to become much less fatal but could cause a pandemic.

Scientists are racing to make a vaccine against it and governments are trying to stockpile drugs that can prevent and treat the infection, but supplies are low.

In the meantime, health experts are trying to work out the best way to deal with a pandemic if it comes, and want to know if schools, businesses and transportation should be closed to try to slow the flu's spread.

The team at Los Alamos and the University of Washington ran a complex computer simulation of what the spread of bird flu might look like in the United States. They say their findings would hold for any highly mobile society.

"In the event that a pandemic influenza virus does reach the U.S., according to our results, the U.S. population could begin to experience a nation-wide pandemic within 1 month of the earliest introductions," the researchers wrote.

The model assumes that about a third of the population would become infected -- the rate seen in the past two pandemics, in 1957 and 1968.

They included several circumstances for people to meet and potentially pass the virus along, including households, neighborhoods, preschools, playgroups, schools, shops and work.

http://news.yahoo.com/s/nm/20060403/...rdflu_usa_dc_1

Originally posted by MarilynB
Here is a map where you can click on your state and read its pandemic plan.

http://www.cste.org/specialprojects/...s/StateMap.asp

GREAT! The state of Ohio's page says it will be post in November!
What do we do til then?????

[bikerduck]

WASHINGTON - Only half of Americans are confident their government will deal effectively with the bird flu if it reaches the U.S., and they want strong steps including quarantine and closed schools if there's an outbreak among people, according to a poll.

Full Article at Link

http://www.theolympian.com/apps/pbcs.../NEWS/60421052

[Deepwater]

Here it is in all its glory:

http://www.usatoday.com/news/washing...flu-report.pdf

[Deepwater]

By Greg Toppo, USA TODAY

President Bush's plan to slow the spread of a deadly pandemic flu devotes seven of its 227 pages to what schools and colleges can do in case a 1918-style flu epidemic hits the USA.
Most of the recommendations, released Wednesday, are standard — communicate, figure out who's in charge, encourage kids to wash their hands.

But one suggestion is a showstopper: If massive absences occur, the plan says, schools should develop "alternative procedures to ensure continuity of instruction."

That is, find other ways to hold class — through the Internet, local TV, telephone trees or even sending lessons to students by U.S. mail.

Educators welcome the suggestion, but say it won't be easy.

"It's a good idea, but impractical," says Terry Hartle of the American Council on Education, a group that represents college presidents. Darryl Alexander, who handles health issues for the American Federation of Teachers, agrees. "On paper, I think it's a fantastic idea. But it's going to take a lot of resources and the federal government is not offering any."

The plan aims to slow the spread of a deadly H5N1 virus, should it mutate into a strain that easily jumps from person to person. In the event of a major pandemic, it predicts, communities could see six to eight weeks of active infections, with schools a prime location for transmission.

Alexander says the plan offers no incentives for teachers

http://www.usatoday.com/news/health/...-schools_x.htm

[Deepwater]

Analysis by Dr. Niman

United States Deploys Tamiflu Stockpile to Asia

Recombinomics Commentary
May 22, 2006

The United States has sent a supply of Tamiflu to Asia to help the region prepare for a human outbreak of avian influenza, U.S. Health and Human Services Secretary Mike Leavitt said on Monday.

"I am not going to specify the amount or the location, but I want to make clear that we are beginning to deploy it," he said

The deployment of Tamiflu treatment courses to Asia is cause for concern. Tamiflu supplies in the United States are below those of most industrialized countries, so deployment from the US signals a potentially serious situation.

The current H5N1 bird flu outbreak in North Sumatra, Indonesia has recently caused concerned because the number of fatalities in the cluster rose to seven today and the transmission chains appears to have extended through three of four generations.

Today's fatality was the father of a member of a large cluster. The father had left the hospital ad refused Tamiflu treatment prior to being readmitted and dying on Monday. Hs time at home may have exposed additional family members and contacts. Moreover, earlier reports had described three additional family members who began to show H5N1 bird flu symptoms last week. The latest case was withheld from the WHO update as were te disease onset dates. Withholding of this information creates additional concerns..

http://www.recombinomics.com/News/05...e_4_Raise.html

[Deepwater]

This is a technical article, but an important one to demonstrate how current pandemic plans are not preparing properly.

"Reducing the Impact of the Next Influenza Pandemic Using Household-Based Public Health Interventions"

National preparedness plans currently focus on reducing the IMPACT associated with the pandemic rather than reducing TRANSMISSION.

Full article:

http://medicine.plosjournals.org/arc....0030361-L.pdf

[Deepwater]

Dr. Woodson is an author of books and articles on pandemic influenza. He posted the following comments Oct 24 on this fluwiki.com forum: http://www.fluwikie2.com/pmwiki.php?...tartFishingIII


Many pandemic-aware people everywhere have been frustrated in their attempt to get their local public officials to come to a realistic appraisal of the risk their communities face from pandemic influenza. I have come to the conclusion that it is futile to persist in this effort. It they ask for your help that is another matter. By all means, do what you can to help but don’t hold your breath waiting for that call.


Public officials at all levels of government are not able to respond to a one-off event of the magnitude of a severe influenza pandemic. It is extremely costly to do it right on a community-wide level and is simply beyond their means. Even the cost of storage, maintenance, renewal and rotation of an adequate level of stocks is beyond their budgets.


The US Department of Health and Human Services Pandemic Influenza Plan published in November 2005 makes the prediction that the case fatality rate for the next severe pandemic will not exceed 2%. I looked very carefully at that number and the underlying assumptions and came to the conclusion that the only way they could have come up with this figure was by using the Top Down method. By this I mean they started with an estimate of the highest CFR the system could manage without an infrastructure collapse, stock market crash, and civil unrest and set that as the value to be used for the CFR. Then the gnomes within the US DHHS built the model around this value.


I am not saying that 2,000,000 American deaths are small potatoes. This many excess deaths will have a dramatic impact on us for years to come. The only comfort in this value is that it can be planned for and survived without the catastrophic consequence that derive from an estimate 5x greater which is what I expect.


The WHO is playing this issue in the same way for somewhat different reasons. The public estimate of worldwide deaths from an H5N1 pandemic is between 2 and 7 million. Internally, they predict upwards of 150 million. They also elected not to increase their Pandemic Alert Phase level to 4 even after H5N1 was passed H2H2H recently in Indonesia fulfilling their pre-established criteria. As I understand it, their reasoning is that most countries they serve simply don’t have the resources to cope with pandemic influenza of any severity. Given this fact, they decided that it was better to play down the risk so as not to cause civil unrest over the issue in the developing world. In their view, the developed nations can take care of themselves and are on their own. At this time the WHO has placed virtually all their resources into the effort to stamp out the pandemic strain when it first emerges by blanketing the outbreak area with Tamiflu. I am doubtful this strategy will succeed in the end but have not counted it out totally.


You see, the reality is governments and NGOs are powerless to affect the outcome of a really severe 1918 style pandemic. On the national level politically and in public health this is well known. In fact, they clearly say it from time to time. My guess is that these leaders want to be sure that they leave a clear public record that they warned us before the pandemic started that it could be really bad. I am sure they fear public reprisals after the pandemic is over as much as they want to avoid public panic ante-pandemic. It is not in the interest of any government to admit they are powerless to affect the outcome of any event, especially one with the potential to really make a mess of things for so long.


So, they all hope for a mild or at most moderate pandemic that will take its toll but remain manageable all the same. This is a risky bet but is what they have decided to do and what we are forced to live with. For this reason, we cannot rely on them for any help. It is why it is so important for the pandemic-aware to prepare to be self-sufficient if we want a good chance of surviving well through the coming long emergency.


Grattan Woodson, MD