I’m so frustrated. I work in an ER and I’ve asked four of the physicians what they thought about Bird Flu. They all knew very little (but of course they tried to bluff their way through) and they all said it’s not going to happen here. They even make fun of me now. They’ll tell me the patient in room 8 has Bird Flu and laugh. They think it’s all a big joke. My ER Director is no better. I asked her what our plan is for Bird Flu and she said “Oh, we’re not going to get that”. AAAHHHHHH!
To top it off, I finally got my husband on board. He got a 55 gallon drum and pump for gas, spare parts for the generator and is supporting me 100%. He had his annual exam at the doctor’s office today. He asked her for an extra prescription for 1–2 months for Glucophage and Lipitor (for Type II diabetes and Cholesterol) for stockpiling. Of course he blamed it all on me (which is fine with me). She said “absolutely not”! and added that “it’s a shame your wife worries so much about this”. Whaaaat??? He thinks she walks on water and now she’s planted the seed of doubt in his mind. That makes me so angry!
I’m beginning to feel like a freak. I feel like it’s a dirty little secret that I’m stockpiling and if the wrong people find out they will “take me away”. So, I’ll continue with my preparations, hoping the doctor didn’t turn my husband against the idea, and not say a word to anyone about it. Am I the only one who is meeting this kind of resistance? How the heck are we suppose to stockpile our prescription meds when our own medical community blows this off?
DebMcRN. I and most others at flu wiki ‘feel your pain’. It was difficult for those before us, it will be difficult for those that come after. My advice would be having made your opinion clear, let them come back to you and they will eventually. Concentrate now on your immediate community and loved ones.
Tom, please read what I just posted on H5N1 RECOMB.thread. Thanks, Sharon (whats with NOVA)
Sharon. OK
My children’s pediatrician has told me that she thinks that it is going to be a time of natural selection. She says that she does not lose sleep over it because there is nothing she can do about it. But she says that she suspects many at NIH are losing sleep over it. She says that she is not optimistic but is cautiously concerned.
My OBGYN told me to stock up on Ibuprofin and flu medications and again said that there is nothing that can be done about it.
Deb…going through same thing, although I am not stockpiling as of yet. Kids are telling me to “ chill”..I am starting to feel like I am paranoid. I did all the preparing for Y2K…and am still laughed at by my children for that…I even laugh at that now! I am not going to “ worry “ until I hear news of definite rapid h2h spreading.
When I used to live near the ocean, in a part of Florida that is rarely hit by hurricanes, I kept an emergency bag in my hall closet and I ALWAYS evacuated. My friends and family made fun of me and my spouse humored me. Post-Katrina I now feel vindicated. Let’s hope you’re not vindicated and all the preps turn out to be unneeded. That’s far better than the alternative. But if it does happen, it will be far better to be prepared.
Don’t let those docs get you down.
My wife broached the subject with one of the big guys at her hospital- his answers were cryptic in nature, but essentially “We are aware and have formulated plans for many eventualities…staff will be brought up to speed on any developing issues as the need arises.”
It sounded like yes, they are developing plans and contigencies, but that they were deliberately NOT talking about it too much in advance so as not to give employees the opportunity to think about it for a prolonged period of time, and possibly come to the conclusion that they would want to “bug out”.
These guys are businessmen first, and they can’t run their businesses if half their staff has the ability to see this coming and have alternatives in place instead of going into work.
I had a similar encounter with medical personnel when I had to take my mom to the ER a couple of nights ago. They were not derisive but I was shocked at the lack of knowledge. Our main nurse (dont know if LPN or RN) was wearing a surgical mask (they had boxes of them out for patients who might be contagious.) When I heard one of the other staff tease her about her mask she said she was on some drug that could lower her immunity. I then asked her if that was an N95 mask becuase it looked like a basic surgical mask. She had no idea what an N95 mask was so I told her what I had learned about masks—that the surgical type are just to keep your germs from infecting others—they are not filtered enough to keep small virus particles from getting IN! This of course led to a discussion of the bird flu (thanks to theirmy mom telling her I am a bird flu “expert”--she doesn’t know the conditioned response most preppers have to keep their mouth shut due to previous mocking)She tried to tell me “those people” live with birds so there is no cause for concern here…I had to explain that I was concerned about the H2H and the more people who get B2H increase the chances for such a mutation. Well, she got an education and it obviously meant there had been NO pandemic education or preparation at this institution. I just had to shake my head…To think a health practioner wouldnt know the differences in mask types or the basics on BF…scary..but not too surprising unfortunately.
The physicians have not read their own state and federal websites. Maybe you could print some pages out and post them somewhere or hand them out.
Your husband’s doctor (why did they tell the public before the doctors?) didn’t see the directive to stock up on meds. They need to see those pages.
US Gov. http://www.pandemicflu.gov/plan/healthcare.html
I guess they will have to check off the box that says, “Not Started Yet” …”Patients and families are encouraged to maintain a 30-day supply of medications and medical supplies as well as a two-week supply of non-perishable food and water.”
They are supposed to “Do No Harm”. Scoffing at a pandemic alert period, and, governmental directives to stock up and make local plans are possibly fatal mistakes and many patients look to them for guidance and help.
Doctors better educate themselves now, while there is still time. “Eating crow” now is better than getting blindsided by pandemic and State of Emergency. Here’s some links for starters (don’t forget Flu Wiki, maybe as a follow-up?):
http://www.cdc.gov/flu/pandemic/healthprofessional.htm#guidance
WHO, H5N1 clinical features: http://tinyurl.com/nplw3
Center for Infectious Disease Research and Policy: http://tinyurl.com/mnqyx
Greytpaws, There IS a lack of education in the medical arena about Bird Flu. My ER Manager went to Texas last week for an ER Leadership conference. I asked her to sit in on any discussions about Bird Flu. Of course she humored me but I could feel her eyes wanting to roll. When she returned she said there was NO mention of Bird Flu. come on…I’m concerned because I’m front line (ER Nurse) and I want SOMEONE there to be taking this thing seriously.
Sharon. I read your post. First, I used to post with my first name only, until someone else with the same first name posted and said something I didn’t like…so now I use Tom DVM hoping there are no other Tom DVM’s around that will make statements I don’t agree with. I would ask you to consider a designation as you appear to be a healthcare worker.
Everyone knows what I am and although the last thing it says is that I am smarter than anyone else…inside secret, most nurses are smarter than doctors…but it helps in considering responses. As I said sometime ago, everyone on flu wiki I consider a colleague whether my fellow scientists have degrees or not…. and most of the smartest people I have met in my life time did not have degrees.
Regarding your post….’since we don’t know the recipe for coughing and sneezing’…we may not know anything about H5N1 but we do know the recipe for coughing and sneezing. If the program is as stated they have no scientific credibility and are seeding misinformation, for whom I don’t know.
One of my points is in the 1918–2006 thread. Evolution doesn’t always occur in small ordered steps but sometimes in leaps. Mother Nature is neither predictable or always ordered as anyone who watches the weather would attest. I gave up trying to convince anyone of anything in feb 2005, so I understand how you feel. How could anyone miss something so obvious? The answer is that science has not played a role in healthcare since 1980, profit drives healthcare and has been driving it for so long, nobody understand what ethical science, scientific principles or the scientific method is about any more. If you follow the principles of science, we have been in big trouble since 2003….we are in a steady progression…the picture is mirky due to politics in regulatory agencies, politics in totalitarian states and politics in western society. What the western governments fail to realize is that unlike the 1918 outbreak, it is our developed countries that are most susceptible and will gave the greatest loss of life due to programs like you mentioned and politicians in agencies and governments who use these programs as an excuse for inaction despite overwhelming evidence.
Sometimes there is nothing we can do except stand by and watch…and be ridiculed at the same time…because people like us have no power. Hang in there.
I’m with you all. I spoke to my doctor and he didn’t know anything about it other than it’ll never get here and not to worry about it. This is why I’m worried that this will sneak into the US under the radar. We’ll have undiagnosed bird flu patients thinking they have a really bad cold/flu, continue to go to work or school and won’t go seek medical attention until they’ve spread it around a bit. The sad part is that the airline industry may be better prepared than our medical professionals. What does that say?
has anyone tried asking a Veterans Administration (VA) doctor for a prescription for stocking up? I didn’t know if they are allowed to write one for you in advance of a condition. I wanted to try and get augmentim or amoxicillin or somethign like that and am a diabled vet. I am afraid of getting a bad earache or toothache and not being able to get to a doctor WTSHTF. -that’s when the hand gun would end up being used!
I certainly have not debated this with my internist. I am not spastic about this, and wasn’t going to get the Tamiflu, until I read about the 0 blood type having the worst reaction to new virulant viruses. My internist commented on the virulant aspect, and we breifly touched on the hospital issue. I think you are mistaken, and there is a definate plan of action evolving. People are not at red alert constantly. Are you. We have to be relaxed in our daily lives, otherwise you are stressing your immune systems. Even if a physician is greatly concerned I doubt that he would show it to the average patient. They deal with life and death issues all the time, and there is at times an attitude that people outside the profession might find offhand and dismissive.I have never found that to be the case with my own physicians, but I understand the pressures, and the physicians I do see have a very kind and concerned manner.
went to my doctor the other day…asked him about bird-flu…he practically laughed in my face! Said there is NOTHING to worry about, and that only birds will get it….starting to feel paranoid, and I dont like it :(
TreasureIslandGal, try those links, get them printed out at the library if you have to, or email them to your doc.
DebMcRN, I hope she didn’t miss it because they titled it H5N1 or Pandemic, or coded it under “Emergency preparedness” or “Bioterrorism”… (yes, they may have left it completely off the radar. Make her read your state pandemic plan, she may be surprised, especially if you remind her they say No vaccines nor antivirals for the first wave, (if it’s this year or next year, for example,) and the CBO macroeconomic report expected each wave to last 3 to 5 months.
For those doctors (or officials) that say “there’s nothing anyone can do” so seem to want to let pandemic sort an unprepared public out, they are confusing the disaster with individual responses.
Of course there is nothing we can do “about” a Pandemic, nor Earthquake, Hurricane, Tsunami, ect; not in terms of stopping it! But, individuals, with the right information, and taking the right actions at the right times, can (and do) improve their individual chances of surviving disasters!
Especially the supply chain issues will be much different if people and states do or don’t stock up at all on imported or essential supplies.
(If that blood type stuff is true, Lily, I say, well, in print anyway, Drat!)
patient— I went Feb. 7th to VA (Veterans Admin) hospital and had similar experienc. They were aware that it might be a concern sometime in the future but did not say they were prepaired. The doc said, “let’s just hope it doesn’t happen.”
I believe it would be suicidal for doctors and nurses to show up for work in the absence of protective gear and prophylactic drugs. That being said, the extraordinary ignorance on the part of so many medical professionals is not only sad for us but also for them and their families. Having seen the ignorance of my child’s pediatrician, I no longer trust any of the medical care my child receives from this person. I have decided to use the yellow pages and call every pediatrician in town and beyond until I can find one with the wisdom of Gratton Woodson, who had the courage to share his plans for his patients with the rest of us. I realize this is a tall order.
Patient, your doctor’s ignorance is showing; the people that have already gotten it have double-digit mortality rates, Indonesia’s strain is over 70% fatal; nothing I’d want to mutate to easily transmissible.
These first 9 (from Oct. 2005) are still good: http://www.who.int/csr/disease/influenza/pandemic10things/en/
…”3. The world may be on the brink of another pandemic.
Health experts have been monitoring a new and extremely severe influenza virus – the H5N1 strain – for almost eight years. The H5N1 strain first infected humans in Hong Kong in 1997, causing 18 cases, including six deaths. Since mid-2003, this virus has caused the largest and most severe outbreaks in poultry on record. In December 2003, infections in people exposed to sick birds were identified.
Since then, over 100 human cases have been laboratory confirmed in four Asian countries (Cambodia, Indonesia, Thailand, and Viet Nam), and more than half of these people have died.
Most cases have occurred in previously healthy children and young adults.
Fortunately, the virus does not jump easily from birds to humans or spread readily and sustainably among humans.
Should H5N1 evolve to a form as contagious as normal influenza, a pandemic could begin.
4. All countries will be affected.
Once a fully contagious virus emerges, its global spread is considered inevitable. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it. The pandemics of the previous century encircled the globe in 6 to 9 months, even when most international travel was by ship.
Given the speed and volume of international air travel today, the virus could spread more rapidly,
possibly reaching all continents in less than 3 months.
5. Widespread illness will occur.
Because most people will have no immunity to the pandemic virus, infection and illness rates are expected to be higher than during seasonal epidemics of normal influenza. Current projections for the next pandemic estimate that a substantial percentage of the world’s population will require some form of medical care. Few countries have the staff, facilities, equipment, and hospital beds needed to cope with large numbers of people who suddenly fall ill.
6. Medical supplies will be inadequate.
Supplies of vaccines and antiviral drugs – the two most important medical interventions for reducing illness and deaths during a pandemic – will be inadequate in all countries at the start of a pandemic and for many months thereafter.
Inadequate supplies of vaccines are of particular concern, as vaccines are considered the first line of defence for protecting populations. On present trends, many developing countries will have no access to vaccines throughout the duration of a pandemic.
7. Large numbers of deaths will occur.
Historically, the number of deaths during a pandemic has varied greatly. Death rates are largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations, and the effectiveness of preventive measures. Accurate predictions of mortality cannot be made before the pandemic virus emerges and begins to spread. All estimates of the number of deaths are purely speculative.
WHO has used a relatively conservative estimate – from 2 million to 7.4 million deaths – because it provides a useful and plausible planning target. This estimate is based on the comparatively mild 1957 pandemic.
Estimates based on a more virulent virus, closer to the one seen in 1918, have been made and are much higher. However, the 1918 pandemic was considered exceptional.
8. Economic and social disruption will be great.
High rates of illness and worker absenteeism are expected, and these will contribute to social and economic disruption.
Past pandemics have spread globally in two and sometimes three waves.
Not all parts of the world or of a single country are expected to be severely affected at the same time. Social and economic disruptions could be temporary,
but may be amplified in today’s closely interrelated and interdependent systems of trade and commerce.
Social disruption may be greatest when rates of absenteeism impair essential services,
such as power, transportation, and communications.
9. Every country must be prepared….”…
TreasureIslandGal— The VA would only give me a two month perscription. I will order a refill at the two month mark even if perscription lasts 3 months (take it when I need it med). This will allow me to build up a reserve.
BTW, I was stationed out of Alameda, and went through firefighting school on Treasure Island.
I find it difficult to believe that physicians et al do not know abou BF. “Loose lips sink ships” or is it cause a panic.
I talked to a very bright research doctor. One of the best in his field. Asked him a very simple question..how concerned he was. He said he hadn’t heard of H5N1.
I was trying to figure out if he was hiding his concern, or REALLY didn’t know. That’s when I started thinking this wasn’t as big of a deal, as it was being made to be. I think docors are concerned, but the realize 1. There is little they can do before hand. 2. The possibility of it happening is remote.
(Suppose any of them are so busy they haven’t heard, or are perhaps believing spin and having blind faith in “the system”, or, because the higher-ups aren’t going to send them a heads-up until it goes pandemic and hands them their marching orders at the same time?)
Nightowl, You’re right, it’s suicidal for nurses to show up for work without protection. I’m already torn about the dilema of do I go to work and risk my life (and my family’s life) and lose my job and benefits or go to work and risk getting sick with a virus that has a 50% mortality rate and keep my job and be useful. It makes me want to bug out when I see that my hospital does not take this seriously. Why should I risk death because they are ill prepared? All I ask is for personal protection gear, a vaccine (if available) and a round of Tamiflu with my name written on it. In any other circumstance, employees would not be expected to go to work in an unsafe invironment without adequate protection.
There is no MSM (medical) information on BF,AF, H5N1 circulating on the buzz channels. It is slowly drifting to the surface. A recent respiratory care monthly had a monthly feature on disaster preparedness, (since KatRita), with mostly same old stuff, but with pandemic influenza inserted here and there. The Just In Time mentality is probably better than throwing out a big condition RED. There is a big scramble at HHS to generate specific plans for medical/critical care. My CIDRAP contact recently requested that plans my group has been working on be forwarded for “immediate” consideration. Hospitals and HCWs will have to be educated and trained on the recommended methods and equipment, and so far, there is no experience on what will work. All will go straight from the drawing board to the factory floor. There will be no testing of our theories til it comes.
After this pandemic the medical establishment may well meet the same fate the Church did after the Plague.
DebMcRN. I’m not sure how much you have heard about the SARS outbreak in Canada but a deal was made with the WHO to lift the travel advisory but to do so the outbreak had to be called over…so it was called over. The politicians wanted healthcare workers to take their masks off because it was bad public relations….some nurses took their masks off and some refused. Within a week, nurses were going to doctors and hospital supervisors to state categorically that there were more SARS cases in hospital. They were told that they were wrong and to take their masks off. Finally, the nurses union president went on TV and stated that there were new cases in the hospitals.
The end result was a second wave of SARS infections. Since there is no justice, most of the second wave of cases were nurses infected after the travel advisory was called off.
You might be interested in reading the thread regarding 100,000$ fine per day healthcare workers refuse to work that was on flu wiki last weekend. This was the response by Government.
Maybe if you show them that the government is working on another flu vaccine it will get their attention, then again maybe not - depends on how open minded they are.
“Government Working on New Bird Flu Vaccine”
I’ve spoken to two personal physicians re:Avian flu over the past month.
The first one tried to blow it off as `unlikely’ at first. I countered by listing the heavy hitters (Nabarro, Olsterholm, Webster) who were taking this seriously. He backed down, and admitted he was worried, too. Said “it would be the worst thing any of us will ever experience . . . if it happens”. We talked at least 10 minutes about it, and I think he really wanted to talk more. Before I left the office, we discussed the possibility of my doing `home visits’ for some of his patients who might be too sick to come to the office.
The second doctor froze when I brought up H5N1. Stopped and considered his answer for a good 20 seconds. Very slowly he said “I’ve just attended a lecture on this . . . smarter people than me feel we are overdue for a pandemic. I believe them.”
We talked 20 minutes. He knew there had been 5 clusters of `possible H2H’ transmission. I left with a script for Tamiflu (I didn’t ask, he offered), and some advice on some supplements I might take in addition. <g>
Both doctors were obviously torn between wanting to be reassuring and being brutally honest. Both spilled their guts over their concerns, and seemed relieved to have someone to talk to about it.
Of course, I choose my doctors based on their willingness to talk and to treat me as if I know a little bit about what I’m talking about, so maybe I got lucky.
There are doctors out there who are concerned and informed. Many, I suspect, have so little to offer in the way of reassurance, that they simply avoid the subject.
Not excusing the dolts out there (I’ve worked with a number of them). Even revived a patient after a doctor pronounced him dead on the scene once. LOL, THAT didn’t go over very well, but at least the patient was grateful. (note: if you’re ever pronounced dead by an OPTHAMOLOGIST … get a second opinion <g>)
Half of all doctors graduated in the bottom half of their class. Fact of life. One we have to live, or die, with.
(They’d do better to look at the lack of infrastructure to monitor and contain the virus in the countries it’s in now. No way to stop it going pandemic if it will; better to start preparing for a pandemic.)
I wouldn’t blame the HCW who bug out and save themselves and their families; all those one who didn’t prepare or who try and make the plans work with not enough PPE nor supplies nor beds may die by the time the waves are over, and we will need wise, trained, smart, health care workers after pandemic, too.
I hope the governments pay for the paths they’ve gone down. Don’t let them say they had no idea it could be so bad, that they didn’t know how to warn the public.
Tom DVM, I really don’t find that hard to believe. I love my job but I am fully aware that I am just another number to our institution. If I were to sacrifice all and go to work during the pandemic, the hospital would be happy that a slot was filled. If I dropped dead, they would step over my dead body and continue on. I believe that politics and PR would have priority over the welfare of their staff. That’s what makes it hard for me. On one hand I feel that I need to be there to care for the patient, however, I know that the hospital does not have my back. The apathy that the physicians and the hospital are showing now does not make me feel safe to work when TSHTF.
Those who think doctors ought to be more able to translate knowledge about H5N1 into ability to make coherent judgements are confusing intelligence with wisdom.
“I hope the governments pay for the paths they’ve gone down. Don’t let them say they had no idea it could be so bad, that they didn’t know how to warn the public.”
Bush did this for me last summer when he explained in his initial comments about bird flu that he had just read John Barry’s book. I figure that made the book important enough for me to read as well because the book had clearly had an effect on him. Reading it was all I needed to know. At that point I considered myself warned.
Calico— that anouncment got the ball rolling more than anything in the previous 2 years. The press and other world governments took notice. Some might say too little too late, but a large ship like the Titanic doesn’t turn on a dime.
DebMcRn: Even if you can’t make the decision now, start ordering your own gear and antivirals if you can. I’ve read that, ultimately, a larger burden will fall on nurses than doctors. As a layperson who knows that most people will be turned away rather quickly from full hospitals, we would be in much better shape if our private doctors and nurses would help us get medical kits together and then be available by phone (ala Gratton Woodson). For example, during a pandemic, when my child has his annual sinus infection, the doctor’s office is the last place I want to take him for the antibiotics that he always needs.
I fully support the right of nurses and doctors not to show up for pandemic work. I don’t want to show up at their workplace either. Further, separate hospitals should be identified for non-pandemic patients only. Other emergencies won’t stop during a pandemic.
I just wish the medical community would help us prepare so we will all be safer. Given the shortage of ventilators in the U.S., absence of a vaccine, and lack of antivirals, I took Woodson’s guide to heart. When I found out that my son and I are on the last of the list for a vaccine (i.e., years), I decided that I had better study up pronto. Sadly, I know what I need in my medical kit, I just can’t write the prescriptions. The ignorance on the part of many in the medical community is inhibiting their ability to think outside the box and help all of us to prepare. Then to top it off, when thinking people like you, Deb, could be of such help, you are stifled. It is appalling. I’m afraid that physicians are no better than the community and culture they come from. Ignorance seems to be the word of the day. Perhaps events will quickly turn this problem around.
You know, Nightowl, thats a really GOOD suggestion. Most people don’t have a clue what to buy, IF they can get it without a prescription - and the last place they would want to be in a pandemic is in a doctor’s office, hospital, or pharmacy trying to find the supplies they need. I would buy a doctor prepared medical kit specifially for bird flu.
Nightowl “I’m afraid that physicians are no better than the community and culture they come from. Ignorance seems to be the word of the day.”
Present company excepted?
generalizations about doctors are as untrue as generalizations about anyone else. The best thing to do with doctors is to point them to the New England Journal of Medicine article by Osterholm or the WHO Writing Group and let them read.
We’ve been into see our doctor several times within the last month due to flu viruses currently ciculating that have had secondary infections of brochitis and/or pneumonia. They have been extra agressive in treating it this year and I get the feeling that they are all worried. They have also been great about calling in persriptions for me when I need them trusting my judgement on some ongoing health issues that I have. I have been blessed to have 2 great doctors who really listen and know that I do my research into any and all health issues that concern my family.
If this thread were not here I would have had to start one. Today I saw my Doctor for the first time since I have become more informed about bird flu. After going through a short list of my medical concerns I said” and last on my list I want to talk about bird flu”. I am left to interrupt the look on his face but it didn’t seem positive. I tried to make it as brief as possible for time is such a premium these days, while at the same time, trying to convey that I had a good bit of knowledge for a lay person. (Thank you fluwiki!) I wish I had a tape recorder for I don’t want to misrepresent what he said but he gave me the impression that he was ill informed. He talked about vaccines being developed and waiting for information from the CDC. Of course, I then talked about rapid spread of the virus and the time to develop a vaccine and the concern of supply lines to get the vaccine out and how most are developed over seas. I said that I understood that it may not go H2H and if it did, it may be like 1957 or even 1967 and not as bad as 1919. I also said that I had read many reports off the CDC web site. I wanted to know with my personal health problems what I might do and would there be any different course of treatment for my asthma. He said that there was nothing we could do. I was so frustrated when I left his office! He works for Kaiser Permanente and I had always had a little security that their doctors were kept informed of current issues and treatment plans. (Now the emphasis in the last sentence will be on the words little and had) Although, after reading through this thread I am now open to the possibility that he does know of the dire possibilities and understands the gloomy outlook for hospitals and clinics if this goes H2H. Yet, if this is the case, I think they could have had a handout with the basics of hygiene and a reference to the Federal Governments flu pandemic plan as a minimum. I am going to consider calling membership services, maybe go in person to see if they are working on a handout.
P. S. I just was able to get my sister to start prepping for one of her roadblocks is her husband who is a CPA in management at a hospital in a mid sized town down state. As I understand it, he thinks we are being “silly”.
In my above comments, I should have said “many” physicians are no better…. I don’t want to imply that all physicians are ignorant. Obviously, there are forward thinking and wise ones out there. I and many of my friends are simply unable to find them at present.
My definition of a wise physician is one who realizes that the patient can do a lot of self care at home for many routine events and illnesses to lesson the burden on an overstretched medical infrastructure and to avoid exposure. It is one who realizes there may be a shortage of everything from antibiotics to insulin. It is one that will give my mother more than a three-month prescription for blood pressure medicine.
Based on other research, I do not agree with everything Gratton Woodson wrote in his first guide. I was not so interested in his specifics (everyone has an opinion) but rather in his respect and support of his patients, his willingness to tell the truth as he sees it, and the arming of his patients with the prescriptions they may need (especially the prescription part). That is wisdom in my book.
I would expect the same for DebMcRn and all nurses that they work with wise physicians who can brainstorm how best to protect themselves and their staff in the event of a pandemic, whether h5n1 or not. Not everyone will agree, but the lack of discourse about a potential pandemic among many physicians and the nurses that work with them is the same as the lack of discourse among physicians and their patients. It is a detriment to us all, and I sympathize enormously with DebMcRN.
Have the CPA go to pandemicflu.gov. You need to point people like that to the ‘official’ sites, or call his state hospital association.
auuuuhhoch! I realy feel your frustration over there.. My last vists to the doktor was a positive experience.. Only one got a little bit angry when I came with a pnaumoshot prescibed by another doktor, he did not like that, and also mumbled something about reserved for the elderly etc.. But they know the pandemic risk here, and there is going to be a big national seminar about H5N1 in a few weeks. I am very courios if they are going to talk about pandemic or only birdflu.
Here’s another article for the CPA. The point I’m making is that you have to tailor the info to the person you need to educate.
send doctors to the medical journals, send HR people here or here, etc…
Thank you, I will!
Here’s another good reference for the CPA.
Yes,anon_22,you excepted. You do good work. I have been unable to make any progress in getting our ER docs onboard. One or our staff RNs suggested that they knew what it was all about and were simply overwhelmed at the prospect of dealing with it. Maybe so but if I do not think, visualize and work a problem though I cannot prepare for it. I am not going to roll over and go quietly.Kelly
A suggestion for ER staff in particular. Every ER in the US is supposed to have a bioterror plan. The same committee that came up with one can be asked to review surge capacity and panflu plans.
These two ACEP articles will help. ER docs will have trouble ignoring ACEP.
it’s one thing to hear it from Flu Wiki or DebMcRN, another to hear it from their own professional organization.
Here are some materials specifically aimed at helping health care workers get up to speed on avian and pandemic influenza:
Three links below:
1. The (United Kingdom) Chief Medical Officer’s short “Dear Doctor” letter was sent out by Sir Liam Donaldson, who has been consistently blunt. He refuses to downplay any pandemic-related topics.
Included in his letter are two longer documents, pdf’s aimed at doctors. One is an FAQ of questions the doctors are likely to be asked by patients. The other is a more detailed description of pandemic influenza, written in the form of a “Dear Colleague” letter.
The materials were sent to every UK doc in late 2005, with a request for feedback and further questions, so that the materials could be revised and updated as needed.
UK official “Dear Doctor” letter on avian influenza and pandemic influenza:
http://tinyurl.com/o28kz
2. Here is a link to Australia’s pandemic information kit for GP’s, clinics, and hospitals. Sent around in 2005.
Preparing for an Influenza Pandemic - A Practical Guide for Medical Practitioners
3. Here is a website guestbook response by Sandman and Lanard. It only addresses a few “talking to healthcare workers” issues, and it is not about raising consciousness among the oblivious. But it is relevant to the topic of intra-hospital communication and planning in advance of a pandemic.
Talking to healthcare workers about pandemic risks,
Great links! I’m going to start a page on this topic (talking to medical people) on the wiki, including linking to this thread.
Thanks, Path Forward, and thanks for starting the thread, DebMcRN.
The medical establishment is no longer controlled by doctors - it is controlled by insurance companies, and influenced by lawyers who specialize in malpractice. Perhaps that is why the doctors will not get involved at this time.
When an ER nurse or Respiratory Therapist (the other white meat) asks about a Panflu response plan, they are told by someone (manager) that someone told them (administrator) that it was being placed in the Disaster Plan.
“Oh,..OK then”.
End of conversation.
It is a protective incompetence that will shed its layers soon. I am many places in the loop and I can see this develop.
When an ER nurse or Respiratory Therapist (the other white meat) asks about a Panflu response plan, they are told by someone (manager) that someone told them (administrator) that it was being placed in the Disaster Plan.
“Oh,..OK then”.
End of conversation.
It is a protective incompetence that will shed its layers soon. I am many places in the loop and I can see this develop.
Not in all places, rrteacher. Some are ahead of the game, some are not. Same as it ever was.
here’s the new wiki page based on this thread.
Training Kit for Pandemic Influenza for Healthcare Workers, from Hong Kong
http://www3.ha.org.hk/idctc/avianflupage/training_kit_pandemic_flu.asp
Very good quality slides, one of the most complete training material set I’ve seen.
excellent!
Will add to page.
Of course, Anon_22. I believe you are in the U.K. In my post, I mentioned the U.S. and can only speak to what I perceive as a problem here.
Path Forward,
Thanks for the link.
Dem, fantastic idea for new page. When confronted with the pediatrician’s ignorance, I handed over the U.S. government’s website and fluwikie’s.
Nightowl, “Of course, Anon_22. I believe you are in the U.K. In my post, I mentioned the U.S. and can only speak to what I perceive as a problem here.”
Nah… The UK docs are just as bad, probably worse. Anyway I was just kidding.
To get ahead on your prescriptions, may I recommend losing your medication. If you call your doctor and tell him the dog ate it, he will write you a new prescription. You should do this a few times (different excuses obviously) and even if s/he suspects that you’re not telling the truth, too bad.
anon_22: “Nah… The UK docs are just as bad, probably worse. Anyway I was just kidding.”
Well, one thing for sure, if I ever move to the U.K., and I need a doctor, I’m going to beg you for your e-mail address. Your insights have been brilliant and greatly appreciated. Do you know any good doctors in Colorado?
NightOwl, I like your idea about a physician prepared medical kit. If patients had the medications, supplements and supplies they needed to remain at home, everyone wins.
DemFromCT, Wow, I’m impressed, I like your new page. I’m going to make copies of the appropriate literature and give them to the ER doctors the ER Director, and to my physician. I think your new page will help a lot of frustrated people. Thanks!
I gave my physician the 21:01 posting by Pfwag from the Forum Differential Biological Susceptibility Thread on Blood Types and viruses. I thought he seemed interested. We get along very well. We all have different attitudes, mine is that I know my own body, and a bit of medicine, but I respect his expertise. If you don’t respect your doctor after years of knowing him or her, its time to change and find someone else. But I doubt that giving a bird flu lecture to your physician is going to make him or her change what they think about a pandemic, only unfolding events will shake people up. I wouldn’t go to any physician who I didn’t consider both well trained, humane and reasonable.
I called 3M today to inquire about the different masks. I told the customer service person I was inquiring because of Avian Flu. He was extremely condescending and make a comment to the effect of, “3M only makes enough of the 1860 masks for the medical profession and it’s because of the bird flu nuts [like me] that there is now such a shortage.” I was extremely offended and I wondered if his superiors support that kind of attitude. At the very least it sure isn’t wonderful customer service…
In seeking factual information regarding other’s attitudes about an impending pandemic, I questioned my physician about what he knew. He stated that he really didn’t have much time to think about it as he was working 12–18 hours a day just to keep up with “regular flu”, respiratory illnesses, stomach bugs and treating his more needy patients,such as elderly, infants and such. He said that he stays pretty low key about avian influenza because he has had so many patients over-react and stress out about AI and getting Tamiflu and different antibiotics and prescriptions. He said he had to work with insurance companies and he had to be ethical in prescribing. For example: he said he would NOT under any circumstances prescribe an antibiotic unless the person had an obvious infection. He felt he would lose his credibility and be unethical if he prescribed an antibiotic to treat something that had shown up yet on the medical horizon and he doubted antibiotics would help AI. He said that some of his patients were demanding different drugs they wanted to stockpile and it was important for him to be the voice of reason at present.
Some friends who are in nursing and medicine (public health and epidemiology) said why aren’t people writing their congressmen and senators and demanding that funds and attention be put towards public health, hospitals and such? All this money ($7 billion)that was allocated towards funding programs and the like for a possible pandemic, where is it and what is it being used for? Is any of the money being utilized to shore up hospitals and clinics? Buy ventilators? Masks? Meds? Equipment? Concerns were expressed that the money is just going to disappear (like all the billions of dollars allocated towards Katrina and for what?)and all the many pre-pandemic meetings and pandemic preparations are dandy, but what is REALLY being done to help the health care workers if and when this thing hits?
AI is going to hold a Mardi Gras, and no one will be there to pick up the streets afterwards . . . .
I guess I am lucky. My physician knew about bird flu a year ago. He already had people coming in before me. The hospital put out a memo that said for everyone to get their Tamaflu before they couldn’t get it. He wrote a prescription with refill. A great guy that listens to your concerns and problems. fj
I work for a surgeon, so we don’t treat people with chronic illnesses and the flu etc. in our office. He doesn’t send people home with perscriptions etc.
I asked him about bird flu several months ago. He became very serious and said that if it mutated to human to human that the consequences would be dire. I believe his exact words were, “It is VERY serious.”
He didn’t seem to be overly concerned and I didn’t push the issue then. He knows that I keep up with it and if there is a problem in the future I feel certain that he will write perscriptions for me and my husband without hesitation.
As for getting it himself - he seems to be resigned to the fact that that is a real possibility. It could be that many of the physicians you all are describing realize the real danger, but because they are dedicated also realize that they might lose their own lives to it. That I believe is one of the reasons that they either don’t or can’t discuss it, or gloss it over.
My employer’s attitude is kind of an “Oh, well” one because he says “Well, I might get it and if I do, that’s that.”
If there were a pandemic, I’m sure that he would lend help anywhere he could in the hospital and not limit himself to the operating room.
I am not a nurse, just the office manager, so I’m not essential personnel. I plan to NOT go to work if sustained h2h starts because our office is actually in the hospital and I would be exposed. I wouldn’t have anything to offer anyway.
The doctor said “Well, we might all have to wear gloves and masks to come to work.” I didn’t say so at the time, but I do NOT intend to work anywhere where gloves and masks are required.
If TSHTF I’ll get serious with him and get advice about how to treat it and what medicines to stockpile. He’ll help me then, but right now it isn’t a topic to be discussed on a daily basis in the office.
I think doctors and other medical people took the threat of pandemics much more seriously after 1918 then they did before spanish influenza struck. And for the same human reasons are not takeing this as seriously. As doctors in 1917 would have been prone to. To a large extent we are all the product of our expience’s and hopes. And the victim of our hopes and expierience’s. When something we choose not to believe in believes in us.
DebMcRN – at 19:31
This is what wikis are for.
For every forum page that has good ideas, a wiki page can be made to distill the best ideas. it might even already exist somewhere on the wiki. And of course, i don’t have to be the one that creates it. ;-)
I believe that one problem with doctors (and many others) is that they just do not want to believe this pandemic will happen. It could be so horrendous that they just don’t want to think it will happen. EVERYTHING as we know it could fall apart. That is no excuse for not wanting to think about it, but I believe that is frequently the case.
My husband has that philosophy. He has tolerated my prepping and the thousands of dollars I have spent. However, when I talk to him about being quarentined for maybe even a year, and the stocks falling, etc., he says, “I just can’t go there with my mind.” My husband is not stupid. He just has a psychological problem with considering the dire consequences of a pandemic bird flu.
You might be interested to know that on Feb 28th, the daily newspaper for the Olympic Peninsula, WA, had a front page article entitled, “Avian Flu’s dire threat” It was written based on an extensive interview with the local health officer for two counties named Dr. Tom Locke. The article did not pull any punches. It talked about number of expected deaths in WA., and school closures, public meetings banned and the vast number of people who would need hospital care. It went on to state that there are not nearly encough beds—and how virulent the H5N1 is likely to be if it goes H2H. It said it comes in waves so it lasts a long time—several months. Then he talked about the right kind of preparations to make. No need for panic, but just like other potential disasters it should be prepared for. He ended on a more hopeful note. I will quote the last three paragraphs: “It’s inevitable, but the severity is largely preventable,” Locke said. “If 1918 played itself out again, we could do much, much better.” “Besides gathering medicines and foodstuffs with long shelf lives and rotating them regularly, he added, it’s important for people to think about how they will care for themselves, their families and neighbors. “Leadership will come locally when the crisis strikes, Locke said, if people are prepared and willing to help others. “This is a survivable kind of thing,” Locke said, “if we have a stong belief that, working together, we can get through this.”
I sent an email to my family’s physician asking about her position on bird flu. Here is her response:
“So far, I don’t think that there’s anything to worry about either among humans or in our country. Our office is in close contact with the public health department-we are a sentinel office for influenza reporting - and I think most of the public health officials are hoping that it will go the way of the swine flu and be a non-event.”
I plan on sending her a little more info from fluwikie and some other sites.
Emphasize that the concern isn’t about what’s happening now, it’s planning for the event, likely or not, of dealing with a true H2H outbreak of any flu that causes a pandemic. The reassurance of knowing we’re okay ‘now’ needs to be coupled with the reassurance that we’re planning for the ‘what if’.
I went to my cardiologist this morning for an annual exam. He knows I’m a healthcare professional so there is no reason to sugar coat anything. I told him I was taking a poll and asking other providers about bird flu. His response was that BF is a bad actor and not to get it…end of subject. To say I was stunned at his lack of interest, lack of opinion and basically dismissing this as an issue of concern would be an understatement.
It seems physician opinions are as varied, as experts and lay people. It would be interesting to poll doctors. But there is the possibility that they are “sugar coating” any and all answers to patients and the curious.
Doctors it seems, need to come to terms with life’s problems each and every day. Perhaps, BF’s current status (nonH2H) makes it much less of a threat than the life threatening issues they deal with each day.
Remember, they don’t treat healthy people often. Seems ridiculous to them, I’m sure, for otherwise healthy people to worry about such things.
It is interesting that the doctors are downplaying it to their patients yet they (according to a pharmacist on the Oprah Special) are the ones who are writing prescriptions for Tamiflu for their families and loved ones!!! “Do as I say, not as I do”????
some take it seriously, some don’t. I know both kinds. Tough to generalize. Dr. woodson, who wrote the prep guide on the wiki, is one who does.
DemFromCT - Thanks
Believe it or not , my doc insisted I get a pneumovax shot last year ( gave it to me herself) and seriously recommended the rest of the family get their butts in for one too. Then she helped me stay 2 months ahead on scripts and told me to educate myself the best way I could on treating flu victims, because if avian flu ever went h2h she didn’t want any of us going to the hospital if we could avoid it, said we’d get better care at home. Insurance won’t pay for tamiflu so I didn’t get any yet. BTW she says most of us don’t have enough respect for the ‘regular’ flu and if its not avian flu next, it’ll be something- we’re overdue. After all of that is when I decided I’d better start paying attention!
EXACTLY Janet! My exact words to my husband the other day after his physical when the doctor downplayed everythig saying “well what can you do?” and refusing to give us anything.
Re: “what can you do?”-I’d love to tell that doc-first thing,doc, is for your to pull your head out of your *&^. Just because there is no vaccine yet or magic pill, since when does medicine stop there?” (Maybe it does, but then nursing would take over) People who don’t get ill and/or die will need mental health services and all the protection from supply chain interruptions that is possible. Ask him/her-what are you planning to do when your child/mother etc asks for food and the store shelves are empty x 2 weeks?
The doctors that think this way could find themselves the victims of natural selection.
Spoke a bit about bird flu to my opthomologist a few days ago. After he measured the pressure in my eyes and reassured me, he asked what I was up to these days. I told him tracking the bird flu. Mentioned the cases in India as he was of Indian descent. Mentioned Scotland, 1859m 150 years in the making. He asked my opinion of what I would take since I am keeping current on this. I said Tamiflu to start with black elderberrry and lomatium, the american Indian remedy. I had been shoe horned in, so I didn’t want to take up too much of his time. I have an appointment in 6 months for another eye pressure check. I wonder how that 6 months will play out. I hope the bird flu takes another 100 years in its experimental sweep of the earth.
Enough complaining on my part - need to get back to my research/wading through all this info about just what I think will be the most helpful “natural” remedy - as that will be all I can get!! :-)
Pulmodoc – at 12:09
Didn’t mean to leave you out. Thanks for all your thoughtful contributions. There are other docs on the site, some are semi-regular readers, contributors, etc..
and don’t forget, this might help:
Forward the above links to the medical people.
My husband goes to the VA, his doctor left him with the impression that they are on the lookout for BF cases. He joked that he was coming to our house if it became H2H.
I ask my Doctor for some antibiotics to stockpile. At first he gave me a hard time though he knew what he was talking about and mentioned that if you live long enough to need antibiotics you are doing well and probably would live without them. He made me justify for a little longer then as he gave me the Antibiotics he mentioned that he had ordered his protective clothing that very same day! Of course he would have the dubious distinction of doing the Post Mortem on any one who should manage a B2H here and we are on shores of lake with H5N1 ducks and swans.
DemFromCT
I was not feeling left out. I sincerely appreciated your comments that medical professionals are not all alike and that many of us are taking this seriously. And thanks also for the links.
Pulmodoc, you and the other docs who post on this site are greatly loved and appreciated by us, but,…you’re in the great minority. I work at a large university health system in Philadelphia, and when I speak to docs- interns, third year residents or attendings I get snide comments, told not to worry or it bears watching…on and on and on…the hospital’s pandemic plan is sitting with the head of ID (who thought SARS was nothing to worry about). I suspect you’re getting the same reaction with your peers.
I am a Nurse Practitioner and I take pandemic flu very seriously. I have given lectures and helped people to prepare as best I can for what may arrive. Our ER docs are not interested, most of our medical is somewhat interested but not engaged. I have studied how best to treat this virus and it’s aftermath and I anticipate that I will wind up doing just that. Until the PPEs run out.
I’ve added a 4th local doctor to my informal survey here in a medium sized (20K) town north of Tampa, Fl. 3 out of 4, after some urging <g>, admitted they were somewhat, or very worried about avian Flu. One dismissed it as pure hype.
None of them wanted to discuss it at first. But 2 become quite talkative after they realized I was reasonably well informed on the subject. The third only volunteered that he was concerned. When when asked if it was `crazy’ to stock up and prepare, simply said “No, it isn’t crazy.” <wink wink nudge nudge>
Doctors are only human. Most are overwhelmed with patients, plus tons of paperwork, and must keep up with the medical literature that bombards them. The ones I know, have little time to surf the internet or watch the news.
But I sense a deep sense of foreboding among most of the ones I’ve talked to. They seem to understand how little they, and the medical establishment, could do in the face of a pandemic. Kinda hard to look into a patient’s eyes and tell they they’re gonna be on their own.
And we wikians are not the average patient, whether our doctors understand that or not. We `get it’, and have accepted for the most part, the realities of a pandemic. Most patients WOULD freak, and these doctors know that. I understand their reluctance to discuss it.
Are some doctors clueless? Sure. Or in denial, or simply whistling in a graveyard. But I suspect most view a pandemic like they view highly aggressive mestastic neuroendocrine cancer.
Not much you’re gonna be able to do if it happens. Best thing is to hope you don’t get it.
I’m a little aghast that I supplied the wrong date to my opthomolgist. Correction, courtesy of European. It all began in 1959 not 1859, correct in it being Scotland.
I know a lot of doctors and many of them share the trait of liking to feel that they are in control of things regarding health. They like to be able to give advice and help. When they can’t, they clam up—they hate to admit they don’t know anything or can’t do anything about a problem. This is a prime example. They know they’ll be pretty much helpless if it hits, so they don’t want to think about that. Also, they don’t want to “disappoint” a patient who asks about BF by saying, “Sorry, you’ll be up the creek without a paddle and so will I.” So they laugh it off,and tell you not to worry (i.e., don’t come here asking me questions I can’t answer).
I know someone who’s a pharmacologist who just wrote a scientific paper on the treatment of children with bird flu. She said the journal she sent it to, to be published, was very hot to get it because this is such a necessary and hot topic—so not everyone in the medical field is clueless. They just don’t have enough answers and it makes them very, very nervous.
Oh, this article has not yet been published and I don’t know when it will come out—she just sent it in—so I can’t give the citation. But when it comes out, I’ll post info.
The big problem in expecting the medical literature to come bursting our mailboxes is that the peer-review publication process is methodically time consuming. It’s not like the 5:00 pm deadline at the times. A few important papers have recently been distributed early ( Concept of Operations for Triage of Mechanical Ventilation in an Epidemic, John L. Hick, MD, Daniel T. O’Laughlin, MD, for one, published in ACADEMIC EMERGENCYMEDICINE 2006, a month later) and some of the Asian case reviews. We will learn a great deal about how to treat this disease on the fly and that seems to change frequently. I spent over a month trying to get specific information on mechanical ventilation strategies from CUHK and Van University and got very little. There needs to be a medical repository for pulmonary/critical care medicine practitioners to review cases and treatment methods so we can better prepare. The difference in H5N1 causing airway pathology vs parenchymal (small airway/alveolar) pathology would create a significant change in our approach to ventilation/airway care/infection control. This needs to be stressed.
The wonderful thing about this site is that most of the people (I believe) that visit here learn more about preparation, prevention, up to date news and significantly more than one will learn from the typical General Practioner. Common sense and a high degree of intelligence seem to be the rule for wikie participants…I’m on the common sense side of discussions!
I have been working on alternate idea recommendations for care and treatment, which, for reasons obvious to most of us here, MUST be fast, cheap, durable and simple. A low tech approach, though lacking the sophistication of modern ICU care, can be effective, I believe and offered to more in need. Some of that approach is inspired by lay persons thinking, (without the limitations we “advanced technocrats” place on ours), the simple question, “how can I make something that will work with the resources I have?” There is a guy at CE trying to make a CPAP machine out of a weight-driven, blow-up mattress and someone else who designed a ventilator that looked like a drawing (almost exactly) of a ventilator over 60 years old. The great thinkers have always been here.
Check out the Dow Jones Industrial index for the 1910′s (including the 1918 influenza pandemic, which is clearly highlighted).
This index accounts for major manufacturing and service stocks of the time.
http://djindexes.com/mdsidx/index.cfm?event=showavgDecades&decade=1910
The 50′s data doesn’t even have so much as a blip. http://djindexes.com/mdsidx/index.cfm?event=showavgDecades&decade=1950
The 60′s data is more concerned about major political events of the time than Spanish flu. http://djindexes.com/mdsidx/index.cfm?event=showavgDecades&decade=1960
Economically, how can anyone say the stock market will crash? History has told us time and again that short-term disruptions have virtually no effect on the overall health of the economy. (I wouldn’t go investing in the tourism sector, though).
The economy is based on more “assumptions” now than it was then: assumptions that your neighbor or business partner will keep up his end of some agreement you’ve made. So individual businesses are so interdependent, contracting out for so many goods and services, that the failure of some portion of the network of interdependencies may collapse the whole thing, in a big domino type cascade, or a ripple effect, or pick your metaphor.
Supply chains are so long and reserve capacity is so lean that there are bound to be more failures now if a pandemic occurs
In short, we are more interdependent now than we were in 1918, so we are also more vulnerable.
I hope I am wrong, and that you are right.
Good graph though, and thanks for bringing it to us.
I agree completely, Micheal. It’s our interdependency that is the greatest concern. Ecomomics is so tight for most businesses and industries, very little is extraneous either in terms of human resources or raw materials or products. Major disruption in this delicate balance has never been experienced by our current level of society. The skills and ability to cope is questionable at best.
Lord knows we’d all like to be wrong but society in 1918 was very different than it is now, both in the US and world at large.
True, interdependency is a very bid concern. But there is also a lot of corporate duplication. Suppliers to Wal-Mart for example are different than suppliers to Target, etc. With even moderate duplication, hopefully the economy can stay on track.
Personally, I will be withdrawing my high-risk investments and converting into government or money bonds at the first significant cluster and reinvesting in the regular market after the first wave has ended.
Remember also that never in history have more people been in the market. There is an unprecedented amount of Americans wealth (and future income) tied up in Wall Street, and no one can tell me that a global pandemic will do anything other than crash markets worldwide-charts and graphs be damned.
We see this coming-and when (if) it gets here, we’ll all know it-and the economic/investment panic won’t be confined to the travel sector.Anyone who says any different is either disingenuous or has no understanding of human nature.
Do you all realize, it is these uninterested doctors who will get tamiflu or whatever else is available before anyone else. First responders, right.
First responders means paramedics, ER nurses, cops and firefighters, etc.
And those docs working during the pandemic.
Deciding who is interested or uninterested now as a decider of “who is deserving of tamiflu” misses the point. Especially because there wouldn’t be any tamiflu for first responders now.
…sorry for the off topic post at 17:41-got caught in the digression by DJ and forgot what the true subject was.
I’m also a little tired of the gratuitous doc bashing I’ve been reading on the threads lately. Are there selfish, immoral docs? Sure. But I know a lot of health care professionals of every stripe and nearly all are concerned about relieving and preventing pain and suffering. Some of them post in this forum. If you knew what their workdays were like, you would be in awe.
Me too, Mel
Do they take it seiously was the thread- yes they do, they monitor it daily, until H2H is widely acknowledged in North America, most will keep on Keeping on.
last 3 posters: right on!
Melanie, We have heard over and over, many doctors/nurses have no idea what is happening. Some of them work at hospitals that have no pandemic plan. Some nurses here, on the site, have been told to stop talking about a pandemic at work. All the local hospitals in my area are silent. This is common all over the country. A couple doctors and nurses I spoke with (my very close friends, we play rugby together) know nothing. This is insane. Why is this happening? The public has a right to be concerned.
No other industry will be affected like the HC industry. It would be like telling GM, (ok bad example) Ford that you will be out of steel in 30 days, you will no longer make cars and everyone will have to walk. “We want you to keep focused on your job, perform difficult procedures and keep everyone alive, and, oh yes, we will be getting 754,000 patients next week, half or more will die and you probably will, too, but keep up the good work”. I am known as the “BF Man from Alcatraz” at my hospital. Denial is a defense. No one wants to know and is sure it will turn north and die of hypothermia at the North Pole. If the HC industry tried to adequately prepare now, it would collapse now. Nothing of any large measure will occur til we go H2H. Then, with our hair on fire, we will scramble and probably create the largest Charlie Foxtrot in modern history. In the mean time, more and more people like the RNs/MD-DOs/RTs/EMTs/ETCs here will have carried the message to enough people to make it less worse than it would be if we didn’t. Hospitals are conceding in preparing for a pandemic, not the pandemic. As long as it is an academic exercize, no one will freak. Shooting at the paper target will come in handy when you face the real bear.
rrteacher, Wrong. Hospitals will be unprepared and no one in their right mind will go there. That may be the plan. They will be useless. The public will be quarantined (self or otherwise) and will treat themselves. That is why the medical communites involvment right now! is critical.
By the way, I’m sure we will hear about how Tamiflu is not really working, more and more. Perhaps your own doctor. That helps cut the demand. wrong, wrong, wrong. Just wait and listen.
Never thought of that
rrteacher – at 09:09 said “we will scramble and probably create the largest Charlie Foxtrot in modern history.”
Please pardon my ignorance… What is a Charlie Foxtrot?
Not my doctor. He has stockpiled 200 rounds (not tablets - rounds) of Tamiflu for himself (for prophylactic use). It is when he told me this (and he only told me this after I brought up the subject), that I started to get very serious.
It seems to me, that he has taken the position that he won’t bring this up to his patients, but if they bring it up, he’ll give’em the straight goods (so he *is* trying to avoid *creating* demand for Tamiflu - which is sensible - but not providing misinformation to reduce demand for Tamiflu - which is ethical).
It is good to know A) that my doctor is both sensible and ethical and B) that he’ll be able to treat patients because he has prepared.
(anonymous – at 14:25, Google says it is a big mistake/failure; big, uh, screw-up. Using the radiotelephony spelling alphabet to give the first letter of each word one is trying not to say.)
crfullmoon – at 12:44 - WWll vets created similar sentiments with: SNAFU!
Sierra November Alpha Foxtrot Uniform!
So, is the word getting out to more physicians, or how can we help with that?
On the topic of physicians not taking this seriously I can only add one more sad anecdote, this time from Europe. I live in Vienna, a city which has already registered many cases of H5N1 in wild waterfowl. (I live right near the Danube, which means I have H5N1 in my neighborhood, more or less.) Recently I had finally managed to convince my sister, who also lives in Vienna, of the seriousness of the present situation, of the fact that a worldwide pandemic is possible and that she should begin prepping for her family. On Friday she happened to speak with one of the leading Austrian internists, a real big shot who is often in the news. She asked him what he thought of BF and the chances of a pandemic occuring. His response: “Nothing but hype! Just another way for Big Pharma to earn money!”
I was speechless when I heard this. Not only did he weaken the resolve of my sister to prepare for her family, but he also gave me a chilling insight into the level of denial (or is it ignorance?) which apparently exists here in Austria.
But I guess I should have known that I am living in the land of denial. *sigh* One look at the posts on the topic of BF in German-language forums that I otherwise like to read is all I need to see that this doctor’s view reflects the general opinion here. I wouldn’t know where to begin trying to get the word out to physicians!
Here is some good news from the American College of Physicians (or at least good news that many more physicians are getting information about BF). The College held its annual meeting in early April. The following link will take you to their policy paper, which was presented at the meeting.
Delphina - that is a chilling story. You live where I have always wanted to visit. I just posted a news story on the news thread that is very convincing about how this thing is mutating toward pandemic. Maybe you could show it to your sister. Good luck.
Delphina - hopefully, physicians in Austria will be holding their annual meetings and BF will be a topic. We who have posted our concerns on this thread sure know how you feel. Take care.
Allquiet and Nightowl: thanks for the support!
Allquiet - thanks for posting that link. My take away was they were basically saying “when” this thing hits, not “if.” Hopefully primary care docs, pediatricians and emergency room docs will act on teh info as the will be the front-line. It also points out that most gov’t plans are insufficient and have not involved healthcare providers as well as they could have. I hope that docs are given the chance to “think outside the box” on this one. They are going to have to do untraditional things to treat patients. I was surprised when the VA announced they are planning to do “drive-thru” clinics. It’s innovations like that which could help get through the crisis - as long as bureaucrats let them do it.
lauraB: Sadly, all over the world, for some time (years) I have seen an unwillingness or inability “to think outside the box”. I blame this on one-dimensional upbringings with too many good-time diversions sapping the formation of a solid foundation of knowledge and critical thinking. And other parts of the globe are “dumbed-down” by the political systems that they suffer under even when their training is superficially adequate.
It is not only the physicians who are not up to the task. It is the top-tier of technocrats and politcial functionaries who are not up to the task. This looming pandemic is one of many monumental problems that we face in the next two decades which would require us to be “at the top of our game”. We are not even close.
Physicians by and large are falling back on their early training which instructed them to first downplay the “deadly and unlikely” outcomes and to concentrate on the likely. Those habits of thought generally serve them well except when the extraordinary event comes along. We won’t have time for acting on that second, belated prognosis when H5N1 (or another virus) reaches criitcal mass.
We are witnessing a slow motion train wreck. All you have to do is open your eyes. And our physicians, who should be the primary grass roots advocates for prepping, are failing us due to a lack of imagination ( or whatever).
Talked with 3 doctors recently about BF. You could call their level of concern the good, bad and the ugly.
Good: saw my GP for a check-up and asked the dreaded BF question. He is concerned and is more than willing to write a prescription for Tamiflu if I want one. No-one else in town has asked him about it and it bothers him. He has tried talking to others but even he gets the ‘blank stare’ we are all familiar with.
Bad: my son is finishing up his residency with the Navy. According to him, no guidance has come down from the powers to be, other than they are stocking more masks. No Contingency Plans, nada. And he is at a large West Coast Hospital. He has read a little about it but is not as troubled as I thing he should be. He will be transferred to Japan in August, so that station may have more directives, hopefully.
Ugly: Neighbor is a retired USAF gynocologist. He is sure this is a big deal about nothing. Anyone who is worried is a kook. End of conversation about that subject with him. However, I live in Utah and he is LDS, so has his year’s supply of food in his basement for other problems, such as earthquake, nuclear war, maybe even a tidal wave, but for whatever reason the stuff is there, he just does not equate a risk factor to BF.
I am now considered the bird flu wife by my husbands partners, he is a family practice doctor and I bring it up whenever appropriate. I am very happy to report the infectious disease specialist are probably the most informed! Yeh for us. Most of the doctors I talk to say, yes my wife has asked for tamiflu also. I do not have any though! Because many think it may be of no use anyway.In reality my husband is one of those who would probably give it to someone really sick to maybe help. Yes, he loves his family but a doctor always keeps his oath. Not one doctor I asked said they would not attend to their patients if this becomes an epidemic. They all agree this is a very very scary thing should it progress to a pandemic. I was very unhappy I had to inform one doctor all about it that had NO CLUE. Glad she isin’t my doctor! He knows I have been prepping and secretly I think he’s happy but won’t admit it.
anonymous – at 14:25 april 2
CF charlie foxtrot , It’s a cluster f*ck (at least in the Navy)
Example would be disorganized action with no one in command, doing things that cancel each other out, and nothing positive is accomplished.
Panic and/or poor training are the biggest causes.
Have commented on experiences with my personal doctor, who is aware, but would not prescribe Tamiflu or other meds. See “Woodson’s Medication Recommendations”
I am impressed with the people who contribute to our Wiki. While some of it is very complex when discussing medical issues, virology, etc., nowhere else is there such broad coverage of the issue and what we can do as individuals in case the big one comes down on us. I also think we are having a spreading effect on educating others.
My personal recommendation to all of you is to take whatever steps you need to protect you and your loved ones, neighbors, etc. After the food, water, masks, gloves and so on, I would urge all of you who have not obtained the medications that are advised for a home medical kit(again, see Woodson’s Guide) to obtain them, with the adddition of possibly a course of a broad spectrum antibiotic. These may cost a few dollars, but all of these medications are available through legitimate channels. It is my fervent wish that none of our preparations will be needed.
Will doing this guarantee that we will all make it through to the other end if TSHTF? No, certainly not, but I would say the odds are a lot better if we do as much as we can. I certainly hope that if this does happen, we can all trade war stories about how we survived the Great Flu Epidemic of 2---!
Good luck to all my friends and fellow Fluwikians!
For this one I will be anonymous. I am a rural physician, I am prepping. I am NOT stockpiling Tamiflu because I do not believe it will really be of any benefit and certainly can be a drain of resources that MAY be of benefit. I have only convinced one other person to prep, and I’m not sure how seriously she’s taking it. Mostly I am belittled for my opinions on the subject. I have even lost one longterm good friend over it. Hopefully that situation will resolve eventually. I have not seen one other person here taking this situation seriously, and no other physicians express concern, except one colleague who had been to Italy recently and was impressed at how seriously they were taking it! Our local hospital “might” obtain one ventilator… that should do a lot of good. I am NOT trying to educate my patients for the very reason that every time I mention such a thing, my opinions are discounted and ignored. I’m accustomed to that anyway, ever tried eduating people about diet and exercise? They don’t listen!
Good luck to you, Rural Physician. Sorry people won’t listen. (Really dismayed your colleagues won’t listen to people like Dr.Osterholm and Dr.Nabarro.)
May I respectfully suggest that “Rural Physician” is an excellent name to use for future posts on the fluwikie, thus continuing your anonymous status.
Rural Physician
Don’t be discouraged that your attempts at informing and educating folks about the coming of a Pandemic are falling on deaf ears. First of all, please don’t equate advice about diet and exercise with info re Pandemic flu. Diet and exercise don’t register with people because the effects of ignoring it are vague and far in the future, unlike a Pandemic, which could happen tomorrow, and could kill you next week! I think you will find as I have, that the people you’ve talked to about this issue will remember it, and when, as is happening now, there is more and more in the press, on the Web, on TV, that they will come around and say, “Hey, I remember the Doc mentioned this too, maybe I should look more seriously into this and it wouldn’t hurt to do a little preparation just in case.”
This has been my experience, and it has encouraged me. The other day my wife was reading The Flu Prep Guide by Dr. Woodson on the commuter train and a fellow passenger started asking her questions, others that I have pestered in the past about this are now coming around and asking me questions and advice, so people are becoming aware, and it is folks like your good self and others here on Fluwiki who are planting the seeds of curiosity.
While I respect your opinion on Tamiflu, we all must make our own decision about that, and I for one think having it may mean the difference between life and death when it happens. I understand production by Roche is ramping up, so it is my belief that there will be plenty available for first responders and now I also understand that the thinking is that the best use may be to saturate an area with antivirals to try and keep it from spreading. One of my pet peeves is Doctors who will not provide it to their patients. I would hope that you would seriously consider doing so. If you have not done so, please read Dr. Woodson’s paper on why he thinks physicians should do so on fluwiki or under www.tinyurl.com/lomje. Those who wish to getit without prescription will be able to, although at a higher cost to them.
Don’t despair and thank you for caring enough to contribute your thoughts and sharing them with us. I firmly believe we are helping, and what we do may save some lives, if and when..
Be well.
i talked to a Doc a week ago about BF and his thoughts were that if 55% of the pop were to drop off it would not bother him. he thought “we need to thin the herd”
kychas – at 11:57 Do you suppose he meant 55% of HIS family? I have heard comments like this and I think usually it indicates that the person does not take it seriously, has not really thought about it. Kelly
There is an element of truth to this the world is filled to breaking point with people. A pandemic that kills 50% of the world population would not really make much of an impact. Inside 50 years we would be back to where we are now in terms of population..
Rhizome: Don’t be too sure. A “50 per cent CFR Pandemic” would be like a cytokine storm for the whole world. It would liquify all of our foundations. The cascade effects from such an event could tax even humanity’s formidable ability to reproduce.
Doesn’t it depend on which segment, agewise , of the population dies off?
Rural Physician et al
I was interested to learn from the trucker who delivered a palate of supplies to me last week that he was making an average of two such deliveries a day. He volunteered this information and allowed as how he was thining about doing this himself. He definitely recognized what the materials were for that I had ordered. After a number of disappointing conversations about the preparation issue, I found this rather good news. He drove a relatively small truck for what looked like a private delivery business. It would be very interesting to survey delivery services nowadays to get a sense of how much of their business is related to emergency prep.
Rural Physician et al
I was interested to learn from the trucker who delivered a palate of supplies to me last week that he was making an average of two such deliveries a day. He volunteered this information and allowed as how he was thining about doing this himself. He definitely recognized what the materials were for that I had ordered. After a number of disappointing conversations about the preparation issue, I found this rather good news. He drove a relatively small truck for what looked like a private delivery business. It would be very interesting to survey delivery services nowadays to get a sense of how much of their business is related to emergency prep.
The problem is, folks should not be broadcasting their preps to the general public. It’s not a good idea. This may be part of the reason some are not sharing the information.
I have been following fluwickie for several months now. As an RN, I have discussed in other threads the dilemma of our workplaces not being prepared, the reality of the odd stares and being the “loony tunes” BF fanatic. I too have experienced the MD’s who know and care and realize that we’re ill prepared, and those who dismiss us as kooks. However, I’ve seen changes since the beginning of the year. More people are owning up to being aware, to preparing, to stockpiling. A recent search on the Web for dried meat and food products came up short, due to overwhelming demand. They have a 4 to 6 week backlog!!
Personally, my kitchen is 75% stockpiled with food. I am now working on medications, IV’s, venous access catheters, and the like. Since I’m rural with a well, also planning in the next few weeks to put up a propane tank near the barn to fuel a propane generator. If anything, at least I can keep the well running and guarantee water supplies.
NBC’s special Sunday on BF was hopefully an eye-opener for “newbies” In the meantime I prepare, keep reading your threads and hopefully jump in feet first whenever my healthcare institution decides to get their head out of the sand.
My name is Robert Lowes, and I’m a senior editor for Medical Economics magazine. I’m writing a story about how primary-care physicians in office-based practices can prepare for an influenza pandemic. I’d like to interview some of the people who have posted messages here. My email address is rlowes@advanstar.com. My phone number is 314–727–4917.
If people contact me and agree to an interview, I can give them anonymity in my story if they request it. I’d like to hear from the following posters in particular:
DebMcRN – at 13:24 anonymous – at 09:26 (rural physician who is prepping) food storage nut – at 13:40 patient – at 14:19 AD – at 14:02
I’m also interested in hearing what physicians posting here have to say about how to prepare for an influenza pandemic at the office level. What are the basic steps to take?
Thanks.
Robert Lowes rlowes@advanstar.com 314–727–4917
Just got back from my physical. My Doctor had not been following the Bird flu at all. She had no idea of what the current death rates were, or that teens are most at risk nor why. It is just a small clinic but I would think that THEY would be following this. Her general response was that if happens, there is not a lot we could do.
Just returned from an appointment with my primary care physician - asked him about pandemic flu planning. To my delight he is very knowledgeable about the issues, current federal planning, how to handle patients in his office that might be ill with pandemic flu, etc. He’s also talked with his son about the need to have food stored that is canned or dry in case there’s no power for refrigeration.
DennisC’s doctor could at least hand something out to all their patients that has how to disinfect water, when to use PPE, how to make oral rehydration solution, how to treat fevers and prevent dehydration, and some basic first aid. Try not to have to go in for medical care during a pandemic. Tell patients to stock up and rotate food and OTC meds, and get better at their handwashing and infection control, now.
Are medical offices going to have call-in lines (tough gig)to give medical advice to people sheltering in place?
crfullmoon -sure, call in line will be outsourced to a country where they don’t speak your language…or maybe just an automated maze (“Press 3 if you are suffering from a cytokine storm, press 4 if you have passed away and need to be retrieved…”)
Actually, it’s a good idea but I’m skeptical of the ability to follow through…I wonder if physicians could arrange this between themselves outside of the weight of a beaurocracy….
Probably better than within some offical emergency plan!
(I’m worried the mental health disasater line will end up with an phone maze)
Just a shame, and maybe not enough time, if every single person has to re-invent the wheel.
I was recently “OUTED” as a BF prepper in my Dept. (critical care/Pacu) at the hospital where I work. I was inquiring discreetly from a coworker who was raised Mormon on the subject of provident living, and she immediately picked up the hint and stated, “oh you’re not one of those BF freaks!” in front of several nurses and a physician present. I calmly announced that I was one of those BF freaks, and mentioned in passing what I had done to prep. They were amazed at all the planning that had been done already, and some even said they were coming to my house if things got ugly (haha!). The physician in question pretty much told me I needed medication and proceeded to make light of the situation. The RN’s I work with were more than politely interested. I managed to steer several of them to the FW website, and now a FW flier hangs in our lounge. THE SECRET IS OUT!! People come up to me now and discuss what they’ve read, what they saw on TV, etc.
Being from Florida, hurricane prepping is a given, I explain. BF prepping just adds a little more. Read and make up your mind for yourself, I explain calmly. The resources are out there. Thanks to the Fluwikie community for making my task so much EASIER!!!!
xoxorn: I have been riticuled at work for attempting to get the word out. For awhile I was hurt and angery. The tide is changing and I now have allies in most dept heads. Keep up the good work. Kelly
xoxorn- I SO feel your pain!!! Hang in there… ;)
the thread is long and I don’t know whether this had been mentioned yet,
but there was a poll among US-physicians here:
http://www.hcdhealth.com/ViewPress.cfm?ID=23
well, they asked whether H5N1 would gain the capacity to spread easily from person to person. Many of us would say that it already has.
“easily” is unclear.
I think this thread points to the need to prepare the families of first responders. I believe first responders are more likely to go to work if they feel that their families are well taken care of. I think until this thing hits no one really knows how they will respond.
Oceanside, CA
I lead a crisis manaement team training law enforcement and public safety agencies. The good news is that many physicians in the VA and private sector are personally preparing and advising their patients on the threat.
I refer them to http://www.ready.gov/america/index.html
Failing to prepare means - preparing to fail Best to all. Yoda
DebMcRN – at 13:24 I sympathize completely.
I just left a job at a hospital 2 months ago. I encountered the same attitude. I now work for a city government and am encountering the same attitude. My new ped. acts like I’m a small child she must humor…same attitude!
I’m a medical librarian and I actually read “the literature”. Many medical professionals don’t keep up with their own professions. Be proud that you have stayed informed and will be a valuable resource for your co-workers should the time come.
Went to my family Doctor last september told him that I had seen a couple of emails about the Bird Flu and asked him what he knew. His response was that it was all hype and the I had nothing to be concerned about. (This man knows what I do and where I work). In January started to get more of them wanting to know our plan and how we would excute. Did a complete google search and found out it was real and that I needed to do some work. (Found Wiki in the process) Went back to my doctor last month. My wife asked him about the Avain Flu. His response was, “as I told your husband nothing to worry about”. My wife started to say something else and I shook my head. This man is a very good Doctor and has always been on top of our medical conditions. He just does not know about the risks. I do not know how to get through to “normal” doctors but I now feel, that one issue has got to happen before the rest of America take this seriously.
Again the response to our attempts to spread the word has varied results, running the gamut from ridicule to acceptance. Have learned not to worry about those who do not want to listen, including a lot of very smart people. They run from ostriches with their heads in the sand to those who believe it is all a government conspiracy. Ignore these people and keep putting out the word. We are being heard and we are making a difference. If each one of us here on Fluwikie persuades five people and they do the same, it will spread and we will possibly have saved a lot of lives. Don’t depair!
Interesting post guys. I played golf with my family Doc last week and we talked about BF over a few beers. He admitted that it’s scary to think about the worst case scenario. He also said that it could never happen, be a less serious strain or be devestating. No way of knowing. I asked him what he is doing personaly and he said everyone should be prepared for a disaster at home but he is not being paranoid. He seems to think that if it starts there will be at least a few weeks notice.
>I played golf with my family Doc last week and we talked about BF over a few beers. He admitted that it’s scary to think about the worst case scenario. He also said that it could never happen, be a less serious strain or be devestating. No way of knowing. I asked him what he is doing personaly and he said everyone should be prepared for a disaster at home but he is not being paranoid. He seems to think that if it starts there will be at least a few weeks notice.
Sounds like a reasonable level headed analysis (maybe not fully informed, but hey, he has a day job). For anyone who is actively monitoring, I think a couple of weeks of “being in the trucks headlights” is a reasonable guess. My trigger is 100 deaths in 24 hours. It could be worldwide 48 hours later, but if there is any decent response from the powers that be, I think a couple of weeks is possible. Although it is certainly feasible to go directly from hard to transmit to easy to transmit, I tend to think it will be a rapid series of adaptations (as the more contagious strain replaces the less contagious strain in humans). If there is a containment response (ultimately unsuccessful of course) this should buy some (but not much) time.
Interesting story. I was in a hotel elevator in Boston a couple of weeks ago and a guy got on carrying a bunch of conference gear from some epidemiological conference, so I said (half joking) “Bird flu huh?” and (to my surprise and dismay) he said “Yeah!”.
I’ve also sat next to a infectious disease specialist on an airplane who actually brought up the subject with me. I have never encountered anything quite like this before, so it is definately wigging me out!
Our local infectious disease MD is very concerned and is saying that he thinks it will be in the US 4th quarter next year.
Sounds like the Surgeon General should issue a warning - maybe the doctors in denial would take notice. The general populace doesn’t seem to be paying much heed to Sec’y Leavitt.
Many doctors feel so “beaten up” these days by the system (insurance/regulations/liabilities/decreased reimbursements….that you won’t see them volunteering much of their time towards any medical “causes”. Action is a result of being scared of personal risk. Caregivers, including doctors, don’t want to belive it can be possible. To believe disrupts your world as you know it. To entertain others who believe disrupts your world. We all go through emotional phases with this pandemic stuff, like a pendulum, extremes over a period of time and then we find our center - which gets shaken occasionally. Keep asking questions.
DebMcRN
Get a new DOC!
To give y’all just how distracted and put-upon the Doctors are these days, my Family Doc suggested I look at to understand what they are having to do, and what they are up against.
Well, that went badly. The site is www.fightingdocs.com
I’d really love to know the % of nuisance malpractice suits settled by insurance co.s versus doing their jobs and actually defending their insureds. I have a feeling fewer nuisance suits would be filed if fewer were paid off as a matter of course. Sorry for going off-topic but it is responsive to Exls’ link. I’m done.
I guess the process of natural selection is alive and well. You can’t pull an ostriches head out of the sand by force. It’s up to them. Sorry DebMcRN, this leaves you in the ER holding the bag!
Closed due to length. Conversation is continued here.