From Flu Wiki 2

Forum: Is the WHO Being Overly Cautious

18 February 2006

Tim B – at 10:51

Its easy to be critical of WHO but we should all remember the monumental job they’ve had and will have in the future. It’s easy for us, you and me, to up what we think the pandemic level should be. When the WHO ups the level they have to be absolutely sure that we are at that level. By going to level 4 most countries will intensify the efforts to prepare for the pandemic. As an example heres a link to the UK’s influenza pandemic contingency plan which clearly outlines the steps that need to be taken at each phase of the pandemic.

http://tinyurl.com/bp4bc

The other side of the equation is if the WHO waits to long to go to the next level then countries might not have time to implement the steps needed for pandemic preparations. In the current situation I believe the WHO is being to cautious. There is overwelming evidence that there has been small localized clusters with limited h2h transmission which is the definition to go to level 4. Here’s a couple links highlighting this comment.

http://tinyurl.com/8ga6n

http://tinyurl.com/br2h6

The world needs a kick in the butt to up the level of preparedness and I feel it’s time for the WHO to give that kick. What do the rest of you think?

Okieman – at 11:09

I believe the advent of bird flu (in birds) in Western Europe will cause the WHO to up the level in the fairly near future. Once it has started to effect the western economies I think the prohibiting reason for not raising the level will have disappeared. I think within the next month or so it will happen.

crfullmoon – at 11:14

…”Once it has started to effect the western economies I think the prohibiting reason for not raising the level will have disappeared.”…

Ring the bell and win a prize!

I just hope that hasn’t left it too long to prepare the public, and at the rate of the authorities and the rate of H5N1, I’m worried I know which will win the race.

Tim B – at 11:16

My third link in my original post should have been http://tinyurl.com/8y6rl.

Melanie – at 11:27

Note to all:

Phase four declaration will result in mandatory politically and economically costly actions in many countries. WHO will be cautious in making this move.

BroncoBillat 11:35

Melanie—I completely agree with your post. If WHO raises the threat level, it ups the ante for many countries, including First and Second world powers, not just Third world areas..I think we would see political turmoil around the globe, since the public will first demand to know why they weren’t informed by their officials, and then demand that those same officials be removed from office.

The economic reality will set in once people see just how much necessary commodity prices rise in response to a pandemic level increase. The gov’ts will say “no price gouging”, but we all know it will happen and won’t be stopped. The costs of trying to calm the public will be sky-high for the government, and stock markets will tumble on ANY increase in the WHO scale.

Tim B – at 11:41

But how much will be lost if these countries are left with no time to prepare because we went from level 3 to 6 in, hypothetically speaking, 2 days. Instead of dollars it would be measured in lives. I don’t think going to level 4 will cause a panic but instill some much needed fear. See Peter Sandman article.

http://www.cidrap.umn.edu/cidrap/co…706sandman.html

anonymous – at 11:46

In a word, it’s all about chaos, on a global scale the likes of which no one has ever seen. I think TBPB are doing all they can to prevent the inevitable human reaction. Crowd behavior is terrifying and most aren’t or haven’t the resources to be self-sufficient.

As the house of cards called modern society falls, the world as we know it ceases to be, at least for a time. Right or wrong, no one is going to set that train wreck in motion until they have to regardless of what nature is already doing. Reasons for caution range from altruism to economic concerns but all are valid since the latter runs the world.

The WHO has a tremendous responsibility on a variety of levels. Are they perfect? Are they free of geopolitical/economic influence? OF course not, but then neither is anyone or anything else. Agendas abound, such is modern living.

I worry about the public at large, but the world cleaneses herself from time to time and we can only do what we can. Tell those you love, tell those you care about, tell your employer to listen. And pray they will. Pass on the info, even if it’s but a germ of thought and hope they explore and do something about what is learned. One person telling another telling another who tells another has power. Don’t discount YOUR role even if the big guns don’t go public for a while.

BroncoBillat 11:48

WHO would NEVER, in a million years, bum the level from 3 to 6, or even 3 to 5, within two days. Going to level 4 may not cause panic within the world of politics and governments, but for the general population, I believe it will cause a lot of stress and alarm. More people would certainly look to start prepping, but there would be outrage in the streets and around the water-coolers (an American metaphor) as to who is to blame for “not telling” them earlier.

FW – at 12:50

The WHO has been pretty straight-forward about what they’ll need to see before they raise the pandemic level: In fact, they said it clearly in their “60 Minutes” interview. Infection chains: Not clusters of B2H, or isolated incidences of H2H, but H2H2H2H and on which prove the virus has figured out how to infect humans consistantly, if not efficiently. Once they see that, it’s level 4 time.

We’re still at level 3.

Ergo, they haven’t seen it yet.

Doesn’t mean it’s not happening, especially in places like Laos or North Korea where nobody knows what’s going on. Just that the WHO hasn’t seen it.

Yet.

Monotreme – at 14:24

I agree with pretty much everyone except FW. FW: Your definition of phase 4 is not accurate. You can get a copy of the plan here.

However, I have noticed that in press conferences, WHO spokespeople are ignoring their own plan and redefining phase 4 to mean phase 5 or 6. Unfortunately for them, too people have a copy of their plan.

IMO, the current Director-General will not declare phase 4 under any circumstances. The economic consequences to China would be too great. I don’t think there is any real concern about causing a panic among the public. Try this out, tell someone you know that the WHO has just declared phase 4. Watch them yawn.

The pandemic will begin while we are at phase 3. Two weeks later we will realize it has begun.

April – at 15:02

You are absolutely correct, Monotreme.

Anastasia – at 15:14

I asked this question on another thread, so forgive my redundancy, but could it already have begun? I always thought panflu would come in a big, undeniable manner, but someone recently made a post that said the 1918 flu came in with a whisper, not a bang (a paraphrase).

Monotreme – at 15:37

Anastasia: It will be difficult to know the exact date the pandemic begins, even if it starts out severe. It will begin, presumably, although not certainly, with a new version of H5N1 in one person. That person will infect several other people, each of these people will infect several others and so on. You must also consider the incubation period for each generation of infection. It will take a while until we see large numbers of infected people. But once it gets over a few thousand, it will take off very fast.

1918 is still a bit of a mystery. Some think there was a relatively mild version that swept through the world before the more lethal strain got started. But its really hard to tell. We have very few samples from that time.

Tom DVM – at 17:18

Anastasia. As I understand it, the 1918 pandemic came in three waves that each lasted about six months. The first wave was relatively mild followed by the virulent second wave, followed by a less virulent third wave. Viruses can mutate to increase infectivity and mutate to decrease infectivity resulting in more or less virulent waves.

Scaredy Cat – at 17:23

Bronco Bill says people around the water coolers of America will be pissed when WHO raises the pandemic threat level to 4. They’ll ask why WHO didn’t do it sooner. Well, people’d have a right to be pissed, seeing as how their lives are in increased danger and all, and the longer WHO delays, the more pissed and in danger people will be.

WHO has not been straightforward about their pandemic threat levels. They’ve shifted, and twisted, hidden data, hidden relationships between cases, not shared viral sequences, played down the threat, insisted it’s only B2H when common sense combined with a look at public data shows that H2H2H2H is not only possible, but likely.

I am amazed at the apologists for WHO on this thread. Absolutely amazed. I’m sure there are many decent and noble people working for WHO, as there are in any organization. But most of us need only look to our professional lives to see that the cream does not always rise to the top, and sometimes people in power value money more than peoples’ lives. And TPTB smooth it over with calming words, reasonable-sounding words, accusing those who challenge them of being disloyal, troublemakers, alarmist, paranoid. They’re conspiracy theorists! Oh, they’ve got the labels all right. The ones that make others dismiss what the alarmists are saying.

But sometimes the alarmist is right.

Yeah, it’s great each person we can reach. I just spoke with an old friend this morning. She is going to get on the beprepared website today and order thousands of dollars worth of supplies. I feel good about that. But what about the masses of people who don’t have a friend who follows Flu Wiki? They are going along oblivious to this threat.

To excuse the WHO by asking the rhetorical question “Are they perfect?” is a specious comparison. Such a question should only be asked when the behavior engaged in is relatively trivial and/or accidental. When a family member leaves dirty clothes on the floor; when a child doesn’t get straight A’s; when someone, well meaning, blunders in any number of average ways on any average day.

But an “inevitable,” “imminent” (labels people in the know are using) pandemic is anything but trivial, so saying “they’re trying hard, they’re doing their best; they’re not perfect,” is, well, nuts. If there is any hope of squashing a pandemic, WHO damn well better be as perfect as they can be.

Some have apologized for WHO by saying they can’t force their way into any country. They have to be invited. Okay, I’ll grant that. But WHO does have the power to raise the pandemic threat level and it appears they aren’t even willing to do that. And not because the pandemic threat level is at the correct place, but because of economic concerns. Such concerns are valid. But they should NEVER take precedent over human lives.

Tom DVM – at 17:30

Scaredy Cat. I believe there is a major problem with the mandate but I completely agree with you. Where are the Whistleblowers?

DemFromCTat 17:56

I am amazed at the apologists for WHO on this thread. Absolutely amazed.

Well, I am amazed at how many people assume no news is bad news or that it must be suppressed news. How many people even now refuse to admit even the possibility that WHO was completely correct about Turkey? Where are all the other cases? Where is the grudging admission that maybe WHO did a decent and accurate job there? Completely absent, because some posters have already made up their minds, data and facts be damned.

I’m not even sure they’re right, mind you. But the constant carping and complaining from those who have no responsibility at all and no understanding of the depths of the job is the amazing, astounding thing. And now you’ve extended that to those who post here that might have some tolerance for WHO.

This pandemic job may be too big for WHO, stretched now like never before. But the sheer pigheadedness of some posters here is astounding. So here’s the challenge, Scaredy Cat. What would it take for you to admit, here in public, that you were wrong about WHO? And if you can’t admit that, then how about some tolerance for others who don’t join you on your anti-WHO crusade? Hmm?

Tom DVM, perhaps there are no whistles to blow.

Tom DVM – at 18:32

DemFromCT. Anyone who looks me in the eye and says (Dick Thompson WHO spokesperson) that the loses (not the overall spectrum of potential losses) from a pandemic would be 2–7 million lives or in contrast anyone who states that the losses from a pandemic would be equivalent to the losses from smoking each year anyway, do not deserve my respect. Those that say…there is little in the way of historical scientific evidence…and on that basis we have no idea and little to make any predictions on other than intuition and my intuition is… have my respect. The fact is the WHO did a lousy job on SARS, they said they would improve things and the spread of H5N1 indicates that they continue to do a lousy job. As a professional, responsible in part for the current state of affairs, I would consider it ethical to at least offer my resignation. Whether or not it was accepted would be for others to decide.

DemFromCTat 18:39

Tom DVM, the fact is that you don’t know if Thompson is right or Nabarro is right (150 million) any more than I do. We all fear Nabarro has the right of it, but we don’t know that as a fact because we fear a 1918 pandemic but could get a 1968 style pandemic, or none at all for 10 years.

In any case, WHO is fair game for criticism (though WHO has more than one spokesperson and is more than Thompson), particularly when it comes to transparency. However, I would expect far more circumspect comments regarding posters here who find something good to say about WHO than I would for WHO itself.

Tom DVM – at 18:48

DemFromCT. I am sorry. I’m not quite sure what the last line in your post means…could you elaborate. I have had some experience dealing with good people within, in my opinion, incompetent and negligent agencies (these agencies were not UN agencies. It continually amazes me at their inability to draw a line, internally or externally.

Monotreme – at 18:55

DemFromCT: Its too late for the Director-General to prove he’s honest, he’s already proved he’s dishonest. You can’t fix data manipulation retroactively. I base this on reading every one of the Situation Updates from the WHO and trying to extract cluster information. Its very difficult. And I’m not talking about Turkey (yet), I’m talking about Viet Nam 2004–2005.

As regards Turkey, what were they right about? We *still* don’t have symptom onset dates or the relationships between the patients, over a month after the outbreak started. We need this information to determine what phase we are in. Continuing to hide it is clear evidence of perfidy in my book. No-one here, that I’m aware, of said that the pandemic had started, although we were all concerned that it might. But we all felt something different was happening there. Was it? We don’t know because the WHO won’t release the data.

All that being said, I think its good someone argues on behalf of WHO. I’d feel guilty bashing them so much if someone didn’t try to defend them. ;-)

DemFromCTat 18:59

Tom DVM at 18:48

The meaning: I took umbrage at the comment which I italicized at 17:56, and was defending Flu Wiki posters who choose to find something good to say about WHO, and who are in the minority most of the time. They need not be insulted as being apologists.

On another note, here is a very good post about Peter Sandman, and the way to do a better job in communicating risk. WHO is not aboive criticism here.

Tom DVM – at 19:04

DemFromCT. Thanks.

DemFromCTat 19:08

Monotreme at 18:55

I recall bitter accusations that WHO was hiding or sitting on data from Turkey. I want the seroprevalence data, but it appears clear that there are not new cases in Turkey appearing daily. The WHO strategy of identifying cases and culling poultry appears to have worked in Vietnam, Thailand (despite a new case), and now Turkey, and that’s what they were right about. It appears not to have worked in Indonesia afaik. God knows what’s happening in China. Right now, Europe is an FAO problem and so is Nigeria.

There appears to be no evidence that WHO or anyone else was suppressing reporting of cases in Turkey. The only issue still remaining is investigation of clusters for whether H2H exists, and how extensive it was. The terms ‘scandalous’ and ‘criminal’ were being thrown around, and by more than just Henry Niman. The truth may be inefficiency and a lack of transparency and not much else. We’ll see.

Medical Maven – at 19:10

Even with five times the personnel, ten times the current budget, perfect timing, and the best of luck would WHO have prevented “Africa”? After “Africa” it all seems moot, and WHO bashing is just a sideshow. Africa is H5N1’s ace-in-the-hole. If all else fails, H5N1 can always fall back on Africa and make those final, unknown changes to go pandemic.

Was there something that WHO (or anybody) could have done back in 1997( in Hong Kong) to have permanently cut H5N1 off at the pass? Just like there was a “phony war” phase to World War II, aren’t we in our own “phony war” phase now with this probable pandemic?

Short of totally reforming Third World farming and husbandry practices, was there anything we could have effectively done back in 1997?

Medical Maven – at 19:14
Tom DVM – at 19:16

Medical Maven. In my opinion, there was something that could have been done in 1997. Dr. Webster and the Health Authorities in Hong Kong dealt with the issue but the index case was in Guandong and the WHO could have or should have known it. China has been the incubator of many diseases in the past including a Foot and Mouth outbreak that went around the world. The WHO could have prevented China from incubating this disease for six years until it re-emerged in another country in 2003. When it did re-emerge the battle was already over. Despite this evidence, the WHO continues to appease the Chinese Government to this day.

DemFromCTat 19:24

I don’t know what WHO could or couldn’t have done with China. They’re not the hyper-police. No one else does any better with the Chinese government.

I don’t know if Webster, one of the authors of the report suggesting the virus started in China, knew it 9 years ago, and I don’t know if WHO knew it.

It’s interesting that it always comes back to China, though. I’m worried about Indonesia, and Africa, but that’s only ‘cause I know about them. China’s a black hole of information.

Floridagirl – at 19:25

DemFromCT: you may be interested in knowing that the other day when Julie Gerberdine (with the CDC) spoke at the Floride Pandemic Summit, she pretty much validated the seroprevalence studies that I have seen. She spoke of the 50% mortality rate and said they had hoped that there might be “mild unreported cases” in the population that are being missed. And that there probably were….. but, there were not many. She said the studies that have been done do not show that this is occuring in the general population in the form of mild cases.

She did begin by saying that(the 50% mortality rate) was one of the CDC’s concerns….. that and the recent events over the last few weeks with the spread of the virus and the mutations they have seen in the virus since Turkey.

Medical Maven – at 19:27

Thanks for coming through again, Tom. Very enlightening.

Tom DVM – at 19:28

DemFromCT. The WHO is a political agency first and a scientific agency second. You can’t mix politics with science. Silence is the great appeasor. ‘We couldn’t do anything about it’ is the excuse used by most agencies (SARS, Foot and Mouth, Aids etc). I ask you where is the serology over the past 9 years. Where is the paired serology that is standard scientific method or it used to be before the WHO.

DemFromCTat 19:33

WHO doesn’t own it. The serology data we got from Thailand came from Ungchusak. The rest is here that we know about, from various sources. We all want to see more.

You’re right that you can’t separate politics from science in international undertakings. But WHO doesn’t do everything, own all data, and have authority to do mich more than they’re claiming to do. Dissing them doesn’t change that, one way or the other.

Pilgrim – at 19:36

Where is the money? The money for UN/WHO comes from member states, some of which are notoriously unwilling to hand money over; I’m talking the wealthy member states. In my opinion, the politics primarily occurs at the level of the member states where there is sometimes a massive resentment of the UN’s very existence. They find many ways to bludgeon the world body they dislike. Especially favoured is the witholding of money. Also, they like to dictate things like we won’t give you money if you advocate condoms in Africa, or anything but abstinence. The UN’s WHO has a very small contingent of personnel and I’ve said it before and I’ll say it again, in my opinion, they do pretty well, all things considered.

DemFromCTat 19:36

Floridagirl at 19:25

Thanks for that. She didn’t show in CT - she was in DC at another meeting. I think the data we’ve collected is all there is that’s known. The implication is that there’s more that’s known but not disseminated. if there is, we want all of it. But the existing data does not support many mild cases somehow being missed. As you say, it’s hard to catch, but when you do, it’s fatal nearly 50% of the time – at the moment.

Tom DVM – at 19:38

DemFromCT. I didn’t say you can’t separate politics from science in international undertakings. I said politics and science don’t mix. If this agency has no power or authority or has left their immunology textbooks at home then they shouldn’t pretend to be an agency that is going to save even one life. In my opinion, they did nothing and I mean nothing of a scientific nature…or at least the science I learned until the horses were out of the barn, down the lane, and in the next county.

DemFromCTat 19:42

Sorry, I deliberately misinterpreted you to put it the correct way. You will not remove politics from the UN in this lifetime. We can’t even remove politics from US science agencies.

Tom DVM – at 19:50

DemFromCT. Then why does the WHO pretend to be what it isn’t? It has not and is not going to stop this thing. Is it not the requirement of an ethical scientist to clearly state the fact? On another issue, I was the unfortunate victim of a rare allergy to rabies vaccine twenty years ago. The Centers for Disease Control was in part responsible for my recovery. I haven’t heard a lot from them in the past six months. This is a scientific agency with a track record I can respect.

DemFromCTat 19:58

CDC is an excellent agency. Alas, they’ve been politicized, too. In the US, the CDC has been nearly invisible on this topic with the main spokesperson being Anthony Fauci from the NIH (not a clinician) or Mike Leavitt, Secretary of HHS and a former Governor from Utah. You can’t get away from politics even when you want to.

However, they’ve leant expertise in some of the teams sent to Turkey, etc. They have nothing different to say than WHO has been saying, either publicly or behind the scene. Is their lack of contradictory information good or bad? Their position is that you can’t stop a pandemic but maybe you can slow it down. The tools are surveillance, quarantine, antivirals, social distancing and luck.

Tom DVM – at 20:01

DemFromCT. Yes politics plays a role in everything..to an extent…but there is a heck of a difference between scientific principles, the science of the CDC which is real science…and the pretend science of the WHO.

Path Forward – at 20:04

Tom DVM wrote:

“The fact is the WHO did a lousy job on SARS,” and also implies that WHO spokesman Dick Thompson made a risk comparison between potential pandemic deaths and annual smoking deaths.

Tom,

1. Would you please document why you think WHO “did a lousy job on SARS?” and

2. Either provide a citation, or retract the implication that Dick Thompson compared pandemic deaths (involuntary) with smoking? (voluntary)? I cannot find any examples of Thompson making that type of misleading risk comparison.

Thank you.

Tom DVM – at 20:11

Path Forward. If you re-read what I wrote, I think I clearly differentiated the two statements. The 2–7 million statment is Dick Thompson’s. He chose to use the mildest pandemic known to calculate his prediction…and he made no acknowledgments as I stated previously. The Chief Medical Officer of Canada stated in Feb 2005 that Canada would lose 50,000 lives in a pandemic (using Dick Thompson’s inaccurate prediction because no one knows what the pandemic will bring and when it will bring it) and that Canada loses 50,000 persons to smoking each year anyway. If Dick Thompson has a problem with my statement, my name is Dr. Tom Gastle and he can get my address from the Ontario Veterinary Medical Association.

DemFromCTat 20:13

If i can find anything at all that CDC says, especially if it differs from WHO, i will pass it along. So far, nothing to report.

Allquietonthewesternfront – at 20:47

Mike Leavitt is a friend of mine and I know him to be a great guy and very sincere in wanting to help. I know he doesn’t have a medical background but he is working his tail off to try and get the news out. He was here in Nevada yesterday meeting with the governor on a prep plan. I don’t trust politicians but I do know they aren’t all evil.

DemFromCTat 20:59

Leavitt’s actually a good spokesperson. He’s got a delivery like a preacher, reading from the Book of John Barry. However, I have two beefs, one of which isn’t his fault:

  1. he left after his speech and never listened to a minute of what CT public health folks put together for the feds
  2. there’s no experienced medical person to go with him who has been given equal stature
Allquietonthewesternfront – at 21:11

Dem, I actually agree with number two, didn’t know about number one. Dang, sounds like I’ve got a potty mouth! :-)

DemFromCTat 21:18

He was there for maybe a half hour of a 4 hour presentation. I wonder if we were the exception or the rule. All the uniforms left with him. Not cool.

dubina – at 21:20

Dem,

Again the concept: “fit to purpose”.

Regardless of what WHO might have done to eradicate smallpox or polio, their license and capabilities to forestall / manage pandemic influenza isn’t up to snuff, and it never has been. The real enormity of that task has grown progressively from current events while WHO’s mission and capabilities remain outdated and woefully inadequate.

How to test that proposition? Review WHO’s draft protocol on organization and management of a rapid containment force; by contrast to its institutional failure to communicate, the draft protocol amounts to a fairly candid admission that its existing capabilities are inadequate.

(Last month, WHO announced it will host a meeting in Geneva from 6 to 10 March to establish its authority and cooperative relationships with nations at risk of a Phase 6 outbreak.)

A good bit of the apology I see here and in other threads has to do with the idea that WHO’s been doing a fair job given what they are and what they have. With due respect, I don’t care that they’re trying hard or any of that if they’re not capable of doing the job fullstop. Of that, Chief Melanite has said, “We work with what we’ve got.”

No. If what we have isn’t fit to purpose, we retool to give ourselves better chances.

[You]

“But WHO doesn’t do everything, own all data, and have authority to do mich more than they’re claiming to do. Dissing them doesn’t change that, one way or the other.”

No. Dissing WHO may have the useful effect of promoting change abd strengthening the hand of individuals to affect change. Recurring assurance that the WHO might know what it’s about is the very antipode of constructive criticism. To call attention to WHO’s inadequacies might even strengthen WHO, as such attention legislates for more and better capability. Near the limit of this proposition, we might not shrink from assigning pandemic responsibility to other agencies or coalitions. Capability and performance, after all, are paramount. At the limit, we might consider reducing WHO’s role in addressing pandemic influenza to whatever it can actually do, at least clearing the way for national and local authorities to take action absent implicit assumptions and assurances that have no basis in fact.

Monotreme – at 21:27

DemFromCT: “a lack of transparency” regarding clusters is criminal in my book. As regards China, of course the WHO can’t force them to cooperate. But the Director-General and Margaret Chan don’t have to praise them for their transparency, as they have done.

DemFromCTat 21:29

I hope WHO will respond the way you suggest, dubina. I know of few examples from the real world that that’s what happens, but I appreciate the intent here.

But you really must distinguish between what you’d like and real world likelihood. Or to turn it around, I don’t really care as much as what you think WHO should do as what WHO can and will do. ;-)

My best guess is that WHO is telling us what they know and not telling us what they suspect.

BTW, while I type, i’m listening to the Arnold Monto lecture referenced above. He’s been in touch with WHO, and is optimistic that Turkey will release the seroprevalence data that hasn’t as of 1/24 been fully collected. It’s Turkey’s to do, and since they’re eager to join the EU, the odds are good it’ll happen - no guarantee.

Path Forward – at 21:35

DemFromCt wrote: “My best guess is that WHO is telling us what they know and not telling us what they suspect.”

My best guess is that they are not telling us what they merely suspect IF what they suspect is merely “more of the same” of what they know (“know” = “confirmed”).

I suspect they WILL tell us what they suspect IF or WHEN what they suspect is far worse than what they know.

And they will be damned for that if they turn out wrong.

And they will be damned for that if they announce their suspicions too late.

Tim B – at 21:37

Thanks for all the comments. I knew this thread would generate some debate but it even exceeded my expectations. I’ve been following the flu wiki for a couple months now and have only recently posted to a couple threads. This is the first thread I created and I did so because It seems to me that we’ve reached level 4 but the WHO seems unwilling to commit which could make the pandemic, when it hits, much more difficult and deadly.

What if they declared level 4 and things started to subside instead of flare up. Is this what WHO is afraid might happen. I don’t remember reading that you must go to level 5 and 6 once you declare level 4. In fact could it be possible that declaring level 4 could bring enough attention and resources to the problem to beat the beast back some. I doubt it but it is a possibility. What needs to be weighed is the cost of declaring level 4 to the cost of not declaring level 4. For me thats an easy answer. I don’t see it as a loss when you get countries to up they’re level of preparedness and increase the level of awareness of the general population. Especially when a pandemic is something that everyone says is going to happen sometime anyway, if not now then 1 year or 5 years, or …… It will happen sometime.

The world needs a good kick in the ass to get them to realize that something very big is about to happen and to get them to realize that now is the time to get prepared. I work with educated people in an engineering environment. People who should be informed however I still get comments like “I just won’t eat chicken”, or “I won’t go to Turkey” or “I just got over bronchitis and the last thing I need is the flu” when I mention bird flu. I don’t even know if going to level 4 will make them realize the urgency of the matter but I’m quite sure it won’t create a panic. Worst case the earth will be better prepared for something that’s inevitable. In the best case we save millions of lives because the world is better prepared when the pandemic happens in the near future.

Let me finish by saying that the WHO does have a very difficult job, a job that I wouldn’t want in a million years. But they do have the job and I say it’s time they earned their pay.

DemFromCTat 22:01

Tim B – at 21:37

Very good thread you created! But it’s not an easy answer. You must realize that in 2003 when WHO issued a travel warning for SARS because of activity in Toronto, it threw Canada into recession. There are still unhappy Canadians I run into over that. Travel to Toronto was restricted, but travel to all of Canada dropped off even though there was no SARS elsewhere and Canada is a big country.

Calling it wrong is a problem in both directions. How many unneccessary recessions would it take to prove it? My point is that those who claim we are in stage 4 (and I’m one who suspects we might be) don’t know that we are and are beating up on WHO based on what we don’t know, and what we fear, not on what we know. And, those same folks never admit they might be wrong or that they don’t know.

You prolly recall the academic translations:

It’s obvious = it’s not, but I don’t have data to prove it It’s beyond the topic of this discussion = please don’t ask me to explain something I don’t understand etc.

I think it’s not obvious and I understand WHO’s caution. More transparency on their part would serve all of us so much better.

Michael Donnelly – at 22:03

This was a good thread. In contrast to some of the recent ones, everyone managed to remain civil, and I for one feel like I learned a thing or two. Only one thing to add, by way of the topic of the US gov’t response to the pandemic issue:

I just received this month’s issue of Harpers, and in it there was a little piece (by Peter Doshi, “a graduate student at Harvard” in what program it doesn’t say) covering the CDC’s talking points for selling the seasonal flu vaccine to the public, in which they appear to strategically stoke public fear by massaging the yearly mortality stats for the regular flu, and he basically accuses them of including pandemic influenza in their public pronouncements about the importance of getting regular flu shots.

He makes a claim that I had not seen before, that the fairly regularly cited 36K annual deaths from seasonal flu is in fact a vast overstatement, with the real number closer to 1K. I have no way to verify his claim, but it doesn’t strike me as impossible, knowing how hard it can be to uniquely attribute an individual’s death to any one cause.

Any comments here? This is a thread about politics, and it seems to me that the CDC, whether we like it or not is a major political player in the question of the status of an avian flu pandemic. Is he basically correct in saying that the CDC has ulterior motives (i.e. trying to create a context for legal protection of drug and vaccine manufacturers) and if so is this a good or a bad thing they are doing?

Tom DVM – at 22:11

DemFromCt. I am a proud Canadian and couldn’t care less what the WHO did regarding a travel advisory that may or may not have caused a recession in Canada. I am mad at the WHO because, to put it simply, they have done nothing…not one thing to protect my family, and secondly they pretend to be scientists when they are actually politicians. Also, in my opinion, the frustration over the stage that we are in is academic and as well how many mutations it will take to become a pandemic. Evolution can occur in steps, it also can occur in leaps.

DemFromCTat 22:12

Peter has written us, and his paper, and the responses by the CDC (who disagree with him - duh!) are online and on our Links page. See for yourself.

Monotreme – at 22:13

I may antagonize some Canadians, but I think the WHO did the right thing with travel restrictions to Toronto. The administrators of some of the hospitals there did lousy jobs and the mayor at the time was an absolute fool. Vancouver, on the other hand, handled SARS quite well. That being said, Canadians were right to be mad about being singled out for especially harsh treatment. SARS was raging in China long before it got to Canada. The WHO did not impose travel restrictions in China until long after everyone knew that SARS was out of control there. So, the iron fist with Canada and kidd gloves for China. The pattern may repeat.

DemFromCTat 22:14

I didn’t mean you, Tom. I’ve heard Canadian economists at recent conferences (pleural) express unhappiness with WHO’s moves, complete with graphs. We Yanks felt like bystanders in a family feud.

Tom DVM – at 22:15

Monotreme. I completely agree with your statement.

Tom DVM – at 22:17

Monotreme. I completely agree with your statement other than the part about the mayor.

Monotreme – at 22:25

Tom DVM: Maybe the mayor was a good hearted person who did good things for Toronto, but he said some ridiculous things about SARS which lessened many people’s confidence that he could control it. He clearly knew no science and had obviously taken no advice from scientists. But perhaps this was his only failing so I should not make too broad a statement.

Michael Donnelly – at 22:29

Actually, BMJ is by subscription, so I can’t see those. I did manage to make it through some of the replies and rebuttals, so I take away from that that the question is far from settled. It seems though that a lot of seasoned veterans are accusing Mr. Doshi of playing fast and loose with his interpretations of the data, so I guess I should take Doshi’s thesis with a grain of salt.

Still, I have to wonder that we should seriously question whether the CDC can be relied upon to act in the US (and the world) public’s best interests re:pandemic flu.

Tom DVM – at 22:29

Monotreme. I mentioned the CDC as a regulatory agency with a track record I could and do respect. In Canada, there is a little agency called the British Columbia Center for Disease Control (CDC-North) that I have a great deal of respect for.

DemFromCTat 22:37

Tom DVM – at 22:29

CDC-North: have they or any of the provincial agencies had anything to add about what’s happening overseas and/or WHO’s actions?

You bring up an interesting point, there. Are there any respected agencies including European CDC’s who disagree with WHO, their approach or their interp? If so, I’ve not heard it.

Scaredy Cat – at 22:47

Dem - “But the sheer pigheadedness of some posters here is astounding. So here’s the challenge, Scaredy Cat. What would it take for you to admit, here in public, that you were wrong about WHO? And if you can’t admit that, then how about some tolerance for others who don’t join you on your anti-WHO crusade? Hmm?”

Dem,

Sorry for the belated response. I’ve been gone most of the afternoon.

I gather from the first sentence quoted above that you are referring to me. I see. So for me to call someone an “apologist” is beyond the pale. “Pigheaded” is far more polite. Right.

But I’ll set that aside because that’s a triviality. And I’ll focus on the rest of your statement.

You ask what would it take for me to admit “here in public” that I was “wrong about the WHO.” There you go, begging the question again, acting as if I am indeed wrong about the WHO, when that is hardly proven fact. (And actually, I’ve been wondering what it would take for you to admit you were wrong about the WHO. I guess we have a difference of opinion.)

“And if you can’t admit that,” you go on to say, begging the question once more, since admitting means acknowledging something as fact (see preceding paragraph.)

You keep mentioning Turkey - on other threads and now this one, asking where is my “grudging admission that maybe WHO did a decent and accurate job there?” - as if the Turkey experience somehow provides exculpatory evidence for WHO. Well I disagree. Perhaps WHO did do a decent job there in suppressing a potential pandemic (although with cases in bordering Iraq, I would hardly call Turkey an unqualified success). But accurate? How can we possibly know how “accurate” they were when h5n1 news from Turkey is being filtered through a government agency. And I would hardly call WHO “accurate” when they have failed to reveal the relationships between many of the cases, vitally important data that would serve as powerful circumstantial evidence for B2H2H2H, and not the B2H, B2H, B2H that WHO would have the world think (in keeping with their apparent mission of calming public fears.)

And tolerate difference of opinion? Please, if you have a difference of opinion, state it. This debate is important. But then defend it. Use evidence and logic if you wish to persuade. I like to think I am a tolerant person. But when the stakes are so high I find my tolerance fading.

DemFromCTat 22:58

How can we possibly know how “accurate” they were when h5n1 news from Turkey is being filtered through a government agency.

We have a clear idea of how many new cases there are. None. There are media, blogger, and other sources besides WHO, but they were very forthcoming up until the cases stopped. There’s no reason to think that’s hcanged. So, disagree. But the evidence is that based on Hong Kong, Vietnam, Thailand and Turkey that the WHO method of human case control works, and they report what they find. The evidence based on Indonesia is that if it’s not initiated with governmental cooperation, it fails.

I’ll admit I’m wrong about WHO (and what they know and what they don’t) when someone shows me they’re deliberately withholding evidence.

And I will continue to challenge you when you suggest that posters that have different opinions than your own strongly-held ones are described in less-than-complementary terms like apologists.

Tom DVM – at 22:59

DemFromCT. There is a strange, unprecedented in my experience, silence from all of the regulatory agencies that I follow.

DemFromCTat 23:04

Tom DVM – at 22:59

Would you think that at least some or one of them would challenge WHO if there were something to challenge? OTOH, because all the ‘action’ is overseas, maybe they feel thay have little to add?

I just can’t imagine everyone is in on a conspiracy of silence.

Tom DVM – at 23:23

DemFromCT. You’re guess is as good as mine.

BroncoBillat 23:25

Damn!! All I said, if y’all would re-read my post from 11:48, was that the World Health Org would not bump up the threat level by 2 or 3 leels over a span of 2 days. Too much panic would ensue aroung the globe. Don’t you understand that? The general concensus is that if and when H5N1 goes H2H, it could take up to around 3 months to travel worldwide. Whether it’s WHO, UN, US, CDC, or whomever, no agency on Earth would DARE to put that kind of panic pill into the general public’s hands!!! I can just see the streets now: “The WHO has just announced that they were wrong. Now is the time to panic. The threat level from Bird Flu has been raised from NO OR VERY LIMITED TRANSMISSION to WE’RE ALL GONNA DIE REAL SOON!!!” Panic and absolute anarchy would prevail everywhere.

I did not say, ScaredyCat, that people would have a right to blame WHO. I believe that WHO would first notify political leaders and let them make up their own minds about whether or not to notify their citizens. I am not holding WHO or any other organization blameless, for there is no blame to pass out……yet. And by the time it comes down to blaming anybody for anything related to a pandemic, it WILL BE TOO LATE to even bother!!!

Instead of laying all of your demons at WHO’s doorstep, why not sit back, look over ALL of the information you’re presented with, and try to make a rational decision, instead of just saying that the organizations trying to abate this bug are at fault. At least they have the money to back up what they say….you, nor I, could afford to go out to all of these countries and try to figure out where H5N1 is headed. They do. And they’re running out of time and resources…

Tom DVM – at 23:28

DemFromCT. I observe to identify previously unexamined or unexplained patterns. I don’t always have an answer as to why. It seems that H5N1 is too hot to handle. Every scientist has an honest opinion and I fail to see why, with qualifications, scientists inside and outside regulatory agencies wouldn’t freely express their opinions; especially given the consequences.

anon_22 – at 23:28

I’m with you, Bronco.

BroncoBillat 23:42

Thank you, anon_22. It just burns my butt that there are so many “ultra-liberal, tree-hugging, oh-woe-is-me, why isn’t the government doing something, where’s my share” people out there with their hands out, instead of taking stock of a situation and saying “What can I do to help?” Too many times people place the blame on someone else, instead of looking at themselves, or the whole picture. Look at NO…..a lot of those folks got nice big fat ATM cards to go out and get the necessary items that would help them get back on their feet. What did they buy? Guns, liquor, dope, strip shows. Not all of them…but quite a few. And then they had the balls to tell FEMA that they were gonna stay in the hotels that they had been in for the past 6 months, and they WEREN’T gonna go get jobs to help pay for them. Same thing here with H5N1 and it’s reports….people blame the gov’t for their woes, then demand that that very same gov’t help them make a life. Neh…not help, but make a life FOR them.

Okay….off the soapbox. Down booboo, down!!

Melanie – at 23:44

Everyone,

Please remember that a WHO stage 4 declaration causes immediate, mandatory and extremely disruptive economic and political actions in countries all over the world. While you are sitting here debating WHO, they are going to have to live with the consequences of their actions. You don’t have to live with the consequences of your opinions.

Stage 4 will close borders and bring international trade to an end in large parts of the world. And it won’t do a damn thing to stop a pandemic.

I hope all of you criticizing WHO have all of your preps finished because a lot of the goods you rely on will be unavailable in days after the borders are closed.

Monotreme – at 23:54

Melanie: The fact that the WHO screwed up in linking travel advisories to phase 4 is no justification for witholding/ignoring the cluster information. They could simply admit they made a mistake. Something like “We know we had it in our pandemic plan that we were going to issue travel advisories when we started to see lots of small clusters. Well, actually we are seeing lots of small clusters. But, we think it would be counter productive for countries to close their borders right now. In the future, we promise to tell you the truth and to tell you who is not cooperating so that you can decide for yourselves what’s the best option.” Of course, this would require the Director-General to put world health before his own ego/career. So, fat chance of that happening.

19 February 2006

BroncoBillat 00:06

Melanie: I agree, and am working diligantly to finish my preps AND get my butt moved across the country in the next few months, from CA to VA. It’s not gonna be pretty if and when level 4 is declared. A level 4 declaration by WHO could very well, by it’s very declaration, be the end of the World Health Organization due to border closing and travel restrictions…they will have to abide by their very rules. On the CNN 360 blog last night, Dr. Sanjey Ghupta said one thing that made a lot of sense: People can close their borders, but birds don’t recognize borders at all.

Monotreme (I wish I knew what that meant :-) ): I think if WHO backed down now and said “Oops, we made a mistake”, it would cause too many folks to say that WHO is just crying wolf about this whole “bird flu thAng”, and then just brush aside any other warnings that may be made. And as long as any person has the title of Director-General, you just KNOW that their ego comes first!!

Berinaidan – at 00:08

Look at NO…..a lot of those folks got nice big fat ATM cards to go out and get the necessary items that would help them get back on their feet. What did they buy? Guns, liquor, dope, strip shows. Not all of them…but quite a few.


Your theory is that these folks were ultra-liberal tree-huggers? I can see the dope, but wouldn’t they turn down the guns at least?


 instead of taking stock of a situation and saying “What can I do to help?” 

Well, a fair number of the ultra-liberal tree-huggers did go into the Peace Corps, teach in inner-city schools, etc. I knew some of them. Now major corporation CEO’s and business lobbyists, those folks may be in trouble shaking off that “hands-out” habit….

BroncoBillat 00:20

Berinaidan: “ultra-liberal, tree-hugging, oh-woe-is-me, why isn’t the government doing something, where’s my share”. You take a very small snippet of what I said and spin it to fit your response. In a Reuter’s report that came out yesterday, nearly 35% of the people who had mis-used the FEMA ATM cards made gun purchase their first priority. My “theory” is a generalization, and MHO, of the people who criticize the US government for what it doesn’t do for them, and then turn around and demand that very same government give them EVERYTHING they want, no matter who else it effects. We are living in a “It’s all about ME” era, and at some point, it’s gonna have to stop. I agree with you about big-wigs probably going to be the first to fall, but it’s not just the “suits”…too many people from all walks of life, Peace Corps, Boy Scouts, Dems, Reps, Libs, Cons, too many, have their hands out right now, crying for someone else to do something, instead of digging down and doing the work themselves. The coming pandemic may be the very thing that triggers an end to the self-centeredness that prevails in our society today.

On the other hand, I think this thread was about WHO being overly cautious, not about my lowly opinion…

anon_22 – at 00:21

I personally don’t even think it is a matter of the DG’s ego. (Here I’m talking about the Director General’s post in general, not specifically the current DG.) You ascribe too much discretion to his post than he actually has. He is a puppet being pulled in many different directions: science, the conflicting interests of different member states, conflicts within the UN bureaucracy, the need to be seen to be impartial, all balanced against his own aspirations to go further up the greasy pole.

YOu need to remember that the DG is a civil servant working in the mother of all government bureaucracies. I don’t think he got to where he got to by fighting for the wellbeing of the people. Anyone who does that would have fallen by the wayside a long time ago. No, he needed to be slick, able to please all parties while not giving anything away, with demonstrated ability to fudge. These posts are not about leadership; it is follower-ship. You follow what you think TPTB want you to go.

I have low expectations from government in any way shape or form. Better to rely on my own efforts.

FW – at 00:22

Monotreme declared:

>I agree with pretty much everyone except FW. FW: Your definition of phase 4 is not >accurate. You can get a copy of the plan here.

Thank you: Been there, done that, have the t-shirt, kissed the cat.

I am not referring to some dry, technical, bureaucratic checklist that was drawn up in the past, I am talking about what the WHO is saying, NOW, they will need to see before they up the level. Reality, in other words.

>However, I have noticed that in press conferences, WHO spokespeople are ignoring their >own plan and redefining phase 4 to mean phase 5 or 6. Unfortunately for them, too >people have a copy of their plan.

Their plan is a work in progress. ^__^

(Really, I don’t know why people are so obsessed about the WHO. The odds that they are actually going to be in the right place at the right time with the right equipment to be able to detect the start of the pandemic, let alone stop it, are SOOOOO small it makes winning the lottery look like a sure thing. And that’s in those nations they have full access; if it starts in North Korea, or Burma, or almost anywhere in Africa, the first we’ll know about it will be when the bodies pile up so high they block out the sun. It’s best to just assume the pandemic may have ALREADY started, and behave accordingly.

Safer, too.)

NW – at 00:24

Melanie – at 23:44 “Everyone, Please remember that a WHO stage 4 declaration causes immediate, mandatory and extremely disruptive economic and political actions in countries all over the world. “

So an arm of an impotent organization such as the UN is going to wield such authority as to make mighty Nations tremble? I suggest that countries will do what they want to do regardless at what stage the WHO indicates. WHO has no authority to enforce any actions. Do you think China is AFRAID of WHO and will follows dictates? Please.

Berinaidan – at 00:29

Berinaidan: “ultra-liberal, tree-hugging, oh-woe-is-me, why isn’t the government doing something, where’s my share”. You take a very small snippet of what I said and spin it to fit your response.


Which is to say I quoted your precise words. Anyway, I’ve been listening to good folks get characterized as “ultra-liberal tree-huggers” since before the Reagan era, and it gets occasionally irksome.

At any rate, I’m a socially liberal, fiscally conservative (well, compared to Bush II, anyway) tree-hugger who’s done my prepping and don’t have an opinion on the WHO cover-up or lack thereof, so I’ll stop hijacking the thread now that I’ve stated my point.

Many Cats – at 00:31

BroncoBill: The Monotremata are the egg-laying mammals including the echidna (spiny ant-eater) and duck-billed platypus. The origin of the descriptor “monotreme” for the genera is a bit more, shall we say, technically detailed…

anon_22 – at 00:34

NW, “WHO has no authority to enforce any actions.”

True, however its actions have tremendous influence because, rightly or wrongly, in the realm of legal obligations and international relations, we (the ‘international community’, remember that one?) have agreed that the UN (and hence the WHO) speaks with some authority. Therefore various entities will act accordingly.

For example, if a travel advisory is declared against a particular country, then insurance companies will not cover your medical expenses if you fall ill. This was what happened during SARS. American companies and consulates abroad had to stage almost-emergency evacuation of their staff and dependents because they had no medical cover, and if someone comes down with SARS, the bill for repatriation of even one patient with full infection control precautions would run into millions.

Same applied to all the college students doing international exchanges, and even unpaid volunteers with NGO’s abroad. I distinctly remember a newspaper article describing the absurdity of having to pay money to withdraw unpaid staff because there would be no legal cover if something happened to them.

anon_22 – at 00:45

Oh, I forgot to add - all the trade conferences that got cancelled. Deals that didn’t get signed, or deadlines that were missed.

Suppose you work in China, as a lot of westerners do, and your company all of a sudden as to withdraw all expatriate staff. What would happen to the business?

What would the scramble for flights be like?

Then suppose you got out, but because you have been on a particular flight where someone was having ‘flu-like’ symptoms, you have to be quarantined. While waiting to be cleared in the quarantine center, you actually caught the virus from someone who turned out to be a real case. Could your company be liable for putting you into this position? Might it be sued for multi-million dollar compensations if you die from the virus?

BroncoBillat 00:45

NW—I agree with you in that individual states (nations) will do as they please, ie. China, N. Korea, et al., and that the UN is not the mighty be-all end-all it may have been 45 years ago. Most countries in the world today subscribe to the WHO as being the most well-informed medical information outlet that any world body has to offer.

However, that being said, think about what Melanie said. If only 1/4 of the nations belonging to the UN were to close their borders after an announcement of a level 4 or above, that in itself would cause economic chaos worldwide. I suggest to you, sir (or ma’am) that in this day of a “just-in-time” global economy, even warring nations have a trade pact of some kind (see news reports of Irag’s “Oil-for-Food program on CNN).

If the WHO announces at some point an increase in the threat level, you will see entire economies totally and completely lock down. Every major stock market, from NYSE to Nikkei, to London, will crash and burn so fast that the Depression of 1929 will look like a hiccup in the California real estate market.

BroncoBillat 00:49

Many Cats---Uhm thanks. I think. :-) I don’t wanna know…. :) :) :)

Many Cats – at 02:42

:)

Melanie – at 13:29

The WHO doesn’t enforce stage 4 consequences. It can’t. Those are the responses to stage 4 required by the emergency plans of member governments.

Monotreme – at 15:51

anon_22: Basically agree with you about the DG. But I think China, for whatever reason, is the country he is most fearful of offending.

FW: I agree about not waiting for the WHO before preparing. The problem is my state won’t start seriously preparing until the WHO declares phase 4. By attacking the DG, I hope to discredit the WHO phase system in the eyes of government officials so that they will de-link their preparedness plan from the WHO.

Melanie: WHO can issue travel advisories which will have consequences. I think some countries will back off the border closing stuff if the WHO explains the significance of the clusters better.

BroncoBill and ManyCats: My namesake doesn’t believe in redundancy :-) Actually, I chose the nick because this group of animals are hard to pigeon-hole. They are mammals, but resemble reptiles and birds in some ways.

anon_22 – at 16:26

Monotreme, “The problem is my state won’t start seriously preparing until the WHO declares phase 4. By attacking the DG, I hope to discredit the WHO phase system in the eyes of government officials so that they will de-link their preparedness plan from the WHO.”

THAT is definitely a worthwhile venture. Let me just say for what it’s worth that some people who are only interested in covering their backsides may use any excuse to shut down such attempts. Hence, alas, you may have to tone down your thoughts somewhat to stay in the game.

Still, best of luck to you and thanks for all your very insightful inputs.

Many Cats – at 17:04

Monotreme: Darn, I had delusions of you doing DNA research in order to determine phylogentic relationships amongst the extant Monotremata for biodiversity studies, hoping to illuminate the plight of these mammals in the face of introduced predators. This would have served nicely as background for your internet persona, using similar skills to try to save humanity from predation by H5N1. I’m crushed… :)

Monotreme – at 18:45

anon_22: Thanks. At a local level, explaining the role of the DG will be helpful. “Unelected bureaucrat at Geneva deciding on what happens here? We’ll see about that!” At a national level, the situation is more complicated. Of course, under my real name, I’m a bit more circumspect.

Many Cats: The heroic role you paint for me is very complimentary. Thanks. I do root for the Monotremata, and hope for their survival. On a another thread, I pointed it out that they have a relatively low core temperature as compared to other mammals and hence might not be as easy prey for H5N1.

Nightowl – at 20:29

Regarding China - They are hosting the Olympics in 2008. This is their opportunity to strut their stuff on the world stage. One more reason to suppress information. One more pressure on the WHO to get it right.

Regarding the WHO - Their overly cautious approach is a problem when you want to know when a pandemic begins. However, it may be useful when you want to know when it ends.

Many Cats – at 20:43

Nightowl: I had also heard a political scientist remark once that China would hold off any thought of “reclaiming” Taiwan until after they could show their prowess to the world. As if we don’t have enough to worry about!

Scaredy Cat – at 21:33

After getting caught up on all the comments, have to wonder why WHO ever invented the pandemic risk phase level stage whatever it is they’re calling it now but will never actually implement because it will cause too many economic problems to begin with. Seems the whole thing’s a farce.

And Dem. Regarding Turkey you say: “There are media, blogger, and other sources besides WHO, but they were very forthcoming up until the cases stopped.” Here you place a lot of credence on such reporting from Turkey, but if I remember corrrectly, you put very little stock in such reporting from China.

DemFromCTat 22:23

True, SC… they’re very different countries. For example, my son just got back from Beijing (a junior in college spending a semester abroad). He had access to the internet as a foreigner that Chinese students did not. And the country is so large that no one knows what’s happening in the rural areas… not even by rumor. Not a free society by any account.

Turkey has Oric (and bloggers like him) and a westernized press. Vast difference in the flow of info in a society trying to get into the EU.

No news from Turkey is no news. No news from China is uninterpretable.

20 February 2006

Scaredy Cat – at 10:01

Dem - “No news from Turkey is no news. No news from China is uninterpretable.”

No new from Turkey is no news. Who could argue with that? But that doesn’t necessarily mean good news, because we don’t know all that the “no news” could tell us. As just one example, if WHO is not revealing symptom onset dates, relationships between cases, who received anti-virals and so on, then indeed a lack of reporting is taking place, reporting which would be useful in determining the type of transmission, the effectiveness of anti-virals and the real-world CFR where very few will have access to Tamiflu, or any medical care for that matter.

As far as China goes, no news from China might be uninterpretable. but I wasn’t talking about “no news” there. I was talking about reports from various non-state entities that you have discounted.

DemFromCTat 10:09

reports from various non-state entities that you have discounted

Just the opposite. I don’t discount them at all; they’re vital, but they’re not reporting.

You seem to have an inconsistent view. I think lack of news is lack of news, that’s all. You agree, yet feel there’s still a sinister conspiracy buried in there. Somewhere. Lack of new cases is a huge piece of ‘no news’, just as it is in Vietnam and elsewhere.

As to the data on existing cases, there’s where WHO and especially the countries that own the data are fair game for criticism.

I just hope people don’t invest magical powers into WHO because they’d like to believe someone somewhere is in charge. The truth is different.

Scaredy Cat – at 13:13

Dem - “Just the opposite. I don’t discount them at all; they’re vital, but they’re not reporting.”

I seem to remember you downplaying the Boxun reports from China.

As far as lack of news, do you believe WHO has been fully forthcoming with all they know regarding the cases in Turkey? I don’t. And if they are not fully forthcoming, I think it not unreasonable to speculate about motive, to take into account past behaviors, to look at what they have in fact said. They have said that the consequences of upping the phase level will have profound economic consequences. All of these factors lead me to believe that the lack of news means more than “lack of news.”

Oh, now I finish reading your above post. Well, then I guess we agree. If they are not providing data on existing cases, then no news is probably bad news. If the data were comforting, I think they would release it.

As to magical powers, it may be (and probably is) beyond the abilities of WHO to prevent a pandemic. But it is not beyond their ability to be open with the data which would be crucial to maximize people’s (I’m sure governments are already more fully informed) ability to prepare.

Scaredy Cat – at 13:17

Dem - “I just hope people don’t invest magical powers into WHO because they’d like to believe someone somewhere is in charge. The truth is different.”

Well I think people actually were hoping that someone somewhere was in charge. As individuals we are certainly powerless to prevent a pandemic. WHO was our best hope.

DemFromCTat 13:25

realism is good, SC, even if not always comforting. The new WHO statement on mutation (you’re also active on that thread) is (my guess) a response to some of these concerns. I think we are pushing them to be more open, just not ebnough yet to satisfy any of us.

BroncoBillat 13:28

Scaredy Cat---could it be possible that WHO isn’t releasing data because they don’t have any proof of anything yet? Could it be possible that even if they had data suggesting that there is POSSIBLE H2H transmission among CLOSE family members, they wouldn’t announce it to the world for fear of starting a panic that could outweigh any pandemic? Could it be possible that your conspiracy theory is just that---a theory?

A lot has shown up in the mainstream media in the past 2 weeks to let people know that this virus is being watched very carefully. People need to wake up and do some of their own research…it’s not that hard to to at all. Again, another case of people wanting the government to step in and tell them what to do….rather than making their own rational decisions based on their own needs.

Scaredy Cat – at 13:46

BroncoBull - “Could it be possible that even if they had data suggesting that there is POSSIBLE H2H transmission among CLOSE family members, they wouldn’t announce it to the world for fear of starting a panic that could outweigh any pandemic?”

Absolutely.

BroncoBillat 13:56

Uh….that would be BroncoBill. No Bull.

DemFromCTat 14:05

;-)

28 February 2006

knowitall – at 22:34

that doshi stuff is comical.

who would you trust a Harvard hippie that writes for a Harvard satyrical paper that looks like the enquirer (http://www.harvardsp.com/) or clinical MDs and trained epidemiologists that publish in well respected peer-review journals.

Grimoire – at 23:07

Hmm…In my own opinion, WHO very well have made some mistakes, But I’d imagine that they would have to be damned CERTAIN about going to 4 and releasing chaos. Right or wrong, conjecture aside, opinion notwithstanding. WHO IS on the front line and they have the not so enviable position of being the authority people look to for assurances. and much of the knowledge known about this threat is at best educated guesses with a lot unaccounted for no matter who you ask. I don’t know about you all But I give them points for volunteering to be the international scapegoat. They are there, and under pressures I can’t concieve of. …I’m not, and thus not qualified to judge them from my armchair.

Are they best we have? I don’t know. Are they making a difference….I believe they are trying awfully hard and their successes will be in silence. their mistakes burned into history. I wouldn’t want the job myself.

Just a thought….

Melanie – at 23:29

Let’s clear up some misconceptions here. The WHO has no authority to act in member states, but most member states have emergency plans which will have enormous political and economic effects if the WHO moves to stage four. Some countries in Oceania will be required by their own law (not by WHO action) to close their borders. Different states in the US will have other expensive things they must do, and most of our states don’t have any fat in their budgets. Canadians, please contribute what you know about stage four in the GWN (great white north, for Yanks.) This is a non-trivial decision that will cause worldwide economic disruption *immediately.* If they get this wrong, it will destroy the organization.

I’m tired of the casual trashing of an organization with has been tasked with a critical mission without having the authority, personnel or budget to do what you think they should do. If you don’t like what the WHO is doing, write to your congresscritter and bitch about the fact that the richest country on earth is contributing so little to their critical mission. I know too many people who are busting their asses in really unpleasant places on earth while so many voices sit here in their American splenor bitching about it. If you think the WHO could do a better job with your assistence, take the pay cut from corporate employment it would take you to go work for them.

If you ain’t on the infectious disease front line and you ain’t willing to do the work, a little modesty might be in order before you criticise the professionals who are doing the work.

Grimoire – at 23:33

Melanie- Well said :D

01 March 2006

Monotreme – at 08:16

There are two different issues which I think WHO defenders are conflating, perhaps because the WHO itself conflates them. The two issues are accurate and timely release of scientific information and the economic consequences of phase 4 declaration. As a scientist, I’m offended by the very poor or absent reporting of basic information such as symptom onset dates and the relationships between patients in Turkey. There is no excuse for this. The WHO has consistently attempted to obfuscate and misinterpret cluster information. I am quite certain of this. This constitutes scientific misconduct, IMO. As regards the economic consequences of declaring phase 4, the WHO plan suggests travel advisories to the affected regions when phase 4 is declared. I agree that this will cause serious economic consequences, but this is in their document and they could remove this provision if they wanted to. The WHO has chosen to distort their science to avoid losing face and admitting they made a mistake with the travel advisories, IMO.

Melanie, the WHO has sequence data of vital importance which is hidden from most of the world’s scientists. Do you favor its release?

DemFromCTat 08:25

WHO detractors, otoh, are equally obligated to be clear about their bjections. They’re such an easy target, but often they’re blamed for things that are not under their control. For example, when data was released by the Korean CDC on previous H5N1 infection, it became clear it was the KCDC’s data to release, not WHO’s.

Monotreme’s concern is valid and real, but even after all the discussion I’m not certain who ‘owns’ the data. Monotreme assumes it’s WHO. I don;t know if that is correct. We know China has data hitherto unreleased, for example. That’s not WHO, either.

Monotreme – at 08:34

DemFromCT: I agree we need to determine whether WHO is being blocked from releasing the sequences in their secret database. However, they have made frequent statements praising the countries from whence the seqeunces came for their transparency. This would be inconsistent with blocking sequence data from the world’s scientists. So, could someone simply ask Margaret Chan and/or Director-General Lee: Who is blocking the sequence data - you or Turkey and Indonesia? This way would could know who to apply pressure to.

DemFromCTat 08:42

Go for it. Contact info.

Melanie – at 09:05

Monotreme,

Don’t assume that WHO owns the data. Based on their constitution, I’d doubt it. Don’t assume they are obfuscating when they simply haven’t been given the data.

giraffe – at 09:55

Melanie 23:29 — Standing ovation!!! applause applause

gs – at 13:05

how to solve it: 60 stages instead of 6, as said before and heavily attacked.
which countries will close borders on stage 4 ?

Melanie – at 13:07

GS,

A kiwi told me that New Zealand and Australia will.

Path Forward – at 14:42

Question for Monotreme at 08:16:

Monotreme writes: “As regards the economic consequences of declaring phase 4, the WHO plan suggests travel advisories to the affected regions when phase 4 is declared.”

I cannot find in the WHO pandemic plan, or the WHO pandemic checklist, regarding Phase 4, any suggestion or recommendation that travel advisories to the affected regions be imposed.

From the WHO plan, it looks like WHO assumes that countries WILL impose travel advisories, but I see no sign that WHO is recommending this. What am I missing? I’ve read the plan and checklist over several times.

Monotreme – at 21:23

Pathforward: Just so we’re on the same page, so to speak, this is where I’m getting the WHO pandemic plan WHO global influenza preparedness plan. On page 44 of the plan, in Annex 1 there is table with a list of recommended actions.

Quote: “Recommend deferral of non-essential travel to and from affected areas.” N for no is indicated for phase 3. Y for Yes is indicated for phase 4 and phase 5. Also, please read the comment on the right of this table.

This would be devastating to China’s economy. Do you agree?

Also, its important to note that on page 29 the WHO recommends that on declaring phase 4, unaffected countries should “Activate pandemic contingency planning arrangements.”

IMO, WHO is sacrificing the preparedness of unaffected countries in order to protect the economic interests of one infected country, China.

20 June 2006

Closed - BroncoBillat 00:55

Old thread - Closed to increase Forum speed.

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