I live in Western Australia and have friends who are returning from holidays in nothern Thailand this week. There are multiple daily flights from Perth to Thailand and Indonesia. (Flight time is 5 hours and 3 hours respectively.) It has occurred to me that, given the number of BTH cases occurring especially in Indonesia, it will be impossible to tell until after the event whether a HTH virus has evolved. How do we distinguish between a limited family cluster and a larger epidemic at the start?
This leads me to the conclusion that the plans by the Aust Government to impose draconian border restrictions (suspending all incoming flights is mentioned) will be quite possibly futile. Not to mention the outrage that will ocur when Australian nationals are stranded abroad. I mention this because it is quite likly to happen given the current ideological position of the Liberal Government.
More broadly this raises the question of whether HTH transmission can be detected in a timely fashion given the ‘noise’ created by the increasing number of BTH cases. SARS did not share this problem but still managed to get Canada. Does anybody think that it will be possible to quarantine the spread of pandemic H5N1 influenza between large cities linked by air transport.
Kyan I completly agree and living on Indonesias doorstep is a worry I too am in Metro WA. So many people travel between Bali and WAus, they could be sick and not even have a symptom yet, and I dont think the AUs govt will dare upset the Indonesian Govt by instituting tough measures that may affect their tourism given it has already taken a hit we will wait and see.
Kyan;
Have been thinking and discussing this a bit lately. The epidemiologist told me the hope is that: 1. The first outbreak of H2H will be in a rural area with a low mobility index ie not much in and out travel to populated centres in the country of origin. 2. The cluster is contained by strict local quarantine coupled with a flood of Tamiflu 3. Alot of work is done VERY quickly to chase down any satellite infections and contain them, as in any infectious disease outbreak. 4. Borders are closed with no exceptions for a perios that will be long enough to monitor the spread of the pandemic.
IF all these things happen, it MAY be possible for island nations to quarantine themselves out of trouble. It happened in 1918, and it might work again.
Now the bad news. If it is even moderately infectious by aerosol dispersion ie sneezes and coughing, AND enough infected persons get to a major population centre (Jakarta, Bankok, Hong Kong, pick ANY big city)AND the onset time is say 2 to 4 days >>>>> we’re screwed.
Yeah well, what got me thinking about this was reading about Exercise Cumpston. This will be held in October and is an Oz Federal Govt simulation of a bird flu outbreak to test the effectiveness of the whole of Govt. response. It’s named after the guy who introduced quarantine measures in Australia to slow the 1919 epidemic. The problem with this is - it’s dubious as to whether he had any effect - and the only modes of transport he had to deal with were trains and ships. Cars and planes make it a whole different ball game. Hence RobT’epidemiologist’s hope is probably a bit silly.
The problem is that the overemphasis on quarantine may (a) create fear and loathing and (b) be useless. SARS, which was a new disease, took less than a month to get from Hong Kong to Toronto despite a global alert by WHO issued 3 weeks before the first cases turned up there. SARS wiki
There have been many a thread on the viability of quarentines. until it is full-blown, governments will be too concerned about keeping commerce/trade/tourism going, not impinging on personal liberties, etc. This gives it more chances to spread before things are shut down. And closing off borders on a national level is virtually impossible. It could work on a local, very controlled level. SARS showed that it doesn’t take much for things to move internationally. And SARS wasn’t nearly as contatgious as this could be. Governement efforts would be better spent getting people to prepare before hand, and after, getting supplies to those in need. I’d much rather see the NAtional Guard handing out MRE’s in San Diego than patrolling the order a few miles a way.
I think the Australian authorities have worked out a realistic worst case scenario, despite the public pronouncements of the ridiculously low case fatality estimates (ie , 0.2 % CFR)that Dep’t Health have put out. Those pronouncements are surely not taken seriously by the planners, at least I hope to God they arn’t. So if that is the case, there is pretty strong incentive to try and keep it out. I agree with you, it’s probably a hopeless expectation given the reasons in my previous post…but I think strict quarantine will be tried here. IF everything went right, it might work, but I for one won’t be planning on it. The fact that it will create “fear and loathing” as you put it, or any number of other nasty side effects like the collapse of airline industry, huge disruption to the economic fabric of society etc etc is just the reality of a bad pandemic. The negative impacts of losing 15 to 20% of the population in one hit will have pretty dramatic downside to the economy and society as well.
So if the planners are considering real CFR figures, it’s not surprising they are conditioning us to expect ALL inbound traffic to be stopped. If they leave it too late, of course it won’t work.
bump
RobT : agreed - I’m at the point of presenting a paper to the local council(Albany) and leafleting local businesses because I feel so frustrated about the lack of awareness and public education.
Currently we are officially at Stage 3 elswhere and Stage 0 in Oz. I think that the current increase in infectivity beuing reported in the last few weeks suggest that we are close to moving to stage 4 elsewhere. It seems highly unlikely that sick birds will get here before sick humans. We’re going to go straight to Stage 6 from Stage 0.
It would be good to see some acknowledgement of these issues in the lead up to Project Cumpston. My fear is that the real thing might overtake the exercise. Certainly the current thinking seems to be a little conventional.
I rang the 3 main pharmacies in this town yesterday and only two had S2 masks. None new what P95 meant, nor did they seem aware of any kind of bird flu preparations.
Regional and national quarantines are probably going to exacerbate problems of distribution while having no effect on the rate of spread within communities and cities. Swift action and solutions to the personal space issues could make huge differences at a local level. People are not going to obey regional quarantine restrictions. People are less likely to obey exhortations regarding hygiene/personal space if they think they are going to be deserted by the government.
This is what will happen if the government completely shuts down air transport and strands australians in hot zones.
I’m much more interested in community prepping than individual prepping (no man is an island). If ‘fear and loathing’ means that local business shuts down becaue they are too afraid to open then everybody loses.
We need plans that are built on a defence in depth and realistic protocols for treatment for victims.
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