I attended Grand Rounds today at Swedish Hospital in Seattle, Washington. The topic was “Avian Flu Update” given by Jeffrey Duchin, M.D., Chief, Communicable Disease Control, Epidemiology/Communicable Disease & Immunizations, Department of Public Health - Seattle & King County. This was presented for the staff at Swedish Hospital.
Unfortunately, because of traffic, I was 30 min late. At that point, Duchin was up to slides showing generalizations listing points to be concerned about, like early recognition, community containment, case & contact management, epidemiological investigation, infection control, structure for outbreak response, management of staff and resources, redundant communication systems to give and receive information to the public. These were all generalizations, no specifics. I had the feeling that up to that point, he had laid out the history of the avian flu situation as, he saw it — however I was not there for 30 minutes, so I can’t say exactly.
He mentioned that the federal government will be coming out will some new guidelines to follow re H5N1 at the first of the year. He did not elaborate.
He finished his talk with giving these web sites: www.pandemicflu.gov/, and www.metrokc.gov/health. He indicated a lot of the information he gave was also there.
The talk was not well attended, and nobody seemed really disturbed about an upcoming pandemic. There was just a couple questions at the end. One doctor asked about whether he should prescribe Tamiflu for someone going to Asia, for instance. Duchin replied that the problem with that is “when to take it, and how long?” He said do you take it not knowing whether you need to or not? He said what if you take it and then get on a plane and mask symptoms, but shed virus on the plane flight. Duchin suggested not to take Tamiflu prophylactically when visiting another country, but to stay away from infected birds. He did then make the statement that most cases of people infected with H5N1 were secondary to exposure to infected birds, and those that were secondary to human contact were because of very close contact (close living quarters etc) with an infected person.
Another person asked about vaccine development. The standard answer about research etc was given.
After the presentation, I went up and introduced myself to Dr. Duchin. He seemed very personable, and low-key. I asked him if King County (which Seattle is part of) was suggesting any more stockpile of food and water than two weeks.
He stated, “No.”
I said that I felt that people in general did not understand how severe this flu could be. If they understood the consequences, many would want to stockpile to SIP for at least 8 weeks. I told him that I have been trying to educate my friends, and most of them thought I was crazy for 1. being so conserned about H5N1, and 2. feeling the need to stockpile for a few months at least.
Duchin stated, “That is interesting. I did’t know that. We have been doing a lot of publicity about avian flu and I thought we had been very informative.”
I said, “No. People in general are not well informed at all. They do not understand the severity of this flu. They do not understand that they may decide their best option to survive is to SIP for a couple of months at least. Some people will continue to work, no matter what — doctors for instance. (Duchin is pensive and nodding his head at this point) But the average person does not grasp the depth of this problem. Nobody like the Surgeon General has been on TV and has gotten the peoples’ attention. Someone like that in the government has to make a connection on TV on prime time, and get peoples’ attention. The average person needs to be told the truth so he can decide how to react, whether to stockpile, etc.”
Duchin said, “The Surgeon General is not the one to do this. He is not very active.”
I said, “OK, then we can have President Bush and Leavitt talk to the people.”
Duchin said, “There you go (with a smile).”
I again said said, “The average person needs to be told to stockpile more than two weeks food for a situation like this.”
Duchin said, “They can’t do it. They just can’t do it.”
I was totally shocked by his response, and I said, “They need to be given the opportunity to decide. How to address the country is a study in psychology. You can’t just one day go on TV and tell everyone that a devastating flu is coming that may kill 50% of those infected, and you should stockpile for three months at least---or you will have mass panic (Duchin nods in aggreement). People need to be informed by using baby steps. You start out discussing two weeks, and then move on after a couple of weeks.”
At this point, I had monopolized Dr Duchin’s time, and I could tell he was not really responsive to my suggestions.
Duchin than stated, “Well, you can call our office up and make suggestions, and help us out.”
Thinking he did care a little about my statements, I asked what number I should call. He stated, “Just go on our web site and there will be numbers to call there.”
I could tell he wanted to leave, and so I thanked him for taking the time to talk to me. I think I made him reflect (for at least a moment) about how much people really understand about this possible pandemic, but I did not get the feeling AT ALL, that I changed his mind about better informing people.
In the end, I was disappointed that none of the doctors there seemed upset about the situation in general, and that Dr Duchin seems to have written people off (my opinion). It was all extremely disappointing!
My quotes here are as best I can remember, very close if not exact.
I am terribly sorry, but I have to go to an appointment, but I wanted to write this up now since I remember it well. I will be back in a few hours and try to answer questions.
I contacted Duchin by e-mail a while ago and got a very canned response. I think the most disturbing thing about your entire post is that King County is supposedly the model for public health preparedness. That so few docs were in attendance is a terrific disappointment.
JV. Congratulations for hanging in there!!
Yes, I had thought that it was going to be a great meeting, and there would be lots of discussion. I was very excited to go, and was quite upset that I got there late.
I just couldn’t believe as time went on with the presentation that there was just no substance there. And on top of that, I didn’t think the doctors understood the gravity of the situation.
When Duchin responded to me re prepping for more than two weeks by saying, “They can’t do that,” I should have immediately asked why. I was so floored by that response, that I just went into the reasoning that it was imperative to appropriately inform people. I remember he did then say that the grocery stores were “making plans.” You just can’t make plans to stock the grocey stores by as much as apparently will be needed.
I simply have the feeling that King County (and possibly many other counties) and the federal government have decided that people “…just can’t do it.” They have all given up before they have even tried. They have given up on the people. Believe me, we are being forced to be on our own not only to survive, but to find out the truth and then act on it without guidance.
I think perhaps you got more info then they had planned on giving you. I think you took him off guard because you were more on top of the subject than he was and he was supposed to be the authority. That is why wyou got the response you did. The gov will dispell the information from the top down and when the feel they are prepared or when the can no longer put off letting the masses know. In a month or two then it will be back in the media limelight. Once they have their plans and the stores are better prepared. The meeting you went to in my opinion is just a way to soften the blow to let you know that they are working on a plan that when the time comes they will be prepared. They cannot let people know when they know. People will ask what do we do and the gov will say “I don’t know.” No now is the time that they are planning and preparing. Lets just hope they all get their butts in gear when there is still time.
JV, it is amazing how much different, that different places give information about the bird flu. I think it all boils down to the individual giving the presentation. This is what happened at the one I attended out in the middle of nowhere, called Tecopa, California. “Just returned from a meeting in Tecopa, California. Drove 35 miles to the meeting. Tecopa is a small spot in the road, blink and you will miss it, and the meeting on Pan Flu was put on by Inyo County. In attendence were about 12 people from the Tecopa area, and my wife and I (from Pahrump, NV 35 miles away. This was way out in the desert). Besides the speaker, the county health officer, I was the most knowledgable one at the meeting. Although I did not learn anything new, I was impressed by how much the county was decribing the potenial flu pandemic, and the speaker did say Tecopa was on the end of the food chain, gasoline chain, and every other chain and the community would have to basically take care of themselves. He did not pull any punches and explained the history of avian, what has happened from 2003 up to the present (including todays notice of another cluster of flu in Indonisia) and he gave the impression that he felt that he would be around when the pandemic hits (he is a young 60 like me). Did not give any estimate on the timeline of it arriving but gave plenty of possibilies that it could be tomorrow or a few years and time now to get your house in order. Too bad he could not teach in my county (Nye County in Nevada), and in my town of 35 thousand, as not anything is done here.”
All the information I have gathered over the last year, not only here on fluwikie, but other sources, was up to the same that he had, up to the cluster that broke out in Indonisia the last few days. He was very pointed to the facts that those on fluwikie also say: Prep, Prep, Prep but he did also explain that where we are located out in the desert area far from any cities, will be totally totally totally on our own and at the end of any FOOD CHAIN, FUEL CHAIN, MEDICAL CHAIN, in other words,,,SOOL. On the other hand, those of us that prep because we are so far out, will be steps ahead of any and most city dwellers that do not do anything, that will rely on gov to take care of them, etc. This meeting was the last one on his agenda as Tecopa was the farthest from his home base but he did say the next round would be teaching people on exactly how to prep for the bird flu and STAY IN PLACE and take care of their own needs. In fact when they have those meetings (I will be notified by email), my wife and I decided that we will go to the town itself (Independence, CA), to attend the first of the meetings, which is about a 6 hour drive and make a mini vacation of it, as the drive goes thru Death Valley, out past Stove Pipe Wells, and past Lone Pine. With that information I will bring back and spread further information to my little neck of the woods.
I don’t now when it was that people lost the knowledge that the government’s job is to preserve essential liberties, not to protect or bail you out.
The day after tomorrow -
Yes, I think you are right that I got more information than he had planned to give out. Can you imagine any official getting on TV or giving an interview and saying that, “They just can’t prep for any more than two weeks?” Unbelieveable! Any official that happens to read what Duchin said will be sweating it because somehow this will come out, wheather secondary to Duchin saying it, or maybe someone else saying it. I simply don’t believe that that statement was all Duchin’s idea. Now we know what many in the government are thinking!
Gary Near Death Valley -
I agree that certainly not all government officials agree with Duchin. There are many who are spreading the truth and telling people to prep. It is too bad that everyone in the government can’t get together and decide how to inform and guide people, especially when they looking at such an immense problem for the whole country.
Day after tomorrow:
Grand rounds at hospitals usually do tell the scoop. They don’t usually soft shoe it—JV must be HCW because that is only the group who usually attend. I’ve rarely attended a lively discussion in Grand Rounds—usually people get backed up because they attend and have to catch up—that’s why so little questions later. It’s just info to them. Now if he had really said something out of mainstream-he would’ve gotten their attention. Shoot I’ve been begged after night shifts to attend Grand Rounds so the presenting doctor won’t be embarrassed—and many have been boring!
JV..The guy at my flu planning meeting said 30 days of food.
Ruth -
That’s good. I am glad some officials are trying to get more of the word out!
JV, thank you for trying;
I don’t understand how “they” can be ok with deciding that more will die because “they’ve” decided “they” can’t tell the public what a pandemic is.
Short-sighted, and bodies of clay. That’s why history “rhymes” a lot.
Thanks also to Ruth’s “Flu Planning Guy” as well; people might take action on hearing that.
(wishing I could sneak in and put Pandemic Awareness Cards on all the chairs before these talks start…Sigh)
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