From Flu Wiki 2

Forum: CDC Warns of Possible Avian Flu Pandemic

23 November 2006

Siam – at 13:48

CDC Warns of Possible Avian Bird Flu Pandemic

CLICK HERE TO WATCH THIS STORY Click on the link at the bottom, you get a short tape story by: Andrew Kennedy

EVANSVILLE - There’s a new warning from the Centers For Disease Control. There is a potential for a worldwide Avian Bird Flu pandemic.

Wednesday, NEWS 25 questioned Tri-State hospitals and emergency officials on how prepared we are to handle such a potential outbreak.

We reported earlier this week on the importance of flu shots, but health officials told us that shot won’t protect you from the avian flu strand, if it hits the Tri-State.

A Department of Health and Human Services Report shows the avian bird flu has not yet reached the United States, but has rapidly spread throughout Asia. There is no indication of exactly how many people have been infected with the virus, but the report does mention the avian flu has claimed more than 250 lives.

Right now in Asia, the bird flu can only be obtained from bird-to-human contact, but health officials say if it finds a way to become obtainable through human-to-human contact. The results could be catastrophic.

Dr. Clifford Erickson, St. Mary’s Emergency Department Director said, “On a national ‘worst case senario’, we’re looking at millions of deaths.”

Erickson runs the ER at Saint Mary’s Medical Center. He said being prepared is the key.

“We’ve ran a scenario just last week here,” Erickson said.

We also questioned the Director of the Emergency Management Agency for Evansville and Vanderburgh County, Sherman Greer.

Greer told NEWS 25, “We have everything in place with Health and Human Services, and everything else.”

Greer said it is more important than ever for Evansville to have a concrete plan, because if an outbreak of this magnitude reaches the U.S., cities like Evansville will have no federal resources from F.E.M.A., because it will be bogged down on a nation-wide scale.

Greer says local preparedness is the key, and that Evansville has it. Still he offers this warning, “We have no idea how bad it will be until it hits.”

Greer said you can take action yourself to be prepared on an individual level, by:

stockpiling water washing your hands coughing into your hands and/or sleeve to prevent spreading germs

http://www.abc25.com/Global/story.asp?S=5720259&nav=menu213_2

Goju – at 14:28

www.cdc.gov

shows you a banner for seasonal flu

http://www.cdc.gov/flu/index.htm?s_cid=newmediaFlu001

They are making sure we know what “seasonal flu” is and how to deal with it. I suppose the next major message will be what “Pandemic Flu” is and what the difference is.

Then they will tell us how to prepare for Pandemic Flu - I’d say we are probably looking for a Mid-late January push for Pandemic Flu Awareness. The 12 week advice will leak out then during public discussions about Pandemic Flu.

All of this is prediction on my part. And will probably be based on the news we are not hearing about.

Argyll – at 14:48

What is the specific date the CDC released a new warning? Is it listed on the CDC web site?

Argyll.

Walrus – at 14:52

If this is true, as reported, then the rumor on a thread about a ‘major announcement” after thanksgiving was correct.

oddthomas – at 15:00

I saw this on CE and looked on the CDC quite a bit this morning trying to find it. Either I missed it or they haven’t posted anything yet. It might not be new either, maybe the TV station just thinks that it is new.

Pixie – at 15:09

The U.S. is going to have its first annual “Influenza Awareness Week” the week of Nov. 27 - 30.

They will educate the public about influenza in general. They will also urge everyone to get their seasonal flu vaccine (this will be a louder message than usual, as I believe they think that the seasonal flu vaccine will perhaps provide some small but important amount of protection from the pandemic strain, although I am certain that they will not mention this). I believe that a lot of flu clinics will also be run during the week of Nov. 27 - 30. This is also, coincidentally, when most of the delayed pediatric vaccines will arrive and be given.

I believe that the government believes it cannot work on pandemic awareness during the period between Thanksgiving and Christmas because the stores need to move their stocks of holiday merchandise (not a small consideration, economically).

During the Syracuse meeting, 10 slides were devoted to educating the audience about seasonal influenza, and 10 slides were devoted to educating the audience about pandemic influenza. I believe that this is the same educational approach they will follow with the general public.

Therefore, if I had to guess, I would surmise that we might see a similar “Pandemic Awareness Week” during the post-holiday period (early January). This, I would think, would be when the PSA’s (public service announcements) will begin to run on pandemic preparedness. We should also see many “experts” and talking heads on major cable and news outlets discussing a possible pandemic throughout January.

I believe that they will present the public with a pandemic scenario that includes a 30% attack rate and a 2% CFR. They will emphasize to the public that “no one knows” when the next pandemic will arrive, unless the existence of obvious multiple clusters makes it necessary for them to speak about “the emerging pandemic” instead.

I think that right now they are trying to come to grips with what level of preparedness to advise for SIP, and the numbers as we have seen, range from 2 - 12 weeks (I am hoping they let that range stand as it is in the State Dept. advisories, 2–12, if they cannot reach agreement on 6–8 or 6–12).

There is little question that any remaining questions about Medicare or private insurance covering prescription medicines will have to be worked out by this time to quickly quell the fears of those who might be affected.

I believe that a high potential CFR will not be a part of any of the government’s public discussions nor will it be part of their public education program.

FrenchieGirlat 15:12

A Department of Health and Human Services Report shows the avian bird flu has not yet reached the United States, but has rapidly spread throughout Asia. There is no indication of exactly how many people have been infected with the virus, but the report does mention the avian flu has claimed more than 250 lives.

Is this journalist reliable?

kychas – at 15:27

i just emailed the link to the story to a guy i know in evensville in and i will let you know his thoughts on it. kychas

Siam – at 15:37

Watching the film you can see they are using a New version of the Gov’t Pandemic Flu planning #3 and that was just released Nov 13 2006. So maybe this station was to run the story next week, and jumped the gun? The numbers are off though. Should be 258 cases, unless they are going to release new numbers? This was a really good catch by Argyll

anon_22 – at 15:45

There’s a new warning from the Centers For Disease Control. There is a potential for a worldwide Avian Bird Flu pandemic.

I would be very hesitant to call ‘potential for pandemic’ a new warning. It’s an old warning.

FrenchieGirlat 16:12

Siam – at 15:37

Actually, what made me question the reliability of this journalist is that the official tally of the WHO is 258 affected, but only 153 deaths. As for the avian bird flu has not yet reached the United States, but has rapidly spread throughout Asia, that’s for chickens, I’d assume. Because although we are worried about the 258/153 deaths in total, since 1997, even though the pace is accelerating, even though there are probably many undetected cases, well, I’d hesitate to call that a “rapid spread”.

Siam – at 16:18

I agree with you, that is off. Does anyone live in the area, who could call the TV station? Maybe this was just a piece they wanted to do locally, and used this wording to pump it up???

Siam – at 16:27

Thanks Kychas, that would be very helpful.

Bump – at 16:38
anonymous – at 19:28

FrenchieGirl – at 15:12 Is this journalist reliable?

No. This is some local TV station hopping on the bandwagon. It’s all heady and breathy like this is breaking news, but it’s not. The journalist isn’t even reporting the death toll correctly. Plus, there are numerous other misstatements. Bird flu only spread from bird to human. Stockpile water (but not food?!). This is a hack job, not any grand sweeping announcement. It belongs in the Pandemic News Hall of Shame.

Argyll – at 22:23

This is a link to an article from The New England Journal of Medicine. I found the last paragraph interesting.

http://content.nejm.org/cgi/content/full/355/21/2174?query=TOC

Argyll.

libbyalex – at 22:49

This is the paragraph to which Argyll 22:23 was referring:

<b><font color=“red”>Clearly, we must prepare for the possibility of an influenza pandemic. If H5N1 influenza achieves pandemic status in humans — and we have no way to know whether it will — the results could be catastrophic. </b></font>

libbyalex – at 22:50

Phooey. I got carried away with my new-found html practice at the new site…..

Argyll – at 22:58

libbyalex, you are two steps ahead of me! Thanks for posting above.

Argyll.

Newsie – at 23:20

Hey everyone, this is not new news. This is based upon the same HHS document we hacked to pieces last week talking about (among other things) drills with the media and using the word “fake.”

We have hashed thru all of the doc already. This is just a local station trying to grab viewers w/ something provacative.

People see this thread title and feak out. Take some nice, deep breaths everyone… Now go eat more turkey! ;-)

Anon_451 – at 23:50

I Know this station. IMHO if they said the sky was blue I would want to check out side and make sure they got it right. As far at the area being ready, trust me they do not have a clue. I live in the area and they are not ready. Their idea of ready is, mass flu shots at the Armory, that is it. No HCW’s even know what the plan is or if one exists and they have nothing out for the general public on their web site. I figure we are toast when the SHTF, again just my very humble opinion.

24 November 2006

KimTat 00:29

Hey, but even tho its a hmm a bit shakey accuracy wise, it was on the news and mayhap a few more people will look into it. I shall be thankful it was on a news station for people to view. My thanksgiving thankfulness :)

Green Mom – at 08:36

I agree with KimT on this-at least we are getting SOME kind of coverage.

stillwaggon – at 08:56

I sent this reporter a pointer to the WHO case information and said that if he gives bad info now, why should people believe him later. I hope he’s deluged by complaints.

crfullmoon – at 09:32

And, there’s been potential for an influenza pandemic for well over a year. I read reputable scientists losing sleep over H5N1 a few years ago; why didn’t he notice?

What coverage did they provide when the WHO’s “Ten things you need to know” and the US pandemicflu.gov sites came online Oct. 2005?

What was passed on in the news after your state’s pandemic flu summit?

Wake up, media… do your homework; it isn’t that difficult - might save lives, too. Non-pharmaceutical interventions may be all cities and communities have; hurry up.

diana – at 10:30

After over a year of watching this I can well understand the publics complacency. It is hard to get excited over something you don’t really understand. I get bored and walk away from a football. baseball, soccer or hockey match unless its one of those really thrilling ,once in a lifetime games that everyone talks about for years afterwards. Its black friday, the American public is out shopping for Christmas. And then it will be New Years, and bargains and then Easter and so on down the line until its next Thanksgiving again.Just think its been going on quite some time, and while y’all can find it riviting, the public doesn’t.

crfullmoon – at 11:04

Public hasn’t read the case descriptions, nor thought about the current fatality rate (with care - which looks to be overwhelmed and unavailable a week in), nor age groups they know and family members drowning in their own fluids, nor read the govt memos about expected duration of pandemic, about the expected lack of fed, state, mutual, vaccine, ect, help, nor seen the Palliative Care guidelines; about triaging out to non-medical personnel those not expected to be able to survive the months and months of pandemic, given how scarce “community resources” are going to be, (the “lucky” ones will be given morphine to ease their deaths; be worse when that runs out -Mental health care for witnesses/survivors is going to be inadequate, too) - it is just a lack of facts, or the public’d find a few spare rivets for this topic.

diana – at 11:08

good response.

Argyll – at 11:48

We really need the media to step in here and fill in the blanks. This just does not ring *real* for many people. It has not interrupted their everyday lives yet. Once it does, then many will be searching for answers. I pray it is not too late.

Argyll.

cottontop – at 12:22

Argyll- And that’s my concern. The very people laughing at us right now, are going to come to us and want help. They won’t be laughing will they?

crfullmoon – at 12:31

We won’t be able to help them really, either. They better go vent at the authorities, not us.

By the time an influenza pandemic is occurring by definition it is too late to prepare for one. Even discussing what to do becomes a problem; we should be using the time and adjustment time, now.

JV – at 13:04

Argyll @ 11:48 - “We really need the media to step in here and fill the blanks.”

I completely agree. When I was at the Public Engagement Project ASTHO, Seattle, on Nov. 4th, this was one of two main points everyone was trying to hammer into the CDC there. Ther two points were really interconnected:

1. The government must be totally open, honest, and timely in the information re H5N1 and pandemic flu it gives to the public…starting NOW!

2. The government must instruct the public via multiple media means (incliding prime time TV) about pandemic flu, how to protect oneself, social distancing, and what do do to prepare (including stockpiling for 12 weeks). We all repeated this endlessly and stated that these media means must be repeated frequently, and be started NOW!

My statement was that my husband and friends are not stupid, but they don’t see this information or warning on prime time TV. Therefore, they say that pandemic flu must not be much of a problem, and they discount what I am saying. One of the CDC officials had said that there is a lot of information on the CDC site. I stated that my husband and friends do not go to the CDC site to read about this subject. (At this point there was laughter in the room.) I repeated that in order for people to take notice, this subject must go out via multiple media means and prime time TV…starting NOW!

A number of other participants were more vocal and angry than I was. I stated what I had to say in a strong, but controlled fashion, but others were visibly angry at the lack of information given to the public, and spoke in a aggitated and reactive manner.

This topic was covered over and over again at our forum. The CDC officials heard us. There is no question. The only question is what they are going to do with this information we gave to them.

Argyll – at 14:17

JV, et all,

Thanks so much for your above posts. This is information is so valuable!

Best Wishes,

Argyll

Pixie – at 14:28

crfullmoon – at 11:04 Public hasn’t read the case descriptions

Thanks, as always for another great idea crfullmoon. I’ve just added a couple to my presentation information.

Pixie – at 14:31

crfullmoon – at 11:04 Public hasn’t read the case descriptions

Oh, and I think I’ll include the photos of the kids in Van, the pictures that got to me, showing them just fine and standing waiting in the hospital. Two days later they were gone. Charts and graphs are great - we need them - but we’ve got to make the people we speak with picture their own kids, put faces side by side with the data.

Grace RN – at 14:37

JV @1304

re:”My statement was that my husband and friends are not stupid, but they don’t see this information or warning on prime time TV. Therefore, they say that pandemic flu must not be much of a problem, and they discount what I am saying.”

This is a problem I’m having and one we can relate to. BThink about it-we are not considered “experts” so it is really difficult for people to understand.

‘All hazard’ planning seems to be more agreeable for people to hear-even if they only prep for a few days at least it’s a start.

ANON-YYZ – at 14:39

Pixie – at 14:31

The program on Nova couple of nights ago showed both an animation of how H5N1 spreads and black and white photos of 1918.

crfullmoon – at 14:45

Pixie, That piece after 1918 from the guy in New Haven, CT, and the recount from Ft. Devens, MA.

The current H5N1 - here’s some WHO snips …” In many patients, the disease caused by the H5N1 virus follows an unusually aggressive clinical course, with rapid deterioration and high fatality. Like most emerging disease, H5N1 influenza in humans is poorly understood”…”the current picture could change given the propensity of this virus to mutate rapidly and unpredictably”…

“Initial symptoms include a high fever, usually with a temperature higher than 38oC, and influenza-like symptoms. Diarrhoea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients. Watery diarrhoea without blood appears to be more common in H5N1 avian influenza than in normal seasonal influenza.

The spectrum of clinical symptoms may, however, be broader, and not all confirmed patients have presented with respiratory symptoms. In two patients from southern Viet Nam, the clinical diagnosis was acute encephalitis; neither patient had respiratory symptoms at presentation. In another case, from Thailand, the patient presented with fever and diarrhoea, but no respiratory symptoms. All three patients had a recent history of direct exposure to infected poultry.

One feature seen in many patients is the development of manifestations in the lower respiratory tract early in the illness. Many patients have symptoms in the lower respiratory tract when they first seek treatment.

On present evidence, difficulty in breathing develops around five days following the first symptoms. Respiratory distress, a hoarse voice, and a crackling sound when inhaling are commonly seen. Sputum production is variable and sometimes bloody. Most recently, blood-tinted respiratory secretions have been observed in Turkey. Almost all patients develop pneumonia. During the Hong Kong outbreak, all severely ill patients had primary viral pneumonia, which did not respond to antibiotics.

Limited data on patients in the current outbreak indicate the presence of a primary viral pneumonia in H5N1, usually without microbiological evidence of bacterial supra-infection at presentation. Turkish clinicians have also reported pneumonia as a consistent feature in severe cases; as elsewhere, these patients did not respond to treatment with antibiotics.

In patients infected with the H5N1 virus, clinical deterioration is rapid. In Thailand, the time between onset of illness to the development of acute respiratory distress was around six days, with a range of four to 13 days. In severe cases in Turkey, clinicians have observed respiratory failure three to five days after symptom onset. Another common feature is multiorgan dysfunction. Common laboratory abnormalities, include leukopenia (mainly lymphopenia), mild-to-moderate thrombocytopenia, elevated aminotransferases, and with some instances of disseminated intravascular coagulation.”

( http://en.wikipedia.org/wiki/Disseminated_intravascular_coagulation …”The prognosis for those with DIC, depending on its cause, is often grim, leading the acronym to be known colloquially as “death is coming”…)

JV – at 14:50

Grace RN @ 14:37 -

I know we are not considered “experts,” but it is so hard when we understand something well, and we are not heard at all.

I am quite happy today though, because we have come down to Portland, Oregon to be with my husband’s family for Thanskgiving, and so I have had another chance to discuss pandemic flu with them. I was so excited when both my sister-in-law, and my mother-in-law both started asking questions. I gave them the most profound facts, and then they wanted to understand again what to stockpile. They actually have listened a little over time, and NOW was the time they were ready for further information. It is really true that they will come to you when they are ready to listen! I am so happy that I was able to help them. They are also the kind of people who will tell their friends. This is a win-win Thansgiving for me!

crfullmoon – at 14:55

Something for you to be thankful for!! Good news, JV!

(The time we’ve spent reading about it perhaps we would out-test some so-called experts who are getting paid to do these useless plans and meetings…)

:-/

Pixie – at 14:59

crfullmoon – at 14:45 Pixie, That piece after 1918 from the guy in New Haven, CT, and the recount from Ft. Devens, MA.

Yeah, I’d love to get into New Haven with that one.

Thanks mightily for the details you’ve shared there - good (really bad) stuff.

stillwaggon – at 15:01

The reporter, Andrew Kennedy, whose article at the top of this thread annoyed some of us, has responded to me:

Thank you so much for catching that! I will change that right away it says 152 have died THROUGH November 13th.. I will change that info.. Thanks again for your concenrn and for catching that!

crfullmoon – at 15:01

Glad someone wants it…

where are you pulling stuff together, and how/when is it going to get out?

crfullmoon – at 15:05

(at 15:01 I asked; Pixie)

Hey, stillwaggon, did you show Andrew Kennedy he has “an actual Flu Wiki thread mention”? I hope he does better next time; people need to get preparing. Plenty of prep threads on the main Wiki… we have a starting page, for journalists, somewhere, too.

:-)

Pixie – at 15:07

JV – at 13:04 My statement was that my husband and friends are not stupid, but they don’t see this information or warning on prime time TV. Therefore, they say that pandemic flu must not be much of a problem, and they discount what I am saying.

I’m working on some pf presentations this weekend and because of what you said, JV, I think I’ll include a few slides that quote directly Osterholm on Oprah (for the Oprah name, rather than Osterholm), statements and questions by Ted Koppel, Lou Dobbs, etc., which may have more value for people than things said by Leavitt, Bush, etc. I think that those media names may have much more crediblilty with some, and they may begin to question their own belief that this information has not been on TV and see that it has. Maybe then, seeing it all in one place, they will begin to see that it is “important” according to the values they hold.

My friends are exactly the same way, btw. When ABC lets the subject drop off the radar for a while, they think problem has probably gone away.

Thanks for the ideas. :-)

Pixie – at 15:17

crfullmoon – at 15:01 Glad someone wants it… where are you pulling stuff together, and how/when is it going to get out?

Yeah, crfullmoon, I want the info! I am pulling this stuff together for my own presentations, and I’ll be forcing them down the throats of anyone who will listen…uh..I mean presenting them with appropriate reserve and professional polish…to anyone who will listen to them starting right when they are finished.

I’ll find some way through Dem or Pogge to link to the slides here so anyone who wants them can use them. They have recommended an offline photobucket thingy or something. (You can tell the technical part is not my forte).

One thing I will be doing right away is putting in a formal request to speak at a Board of Ed. meeting. In New England, sometimes you can’t just show up if you want to be on the agenda (or, you can show up, but they do not have to recognize you or let you speak). If I write the formal letter first, they must let me appear, then any other document or letter can be read into the record, formally, and any other pertinent documents can be attached (i.e. my presntation) and must become part of the official meeting record and public file. That will make them accountable, no getting around it. Following this official procedure will also be a great way to have the material covered in the proceedings covered by the local press.

stillwaggon – at 15:22

crfullmoon: I did refer the reporter to the wiki as well as the WHO site. I didn’t tell him he was mentioned here.

Argyll – at 16:39

Thought I would throw out some ideas after reading the above posts.

1. MTV — can we get coverage? I know on their awards show in the fall they had a large picture with a guy wearing a surgical mask as part of their backdrop for the awards show. They are very progressive and cutting edge.

2.A homemade video ( like mentioned above) that could be submitted to YouTube. Or some other type of video internet program. A day in the life of … avian influenza. show the impacts on one’s life.

Argyll

Green Mom – at 18:01

Argyll-I think those are great ideas. I know that some folks from the wiki have been posting on other folks blogs- I think the more stuff we can get on the Net the better!

Argyll – at 19:24

So glad you liked the ideas Green Mom. Every little step we take now can make a big difference in the battle against avian influenza. This forum has so many talented people. The ideas and information seem endless!

Argyll.

25 November 2006

bumping for bill – at 02:01
diana – at 11:00

I was talking to someone who just got back from Japan. Much impressed with the cleanliness of the subways and the fact that they were wearing surgical masks. I said it was a good idea. They were strangers just standing around waiting to be seated for dinner so naturally I didn’t go into details, but mentioned avian flu. Blank looks.I mentioned the school closings in N.C.. This interested them, and they mentioned that in Long Island right now, lots of flu. Even when we don’t really connect, and I never go deeper than people either can absorb or want to know, we are putting a germ of an idea into their minds. It won’t click until something actually frightens them.

diana – at 11:03

Since the had been in Asia last week, I did touch on Indonesia and also the cases in Egypt. Blank looks.You can’t get people who are only interested in their personal concerns a world view.

Grace RN – at 11:09

Argyll – at 16:39

re: “2.A homemade video ( like mentioned above) that could be submitted to YouTube. Or some other type of video internet program.”

check with your local cable provider to see if they offer any free air time to your township on a community channel. For example, our town gets 5 hours a week ie every Fri from 5–10PM. Our township approved giving us some of their time, we are in the process of getting an pandemic education video made at our local high school-as they have a studio and it’s a great way to teach a few more kids and the teacher.

Every little bit helps.

History Lover – at 18:28

JV - Well done!

Agyll - Great ideas.

I mentioned some time ago that I thought we could try a petition to congressional members asking them to create or provide funding for countrywide public service announcements to promote prepping. Flu Wiki had a very successful campaign with their petition to get the sequences released. Any ideas, comments?

Pixie – at 23:23

ANON-XYZ – at 14:39 The program on Nova couple of nights ago showed both an animation of how H5N1 spreads and black and white photos of 1918.

Thanks ANON-XYZ! I have just found it on the Nova site, and the parts on how the virus spreads are great. I like those b&w photos too. Here’s the site, for anyone who missed it you can watch te segment online:

http://www.pbs.org/wgbh/nova/sciencenow/3318/02.html

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