http://lfpress.ca/newsstand/CityandRegion/2006/03/01/pf-1467449.html
….cabinet power to “authorize” any person reasonably qualified to provide services in a declared emergency.The penalty for violating the proposed law is a fine of up to $100,000 and a year in jail for each day the order isn’t obeyed.
“What happens when you come home at night and you have a tickle in your throat. Do you want to expose your wife, your kids to something because you have answered the call?
“It is one thing to lose your dad or your mother, it is another thing to bring it home and wipe out your family,” he said.
If my math is correct jail time per pandemics wave is 30–60 years …
Maybe it is all part of the plan to get rid of uncooperative malcontents and burdensome prisoners at the same time.
http://www.stuff.co.nz/stuff/manawatustandard/0,2106,3533357a6407,00.html
I am not liking this. Forcing healthcare workers to provide healthcare and forcing pharmacists to do something against their religion. This is not a good trend.
…”“I have already given the best years of my life training to become a physician and in providing care. Now that I have a family, do not ask me to sacrifice myself in a pandemic for which most medical treatments will be useless anyway, and in which health-care resources like respirators are likely to be overwhelmed,” …
This bill came in response to two events. During the SARS outbreak in Ontario, many healthcare workers refused to report to work or refused to treat SARS patients. They had good reason to refuse. They were provided with surgical masks rather than N 95 masks. They were kept and the dark and were not informed of the situation or allowed to give input into personal protection for nurses. Secondly, there was a mysterious outbreak at a Toronto hospital this fall in which more than two weeks elapsed before the diagnosis of Legionnares and even then there were many questions due to an abnormal clinical presentation. At the affected hospital, it was reported that 50 % of healthcare workers refused to report for duty. A lesson does not seem to have been learned by regulators, in Canada and elsewhere. Healthcare workers and particularly nurses are not stupid. The ‘don’t worry be happy’ message regarding H5N1 will come back to haunt them in the future. Engage all healthcare workers and involve them in decision-making regarding H5N1. Not having done that, the governmental response was this bill.
It will not stop with health care workers…
If HCW are forced to perform, who will take care of their needs (day care, transportation, etc.)?
Simple solution for complex situation will never work…
Informatic. Something I didn’t say…the victims of the SARS outbreak were predominately nurses. Although information has not been forthcoming, I assume some of these nurses are still impaired by their illness. Secondly, not only were nurses not consulted but they repeatedly went to supervisors to state that there were new cases after the provincial government had publicly announced the outbreak was over. In the second wave of SARS infections, a great number of nurses were infected. The time to consult and empower nurses, doctors etc. is long before the event occurs….and even though we can’t predict with certainty, it will be clear to all healthcare workers that there is a potential imminent threat
I can think of nothing more dangerous than trying to force HCW to provide care at the point of a legal gun. Trying to force intelligent, well-trained people to do your bidding by force is like trying to stop a Cat 5 hurricane with a New Orleans levee.
Some will simply disappear off the grid. Others will do only the minimum demanded to keep out of jail. Some will give their all and be overwhelmed. It won’t help the sick and dying, it will only make things worse.
Hmmm. This is a tough one. If someone has signed a contract to perform, then they are legally obligated to perform.
On the other hand, a contract takes two, and if the company/hospital/etc. is not holding up its end of the contract then that contract may be assumed to be null and void.
I’m not sure how they could enforce a legal obligation on one party (e.g., health care workers) without enforcing it on the other party (e.g., hospitals).
I’m not saying they won’t try it, but I’m not sure it would stand up in court.
In the US there is a law that prevents individuals from suing a doctor/nurse/whatever if they are helping at the scene of the accident if they were just there as a bystander as opposed in a professional capacity. There has got to be something in that idea that can be used to safeguard our healthcare workers from being prosecuted if they chose not to act in their professional capacity.
The worst that should happen is that they get fired.
Perhaps there are other first responder career protections that could be investigated with regard to this situation.
Tom DVM: I followed the situation in Toronto during SARS very closely. And you are exactly right. How many nurses will trust hosptital administrators there when they say its say is safe to work during a flu pandemic? A study in New York suggested that 50% of the HCWs would not show up for work during a SARS epidemic. I suspect it will be far worse during a flu pandemic.
Most HCWs are being told absolutely nothing about a flu pandemic. No stockpiles of N95s or tamiflu are being acquired for them. If it happens soon, and its severe, the administrators will simply expect them to work with nothing more than a surgical mask for protection, if that. We’ll see how that works out.
I wonder if HCWs could be persuaded if they were the FIRST to recieve the Tamiflu and supply of N95 masks?
I would not want a doctor or nurse who was being FORCED to “do their job” taking care of me or my loved ones. I want a doctor or nurse who is happy and enjoys what they do, not someone who’s preoccupied about whether their kids or spouse are sick or dying, or someone who’s terrified of working on me. If I was a health care worker in Ontario, I’d sure keep track of who voted in favor of this and keep a list in my pocket in case one of them ever came under my care, I’d make sure to give them the super-heavy-duty enema at the very least:-)
… “We have an extremely limited armamentarium with which to handle millions of cases of ARDS — one not much different from that available to the front-line medical corps in 1918.” ….
Kathy in FL: A long time ago (last summer), I suggested that every hospital purchase bulk tamiflu to use as a prophylactic. Taking tamiflu every morning during a local outbreak (6–8 weeks) would just be part of the routine. So would wearing an N95 and making sure that patients were wearing surgical masks as much as possible. HCWs with young children should be sheltered from high-risk exposures. If administrators took HCW safety seriously, and real steps were taken to protect them, I think many more would be willing to come to work. Sadly, I don’t think that’s the plan.
The public will pick the health care workers over the politicians, given the facts. They know who is more important.
Tell the voters there is not a medical solution to a very bad pandemic and get them prepping and ready to self-isolate, and nurse the sick and live or die at home. Truth is better than fiction, for long-term societal outcomes.
Say any politician who says, “Don’t worry, it safe” is going on the record.
All those popular “reality shows” will come home to roost. “Live Like it’s 1918″
:-/
I have advised our risk management team that if nurses are asked to work without proper PPEs in a pandemic situation that afterwards OHSA will want to know why the law was broken. Big,big class action suit. An ounce of prevention…….. Kelly
I didn’t know OHSA covered that area. Might be a good idea to remind local health care providers that they have legal obligations to their staff if they expect that staff to fulfill their obligations to them.
crfullmoon: The politicians are saying that people should self-isolate. They are saying that people should have 6 weeks of supplies. They are on record saying this (see below). They just don’t say it loudly enough so a significant number of people hear it. Why? Because there isn’t enough usuable food in the US for everyone to have a stockpile. I crunched the numbers for rice. If we stopped all exports, there would just be enough rice for every American for 8 weeks. That would be the entire harvest.
Technically, they have warned people about what to do. Practically, they can’t. CYA is the order of the day.
Threat of avian flu prompts call for preparedness
Federal officials on a nationwide awareness tour urged communities to prepare in advance for worst-case scenarios, including a possible six-week quarantine, if avian flu becomes a virus transmitted from person to person.
“You need to do this now. You need a plan and a strategy for preparedness,” said Alfonso Martinez-Fonts Jr., special assistant to the secretary for the private sector of the U.S. Department of Homeland Security.
Small communities and even neighborhoods need to organize, officials said, because if a pandemic strikes, many people will be confined to their homes. Under quarantine, people will have no way to get to hospitals, grocery stores or town centers, officials said at the Feb. 21 meeting in Dover.
Well, given that there will be fewer Americans each week into a pandemic, I think they should try and stock up anyway…
Oh, I’m sure some people in the states where Mr. Martinez-Fonts has delivered the 6 weeks message are stocking up. Its the people who live in states that haven’t gotten the message that are SOL.
Kathy in FL —
This contract to perform you are talking about---what kind of contract is that? Are you talking about something like a union contract? Are there any unionized healthcare workers? Are you saying that healthcare workers cannot resign from their job for any reason and at any time?
All essential personnel are required to report.
If they want to keep the job, yes. But they can quit, right? If I was a healthcare worker and schools suddenly closed, I would need to resign from my job in order to take care of my kid.
Montreme - ‘Take Tamiflu every morning for 6 to 8 weeks’
If you would, please explain - does this mean that the ‘normal’ treatment course I have seen of two pills a day for 5 days is not valid? Does it mean that in order to continue to function outside of an isolated environment that you would have to take a pill a day?
If the current planning is for each course (10 pills) for each person and with the above of a pill a day (8 months = 240 pills) then it seems that even if the government has 14 million courses of Tamiflu on hand (140,000,000 pills) then it will take care of (provide protection) for just a little more than 583,000 people.
Am I looking at this wrong?
April: In the US I believe there is a law that permits the government to draft medical personnel in an emergency. If this is correct, well, you can’t say no to a draft.
Thom: I would have to check on the current thinking is for a prohylactic dose, but yes, if you are going in to any area where you might be exposed to people with panflu, you would have to take Tamiflu every day that you are at risk. My understanding is that this is what the CDC and WHO personnel do when they go into an area with an outbreak.
I don’t think the current planning comes even close to enough Tamiflu. The only solution I see is for hospitals to buy buckets of bulk Tamiflu. They should NOT count on allocations from the federal government.
Monotreme - Thank You for the quick response - although it sure dosn’t look good for the home team. I would then think that everyone who has their supply of Tamiflu (10 or maybe 20) pills per person can only venture outside once or twice before then are just plain stuck going nowhere. Those of us with out any Tamiflu are really stuck. I think we are in very serious trouble.
Did that light at the end of the tunnel just get a little dimmer?
Thom: I have never tried to get Tamiflu, even though I have been thinking about this for over a year. It will do more good in a health care workers hands, than in mine. Also, I think it might give people a false sense of security. I plan to self-isolate during local outbreaks. Hence, I, and most people here, are into prepping. You can’t get infected if you aren’t exposed to someone who is. If I do go out, I’ll be wearing a fit-tested N100, goggles, double-gloves, disposable booties and disposable coveralls. Much, much rather have these than Tamiflu. H5N1 may become resistant to tamiflu. It won’t become resistant to a N100.
Monotreme - Sounds like what I will be doing also as I currently have no plans or means to acquire Tamiflu. I also do hope that our medical workers are on the top of the “To Receive First” list, as you said, they will be our first and best line of defense. I’m good for maybe two months of isolation so still have a lot of work to do.
The wife saw a 30 second report on CNN about the first mammal to die (cat) this morning and for the first time asked is this something we should be worried about. Using what I have picked up here I explained what I knew – her comment to that was – “Thanks for scaring the hell out of me’. It looks like I now have her support in my prepping.
April, the area I’m in usually “contracts” the kind of personnel that are high-demand or specialties. Its like any other kind of work contract, you agree to such-and-so benefits/salary and to work for us through the contract term.
Its a legal and binding contract … same as a lease or what have you. Different contracts and statutes would allow for remedies in the contract was broken. I can tell the remedies allowed in Florida if a lease agreement is broken but I haven’t a clue what remedy there is if a work contract is broken.
And different situations may allow for different remedies. If a contracted employee bugs out right in the middle of a crisis situtation, the penalties could be pretty severe because they not only affect the contractee and employee, but the population that the employer serves.
Of course I would think this would all be civil law. Arrest would mean that a criminal offense has taken place. That would be covered by separate statutes I would think.
Well, we want live, trained, experienced health care workers for after a pandemic, not to have had them all die off after a few pandemic waves!
Perhaps in a catastrophic pandemic seems likely, some people would quit now, and get out of the prefession, if it was a choice between that and their own minor children.
We don’t send firefighters out to wildfires and burning warehouses with boots and buckets. (Nor threaten them with jail for not wanting to go.)
If fatality rate doesn’t evaporate, I don’t see what use forcing people to work in what are in their professional opinion suicidal conditions to try and save patients triage says aren’t going to make it (high ARDS cases, ect), is going to be, long-term. If you have major losses in the HCW segment of the population you will continue to have losses decades after; not enough nurses, surgery teams, ect.
Thom, that was so not the first mammal to die of H5N1 - only the first mammal known in Europe! Hope your wife can stay calm as she catches up on the news- or- just get her prepping.
News isn’t helping me lately; it’s keeping me from actually getting things done. I should be out trying to get through to officials and organizations, (and, taking care of my home).
They can’t take the government’s word that a pandemic might only be like in the 1950′s or 1960′s, or not prepare the public, but say, if it isn’t mild they will declare martial law and force things to keep running as people drop. (Well they can, but they shouldn’t try!)
Kathy (11:36 post)-Yes the two areas of law are very different(employment contract vs.federal law).
As far as the article about the proposed law in Ontario goes, this is what you get with government health care-when you sign over the responsibility to the gov’t to provide it, you are in effect giving them carte blanche to provide it in any way necessary. I have seen some folks trumpeting the health systems of other countries, but I suspect that is because they have never had to deal with the worst aspects of what those systems bring.
crfullmoon- carrying you firefighter analogy a little further, we don’t send firefighters into burning buildings at all (regardless of equipment) when we know the roof is about to collapse on them.
Kathy—
I used to be a contract IT employee (not where I work now). Almost everyone was a contract employee where I worked. All it meant was that you might have a job through the end of the contract. Then again you might not. If someone got a better job, they would just leave without giving the contract another thought. Some people would not even give two weeks notice because if you gave notice, for security reasons the company might escort you out the door that minute and you’d be unemployed for a couple of weeks until your start date at your new job. The company you were contracting through had no qualms about letting you think your contract would be renewed at the end of the contract… but the day your contract ended you might learn the project was going to be rolled into something else and they had to cut back on staff. The company didn’t give any notice, so neither did their contract employees. It was a very mercinary-like environment but it was just business. I never heard about anybody getting sued over an employment contract because everyone knew what it meant (very little). This was during and after the IT/dot com bust so there was distrust all around. I think it might be different now. It sounds like it is much different in healthcare.
Pentagon plan calls up medics, nurses, doctors in national emergencies
“The Pentagon will draft experienced medical personnel, including medics, nurses and physicians, in the event of a national emergency. The “health care personnel delivery system” is being readied by the Department of Defense, according to a report published by the Newhouse News Service, to cope with military casualties from a large-scale biological or chemical attack. The plan was authorized by Congress in 1987 to deal with large-scale casualties that outstripped the active-duty military’s ability to handle them.”
“If you were to ask 10 doctors, maybe one might have heard something about it,” Dr. Marybeth McCall, chief medical officer at Crouse Hospital in Syracuse, N.Y., and an Air Force veteran, told the news service.
informatic … that is to treat military personnel. Would they be able to enforce the same set up to treat civilians?
Drafting … removing them, meaning civilian health care workers, from their current workstation … may not work in a pandemic situation. I don’t think you’ll be able to move personnel, possibly infected personnel, assuredly exposed personnel, around like that in quarantine situations. Instead of helping a situation, that might create an even worse.
They would probably have to exhaust the military retirees and national guard resources first. By the time they do that, I’m not sure what the situation would be.
Well, my husband worked for FEMA almost 16 years ago, and he was “drafted” back into service on 9/11.
As of now, he is supposed to be “deactivated” again, but we suspect that if the you-know-what really hits the fan, FEMA (aka Homeland Security) will simply “draft” him again. (They do still keep tabs on where he lives and works).
So do I think they will “draft” medical personnel if necessary? Sure.
Under normal circumstances we would all expext doctors and nurses to follow their profession and help and assist those needing care.
A pandemic on the scale some of us believe may happen is not normal circumstances. The least they can demand is the full protective equipment to do their job. Failure to provide proper equipment and facilities in my opinion makes giving two fingers to the authorities almost mandatory.
They can fine…imprison all they like but if you are faced with death for yourself and your loved ones then tell the authorities to go to hell. If they are so fussed about sacrificing lives let them lay down theirs.
You and your family are what matters and if the authorities dont provide the very best for you and yours then do the very best for yourslf and those family members who depend on you.
Who is more important. Your patients or your family. They cant arrest or imprison everyone no matter what they threaten to do.
As I understood the laws when I lived in Maryland, it was OK for nurses to belong to unions, but they were not allowed to go on strike. Technicians and cleaning staff could go on strike and the nurses would have to provide nursing care AND all the services that the others weren’t providing while on strike.
A very unfair situation, in my opinion, and I think the overall lack of care of nurses is what is driving the increasing shortage of nurses. From a report I read recently that was based on Bureau of Labor Statistics data, nurses were ignored for decades regarding injuries they received from lifting and moving patients, which still has not improved very much via lifts and team approaches — not to miss the overall increase in the sizes of the patients.
Certainly, it would make sense that medical personnel should be the first to get protective gear, medicine and vaccinations, but, well, a lot of people who are in charge of things these days don’t seem to have much sense.
In any case, I think a nurse or a doctor could say that they felt sick and then not be required to care for patients because of the liability that would ensue. And I think a lot of them would feel ill, though perhaps from fear rather than a bug.
Thanks for all the links and comments related to figuring out how to survive independently. As a long distance hiker, I already know that I can put on my boots and a pack and be just fine for a minimum of 10 days at a time by myself, but I don’t know how I might handle things if I had kids.
Kathy in FL- Think MASH, alan alda, most of those Doctors were drafted. Now, if the US Military is supposed to come to the rescue of thousands of sick Americans, and you are drafted because you are unlucky enough to be in one of the 60 job classifications the Gov desires, You will end up treating civilians, as an Army Medic, Dr. or nurse, or whatever. you will be given a physical when you go through processing, and if you are infected, you’ll probably be quarentined. I was a Navy Corpman befor becoming a Paramedic when I got out of the service. I am one of the lucky few… I’m now to old for the draft. But my wife is just right. She’s an EMT Specialist, and our son is an EMT/FF and about to turn 21.
The Beatings Will Continue Until Morale Improves…..so say the Canadian Health Department heads!
I just read back over this thread and I realized that my posting at 12:07 kind of sounded like I advocated that kind of behavior I was describing. For the record, I really didn’t, but I was just pointing out how and why many people in that industry ignored employment contracts. I never did that but I saw it happening a lot. Of course, I wouldn’t advocate anyone doing that and especially not healthcare folks. Still it makes me uncomfortable that the government thinks they can single out a group of people with a particular education/skill set.
April…the fact that the government thinks they can force a citizen to risk their life and that of their loved ones is heinous at best.
We truely do live in dangerous times and I am starting to fear our own government more than the risk of H2H H5N1
April - Many of us out there have also worked under an arrangement called “At Will Employment”. In such an arrangement, you work there at the pleasure of your employer. The moment they decide your services are no longer required, they can escort you to the door with no explanation. In such an arrangement, the employee is also free to do the same thing, that is, leave without any prior notice.
It sounds like such an arrangement may have been in place where you worked, otherwise the employer could march you to the door, but would still be liable for payment in lieu of work for the notice period.
Of course, you will need an attorney to explain it to you fully. Don’t take my word for anything as I have no expertise in lawyer stuff. Just things that are rational.
Unless you are covered by a union contract or a formal memorandum of agreement, most of us are “at will employees.” This is an area of expertise for me. If you have questions, ask.
Melanie….I appreciate your expertise in law….but if Martial is declared I fear no amount of expertise would be of any use.
Please correct me if im wrong.
If martial law is declared, the entire US Code goes out the window.
Melanie…just out of curiosity…is there any comeback for the gov once martial law is repealed or do they get away with whatever they like ?
They get away with whatever they like. Congress will be out of it. So will the SCOTUS. Wish us all luck.
Yes, I guess At Will Employment was essentially what it was even though there was a contract with an hourly rate. Actually “contracts” had degenerated into a month-to-month basis so people were constantly looking for a job and if they found a real job they weren’t about to be tied down. In fact there were times that I worked with an expired contract and the only way that I knew that I was still employed was that I could still log in. Eventually someone would get around to filling out the paperwork so I could get paid. In general people attempted to give at least 2 weeks notice with the understanding that the employer would allow them to work those two weeks. However, when it stopped working that way, people stopped giving notice and… well, it was not a real uplifting kind of a work environment, let me tell you.
Eccles, you of all people should know that “lawyer stuff” and “rational stuff” are mutually exclusive ;-)
Melanie….if we declared ourselves a religion and you issued us with purple cloaks and slippers would we be free of government intervention and would we qualify for charitable status ?
If so I say Hail melanie and let us meditate. :)
April,
“Month to month” is actually “day to day” in practice. If you have a contract with a separation clause, you’ll get paid for the duration of the agreement. But you’ll probably have to go to court to get it enforced. I was a union rep who spent a lot of time in court so I know a lot about this.
Kim - It gets to be really fun when the two must play nicely together. I have filed more than a dozen patents in my day, and I have always been convinced that the documents the lawyers prepare are actually written in Klingonese. It always amazes me to see an elegant piece of technology turned into such an incomprehensible set of blather that even the inventor has trouble finding his way around in it, let alone recognizing his own work.
..martial law with the current pres in place…Whaaaaaa I want my mommy!
(Sorry Dem)
swansong 3/1/06 @2132…”like trying to stop a Cat 5 hurricane with a New Orleans levee.” OOOOhhhh Good one…I think I’ll borrowt hat from time to time.
With regards to forcing medical professionals to report in case of a pandemic, I think there are two very good reasons why this is less than advisable.
1) This government has done little to show that its power and authority is accompanied by wisdom. So for me personally, I do not think the the federal planners will make good use of the professional resources.
2) If the pandemic hits on any scale above ‘mild’, centralized healthcare will be impossible… not enough beds, etc. As ‘human resources’; doctors, nurses, paramedic, etc. would probably best serve the public good by administering to the health needs of those around them — their neighbors, friends, etc. This decentralized approach is a far more feasible and effective response to a real pandemic that a centralized approach, which has been shown, all too vividly, as being completely and immediately overwhelmed by even the most moderate emergencies.
Lastly, I do think that the question as to whether the gov’t should have the authority to draft citizens into service, and whether health professionals have a right to tend only to their families is a legitmate question to debate.
Sure, we can debate it, as long as we come to the conclusion that no, the gov’t. should not be able to draft.
I, personally, am in 100% agreement with you, pipes.
would you die for a crooked sleazy politician not fit to work as a dog catcher? the times we live in. it’s just the way it is. family first always without question.
You mean like Tessa “Bribe me Baby” Jowell one of Tonys croanies caught with her fingers in the till ?
In 1863, when the first National draft was passed by congress, a person drafted could “buy their way out” of having to serve in the Armed forces by paying the sum of $300 dollars. Doesn’t seem like much, but if you consider that at the time the average infantryman in the US Army was being paid 13 dollars a month, 300 might as well have been three million. Riots broke out in New York lasting five days killing between 70 and 1000 people depending on who tells the story. The draft in the United states has always been a thing of disagreement. If the Government should not be able to draft citizens in times of war or National emergency, who will step up to the plate and shoulder the burden? For thirty years as a Fire Fighter, I was the one running into the burning building while others were running out. I voluntered for the Navy when I was 17 years old. The draft was never an issue for me. If I was drafted now as a Paramedic, I would go, because that’s what makes this country function. Since most of us are at or around the “fiftyish” point of life, ask your fathers if they were drafted into WWII or Vietnam, or if they voluntered. Do I like the draft? no. Do I see it as necessary? yes. is it fair? you be the judge.
The draft is only necessary when gov’t doesn’t “fight the good fight”. I have no doubt that plenty of Americans (even in this day) would step up to fight for what is truly right. Appropriate though, that the draft can be traced back to that date.
I’ve been reading John Barry’s book, The Great Influenza (which BTW everyone on the planet should be reading right now…) It describes with chilling clarity what happens when medical personnel are drafted and a pandemic is going on.
In following this thread, I note a lot of discussion about using Tamiflu prophilactically for medical personnel, which only makes sense, so probably won’t happen. But I haven’t seen a lot of discussion of the priority list for treatment. The ones that have been published so far talk about the sick in various stages, but I haven’t seen the secret documents that will no doubt discuss giving Tamiflu and priority treatment to the Federal officials and the military.
There probably will not be enough of anything for everyone so the thought that doctors and nurses will be drafted and have any opportunity to treat civilians other than politicians and their families, and key Federal civilian personnel (FEMA, HHS, Secret Service, maybe the public health service, etc.) is, IMO, highly unlikely.
As a thought, if a doctor or nurse gave up his/her license to practice, would they be eligible for the draft? Is this a pre-emptive strike that folks might be able to keep in their hip pockets? Or does a military commission automatically convey a license to practice?
Melanie?
The key of fighting pandemics is decentralization, demobilization instead of mobilization, horizontal instead of vertical organization. Actually, all preparations for pandemic is nothing else then decentralization of distribution system and demobilization of vertical social interactions.
If draft and martial law is the solution, then we should not be worried about oil crisis, global warming etc. Unfortunately, we did not learn the lessons from the principle of Internet development (decentralization).
Saddle tramp,
Don’t know, but I’ll bet some of the medical professionals around here do.
License to practice medicine or nursing is granted by the individual states. The military cannot use these professionals until the states have vetted them. I was drafted once; I might rather be drafted again rather than loose my license. After all they failed to kill me the first time. Kelly
I am licensed to practice respiratory care in Texas. During Katrina, I was scheduled for deployment to the Federal Medical Shelter at NAS Meridian, Ms. No license required under federal jurisdiction. If Mike Leavitt declares a National Medical Emergency, USPHS Uniformed Corps will be in charge and all federal civilian medical personnel (me), volunteers and draftees will fall under their command. No license required.
many states are already putting the mechanism in place to grant temporary license to medical personel with lapsed licenses. When I went through Hospitalman “A” school in the navy, it was an eight week course. I’m sure that a short refresher course could be ramped up in much less time. as an example, in my state, Michigan, all EMT’s/Paramedics must have X number of hours of coutinuing education credit in order to re-license. this education is now done online with multiple choice questions done at your own pace. I was able to get the required number of credits in a couple of hours. I have no doubt I could be recertified and licensed in as little as a week. Advanced Cardiac Life Support certification is a weekend seminar. and besides, they are the Government, they can do whatever they want.
You cannot practice medicine without a licence.There are faderal and state laws on this and people are proscututed all the time under these statutes.rrteacher: you have a licence to practice in Texas. This is very different from having NO licence.Do do really think that any state or the federal Gopv will put a doc who has lost their licence to practice for, say repeated malpractice, to work? When all is said and done we will have a court system and somethings will still be behone the pale. Kelly
as a person likely to be declared essential and drafted if the shtf i have mixed feelings on this.
on one hand i dont want to be compelled to expose myself and my family to the contagion. however how are we to respond to a pandemic at a governmental level if all the essential workers who will be required to keep the wheels turning disappear into their caves.
the social disruption may well be more dangerous in the long term than the virus if order is allowed to collapse.
my readings regarding anarchic situations in history have convinced me that civil order is worth preserving - even at the price of a little oppression.
Go to the left sidebar and read the Influenza plans; the US state plans (besides working out how to get, guard, and distribute all that vaccine they don’t have, to every location, down to the mileage) also spent lots of legalese work into having paperwork in place so medical people who normally do not distribute vaccine could, that basic patient care could be given by citizens without licenses, retired could be brought in for the emergency ect. Liability, ect, all thought of.
If they were able to stay relatively safe from catching it, of course the medical workers will work (they were sort of promised vaccines, only sort of); but if the pandemic is very virulent, with cytokine storm and ARDS, what good is running hospices instead of hospitals? Making community Superdomes to die in?
Power corrupts, and martial law once declared, really concerns me. Really, really. Endless, if they keep saying it’s not safe enough to give us our liberty back yet… Hasn’t the US had a whole duplicate government (expenses mixed in there somewhere since 9/11, don’t ask they can’t tell) “just in case”. “Continuity of Government” ? Oops no that’s just a whole duplicate Executive branch, living in shifts in bunkers; not the other two branches of government.
I do not feel secure in my “homeland”. :-/
O Canada, you shouldn’t be forcing health care workers to work, but teaching the public how not to get sick…and, buying what will help the HCW work safely, if they choose to.
In the end the practice of medicine,nursing,physical therapy, ect is defined by society. In times of emergency some duties ( such as giving shots, starting IVs, cleaning and suturing ) can and will be degalated to trained nonprofessionals. However, diagnosing the difference between chf and pneumonia takes education and training. It does not take a license. Western societies require a license because it allows the state to protect the public. In a pandemic arrangements will be made to quickly relicense those who need it to function.The regulations rrteacher wrote of above are part of that mechanism. Rest assured that state and feds will do all possible to put enough medical troops on the ground. But they will not act until it is too late, they will not have, on the state or local level registeries of retired , married, not working, working in other fields, ect. So as hard as they may try, if they have not preped, it will not work. I have talked to about 2 dozen younger nurses, and when TSHF they will not come to this hospital. I know many in this community and I cannot imagen any of our local law emforcement going to their houses and saying “leave that 3 year old, you’re coming with me to work at the hospital “
as a person likely to be declared essential and drafted if the shtf i have mixed feelings on this.
on one hand i dont want to be compelled to expose myself and my family to the contagion. however how are we to respond to a pandemic at a governmental level if all the essential workers who will be required to keep the wheels turning disappear into their caves.
the social disruption may well be more dangerous in the long term than the virus if order is allowed to collapse.
my readings regarding anarchic situations in history have convinced me that civil order is worth preserving - even at the price of a little oppression.
as a person likely to be declared essential and drafted if the shtf i have mixed feelings on this.
on one hand i dont want to be compelled to expose myself and my family to the contagion. however how are we to respond to a pandemic at a governmental level if all the essential workers who will be required to keep the wheels turning disappear into their caves.
the social disruption may well be more dangerous in the long term than the virus if order is allowed to collapse.
my readings regarding anarchic situations in history have convinced me that civil order is worth preserving - even at the price of a little oppression.
sorry - my browser reposted when i refreshed screen -
I cannot imagine the difficulty in practising any form of my specialty of Internal Medicine under the conditions under discussion. In fact, under such a scenario, I imagine little attention would be paid to specialty training—an orthopod might be treating renal failure and a plastic surgeon might be asked to manage a newborn with pneumonia.
If martial law is ever imposed in a pandemic, the smart folks wil tsaty away from crowded facilities if they can.
A very ugly and terrifying scenario
“The news service also reported the Pentagon is considering other “special skills” drafts, to include military linguists, computer experts or engineers, that could arise from other immediate needs.” link
In the case of pandemic, medical personnel will not be the only group to be drafted. In order for system to function, even with a minimum efficiency, other skill sets will be needed.
All this talk is making me very nervous-I work in a Children’s Hospital.We would have no place to put anyone…. When I was there the other day the ED was full(this is a big hospital) our ED observation unit was full and all our overflow units were full. We already are short of nurses for ICU. I am thinking of changing my address now and several times over the next six months before TSHTF so they can’t find me or hopeflly give up on looking. I too am not willing to die in a situation that I cannot help others to survive and leave my own children motherless. I am not that self sacrificing. An excellent point brought up was the fact that there will be so few nurses after the pandemic-will they really lock us up in prison? I will make payments on that 100,000 for the rest of my life I guess…..I am prepping heavily-food as well as medicine and PPE. I will soon be purchasing prenisolone online as well as antibiotics and nausea medication. I have already purchased IV fluids, needles and tubing-again online. We live in the country area of a city that is 20 miles from where I work. Are the police really going to have time to round us up? I don’t think so. Social unrest in the city will be rampant. They will have there hands full.
I also work at Vandy and I would like a bit more information from the administration. We’ve heard nothing on the University side.
I also work at Vandy and I would like a bit more information from the administration. We’ve heard nothing on the University side. Have they said anything of the MedCenter side?
I am a nurse also and I have been terrified that this would happen. I feel being forced to work in this, without proper protection, is like commiting suicide. I will not leave my babies, I am first and foremost a mom…take my license, fine me, etc. I plan to resign, take leave, whatever as soon as I see efficient h2h. Will they really hunt me down and force me to work? will they really have the resources to find out that I am a nurse and where I am? How valuable to them will I be when I’m a raging lunatic worrying about my family?
As far as I know nothing has been mentioned regarding bird flu at Vanderbilt. In fact, of the few people I have felt out a little with a casual, “What do you think about the bird flu” the overwelming response has been I’ve heard of it but nothing from the hospital. I too will quit when the transmission becomes h2h. When we even get a warning of severe weather that would possibly effect other nurses from getting to work we go on yellow alert. We can’t leave until there are enough nurses to care for the patients. I see the logic of this but I don’t want to be there when tshtf. Vandy is one of the few trying out a vaccine so you know that they are very aware of the consequences of h2h transmission….
see also this discussion about nurses and other med ical workers showing up for work.
VandyRN – at 22:14
Being an RN you should know better than purchasing meds online, especially in today’s atmosphere. Are you ready to send those prednisolone,etc. through the lab’s photospectromoter? ‘Cuz that’s what it’ll take to find out if there the real deal. As a pharmacist, I am all too aware of the potential for medication fraud (remember Norvasc in Hamilton? That’s not even a “hot item”).
Remember folks, this is a flu. It has no intelligence, no discrimination. Wash your hands, keep yourself sleeping and eating well. If you get moderately ill, STAY HOME! If you get SEVERELY ill, seek medical attention.
That said, I think the idea of conscription is ludicrous. In the medical field, lapses of attention (read sick kids at home) is lethal.
Properly train the staff to deal with what may, and educate the public to stay at home, unless their illness is life-threatening. Grant special powers to trained professionals to lighten loads on high-demand physicians.
Also, designate at least one hospital in the region “flu-free” to treat the day-to-day things hospitals do, using as many private and semi-private rooms as possible. If you have a sniffle… try next door.
informatic – at 19:08
your link / the article was dated Friday, July 25, 2003
in part: “The plan calls for the president to issue a proclamation ordering 13.5 million health-care professionals to register for a draft within 13 days.”
Does anyone one if that “happened”… ?
I am a healthcare worker and I did not, nor will I ever, register for a draft.
Didn’t happen, afaik. Bad idea, in any case.
Flu Nubi. You mentioned setting a hospital aside for other treatment and not for flu. Its a great idea except that people with flu will still go there and infect whoever sees them or turns them away. Thats people im afraid. They dont always follow directions or rules.
This is also a highly infectious disease. In fact only measles I beleive is on such a similar par for infection. That said this virus is going to spread out of control and I dont see how it can be stopped. Even total isolation may not always work and how can you do that in a hospital where hundreds and very likely thousands of people will be heading to for treatment?
Frankly….the only way you are not going to catch it is by not being there.
This was posted in the breaking news Forum
http://www.wnbc.com/health/7853812/detail.html
From the article “Local Officials Want Answers From State On Flu Plan” (NY State)
“In fact, research has shown that in a disease outbreak with no known cure, as few as 18 percent of hospital staff could show up for work, she said.”
IMHO 18% might even be a bit high…
For a “flu-free” hospital to work, it would require a trailer set-up as a triage unit. Any persons with flu symptoms will be turned away. Any patients who develop flu symptoms will be transferred to another hospital, or perhaps eventually what will have to be a “flu wing”. Granted, this isn’t perfect and eventually the hospital will no longer be “flu free”, but maybe it can ease some pressures for a couple of weeks. The point is this…. if all hospitals accept all flu patients, then there won’t be enough capacity for any of the things hospitals do now, as all the beds will be occupied by flu patients within a day. The hospital is not the best place to treat these patients.
Flu-Nubie Actually I have had very good success in the past with purchasing medications from Canada. I was without insurance for a few months and on a very expensive medication.No generics-medications worked fine. I also purchased by Roche tamiflu early last fall before it became to expensive and unavailable. In the situation we will be in should a pandemic occur-(And having done my research on pharmacies) I am willing to take my changes rather than waiting to die or watching my husband or children die. I think you are still in a state of denial of what a pandemic means-seek medical attention????? From whom,where, no ventilators…. I’ll take my chances to try to prevent getting to the ARDS(ventilator) state or dying. But that’s just me :))
I think you’re missing the point, Vandy. The people in Hamilton did not die because their “medicine” was tainted. They died because their medication was INEFFECTIVE. Your comment had made it sound like you purchased this medication without a prescription through an “internet pharmacy”. I can assure you that there are not very many of these in Canada, and ALL of them require a Canadian physician’s prescription.
Prednisolone (not prednisone) is not available (in Canada) in a solid oral dosage form, but only as Pedia-Pred, an oral liquid marketed by Aventis Pharmaceuticals.
It’s also curious that you mention that Tamiflu became “too expensive”. The price of Tamiflu has remained virtually unchanged since the product was brought to market. It is, in fact, still available (and yes, in stock at Roche) to pharmacies to supply to nursing homes in the event of a documented Influenza A outbreak, and at the same per capsule cost as always.
These facts lead me to believe that your orders for medications were filled at some sort of “black market” pharmacy, where you have no idea what’s in the pills (hence the need for photospectroscopy). I, for one, wouldn’t want to delay seeking yes… medical attention… if a cytokine storm is at hand. By taking pills filled with God-knows-what, you only delay treatment when you are giving the pills “time to work”. That, my friend, INCREASES your risk of dying.
I’ll take MY chance at emerg.
If you want to put your faith in a pill that may or may not contain Ta
There is a major scramble at HHS to prepare. I do know that RTs are not part of the USPHS Uniformed Officer Corps. We have been pushing for this for 20 years. There is, at this moment, a immediate effort to do this. My work group’s plans for a worse case pandemic have been, until recently, ignored. My professional organization and Doc O has requested them for consideration and we have been ask to collaborate. They do not know what to do just yet but they are not putting their collective heads in the sand. Things are moving in the right direction.
Remember: be nice to the newbies….grumble…be nice to nubies…grumble…oh shit, why the hell should I be??? never mind. I’m going to go wash my mouth out now for what I was thinking of saying to Flu Nubie.
NEMO – at 18:36
3 gold stars for restraint ;-)
FLU NUBIE – at 16:37 — “The price of Tamiflu has remained virtually unchanged since the product was brought to market.” Uhm…yeah. Okay. Whatever you say….must be good. I must be good. Don’t argue. Be nice. GGGGgggrrrrrrrrrrrrr……..Nemo….save some soap for me!
Swiss healthcare: Flu worries rattle Roche Dated November 25th, 2005
BroncoBill:
Regarding: “thanks to the scarcity of the drug and increasing demand, the price of Tamiflu has been soaring.” How dare you bring the facts into the argument!!! Why I never! <g>
You need to add a head toss in there (right on the ‘never’) with long hair flowing around from left to right and smacking someone in the face (hmmm…take your pick for the smackee)
Aw, just when I was thinking of sending this thread to some hospital and state planners to read…
Well, there’s always cut-and-paste ;-) and a link for reference (-most people I contact don’t seem to look at the links I give them anyway.)
Plans on paper are nothing without taking current H5N1, and projected worst-case pandemic, and supply-chain collapse side-effects into consideration, also; willing participants, supplies, and openly-discussed plans that make sure implementation is actually possible, and, an educated, informed, stocked-up public. The public does have everyone else outnumbered: get started with them, it’s a big job.
Flu Nubie- I can see a power struggle and pissing contest when I see one. Sorry-I don’t play those games. I respect your right to think the way you do-I would hope you will do the same in other comments on this forum in the future. If not, I hope it will be addressed by the moderators. The pharmay I used is one that has been covered many times in this forum. I do sincerely wish you the best of luck in finding emergency care but especially if you have children. With a mortality rate of over 80% in kids its going to be rough. Good luck.
Flu-Nubie- By the way-Did I say I didn’t have prescriptions? I did.
Here is a link to a Practice drill at Tufts Medical Center in Dec. 2005. Not a pretty picture. But that’s why we are all prepping here on flu wikie:)
Http:tinyurl.com/c5e4g
I am computer challenged. Can anyone make this so you can click on it and explain to me how to do it for future reference? Thanks
NEMO—Sorry to bare the truth. It hurts so. (hair tossed, left to right. Smackee in receipt!!)
VandyRN - Here is the link: http://tinyurl.com/c5e4g
‘twould appear that FLU NUBIE was a troll. No response, no posts on other threads. Buh-bye Flu-Nubie.
For the first week there will be a terrible panic, crowds rushing each other, national guard called in to stop the violence (many will be shot) and the stores will be bare at the end. During that time there will not be a lot of illness, but the silent infection will spread like wildfire throughout the masses. The second week will be the onslaught at the hospitals, the sick lining up and dying in the lines. At the end of this week, all the medicine will be gone. The third week will be quiet, the dead do not make noise.
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Flu Nubie made some very good points. Flu Nubie happens to reflect the current thinking in the fed and state plans.
I think they’ll succeed at some level, fail at most others. But they are a start. No need to drop burning oil on those sticking to them.
It seems like one could just resign and that would be the end of it.
VandyRN – at 23:32
Somehow when you pasted the tinyurl… the begging of it changed… notice how yours became a capital H … so when the post loaded on the page … Internet Explorer (or whatever webbrowser people are using) did not “ know what to do with it”, and made it “text” instead of a link.
In future posts, just check to see if it starts with “http://” and it’ll work.
As a nurse, all I ask for is the proper protection to do my job safely. I don’t think that’s asking too much. I want to have a guaranteed round of Tamiflu (if that is in deed effective at the time) with my name on it and a vaccine, if available. Then, I’ll gladly work. It’ll be hard. Health care providers needs to be able to concentrate on patient care and not have to constantly worry that they are at high risk of dying because their Administrators didn’t care enough about the staff to provide a safe work environment.
It worries me to see the apathy about PanFlu at my hospital. I’m hoping they are working on a plan and not letting us know. But, I doubt that’s the case. Right now I feel that it’s MY butt on the line and their lack of planning impacts ME and my family.
Shame on you Bill and NEMO…Flu Nubie doesn’t sound like a troll to me. He sounds like the “medical establishment”- telling us their thoughts and now you’ve chased him away.
You made fun of his comment on the price of Tamiflu. Well do you know what it was selling for two years ago versus what it’s selling for today? (And I don’t mean over the internet.) At a legitimate source? Do you believe everything you read without question?
O- – at 09:14 --- “Well do you know what it was selling for two years ago versus what it’s selling for today?” --- Even though I am a computer geek in an IT dept, that dept. happens to be in the second-largest health insurance company in the US. I can find out the price of most legitimate medicines just by looking through my company archives. Herewith are prices for Tamiflu as you have requested:
Six years ago (when Tamiflu was introduced)--- $10US per tablet WITHOUT insurance subsidies;
Two years ago--- $5US per tablet WITHOUT insurance subsidies;
One year ago--- $6US per table WITHOUGT insurance subsidies;
Today---between $7 and $10US WITHOUT insurance subsidies.
FLU NUBIE does NOT sound like the medical establishment. The medical establishment KNOWS the price of drugs in the US and KNOWS that those prices are continuing to spiral upward at an increasing rate.
Sorry. FLU NUBIE came in here without much knowledge of what he/she was talking about.
Sorry. The medical establishment would never, ever, in a million years, say to a pandemic-filled public “Hey Y’all. I’m goin’ down to the ER ‘cuz I might have the flu. Why don’t Y’all come on down too?” That message was implied by FLU NUBIE in his/her statement “I’ll take my chance at the ER”.
Dem---you are correct in that FLU NUBIE had some valid points—the “flu-free” hospital was one, but logistics to set it up to truly be “flu free” would be tremendous and prob’ly unneccessary as a pandemic spreads. But, sorry. Consider my hand slapped :-(
As I sit here at work this morning, the Tamiflu capsules are priced at $4.095 per capsule (including wholesaler markup). This represents approximately a 10% appreciation in price since it came to market. This does not even match the rate of inflation. This is fact. Current supplies at Roche are offered slightly cheaper (3%). The catch is that they are ONLY available to institutionalized patients during an Influenza A (note, not BF) outbreak confirmed by public health.
I am not here to spout any government message, and in fact I don’t trust the boys in Ottawa any more than anyone else on this board. BUT!! Believe me, there are many, many more sleazes out there who are more than willing to sell you “Tamiflue” (note SP) or some other knock off in the hopes of making some $$$. I am merely saying that placing faith in questionable meds is folly.
BTW, if you did get an Rx for the meds, and they were in fact filled in Canada, I can assure you those pills are NOT prednisolone (maybe prednisone?).
If that is the case GREAT! Because all glucocorticoids would have some benefit in treatment of a cytokine storm. The guidelines base their doses on prednisolone, but an equivalent dose of prednisone (1:1) would work just as well.
We don’t even know if Tamiflu, Relenza, etc. will work on a human form of this flu, do we?
If you have some, great. I can’t get it except through internet pharmacies, and I don’t trust those for heck (same people who constantly spam my email??!), so I am looking at alternatives, such as those posted here on Flu Wiki.
While we’re at it, let’s have a dose of realism. Highly virulent strains of viruses die out quickly and are (relatively) easy to contain, because sick people don’t travel. If any pandemic virus emerges, we should be safe to assume a few thinks about it, as it would likely be VERY similar to existing Influenza A viruses.
In fact, birds have been the natural reservoir for virtually ALL flu viruses since time immemorium. The 1918, Hong Kong, Swine, Asia, etc. viruses are STILL CIRCULATING!
Therefore it is likely that the majority of people will get ill and many of these people will be very ill for some time (3 weeks?). But it is also very likely that most of those that are ill WILL SURVIVE. Those that get sick during the “first wave” will have some immunity during subsequent waves and will be able to function in society.
No doubt we are ill prepared for a novel virus. No doubt it will be bad. I’m all for quarrantine, but I don’t think it’ll help much. We still have to eat, pay our bills, take out the trash, etc. and all of that will require contact with other people. If you’re going to get sick, you’re going to get sick.
Society will not crumble, governments will not collapse. We have been through this countless times before, and it will continue to happen in the future. Nature is thinning the herd, and all of the doom and gloom that most people here are talking about comes down simply to “I hope it doesn’t affect ME!”
Wash your hands, eat well, sleep well. The sun’s going to rise, and the world will still turn. Some of us may no longer be on it, but most of us will.
Flu Newbie, if you had to buy Tamiflu today, without a prescription, what would you pay? The point is, that the price is the price under current non-prescription conditions which exist, not prescription conditions that dont exist. so the price is really about 10 bucks a pill. Also, the longer the expiration, date the higher the price is. For example, my 11/2007 expiration date Tamiflu was less then my 11/2009 tamiflu. Its sort of like stock options if you know what I mean.
Flu Newbie, what we are worried about is humans infected with bird flu may very well be asymptomatic but shedding for 7–10 days which concerns us whilst still maintaining its high CFR. Otherwise you are right. The other end of the spectrum would be say Ebola, highly virulant and shedding while showing symptoms. Bird flu tends to shed before symptoms, which makes screening and containment more difficult.
John - NO. Just because a product is available in the market and you can’t get a prescription for it doesn’t mean that all rules go out the window. Tamiflu requires a prescription. Period. Canada has price controls on all prescription products to protect the public from gouging. That’s why Americans want to get Rxs filled north of the border, because they have a supply and demand system.
Prescriptions in Canada are: cost + 10% + fee (about $11). Therefore a prescription for 6-week prophylaxis cycle costs about $200. The challenge right now is acquiring said product, because it isn’t available to the general public (see above). However, this higher demand, by law, can not translate to higher cost. It is still worth $200. Expiry date has NO IMPACT on cost. NONE! It is unlawful for any pharmacy to dispense expired meds.
If you paid $10/pill for Tamiflu, you got taken, probably twice. Any reputable pharmacy sells at the above cost model, and you would have paid about $200. Questionable sources charge what the market will bear, and usually DON’T sell the real deal.
FLU NEWBIE - I have concluded you dont know what your talking about. Go buy tamiflu and let me know how much you spent. Report back in a week. Without prescription. Pretend your life depended on it…now run along.
John - you are not listening. Tamiflu is NOT legally available without a prescription. Therefore there is no regulation on its sale in that circumstance. You are therefore not assured that you are in fact receiving Tamiflu. That’s the point. You could be paying $10/pill for aniseeed, which is worthless. I am a fully licenced pharmacist. I know exactly what I am talking about. I don’t want my life to depend on what some shady Joe decides to funnel into a few empty green gelatin capsules and calls Tamiflu.
Legal in what country? I have validated Roche packaging with lot numbers and expiration dates. It looks real to me having validated lot numbers from Roches web site. I purchased it from bbonlinepharmacy.com
good grief.
bbonlinepharmacy.com - no phone number - no address - what country? Who filled your order? Are you sure?
Remember Hamilton - those “Norvasc” were in a bottle that bore genuine Pfizer labels too. They contained nothing but talc. They came from out of the country. It takes time to build trust with any healthcare provider. Tell you what. Go to your family pharmacist. Pose a hypothetical question. “If you were able to dispense me 10 Tamiflu, how much would it cost me?” - I guarantee you no more than $75.
BTW - how can you “validate” lot numbers from Roche? Pill packaging is very, very, very easy to duplicate. Plus at the prices bbonlinepharmacy is charging - very profitable. Caveat emptor.
Update: March 9, 2000 from Roche Pharmaceuticals.
JUST received this fax. Tamiflu is now on allocation to retail pharmacies to the general public. THEY REQUIRE A PRESCRIPTION PEOPLE!!!!
Allocation means that there is a limited supply, and the companies priority remains to institutionalized patients. Any pharmacy that orders an inordinate number of boxes will likely only receive 2 or 3 at a time. Don’t go stockpiling weeks worth of caps - just in case - or some grandmother in BC who might benefit now can’t receive it and could die (yes, people die from the regular flu too).
At any rate, it won’t be on shelves until next week at the earliest.
“Highly virulent strains of viruses die out quickly and are (relatively) easy to contain, because sick people don’t travel.”
Not true on either count. You missed the important facts that millions of people travel by air (and every other way) all over the globe, everyday, and that H5N1 is on at least three continents, in many many places with no monitoring infrastructure.
H5N1 is contagious a day, or a few days, before any symptoms of illness. Regularinfluenza is,and very contagious, as a pandemic strain will be.
Airport screening will not catch a pandemic strain. Airports are not ready to hold a planeful of passengers until test results come back, even if someone was very ill and had just come from a suspect area. Air travel may sow a pandemic strain broadcast over several nations before authorities have even decided (or, agreed to announce) that a pandemic strain has mutated.
People certainly do travel when sick, just as some birds with H5N1 can still fly!
(That person reporting in Turkey got himself out of the hosptial and went home to his country as a possible bird flu patient because he didn’t want to miss his flight!)
There is no reason it will not still be virulent during a pandemic; it will not mutate its way across continents; it will start off in many places worldwide because of air travel, and car travel, subway cars, and even if a virus was 100% fatal as long as it is spread while people still feel well and do not know they are infected, a virus could spread. Children have been known to shed virus as long as 21 days afer illness. Low-immune people like HIV+ and cancer or other people may not be able to clear the virus from their system, but give it longer times be shed, and to mutate.
Right now it is at 50% mortality rate, with functioning societies, and hospitals, with international medical aid.
We have been told there are not enough medicines and we may be at 1918 levels of medical care. We know hospitalsare not stocked up and with others in the supply pipeline getting sick supplies will stop in a pandemic. Health care workers cannot abandontheir families, and cannot work without protection from the virus.
As long as we have time to prepare against pandemic we need to do so on regional and individual levels.
India reverse engineers many common drugs, including the erectril dysfunction class. Many people have had great success with these reverse enginerred drugs. However we are not dealing with bad sex but a potentially very bad virus. If, and I say If, I were going to trust me or loved ones lives to this drug I would do anything I could to assure that the drug was genuine. This is actually a small part of a total preparation pack to weather a panflu. Kelly
“Right now it is at 50% mortality rate, with functioning societies, and hospitals, with international medical aid.”
Are you certain of that? WHO only provides details that can be validated via laboratory results. I am curious how many people got sick and got better without reporting to anyone. I suspect the actual mortality will fall below 10%. Keep in mind, that’s still 600 million people worldwide.
The treatment for the flu belongs at home, unless accompanied by secondary pneumonia or some life-threatening complication.
The problem with knowing how many people have actually been exposed is lack of seroprevalence studies. We need that data now and why WHO or someone has not done these the 64K question. We have NO data to expect that the CFR will be lower or higher, or if this panflu will happen or not. We continue to make educated guesses. Kelly
“I am curious how many people got sick and got better without reporting to anyone.”
If large numbers of asymptomatic or subclinical cases are going unreported, it shouldn’t be too difficult to ascertain that by testing for antibodies among those with whom confirmed patients have come into contact. There is a paucity of such studies, but where they have been done (and where results have been made available) the results so far do not suggest that this is the case.
people have done some; just not enough.
But, the public is uninformed, and unprepared to do that.
H5N1 may well have lots of complications, and the medical system can’t do much for ARDS, let alone any number of ARDS cases and medical personnel getting sick too. Avoiding infection, especially for certain populations seems the only way until new effective vaccines are made, long time from now.
Local officials keep stalling clearly telling the public, “to prevent panic”, thinking they can somehow educate everyone about everything after it is already happening.
(We told you to stock up a couple of weeks “for emergencies”, we told you there would be disruptions in banks and electricity and medical care, on that federal pandemic website we never told you all to go look at, though we sure can send out campaign ads when we want to.)
Millions of people in the world are already at risk from militias, famine, drought, diseases, and, the “developed” countries have made themselves totally dependent on a functioning just-time-economy, Rx meds, and uninterrupted electricity and fuels, and do not grow and store their own food.
We are not getting prepared for pandemic. Legislating health care workers to show up is not planning.
“If large numbers of asymptomatic or subclinical cases are going unreported, it shouldn’t be too difficult to ascertain that by testing for antibodies among those with whom confirmed patients have come into contact. There is a paucity of such studies, but where they have been done (and where results have been made available) the results so far do not suggest that this is the case.”
We already know that H2H is poor at best, which is what the above would prove. I am referring to a chicken farmer who gets flu symptoms, shakes it off and goes about his/her business. They are not necessarily contacts with known H5N1 cases, and they are not likely to have been tested. Just a hypothesis.
Laws of nature usually prevent organisms from killing themselves off. In the case of viruses this means becoming less virulent for the benefit of procreation. I’m not belittling any impact any pandemic would have, and certainly not condoning ill preparedness, just offering some food for thought.
FLU NUBIE – at 11:34 --- since you are so certain that ALL Internet-ordered Tamiflu prescriptions are illegal, and that YOU are correct in EVERYTHING that you say, how’s about starting a program where you go around the countryside and just call every police department and DEMAND that every person’s home be searched for ILLEGAL Tamiflu?
FLU NUBIE – at 10:35 --- “Prescriptions in Canada are: cost + 10% + fee (about $11)”. Canadian prices! American $$$= $9.49 per pill. FLU NUBIE—See my post at BroncoBoncoBillBull – at 09:45, ESPECIALLY “Today---between $7 and $10US WITHOUT insurance subsidies”. Canadian drugs are subsidized BY THE GOVERNMENT. That’s why it’s called socialized medicine! HELLOOOO???
FLU NUBIE – at 11:58 --- “The treatment for the flu belongs at home”. Agreed, THAT, sir, is exactly why we are all here. We are preparing for treating our loved ones AT HOME!
FLU NUBIE – at 11:58 --- The ONLY information we can get substantiated is that from WHO. No one else. Not newspapers, not blogs, not governments anywhere. If you are truly curious how many people got sick and then got better, start searching. Perhaps you’ll come up with something that WHO has missed. If you do, post it here, with links, so the rest of us can see exactly what was missed in the counting process.
It is becoming more and more apparent that you are ABSOLUTELY convinced that we are ALL in the wrong and YOU are right, no matter what argument is presented to you. All of your arguments have been presented innumerable times in this Wiki. All of your arguments are SOMEWHAT valid, but don’t come here and start spouting off like you are the one and only source for legal arguments about the pharmaceutical trade. You are not.
Dem….sorry. My spark plug misfired…..
I’ve had my say - take whatever pills you like and pray - good bye
But…but….but….I LOVE a good argument! :-(
it’s actually been a controversial topic since Day 1. Or since WHO elected to advise their own employees to stock up, while other authorities were telling people not to (true story, documented).
We’ve preserved the discussion here. FLU NUBIE, before you go (and I’d be sorry if you did), you should check out the page. There really are two sides to the argument. Those that have made the argument for acquisition aren’t ignorant and have thought about it.
FN:
“We already know that H2H is poor at best, which is what the above would prove. I am referring to a chicken farmer who gets flu symptoms, shakes it off and goes about his/her business. They are not necessarily contacts with known H5N1 cases, and they are not likely to have been tested. Just a hypothesis.”
Ok, you have a good point there. But in Turkey and elsewhere that H5N1 has appeared, people have jammed hospitals asking to be tested. You’ve got me wondering how many samples have been tested so far.
Searching…
“Laws of nature usually prevent organisms from killing themselves off.”
It is often estimated that approximately 99% of all species that ever existed are now extinct. There doesn’t seem to be any “law of nature” that prevents us from postulating that at least some of these extinctions may have been the results of the activities of microbial pathogens, which perished along with their last victims.
FLU NUBIE—What DemFromCT says is true. We have all made our own decisions based on availability and research. Don’t leave. What this Wiki needs (and has) is two sides to every argument/discussion. Your’s is as valued as anybody elses on the site. We will argue with you, and you will disagree with what some of us do. That doesn’t mean that your input is not appreciated, just not necessarily agreed with.
Sorry Bronco,
“It is becoming more and more apparent that you are ABSOLUTELY convinced that we are ALL in the wrong and YOU are right, no matter what argument is presented to you. All of your arguments have been presented innumerable times in this Wiki. All of your arguments are SOMEWHAT valid, but don’t come here and start spouting off like you are the one and only source for legal arguments about the pharmaceutical trade. You are not.”
That statement doesn’t support rational arguments or dialogue. I appreciate the offers to stay. But I have no more information than anyone else. I have listed my hypotheses as best I can. There is no way to prove or disprove any of them. I can assure, however that all that I have stated regarding legal sales of prescription medication in Canada is true and 100% accurate (check with CPhA, OPA, OCP or whatever organization you like).
Signing off. Not likely to return.
Someone had to say it…..I think you work for Defra Flu nubie.
Department for the Environment and Rural Affairs in UK.
They are the Gov Experts who botched BSE and we fear will do the same in a Pan Flu.
If you dont currently work for them perhaps you should consider it.
They dont have much of a clue either………
………scurries away before someone shouts……..
I DIDN’T SAY THAT, DEM!! I DIDN’T SAY THAT! IT WASN’T ME!!!
++(Must try harder to be nice, must try harder to be nice…)++
:P
DEM DEM….Bronco told me to say it
…..Points finfer at broncoBill…….nah nah.
Being a nurse practitioner practicing in a hospital this thread WAS important. It is not much now, but you guys are a hoot! Kelly
……sorry Np1…….
…….walks away and stands alone in the corner……contemplating…..things….sniff…
Still trying to find information on the total number of samples that have been tested. Not much luck so far. This, from WHO update 6 Indonesia:
“The Ministry of Health and WHO are monitoring the situation closely. Many patients under investigation have subsequently been ruled out by tests conducted at local and WHO-affiliated laboratories.”
Yes, but how many?
standing in corner…placing pointy cap on head…apologies passed all around…
But wait! Brilliant idea comes to mind, Kelly---cut ‘n paste!
Contrition just is not what it used to be…….Kelly
Has anyone seen any follow-up on this story? last I can figure, the motion was tabled and got some pretty bad press.
bump
would anyone like to take some collective action against this mandate? I can start another thread on it if anyone is interested. This is just wrong (getting back to the first post).
Apparently, the Ontario Medical Association has already started lobbying against this mandate. Not sure if the link below is still current:
The politician’s playbook: do nothing, CYA, deflect, and run to the command-post bunker - stay away from the front-lines. This time, I hope the public is smarter than that.
Oh, BTW, award some more contracts to spin-doctor friends in legal firms, media communication firms, advertising firms etc. That’s where money can bring some real political results, nevermind public health results. Pandemic is a lost cause anyway. Why fight it. HCW are just statistics, they are dispensable. So don’t throw good money after bad.
Here is a more recent story for Globe and Mail subscribers:
Anon-yyz: Where have you been living? In the REAL WORLD?? Lucky for the pols, most people celebrity watch these days and don’t vote.
Many Cats – at 00:53
Actually, I do live in the real world. That’s why I come to fluwikie instead of listening to ‘the government’. That’s why I advocate being personal prepared. Don’t expect ‘the government’ to make it work.
At the same time, not voting means the politician can get away with anything. It’s not perfect, but voting is the best we can do.
Anon-yyz: Agreed. The failure of the common man to vote in a democracy never ceases to amaze me. We have so much power yet we are so willing to abdicate it “well-intentioned” pols because we have gotten fat and lazy as the by-product of freedom. We can do most anything and we choose to do nothing because the battles have been fought for us and we have the luxury of indifference and self-indulgence. Well you know what the road to Hell was paved with… :(
That should have read “to” the “well-intentioned” pols. Either way, you know where we are going…and in a hand-basket, I might add…
The occupations most-trusted by Canadians, according to a recent poll by Leger Marketing (polling firm):
Firefighters 96 per cent of respondents Nurses 95 per cent Farmers 92 per cent Doctors 89 per cent … Car salespeople 19 per cent Politicians 14 per cent
Isn’t it ironic that the least trusted profession has the power to legislate 3 out of the top 4 professions to work or go to jail?
How could we as a society let this slide so far?
AnON_YYZ,
Would you care to contribute an essay on that subject?
Melanie – at 01:39
I may not be qualified to write an essay on this subject.
I only have one more point to add. The attempt to legislate is a dead give-away. The Ontario government is no longer trying to fight the containment war against possible pandemic flu. That explains why cheap masks were ordered. There really is no need to legislate if there is any reasonable chance of containment as most HCW will not hesitate to work in risky situations (vs. hopeless situations).
We survived SARS not due to government but in spite of it. It was possible because of heroic acts of many HCW’s to deal with a complete unknown. Legislate and you lose heroism, and you get some measure of work to rule.
There is an old saying:
Lead, follow, or get out of the way
If the government gets out of the way and becomes really transparent, and a grass-roots movement organizes personal preparation (with celebrity help), it might work. We don’t need our HCW to feel it is hopeless. We need our HCW to be motivated.
ANON,
Your health care workers are already motivated by the same things that get them out of bed every morning to do the jobs they are already doing. The government simply needs to get out of the way of that and make sure that they can continue.
Old thread closed to speed Forum access
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