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Friday, October 07, 2005

Romania Reports Bird Flu (in birds)

Reuters. Samples from the three dead domestic birds found in the Danube Delta will be sent to Britain for further testing to see what strain and whether it is H5N1. This is where you would expect migrating waterfowl to stop.

Dow Jones reports that Romania has banned hunting wild birds.

In the meantime, there is some advance word up in CurEvents.com about key assumptions for the US Pandemic Plan. The mortality rate is just a guess (as good as any other), but the predicted illness rate is alarming:
* 25 - 30% illness (20% - 30% in working age group), plus additional absenteeism for care-giving
* Outbreak period in a community of 6 to 8 weeks per wave, with possibly more than one wave in a community
* Length of illlness of an uncomplicated case, 5 days
* Hospitalization rate of 1 - 10% of those who are ill
* Mortality rate of .1 - 1%
Imagine what would happen if 25% of your employees were sick for a week and another 10% were out taking care of sick children, etc.


Comments:
These numbers are supposed to be from the current draft official US pandemic plan. I suppose we will find out when they finally release it. I would think the casualty rate is too low. Once the hospitals get overwhelmed the ability to treat all patients as they ordinarily would be will go, and that will increase the mortality rate.

The point about the licensing restrictions is a good one! It reminds me of the licensing issues for volunteer doctors in LA.

Don't you think there need to be special exceptions in law for a possible pandemic? I would think also some healthcare units would need exemptions for insurance liability purposes.
 
I can't see legal/licensing laws being issues in the event of a real pandemic- mostly because I believe there will be an acute shortage of medical personnel willing to take on the job.

Based on 1918 numbers, the potential deaths numer 150 million, worldwide.

Don't look to a huge response from the medical community. They're going to be duct taped in at home, like the rest of us.

They have families, too, as one MD told me last week.
 
You might be interested in this info on innovation in administering flu vaccine. I follow the stock and came across this news.
Ampligen (R) Enhances the Effectiveness of Tamiflu Against Avian Influenza
 
Roger, you wrote:
many of the emergency response departments in our fragmented federal system are run by elected law enforcement folks who neither understand public health issues or view the public as a resource rather than a threat.

That's it in a nutshell. That mindset can become a self-fulfilling prophecy if we let it. It doesn't have to work out that way. I think most healthcare personnel will rise to the occasion. The public will if they are told how they can deal with the risks.

The thing is, cutting down the rate of contagion is key to allowing healthcare personnel to be effective. They are a limited resource. Other steps - establishing emergency medical overflow centers, etc, will also help, but the bottom line is lowering infection rates. And that is not impossible, but it takes some preparation and training. It requires changing our daily routines and we humans are creatures of habit.

SC&A, as long as doctors can do some good they will be out there doing it. If they find themselves unable to cope, out of supplies, etc they will conclude they can do no good.

But masking, gowning and gloving are steps that will prevent doctors from getting ill. It will take an adjustment on the part of the patients, but it will work.
 
Ilona, I am not so sure about Ampligen in a fast-growth virus. The idea of using it in combination with oseltamivir is interesting, but that's all. The 1918 flu was believed to kill young healthy people by cytokine storms, so futzing with immune responses this way might have more of an adverse effect than an advantage.

If you want a pretty safe investment bet, research medical supply houses. They will be doing a roaring business over the next year and a half.
 
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