Pandemic Plan

Europe anticipates surge in swine flu; triggered by schools?

From Reuters:

Health authorities across Europe are bracing for a third of their populations to become infected with the new swine flu virus this autumn, but do not plan to close schools or take other drastic measures to stop it.

Instead, they plan to educate people about hygiene, get vaccines out as soon as possible, and hope the H1N1 pandemic does not become deadlier than it has been.

U.S. tells businesses, let workers with flu STAY HOME

U.S. officials Wednesday repeated for the jillionth time some key guidelines for how businesses should respond to the H1N1 swine flu pandemic. Highlights:

• ENCOURAGE employees with the flu to STAY HOME at the first sign of illness. It's best for the worker; it's best for co-workers.


• Don't request written doctor's excuses. That just further burdens a healthcare system that will be overloaded.


• Educate employees about respiratory etiquette and hygiene: wash your hands frequently and well ... use hand sanitizer ... cough into a tissue/sleeve/arm, not your hand.


• Disinfect work surfaces regularly, especially those frequently touched by many people (e.g., table tops, counters, telephones, door knobs).


• Encourage vaccination against both seasonal flu and H1N1 swine flu.


• Plan for continuity of business operations: cross-train to fill key positions ... use teleworking, work-from-home arrangements (e.g., GoToMyPC) ... reduce travel ... limit face-to-face meetings, spread workstations farther apart. (Several of these are so-called "social distancing" tactics.)

ER Depts unsettled about possible severe flu complications

Writer Maryn McKenna, who writes feature news stories and is authoring a book about drug-resistant staph (methicillin-resistant Staph aureus or MRSA), says another person has died of a combination of H1N1 flu and MRSA pneumonia. She notes that MRSA pneumonia is a known and dangerous complication of any flu infection.

Then Maryn adds this side observation, based on interviews of emergency room doctors:

For stories for CIDRAP and the Annals of Emergency Medicine, I've been talking to ER physicians about their expectations for the fall, when the regular flu season begins and H1N1 is expected to intensify. (A friend's school already has cases circulating.) It's fair to say that emergency departments are unsettled about the possibility of severe complications from this flu.

More details on slower roll-out of pandemic flu vaccine

The Associated Press has more details on the much slower-than-expected delivery of swine flu vaccines. As reported earlier, the U.S. won't have nearly as much swine flu vaccine ready by mid-October as long predicted - 45 million doses instead of the anticipated 120 million. About 20 million more doses will be shipped weekly until the government reaches the full 195 million doses ordered, Health and Human Services spokesman Bill Hall said.

It's not a shortage but a delay, Hall told the AP. Vaccinations will still start around Oct. 15 - just on a smaller scale than originally planned, as the supply trickles in more slowly.

Officials lower estimates for initial amount of pandemic flu vaccine

During a pandemic H1N1 planning update today, federal officials dialed back the number of novel flu vaccine doses they expect in October from 120 million to 45 million, listing several reasons for the smaller projection.

The University of Minnesota's Center for Infectious Disease Research & Policy (CIDRAP) reports that in late July, authorities projected that 120 million doses would be available in October, with another 80 million per month in the following months. But, in a National Biodefense Safety Board (NBSB) teleconference today, a U.S. Department of Health and Human Services official said the latest expectation is 45 million doses by mid October, with manufacturers delivering 20 million doses per week after that.

Among the reasons for the slower vaccine delivery:

• Yields of the novel H1N1 antigen are less than for the seasonal flu vaccine.


• Vaccine makers have a limited number of fill-and-finish sites, which are just completing seasonal flu vaccine production.

WHO global pandemic update 61

The World Health Organization (WHO) says pandemic influenza H1N1 has now been reported in over 170 countries and territories worldwide.

As for the temperate countries of the Southern Hemisphere, now experiencing winter:

Swine flu: How experts are preparing their families

From New Scientist magazine:

As the swine flu pandemic continues to sweep the world, what do public health officials, epidemiologists and flu researchers think will happen in the coming months? When New Scientist asked 60 of them, it turned out that half are concerned enough about the possibility of a virulent swine flu outbreak to take precautions such as acquiring a supply of Tamiflu for their families. Though most do not think it likely that a nastier strain will emerge, many are worried that if it did, their local hospitals and other parts of the health infrastructure could not cope.

[SNIP]

Do their personal views matter? Probably. After all, these are the people who work day-to-day either studying flu or planning how to deal with it, and they influence regional, national and international strategies for managing the pandemic.

[SNIP]

In the coming months, health authorities should not be complacent just "because they know that the vaccine is coming in a few months and because they have large stocks of Tamiflu in their freezers," says Walter Fiers of the University of Ghent. After all, if the virus mutates significantly before a substantial percentage of the population are vaccinated it will be useless. What's more, Tamiflu resistance can emerge if the drug is widely used on those with very mild symptoms. "The situation needs to be carefully monitored," says Fiers. "Influenza has surprised us many times before."

WHO says pandemic vaccines will be safe

The World Health Organization has issued a briefing on the safety of pandemic flu vaccines. The purpose is to reassure the public that regulatory procedures are rigorous and do not compromise safety or quality controls.

Excerpts from the briefing statement:

CDC updates guidance re: flu isolation

The U.S. Centers for Disease Control and Prevention (CDC) yesterday revised its guidance regarding how long someone with flu-like illness should avoid other people. CDC now recommends that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8°C]), or signs of a fever without the use of fever-reducing medications (i.e., medications containing acetaminophen or ibuprofen).

This is a change from the previous recommendation that ill persons stay home for 7 days after illness onset or until 24 hours after the resolution of symptoms, whichever was longer. The new recommendation applies to camps, schools, businesses, mass gatherings, and other community settings where the majority of people are not at increased risk for influenza complications. This guidance does not apply to health care settings where the exclusion period should be continued for 7 days from symptom onset or until the resolution of symptoms, whichever is longer.

What is a flu pandemic? What's the risk? What to do?

UPDATE (July 17, 2009): It's probably reasonable to say we're at the 11th hour. You must decide for yourself, but I believe we've entered a phase where the majority of pandemic preparations should be completed very soon. The flu pandemic is underway and spreading quickly worldwide. As the number of sick people grows, it may become increasingly difficult to make pandemic plans and obtain supplies. It's better to be prepared for something that doesn't come than to be unprepared for something that's overwhelming. ["Why waiting till the last minute to prepare is dangerous"] NOTE: This summary post now always appears first on my home page.

 

Ideas: How to prepare your household
or business for the swine flu pandemic

 

Quick Summary

Currently, there is a worldwide outbreak - a pandemic - of a new strain of flu. Since it's new, people have little/no immunity and many will get sick (an estimated 2,000,000,000). Direct Impacts: (1) Caring for so many sick, (2) Unusual number of cases in younger age groups, (3) Large absolute number of deaths (though small overall percentage). Indirect Impacts due to so many people either being sick, caring for the sick, caring for children during school closures, or reluctant to go out in public. Overwhelming surge in demand for healthcare. Employee absenteeism may disrupt business. Goals: Avoid the flu. Why? [a] Who wants the flu? [b] You may have trouble getting healthcare because of clinic/hospital crowding. Slow the spread of illness. This reduces strain on healthcare systems; buys time for responses. If sick, stay home. Be prepared with supplies to treat the sick. Be prepared to cope with changes in daily life. Governments can't meet all needs. Be as self-sufficient as practical. Pharmaceutical interventions: There's no cure for flu. A pandemic flu vaccine will take time to manufacture. Even then, there won't be enough. Antiviral drugs like Tamiflu shorten & ease the flu and are effective on H1N1 swine flu for now; but the virus may mutate and make antivirals ineffective. Emphasize NON-pharmaceutical interventions: Space - "Social distancing" to avoid crowds. Stock up on essential goods to reduce need for shopping. Wash hands or use hand sanitizers. Clean frequently-touched surfaces with disinfectants. Businesses: Stock up on operating supplies/materials. Protect your human assets. Plan how to staff essential functions. Scale back non-critical functions. Consult suppliers, transportation companies, utilities, others re: continuity.   Things you may need (a starter list of ideas): Hand sanitizer [Example ] Why? Kills virus. N95 respirator masks [Example ] Why? Blocks inhaling virus. "Surgical" face masks [Example ] Why? If sick, traps coughs. Latex gloves [Example ] Why? Protection if caring for sick. Businesses: Use GoToMyPC for telecommuting. Why? Easy work-from-home. Businesses: Use GoToMeeting for teleconferencing. Why? Easy company/customer meetings.