Dr. Andy

Reflections on medicine and biology among other things

Wednesday, September 14, 2005

Katrina and avian flu

I'm struck by similarities between Katrina and a probable future avian influenza pandemic.

In both cases, a clear, well thought out and well implemented plan is/would have been vital. In Katrina, wherever the blame lies, lack of communication and confusion about decision making power among different levels of government were major factors. Despite the fact that the flooding of New Orleans seems predictable, no one did anything to evacuate those who didn't have their own transportation or to make sure the shelters at the Superdome and convention center were secured and supplied.

You think Katrina was bad, imagine a bird flu pandemic which will spread from country to country. The UN and WHO will be in the position of the federal government!

You think the Katrina situation was confused, imagine what an avian flu pandemic would be like: poor countries trying to cover-up cases while the outbreak becomes increasingly widespread while the UN/WHO stands by impotently.

A top H5N1 researcher Yi Guan agrees with me

He urged the World Health Organization and Food and Agriculture Organization to take a more direct role to avert the looming pandemic, which he believes will happen if aggressive action is not taken
"The WHO and FAO must set up a joint expert team. They must get into the (affected) countries and compel them to make changes, take drastic action. The U.N. must say that if you don't follow suit, you will be punished," said the scientist.

A plan that included close surveillance, rapid quarantine, stockpiles of antiviral drugs (and hopefully a vaccine) might be enough to halt spread of the virus andprevent a pandemic, but right now it seems unlikely that will happen. The idea of UN punishment as a stick is, unfortunately, almost laughable.

I'd be a lot happier if Congress and the media would focus on what to do about the next predictable crises, not on what went wrong in Katrina. 1,000 dead seems to be the upper limit on the number who died in Katrina. The number who'd die in an epidemic could be 4 or 5 orders of magnitude large.

The article contains more bad news. Guan recently showed that the current avian flu strain probably originated in southern China. The Chinese goverment, sadly predictable, has now shut down much of Guan's research:
. . . his biggest challenge comes in the form of China's Ministry of Agriculture, which forced his Shantou laboratory to stop its surveillance work on H5N1 around the time the Nature article was published.

The ministry criticized the findings saying Guan's laboratory -- which Beijing has designated a key state facility in the study of influenza viruses -- was not up to standard and had not obtained government approval for its research


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At 11:11 AM, Anonymous Anonymous said...

I've been following the avian flu story and recall reading that people generally do not respond to disasters until the disaster has affected them personally. What bothers me most is that even though President Bush acknowledged the avain flu pandemic before the United Nations yesterday, the general public will not pay attention until they begin to see their neighbors dying in droves at which point it will be too late for them to survive.

Obviously none in the State of Louisiana paid any attention three years ago to Homeland Security Advisor Tom Ridge's detailed recommendations for disaster preparedness at all.

The avian flu pandemic is not even on the general public's radar. I do find some comfort that it is on President Bush's radar, however, I live in NYC and am preparing now to make arragements to leave the city and return to my rural roots immediately after the first case is announced either in mainland Europe or here in America.

This avian flu pandemic is serious stuff and once it takes off it's going to be quite a long and drawn out disaster particularily for those who have not prepared for the onslaught.

As we have seen time and again, the media certainly will not be mentioning the avian flu pandemic until they begin journalism's dead American body count.

At 11:31 AM, Anonymous Anonymous said...

Ah, yes, the avian flu. And SARS. And swine flu. And [your bogeyman here].

Yawn. Snore. Every year, THE KILLER DISEASE FROM ASIA!!!! explodes through the media. And every year, it turns out to be just hysteria.

You folks may want to look up the old story of the boy who cried "Wolf!"

It's oh, so apt in this context.

At 11:42 AM, Blogger Cosmo said...

annonymous 11:31 am:

You're right, of course. That is, until the wolf actually shows up, which it does in the story . . . and as it did in New Orleans, after decades of warnings.

I'd balance your healthy skepticism with sensible preparation, and avoid the cynicism which could lead to complacency.

At 11:47 AM, Anonymous Anonymous said...

Imagine this: Your elderly parents are in the hospital, but you can't go visit because you have to take care of your entire family, who are sick in bed. At work, 1/3 of your workplace is out sick or caring for the ill. The economy suffers and unemployment rises. This scenario will happen someday when the next pandemic hits. It might not be next year with the avian flu, but it will happen. People "yawn" because they don't remember the last one, so they don't think it will happen. That's why we have 1) history and 2) science.

At 11:50 AM, Blogger Russ said...

The avian flu isn't "on anybody's radar," because there's precious little that the public can DO about it. That's part of why it's so dangerous. I've got all kinds of general emergency stuff... but what, besides having a stock of essential oils and other generally antiviral agents, is Joe Public going to do? (note that said oils are almost completely worthless for the purpose)

At 11:52 AM, Anonymous Anonymous said...

Dear anonymous, 11:31:
I certainly hope you are not in charge of any preparedness efforts. Or is your name perhaps Mike Brown?

At 12:17 PM, Anonymous Anonymous said...

Doc -

Don't forget the cases where there is a plan, but it isn't followed.

At 1:07 PM, Anonymous Anonymous said...

So just how does one prepare for something like this? A box of twinkies and a case of perrier? Are there any good links to sites which talk about that?

At 1:22 PM, Blogger jaycurrie said...

Basic prep: a plan, gloves, masks, food stocks, handwashing.

Advanced prep: awarness.

There are plenty of people who make it through flu season with no shots and no flu. They don't plan it, rather their lives do not touch that many people.

If the avian flu hits being anti-social is going to be a key strategy. Keeping your kids home from school, avoiding crowds, staying at home may do more to protect you than all the anti-virals we currently don't have.

Final, really advanced prep, be as healthy as you can be. Fitness, exercise, good food: if you do catch this strain and there are no anti-virals available your chances of survival will depend, to a degree, on how healthy you are going in.

At 2:21 PM, Anonymous Anonymous said...

Poster 11:31 is responding exactly like NOLA elected officals and the populace responded to this current predicted flood disaster 'Why evacuate NO before the hurricane hits since we haven't been flooded for years despite the fact we've joked for years about living in a city sinking below sea level while everyone else kept fearmongering about how disasterous floods would cause so much chaos and misery.'

This is why the absurdity of blaming NOLA's problems on El Supremo Governmente for everything under the sun including not having signed the Kyoto agreement in order to stop global warming is poetic insanity.

Historically, just as NO was eventually due for a devestating flood, the world is overdue a pandemic.

Jaycurrie offers tips for preparedness now because when the flu hits everyone will be buying up all those supplies all at once in a mad rush to save themselves. Of course, all these supplies will be sold out in less than an hour after the disaster hits leaving the rest of the people left with nothing or faced with having to pay a great deal of money in order to buy those cheap plastic gloves. This behavior happens everytime a disaster hits, even in known disaster areas.

At 4:29 PM, Anonymous Anonymous said...

...."You folks may want to look up the old story of the boy who cried "Wolf!"

It's oh, so apt in this context."

However, the wolves were always a real risk, and the Avian Flu is a very real risk as well, especially with a virus that has shown to have a nearly 50% mortality rate.

You might expect a lower mortality rate in more developed countries due to the ability to better treat the symptoms..but that is true only as long as the doctors and nurses and beds and supplies hold out. Which won't be long in a pandemic situation.

Hence the need for proper plannning. Even if THIS one doesn't go pandemic, there WILL be one that does.

Here's a little cut and paste from the CDC website ( http://www.cdc.gov/flu/avian/gen-info/pandemics.htm ) about pandemics in the last 100 years:

During the 20th century, the emergence of new influenza A virus subtypes caused three pandemics, all of which spread around the world within 1 year of being detected.

1918-19, "Spanish flu," [A (H1N1)], caused the highest number of known influenza deaths: more than 500,000 people died in the United States, and up to 50 million people may have died worldwide. Many people died within the first few days after infection, and others died of complications later. Nearly half of those who died were young, healthy adults. Influenza A (H1N1) viruses still circulate today after being introduced again into the human population in the 1970s.

1957-58, "Asian flu," [A (H2N2)], caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957.

1968-69, " Hong Kong flu," [A (H3N2)], caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968 and spread to the United States later that year. Influenza A (H3N2) viruses still circulate today.

Both the 1957-58 and 1968-69 pandemics were caused by viruses containing a combination of genes from a human influenza virus and an avian influenza virus. The origin of the 1918-19 pandemic virus is not clear.

At 5:34 PM, Anonymous Anonymous said...

Thanks jaycurrie!

At 4:39 AM, Anonymous Anonymous said...

I highly recommend http://www.fluwikie.com and, for those who prefer less words per page, http://www.iflu.org. Maybe doctorandy may want to link to those from the blogroll? A "pandemic awareness week" is slowly warming up. Thanks!

At 9:14 AM, Anonymous CJ said...

Honestly - whether or not you believe that avian flu will hit or not, or whether it be another disaster or pandemic or natural disaster or...or...

the list goes on...

but regardless of what you believe, I think it is wise to take heed to warnings and use it as an opportunity to start or maintain an Ć«mergency supply in your household. Medicines, some non-perishables, cans of fruit, veggies, Toilet paper, rice, dried beans, some water, crisco, olive oils, seasonings etc. It doesn't take a lot to have a few weeks supplies on hand. Just rotate it with your regular shopping and it never goes to waste.

Pandemic awareness is important - preperation is an excellent alternative to fear.


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