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The Associated Press released a nice summary of the UK Health Minster’s comments to the House of Commons earlier today. Including some critical analysis of his projection that vaccines for the virus would begin to arrive in August.
When we reviewed his remarks, that optimistic projection caught our eye as well. According to our sources in health care and related fields, that timetable is unrealistic in the extreme. Vaccine development and production typically takes a much longer cycle, and even with additional funding, it simply isn’t possible to “gear up” the production cycle much quicker than that.
Britain faces a projected 100,000 new swine flu cases a day by the end of August and must revamp its flu strategy, the nation’s health minister said Thursday.
Britain has officially reported 7,447 swine flu cases and three deaths, but officials acknowledge the real number of cases is far higher, since many with the virus have not been tested.
Britain is the hardest-hit nation in Europe amid the global swine flu epidemic. Many flu experts believe numbers could jump exponentially now that the virus is entrenched. Because swine flu, or H1N1, is a new virus, few people have any natural immunity, allowing the virus to spread rapidly.
“Cases are doubling every week and on this trend we could see over 100,000 cases per day by the end of August,” Health Minister Andy Burnham told the House of Commons on Thursday.
Britain has been reporting several hundred new swine flu cases daily for the last several weeks. If that surges to 100,000 cases a day by the end of August, there could be 6 million people infected by the fall, or 10 percent of Britain’s 60 million population.
Since flu spreads more quickly in densely populated areas, cases will probably be concentrated in cities like London, Birmingham and Manchester.
Britain had been trying to contain the disease by liberally giving out the drug Tamiflu to all suspected swine flu cases and their contacts. Yet many experts have criticized Britain’s attempt to contain the outbreak, saying it wastes resources, drugs and could promote antiviral resistance.
Burnham said Britain will now only give the antiviral to people believed to have the virus.
The World Health Organization has said that 2 billion people could eventually be infected with swine flu worldwide. Most cases are mild and require no medical treatment. More than 77,000 cases, including 332 deaths, have been reported worldwide.
Other countries including Australia, Japan and the United States initially tried to contain swine flu by giving out Tamiflu widely, but dumped the strategy within weeks.
Still, Britain’s top medical officer defended the country’s earlier approach.
“We’ve been fighting this pandemic very aggressively,” Sir Liam Donaldson said during a press conference. “We’re unapologetic about that.”
Donaldson said Britain probably had the world’s largest stockpile of Tamiflu. The antiviral can alleviate swine flu symptoms and shorten the course of illness by about a day if patients take it within 48 hours of getting sick.
Earlier this week, health officials reported the first instance of Tamiflu resistance, in a Danish patient who had been taking the drug. Experts worry that if Tamiflu is given out widely _ as per Britain’s earlier approach _ that could make it easier for the virus to develop resistance.
Burnham said people with swine flu symptoms should check health services websites or call flu hotlines to get help before seeing their doctors. He said patients should stay at home and have friends pick up drugs for them from designated community centers.
The sharp jump in Britain’s numbers may also reflect the country’s previous refusal to look for the disease. When swine flu arrived in the U.K., officials only tested people who had traveled to North America, where the epidemic began, or those in contact with a confirmed swine flu case.
That meant the testing system did not pick up the virus’ spread into communities.
WHO’s declaration in June that swine flu was a pandemic _ a global epidemic _ was made partly because the agency felt some countries, including Britain, were not accurately reporting their swine flu outbreaks.
Burnham also predicted the first doses of swine flu vaccine would arrive in Britain in August. Britain has ordered 60 million doses of vaccine, enough to cover the entire population.
Other experts, however, doubt the vaccine will be available that quickly, since it needs to be produced, tested in humans and meet regulatory approval _ a process that may take longer than two months.
CDC Braces for Flu Vaccination Effort
The United States seems poised to undertake the largest flu vaccination program in history as it braces for the next wave of the H1N1 (Swine Flu).
Homeland Security Today has the complete story on the web site:
Drug Resistance May Alter Pandemic Planning
According to Twitter’s BNO (Breaking News Only) Danish health officials are confirming a case of H1N1 (Swine Flu) that has appeared in their country that shows resistance to the anti-viral drug Tamiflu.
While the virus continues to be mild, even compared to seasonal flu outbreaks, one of the biggest fears for the World Health Organization is that the virus would mutate over the summer months into a more viral strain and/or acquire resistance to anti-viral mediciations.
This development should be watched closely, and influenza plans reviewed to insure that adaquate safeguards are in place if your organization should end up facing a virus that cannot be treated with anti-virals.
Resistance to anti-virals would certainly mean higher absenteeism rates, increased infection, especially among family members and caregivers who are have close contact with victims, and more strain on the health care system during an outbreak. If the resistance to anti-virals becomes widespread, it will be necessary to adjust planning for these realities.
Ranking storms may contribue to the problem.
The Saffir-Simpson Hurricane Wind Scale is a 1 to 5 categorization based on the hurricane’s wind speed at any given time. Developed in 1971, by civil engineer Herbert Saffir and meteorlogist Bob Simpson, who at the time was the director of the National Hurricane Center.
Prior to 1971, there was no usable scale or metric to use to help gauge the potential for damage from an approaching hurricane. The dirty little secret is that the scale is flawed on a number of levels, and may have contributed to the deaths of hundreds of people.
Template for Hospital Disaster MOU's.
A nicely done model MOU crossed our desks today. It’s from the Preparedness and Catastrophic Event Response (PACER) consortium, based at John Hopkins.
Great tool for public safety officers and Hospital EM staff who are forging these agreements in their communities.
Metro Crash Response Gets High Marks
The recent passenger train collison on the Washington, DC Metro system produced a well coordinated regional emergency resonse, that is receiving high marks from all quarters. Particularly noteworthy is how well interoperable communications between various agencies and departments worked.
It appears that the growing professionalism of the Emergency Management field, and efforts at improving all areas of emergency response in the Post 9/11, Post Katrina world are starting to bear fruit.
One area that remained problematic in this incident was a coordinated public communications effort. Proof positive that just establishing a JIC and putting up an organization chart isn’t enough to combat personalities and politics. Only when all involved recognize not only the benefits of a unifed public information effort, but also the necessity of putting aside short term political benefits of media expsoure, will we see real progress on this issue.
Despite what the manuals all say, the PIO position and function is often still a step-child in any incident command. Only when leaders begin to recognize that an informed public is actually an aid to the response effort, and that people can be trusted with information, will those attitudes begin to break down.
In a town that thrives on security clearances, and the “need to know”, it may be a difficult mind set to change. Overall, a textbook example of how a large scale incident should be handled.
See a nice recap of the efforts on The Christian Science Monitor page.
The Revolution Will Be Twitted
A well thought out opinion piece crossed our desks today from Government Technology. The entire piece is worth the few mintues required to read the entire article, which is available on-line here.
The key points of the piece are that people can & will communicate during a disaster, they’ve got the tools to do it now (and it’s impossible for the “authorities” to control them), the tools change the game. They completely change the game. The other point it makes that we love, is that you can trust people to do the right thing.
I’m not sure about some of the hyperbole of the piece (and other media accounts) of how this is an “electronic revolution”, etc. But it is clear to even a casual observer that social media is a powerful weapon against an attempt to control the flow of information.
Emergency Managers and PIO’s should realize that is represents a double edged sword. Just as the regiem in Iran cannot exercise their ability to control the media (thanks in large part to social media tools) you won’t be able to control the flow of information during an incident at home.
We preach to our clients that;
A.) Yes, a lot of the information that is put out will amount to “high tech rumors”. But the information is largely self-correcting. Events in Iran have demonstrated that too. Initial reports may be inaccurate, but usually valid information is posted within mintues. That’s the beauty of this medium.
B.) You can’t put the genie back in the bottle. If your communications plan dosen’t include social networking like Twitter, MySpace, Facebook. Your plan isn’t valid for June 2009. Period. Deal with that and move on. There is no longer anything to discuss on that front.
C.) It bears repeating–YOU CAN TRUST PEOPLE TO DO THE RIGHT THING. Emergency Managers and PIO’s have to begin to change the culture and the mindset that treats civillans like the enemy. Given the facts, people usually will not panic. They will not loot, they will not riot.
More than anything else in a disaster, people crave information. They want to know about their loved ones. They want to know the risks that they face and what they can do to impact change. Give them the facts, and they’ll almost always do the right thing.
Start believing in the people that you serve. You may be surprised that communications really is the key to making your job easier.
So, my friends in the EM craft—does your communications plan include social media? PIO’s-are you using these tools to reach your audience? If not, maybe the wake up call is for you too.
Employee's Union Wants Clear Policy on PPE
In what may become a trend for federal workers, The National Treasury Employee’s Union (NTEU) urged the Department of Homeland Security to provide employees with a clear and rational policy on the wearing of personal-protection-equipment (PPE) before the widely predicated return this fall of the Swine Flu (H1N1) virus.
The appeal was made during testimony by the NTEU to a key Senate subcommittee examining pandemic influenza preparedness and it’s impact on the federal workforce.
In their testimony, the union urged “DHS and its components need to have a rational policy on this issue now, before this fall, when many predict a more virulent form of the H1N1 virus will return.” NTEU’s hope, it said, is that today’s hearing of the Senate Homeland Security and Governmental Affairs Subcommittee on Oversight of Government Management, together with actions recently taken by the House, “will help achieve that very modest goal.”
The House action NTEU referred to is the inclusion of an amendment offered by Rep. Stephen Lynch (D-Mass.) to the Transportation Security Administration (TSA) authorization bill ensuring the right of TSA employees to wear protective masks while performing their homeland security duties. Initially, he sought to offer an amendment providing rights regarding personal protective equipment for all DHS employees. His current amendment would only cover the Transportation Security Agency, but many believe that similar requests will come from other federal employee advocates, including unions at a number of agencies.
Since the Swine Flu (H1N1) virus may well mutate during the summer and return in a “second wave” that is more viral that the mild form experienced to date in the US, many fear wide-spread absentism by federal employees, and the impact on critical services.
Addressing policies on pandemic flu on a broad variety of topics including telecommuting, PPE, child care, and other issues as it affects the federal workforce is viewed as being critical by many to insure continuity of operations.
Montgomery County, MD Leads The Way
The recent Swine Flu H1N1 Pandemic has caused a number of agencies to revisit their risk communications plans, and try to address the need to keep the public informed during emergencies.
For a lot of smaller offices, this often means that someone is putting on yet another hat, and attempting to become a Public Information Officer (PIO) overnight. Most recognize the need for effective communication with the public, but are unsure of how to get started.
A free guide that we often recommend is available from the Montgomery County, MD Department of Health & Human Services. It’s called, “Public Health Emergency Preparedness” and it contains a quick guide, and a lot of good sample check-lists.
While you’re on their web site, also take a look at their equally well-written PowerPoint Presentation on Pandemic flu, and toolkit for reaching the Latino population. All are filled with common-sense practical steps that apply to virtually any risk communication need. If you follow the checklists, and take time to read the short guides, you’ll be on your way towards developing a good communication plan.
Swine Flu's "Second Wave"
Homeland Security Today’s Anthony Kimerly has written a “must read” article on the World Health Organization’s declaration of H1N1 Swine Flu has a Stage 6 Pandemic, the first since the 1940’s.
In the article, entitled “Now a Pandemic H1N1 Is Being Watched For What It May Do Next Flu Season” details the threat of a mutation of the virus into a more lethal form this Fall. Many scientists believe that this evolution is more likely than not to occur.
It’s good reading, and a real aide to outlining the threat to your organization.
Emergency Management News
