Friday, April 18, 2008

Have Your Heard of TED?

Have you heard of TED? TED stands for Technology, Entertainment, Design. It's an annual event where the world's leading thinkers and doers gather to share information. They have a listing of prominent people in those fields who are invited to "give the talk of their lives" in 18 minutes. This site makes the best talks and performances from TED conferences available for free. There are more than 200, with more added each week and are freely shared and reposted.

For the research work we're doing here at Pitsel & Associates, Ltd., the talk given by Dr. Larry Brilliant is notable. He's in epidemiologist and philanthropist and speaks, in this video clip, on pandemics.

His video is very conversational in tone and easy to listen to, and his message, in brief, is that having overseen the very first eradication of a disease, namely smallpox, he believes the answer to pandemic prevention is "Early detection. Early response."

He goes on to describe the 1980 efforts, without the advances of today's technology, to mark that as the first year in the history of mankind, that a disease was eradicated through human intervention. He describes how even Sovereigns were killed by smallpox, and underlines that diseases spare no one. With an army of volunteers his team canvassed every household in India as part of their awareness and treatment campaign.

Today, he is an executive director of and supports GPHIN, Global Public Health Information Network, which uses advanced technology to track diseases worldwide, which is credited with preventing a worldwide outbreak of SARS because of early warning capability. The GPHIN has capabilities unavailable to the World Health Organization by virtue of the fact that they are not limited, as WHO is, to only government reportage. They were able to find and contain areas of outbreak before they reached levels where governments were compelled to report to the WHO, giving them a full 3 months advance on SARS.

Here's the site:

On the first page, at the top, is "Speakers". Click on that.

At the bottom of the new page that comes up, in red, it says alphabetical listing of speakers A-Z., click on that.

Under the "B" heading, near the end of the list, click on Dr. Larry Brilliant. It's well worth your time.

Thursday, April 17, 2008

Low Tech Solutions

Laurie Garrett is the only writer to have won the three "P's" of journalism, the Pulitzer, the Peabody and the Polk prizes.

Ms Garett was speaking yesterday as a senior fellow at the Council of Foreign Relations in New York. Referring to widespread panic as a possible reaction to a bird flu pandemic she said, "Personally, I am a lot more worried about pandemic flu than Al Qaeda."

In her statements she not only underlined the low tech solutions of basic hygiene and personal responsibility as our best defense against this disease, she also outlined community solidarity and social resilience as critical elements.

The implications are that the solutions lie in improved frequency and content of information, message, and education. The more people prepared and reassured with knowledge, the best able we are, collectively, to protect ourselves. It is a collective problem, and those who are not involved in being part of the solution, will, detrimentally to us all, be part of the problem, and it will be all of our problem.

The larger implication is that if more people take simple, adequate precautions, perhaps it can prevent the mutated virus from full pandemic spread. We don't know and can't guess, because it is, so far, beyond our knowledge, and beyond our experience. But, at no time in history has a message been so dispersable as it is today with the light speed of communications. Words spread even more quickly than viruses. Is it possible that since we know how to protect ourselves individually with sanitary precautions, and ourselves collectively with socially responsible behaviours such as cough and sneeze etiquette and social distancing, that more people solidly behind these measures could ameliorate some of the effects of influenza spread?

It would, indeed, be very naive to assume we could prevent the pandemic wave in this way, but surely besting this threat is going to require the combined will of everyone to minimize its effect. This will require massive education measures. Governments have been reluctant to overtly address this issue for fear the threat of pandemic would result in panic. Messages of this order, "from the top down" so to speak, would no doubt be seen as alarming.

Precautionary messages must be supported from "the bottom, up", from a common understanding that we all develop, and new behaviours that we all adapt. We cannot wait for the Government to "do something about it." "The Government" is less able than we, individually, to impact social behaviour.

Now is the best time to discuss it in the open, while there is time to prepare and prevent. Talk to your friends and families. Calm and open discussions in workplaces, along with informed presentations, and home and workplace planning would be the best efforts to convert panic into planning.

Thursday, April 10, 2008

If Not NOW, When?

If not NOW, when?

It sounds like a silly question, but there are events in our lives we know are going to happen, but they seem so far away it's hard to take them too seriously. Saving for a rainy day. Making a will. Yearly dental and medical appointments. Investing in life insurance.

We're all the same. "It's a good idea, but...." "Oh, yeah, I'll do that later, just after...." We say these things to ourselves, especially when the task requires some of our time or some of our money.

Making a home preparedness kit for a disaster or a pandemic situation is one we also tend to settle comfortably into the "One Of These Days," category, and then forget about it.

A likely trigger to motivate this preparation may very well be the first human-to-human transmission (H2H)of the H5N1 virus. This is when the influenza virus that is killing birds worldwide has adapted itself enough to become easily transmissible to humans, not just through contact with birds, but from other humans. Up until now, if you weren't a bird farmer, or lived in the far East, the idea of catching the bird flu seemed very remote indeed, despite what scientists have encouraged us to prepare for.

This week, the World Health Organization has confirmed a small number of H5N1 influenza in humans occurring as a result of human to human infection. In China and in Pakistan there have been isolated incidents and reported deaths.

The cases of suspected H2H transmission have been limited to blood relatives. 91 other, non-related, people coming into contact with the 24 year old man in China, who died, and his 52 year-old father who contracted the disease from his son and survived, have all remained free of infection. Scientists who have examined the particular virus in this incident are saying it shows no indication of an H2H mutation. They believe there are still several barriers the virus must overcome before it acquires easy human transmissability.

Until a vaccine is developed for the particular strain of influenza the virus will eventually mutate to, prevention is still more effective than cure. Prevention will require preparation. Washing hands frequently, observing cough and sneeze etiquette, and maintaining social distancing, and keeping your immune system healthy are still the best proactive measures.

The time and money to stock supplies to "shelter at home," to reduce your exposure in public places where contamination will take place, can take place over time. The effort and added cost to assembling 2 - 4 weeks of food and supplies can be spread out. No one can foresee when the window of time to prepare will close, but the fact that human-to-human transmission has begun, however limited, adds to the credibility of what scientists have been telling us.

If you are not going to begin these preparations now, then when? What other time seems more likely. If you're waiting for a signal, these first H2H transfers are as good as any.

Friday, April 4, 2008

No One Wants to Yell "Fire!"

You remember the story about the consequences of yelling "Fire" in a crowded movie theatre. Mother nature has designed us to flee, and quickly, from emergencies until we are at a safe distance and with a bit of time to think about how best to save ourselves. We call it panic, and can see that it's the least productive preparation for dealing with attack.

International agencies are very cautious about announcing pandemic information for this reason. Now is the time and this is the distance we have to save ourselves from possible pandemic consequences. With each new development, or viral mutation, we move closer to what scientists and history tell us is most likely to happen.

The most recent news is from Pakistan that at least three brothers were infected with the bird flu virus, and it is likely there was human-to-human spread in that instance. This is confirmed by WHO, a cautious and thorough monitor of the world pandemic situation.

Though this news has been expected for some time, no one wants to name this as the signal that the virus has mutated to the point where we now expect widespread contamination. It is, however, an indicator that another obstacle has been breached, and the virus continues to adjust to new hosts.

There is, however, encouraging news in this new stage. There is a great deal of awareness and preparation going on world wide, and the best minds are helping to analyze and track the potential threat.

This news is also a reminder that awareness leads to precautions, and being prepared is our best hope of besting this threat. Even though in China and Vietnam there are human trials entering a second stage for an experimental bird flu vaccine, the nature of a virus is for it to mutate and change, perhaps rendering this vaccine, in its current form, useless. These vaccine trials do lay the ground work for an eventually effective vaccine.

More good news is that our best protection still lies in our own hands, so to speak. Frequent hand washing, social distancing, and proper cough and sneeze etiquette are still our best lines of defence.

The recent news of the isolated human-to-human transmission of the H5N1 virus is perhaps the motivation we need to not only practice our personal hygiene habits with regularity, but to prepare the home and family with information, materials and supplies to shelter at home. A stockpile in the home of food and other supplies gives us the option of reducing our public exposure (where the virus is going to be exchanged) to a minimum.

It appears that we still have time to develop our stockpiles gradually. This spreads costs over time, and gives time to develop storage and maintenance strategies.

Most websites recommend: a supply of water to supply four litres per person, per day; non-perishable foods that need a minimum of preparation; and first aid supplies and medications. Don't forget pet supplies and special considerations if there are infants or others with dietary restrictions to provide for. There are many excellent web sites on-line for more details regarding disaster preparations.

Personal disaster preparedness can sustain you and your family through any emergency or disaster that could potentially happen, from a natural emergency, to service disruptions, or environmental disaster.

If you are unprepared for a disaster, it can be devastating. Your best protection is having a plan and knowing what to do. Set up a family meeting to discuss how each of your family members can contribute to the plan and be best prepared.