The good news is that Indonesia has at last agreed to submit influenza samples for testing to the World Health Organization (see previous blog posting, Feb 21, 2008)
The recent news from Hong Kong is also encouraging in their responsiveness to recent events. Hong Kong is closing its schools for two weeks due to an influenza outbreak that unfortunately took the life of one young boy. This step indicates how seriously governments and institutions are viewing the influenza threat. Hong Kong is assuring us that the infection is not due to the H5N1 virus called bird flu, but is taking precautions as though it were.
A recent article in the Proceedings of the National Academy of Sciences in the United States suggests we can reduce the likelihood of a pandemic influenza outbreak by quickly implementing social-distancing measures alongside antiviral treatment and preventive measures (frequent hand washing, cough and sneeze etiquette, prompt and careful disposal of used tissues) until a vaccine becomes available. This is what they are doing in Hong Kong.
What follows is the most recent summary of pandemic flu matters. It indicates the 15 most populated countries and their percentage of the world's population.
A) shows the country has reported bird flu in poultry, and
B) shows the country has reported human cases of bird flu.
The summary shows that 4.3 billion people live in these 15 most populated countries, and represent roughly two-thirds of the entire world's population. The percent figure following each country's population total represents the percentage of the world's population that lives in that country.
1. China: 1.32 B. 20% of the world's population (both A and B)
2. India: 1.12 B. 17% (A only)
3. United States: 300 M. 4.6% (neither A or B)
4. Indonesia: 225 M. 3.5% (both A and B)
5. Brazil: 186 M. 2.8% (neither A or B)
6. Pakistan: 165 M. 2.5% (both A and B)
7. Bangladesh: 147 M. 2.3% (A only)
8. Russia: 143 M. 2.2% (A only)
9. Nigeria: 135 M. 2.1% (both A and B)
10. Japan: 138 M. 2.0% (A only)
11. Mexico: 108 M. 1.7% (neither A or B)
12. Vietnam: 87 M. 1.3% (both A and B)
13. Phillipines: 86 M. 1.3% (neither A or B)
14. Germany: 82 M. 1.3% (A only)
15. Egypt: 75 M. 1.2% (both A and B)
Bird flu in poultry (infestation) has been reported in eleven of these countries, and human infections have only been reported in six countries. Note that India and Bangladesh have reported and continue to report extensive and repeated poultry outbreaks, massive culling operations, but not one human infection.
Friday, March 14, 2008
Friday, March 7, 2008
Insights From the Conference Board of Canada Pandemic Planning Conference, March 2008
These are some of the helpful insights from the 2 day Pandemic Planning Conference sponsored by the Conference Board of Canada, in Toronto:
1. SARS - Toronto has had a "dry run" so to speak, in preparing for a pandemic because of their experience with SARS. Health Care workers were among those most heavily impacted by this disease, and the session on Mental Health during Response and Recovery states that of those who had recovered from SARS (the vast majority), more than 50% had long lasting psychological impact.
This suggests that as part of your pandemic planning you will want to have conversations with your Employee Assistance Providers to see if they will be abil to provide support services during and after a pandemic.
2. "Presenteeism" - is the practice of coming to work when you are ill. A Decima study showed that 79% of Canadians go to work sick. You can begin to plan for a pandemic now by starting to change employee health habits. Frequent hand washing and clearning surfaces are the two most effective areas to focus on, but having people stay at home and NOT come to work when they are infectious will be a major part of your plan to manage the pandemic.
3. Retirees - people who have recently retired from your organization, are a good source of people you can ask to return and fill in for people who are ill during a pandemic. Include them in your pandemic planning BEFORE the pandemic hits. Make information and supplies available to them that are being dispensed to staff. In this way you are much more likely to have them willing to return and assist in a time of staff shortage that might reach 40%.
4. Most presenters at the conference stressed communication, communication, communication. Companies who had successfully weathered the SARS event laid their success to the amount of communicating with staff that they did during the event. Ontario Hydro (who runs nuclear plants among other things), would send out messages two or three times a day on some days, to keep the staff informed. Studies have shown that staff look to and trust information that they get from their employer (if there is a trusting relationship between employer and staff) more than they trust media. This means that you will have to have dependable communication channels for everyone working for you.
5. Privacy Issues - Personal privacy issues will probably come up during a pandemic, and one has to consider individual rights vs. the rights of the whole. Ordinarily, organizations may not disclose health problems of employees to anyone - but what do you tell people in your organization if the person working next to them is ill with the flu? This issue should probably be checked with your corporate lawyer prior to a time of pandemic when it will probably be impossible to reach a lawyer in a timely fashion.
6. Incident Control Room - Most organizations that have to plan for emergencies and business continuity planning that deal with things like fire, floods, etc., will want to re-think the value of having a central incident control room. People will want to maintain social distancing during a pandemic, and a central room with phones, faxes, computers, etc. that are used by everyone has a high likelihood of spreading viruses. How will you ensure that people in a critical incident room are not going to infect one another, thus taking out the very people you need most?
7. Force Majeure - Speakers from law firms stressed that a pandemic would not fall under Force Majeure clause in contracts that you have (this type of clause excludes liability from non-performance) unless it is specifically mentioned. This means that ALL contracts should be checked. As well, a pandemic event is probably non-insurable (again, check with your Insurance people to see what advice their company is giving).
8. Ethics - Ethics is a huge issue for the medical profession but will also play a part in businesses as well. Companies may have to make difficult decisions in choosing who to ask to perform certain duties that may be hazardous - and what action they will take if staff refuse this request.
1. SARS - Toronto has had a "dry run" so to speak, in preparing for a pandemic because of their experience with SARS. Health Care workers were among those most heavily impacted by this disease, and the session on Mental Health during Response and Recovery states that of those who had recovered from SARS (the vast majority), more than 50% had long lasting psychological impact.
This suggests that as part of your pandemic planning you will want to have conversations with your Employee Assistance Providers to see if they will be abil to provide support services during and after a pandemic.
2. "Presenteeism" - is the practice of coming to work when you are ill. A Decima study showed that 79% of Canadians go to work sick. You can begin to plan for a pandemic now by starting to change employee health habits. Frequent hand washing and clearning surfaces are the two most effective areas to focus on, but having people stay at home and NOT come to work when they are infectious will be a major part of your plan to manage the pandemic.
3. Retirees - people who have recently retired from your organization, are a good source of people you can ask to return and fill in for people who are ill during a pandemic. Include them in your pandemic planning BEFORE the pandemic hits. Make information and supplies available to them that are being dispensed to staff. In this way you are much more likely to have them willing to return and assist in a time of staff shortage that might reach 40%.
4. Most presenters at the conference stressed communication, communication, communication. Companies who had successfully weathered the SARS event laid their success to the amount of communicating with staff that they did during the event. Ontario Hydro (who runs nuclear plants among other things), would send out messages two or three times a day on some days, to keep the staff informed. Studies have shown that staff look to and trust information that they get from their employer (if there is a trusting relationship between employer and staff) more than they trust media. This means that you will have to have dependable communication channels for everyone working for you.
5. Privacy Issues - Personal privacy issues will probably come up during a pandemic, and one has to consider individual rights vs. the rights of the whole. Ordinarily, organizations may not disclose health problems of employees to anyone - but what do you tell people in your organization if the person working next to them is ill with the flu? This issue should probably be checked with your corporate lawyer prior to a time of pandemic when it will probably be impossible to reach a lawyer in a timely fashion.
6. Incident Control Room - Most organizations that have to plan for emergencies and business continuity planning that deal with things like fire, floods, etc., will want to re-think the value of having a central incident control room. People will want to maintain social distancing during a pandemic, and a central room with phones, faxes, computers, etc. that are used by everyone has a high likelihood of spreading viruses. How will you ensure that people in a critical incident room are not going to infect one another, thus taking out the very people you need most?
7. Force Majeure - Speakers from law firms stressed that a pandemic would not fall under Force Majeure clause in contracts that you have (this type of clause excludes liability from non-performance) unless it is specifically mentioned. This means that ALL contracts should be checked. As well, a pandemic event is probably non-insurable (again, check with your Insurance people to see what advice their company is giving).
8. Ethics - Ethics is a huge issue for the medical profession but will also play a part in businesses as well. Companies may have to make difficult decisions in choosing who to ask to perform certain duties that may be hazardous - and what action they will take if staff refuse this request.
Thursday, February 21, 2008
Politics and the Pandemic
The H5N1 virus may well flourish because of political as well as biological conditions.
There is currently an international agreement in place whereby all countries share samples of avian flu virus collected from local incidents. This is an effort to track the various mutations that the virus is undergoing to anticipate how close we are to a mutation that allows human-to-human transmission, and to construct an effective anti-viral for it. At this time, we are told, there are seven or eight sub-varieties of the virus in various stages of adaption to a new host - us.
However, one should be cautious in expecting a pure motive of mutual aid and benefit to be the primary motivator between nations. Nor do we have ample evidence of world wide governments being transparent and forth coming with all pertinent data.
Reports today describe the Indonesian Health Minister accusing the United States of using bird flu samples to produce biological weapons, and consequently Indonesia refuses to submit viral samples to the World Health Organization. Their suspicions have prompted Indonesia to state they intend to resume sharing of bird flu virus samples only if nations agree on a fair and equitable framework. The United States denies Indonesia's accusations.
Indonesia is reported to be the nation worst hit by bird flu. They have held back virus samples since last August and intend to continue to do so until they receive guarantees from richer nations and drug makers that poor countries get access to affordable vaccines derived from their samples.
Indonesia claims that foreign nations misunderstand their non-compliance in the sharing of viral samples, "but concrete cooperation has to be based on fairness."
WHO specifies that sharing samples is vital for tracking the H5N1 virus and for developing vaccines against a potential pandemic. Meetings to work out a new virus sharing draft with key nations are scheduled to take place in March or April.
There is currently an international agreement in place whereby all countries share samples of avian flu virus collected from local incidents. This is an effort to track the various mutations that the virus is undergoing to anticipate how close we are to a mutation that allows human-to-human transmission, and to construct an effective anti-viral for it. At this time, we are told, there are seven or eight sub-varieties of the virus in various stages of adaption to a new host - us.
However, one should be cautious in expecting a pure motive of mutual aid and benefit to be the primary motivator between nations. Nor do we have ample evidence of world wide governments being transparent and forth coming with all pertinent data.
Reports today describe the Indonesian Health Minister accusing the United States of using bird flu samples to produce biological weapons, and consequently Indonesia refuses to submit viral samples to the World Health Organization. Their suspicions have prompted Indonesia to state they intend to resume sharing of bird flu virus samples only if nations agree on a fair and equitable framework. The United States denies Indonesia's accusations.
Indonesia is reported to be the nation worst hit by bird flu. They have held back virus samples since last August and intend to continue to do so until they receive guarantees from richer nations and drug makers that poor countries get access to affordable vaccines derived from their samples.
Indonesia claims that foreign nations misunderstand their non-compliance in the sharing of viral samples, "but concrete cooperation has to be based on fairness."
WHO specifies that sharing samples is vital for tracking the H5N1 virus and for developing vaccines against a potential pandemic. Meetings to work out a new virus sharing draft with key nations are scheduled to take place in March or April.
Thursday, February 7, 2008
Where Is Our Concern Level Now?
When multiple daily threats compete for our attention and adrenalin supply, it's often difficult to keep all the causes for concern on the front burner, all of the time.
Many of the day-to-day warnings and predictions have come from someone's interest in making money. We are too often bombarded with scare tactics and sensational reportage because someone, somewhere, wants to sell us something. It may be a product they are selling; it may simply be the news they are selling.
Needless to say, we are exhausted by analysing our personal vulnerabilities at every turn we take. A new study tells us that Canadians have lost interest in the influenza pandemic. It no longer "sells".
We are told that fewer than half of Canadians think a pandemic disease outbreak is likely in the next five years, and only one in 10 has drawn up any sort of emergency plan for how their family would cope if one occurred (based on a survey of 4,463 of our friends and neighbours). Science and history assure us that the pandemic event is not an "if" event, but a "when" event.
However, preparation can replace that low level anxiety we experience when we are facing a threat that is not immediate, but real none-the-less. A few simple sheltering-in-place precautions can give you the flexibility to reduce your time spent in public spaces during an influenza crisis. Many internet sites outline supplies to have on hand that could be vital for any emergency from an environmental one to a public health event.
The Calgary Health Region provides one at:
www.calgaryhealthregion.ca/hecomm/envhealth/program_areas/emergency-planning/Documents/AHW-shelter
Preparation = pre-prepare.
Many of the day-to-day warnings and predictions have come from someone's interest in making money. We are too often bombarded with scare tactics and sensational reportage because someone, somewhere, wants to sell us something. It may be a product they are selling; it may simply be the news they are selling.
Needless to say, we are exhausted by analysing our personal vulnerabilities at every turn we take. A new study tells us that Canadians have lost interest in the influenza pandemic. It no longer "sells".
We are told that fewer than half of Canadians think a pandemic disease outbreak is likely in the next five years, and only one in 10 has drawn up any sort of emergency plan for how their family would cope if one occurred (based on a survey of 4,463 of our friends and neighbours). Science and history assure us that the pandemic event is not an "if" event, but a "when" event.
However, preparation can replace that low level anxiety we experience when we are facing a threat that is not immediate, but real none-the-less. A few simple sheltering-in-place precautions can give you the flexibility to reduce your time spent in public spaces during an influenza crisis. Many internet sites outline supplies to have on hand that could be vital for any emergency from an environmental one to a public health event.
The Calgary Health Region provides one at:
www.calgaryhealthregion.ca/hecomm/envhealth/program_areas/emergency-planning/Documents/AHW-shelter
Preparation = pre-prepare.
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