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  #341  
Old 01-20-2018, 12:27 PM
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Mary Pat Campbell
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PANDEMIC PREPAREDNESS

https://www.wsj.com/articles/were-no...mic-1516372986

Quote:
An Action Plan for Averting the Next Flu Pandemic
This year’s flu outbreak is unusually bad, but it could be much worse. It’s time to accelerate a range of public-health measures, including work on a universal vaccine
Spoiler:
By Jonathan D. Quick
Updated Jan. 20, 2018 1:00 a.m. ET
16 COMMENTS
This year’s flu season is hitting early and hard, the worst the U.S. has seen in more than a decade. Every day more people are falling ill and getting hospitalized, and some are dying, including young children. Though we are not yet at the peak of flu season, schools have closed in communities across 49 infected states. Businesses can expect employee absenteeism to soar, and the Centers for Disease Control and Prevention expect the death toll to rise.

The outbreak has thrown the health-care system into turmoil, with some hospitals unable to treat the people flocking to emergency rooms and clinics. Crucial supplies are running low across the nation, including lifesaving ventilators, and staff shortages are deepening as nurses and other personnel fall ill.

Our current flu crisis eerily coincides with the 100th anniversary of the 1918 Spanish Flu Pandemic, which killed 50 to 100 million people world-wide. The disease arrived in the U.S. early that year, resulting in a cascade of illness and suffering, family and community chaos, stymied businesses and industries.

Despite medical advances, we are just as vulnerable today to a flu pandemic as we were a century ago. Vaccines in recent years have, on average, reduced the risk of flu illness among those vaccinated by just 40% (less than 30% this year). Current antiviral drugs only slow the virus—we have no reliable way to destroy it.

A flu as deadly and contagious as the 1918 strain remains a very real possibility. Worse, in today’s world, it would be able to leapfrog on the back of air travel and spread quickly through our much more urbanized populations. It could kill 200 to 400 million people world-wide and throw the global economy into a deep downturn.

Despite the starkness of the threat, we seem to be so used to wasting lives and resources every year on flu that we’ve grown numb to the annual onslaught, much less to the prospect of something far worse. There are five critical actions we need to take to stop future pandemics.

Influenza victims at an emergency hospital near Fort Riley, Kan., in 1918.
Influenza victims at an emergency hospital near Fort Riley, Kan., in 1918. PHOTO: NATIONAL MUSEUM OF HEALTH/ASSOCIATED PRESS
First, we must accelerate the development of a universal flu vaccine that would offer broad protection against most types of flu. Flu viruses are perpetually evolving through mutation in order to evade human immunity, and today’s vaccines target the most frequently mutating parts. A universal vaccine would eliminate the need for annual flu shots by attacking those parts of the virus least apt to mutate and most common across different strains. It would be akin to ripping out the roots of a giant deadly weed rather than just chopping off each year’s new growth.

A universal flu vaccine would be a triumph for humankind on a level with the smallpox or polio vaccines. Half a dozen major labs around the world are taking alternate approaches to create one. But we need more public and private investment for these labs to continue through the costly and unpredictable development process to the finish line of a safe, effective vaccine.

Second, we need more targeted investments in vital areas of flu prevention and treatment. This includes better antiviral medicines, more accurate and widely available diagnostic tests, and low-cost face-masks that are truly protective.

‘Surgical masks aren’t the germ barrier that people think they are.’

Tamiflu, Relenza and other antiviral drugs are modestly effective, especially when taken early by individuals at high-risk of flu complications. This year’s most dangerous flu strain (H3N2) is not showing resistance to these drugs, but others strains have. When used appropriately at home, low-cost diagnostic tests can help in making decisions about staying home from school or work, which can reduce the burden on hospitals and doctor’s offices.

But the tests available today vary in their ability to detect different flu strains, and they are less accurate for adults. As for the inexpensive surgical masks available in pharmacies, they aren’t the germ-barrier that people think they are. Wearing one in a crowded subway is unlikely to help you if the person next to you is ill with the flu.


Third, we must do much more—through media campaigns and programs in schools, workplaces and communities—to encourage the adoption of personal prevention habits. Good flu prevention habits (staying home when sick, proper hand-washing, covering sneezes and coughs, etc.) have been shown in previous flu pandemics to significantly reduce transmission of the virus.

Social “distancing” measures, such as school closures and the cancellation of large gatherings, also reduce the spread of flu. During the 1918 outbreak, infection rates varied dramatically among U.S. cites, depending on how quickly localities undertook such measures. By acting early, New York City had the fewest number of deaths of any city on the East Coast. Pittsburgh delayed and paid with the highest mortality rate.

Fourth, every school, business, government agency and place of worship and even every household should have a flu-preparedness and emergency response plan. Annual drills and exercises are essential refreshers and provide an opportunity to update the list of actions to take to reduce the spread of flu, maintain essential services in the face of absenteeism and step in to help others. Hospitals and doctor’s offices, particularly, should use annual drills to review methods that can reduce demand and stretch capacity during large-scale epidemics. Households and individuals can find help on Ready.gov, and businesses can work with public health officials.

Preparedness also includes making sure that a range of health professionals are ready to act quickly. We must be able on short notice, for instance, to staff call centers with nurses and other medical personnel to provide information to the public, and we must have mechanisms set up for rapidly dispensing antiviral drugs.

MORE ESSAYS FROM REVIEW
An Action Plan for Averting the Next Flu Pandemic January 20, 2018
The Curious History of ‘Chain Migration’ January 19, 2018
The Many Benefits of the Occasional Swear Word January 12, 2018
Bad Weather Is No Reason for Climate Alarm January 12, 2018
A Cure for Our Fixation on Metrics January 12, 2018
Finally, we must stop starving state and local health departments of needed funds for preparedness. We depend on these agencies to stand sentry for the nation’s disease detection—not only for flu but for all infectious diseases and agents of bioterror. Their job is to slow and stop the spread of a pandemic while limiting the impact of such an emergency on the functioning of society. That’s a very tall order and can’t succeed at current budget levels.

Every dollar spent on preparedness results in savings, by my own calculations, of $2 to $10 from reduced emergency costs and economic disruption. The overall return on investment would be substantial, considering that the U.S. loses as much as $90 billion a year on direct and indirect flu costs, according to researchers at the CDC. Beyond the flu threat, the benefit of preparedness is that it builds a system that works in the face of any biological, chemical or radiological emergency or natural disaster.

It might seem impossible to prevent future pandemics, but when leaders in public health, government and business have come together in the past, we have won the wars against smallpox, SARS, Ebola and a whole host of other devastating attackers. Too often, however, we have waited until the body count and panic rose to a crescendo.

What turned the tide in every instance was the combination of urgency and political will. We need to approach the problem of flu as if all the fury of a pandemic were bearing down upon us today.

—Dr. Quick is a senior fellow at Management Sciences for Health in Boston and an instructor in global health and social medicine at Harvard Medical School. His new book, “The End of Epidemics: The Looming Threat to Humanity and How to Stop It,” will be published later this month by St. Martin’s.
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  #342  
Old 01-20-2018, 12:29 PM
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Mary Pat Campbell
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FLU
ALABAMA

http://www.al.com/news/birmingham/in...d_schools.html

Quote:
Alabama flu outbreak declared emergency: Schools close, hospitals reschedule surgeries

Spoiler:
Alabama Gov. Kay Ivey has issued a State Public Health Emergency as the flu continues to ravage the state, causing school closings and over-filled hospitals.

The outbreak has already caused one Birmingham-area school, Briarwood Christian School, to close due to a large number of students and teachers with the flu.

Emergency departments and outpatient clinics are also seeing very high volumes of patients. At this time, this is not a pandemic flu situation, but a major seasonal flu situation, according to the Alabama Department of Public Health.

The ADPH is encouraging Alabama residents to do these things to prevent the flu:

Get the flu vaccine, it is not too late
Stay at home if you have a fever
Wash your hands
Cover your cough and sneeze
Clean and disinfect
Learn home care
Refrain from visiting friends and family in the hospital
Crowded hospitals

Children's of Alabama issued its diversion protocol Thursday due to a bed shortage at the hospital, said hospital spokesman Jody Seal.

The hospital is requesting the Birmingham Regional Emergency Medical Services System to divert patients to another pediatric hospital due to the shortage of available beds.

"Additionally due to the shortage of available bed, Children's may transfer patients to other hospitals in order to provide the patients with the best available care," Seal said.

UAB Hospital is rescheduling some non-emergency elective surgeries originally scheduled for Thursday and Friday due to the hospital being over capacity due to flu patients, UAB spokesman Bob Shepard told AL.com.


"We are still performing surgery for trauma, urgent cases, inpatients, or day-of surgery where the patient goes home on the same day and there is not a need for a hospital bed after the procedure," Shepard said. "We do not typically schedule elective surgery on the weekends or holidays, so we will re-evaluate the situation at the beginning of next week."

School closings due to the flu

Briarwood Christian School will be closed Friday due to a large number of staff and students sick with the flu.

Home sports events scheduled for the weekend will be rescheduled.

School officials said the school will be closed until the end of the Martin Luther King Jr. Day holiday.


Briarwood Athletics
@BCS_Lions
BCS is cancelling school tomorrow (fri) due to large numbers of students and staff with flu. All home sports activities will be rescheduled. We will stay closed thru end of MLK holiday. Prayers for quick recovery!

5:42 PM - Jan 11, 2018
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Several campuses of Randolph School in Huntsville were also closed this week due to the flu outbreak.

The Jefferson County Department of Health discussed the flu situation in the Birmingham area at a press conference Wednesday night.


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  #343  
Old 01-20-2018, 12:32 PM
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Mary Pat Campbell
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FLU

http://www.sfgate.com/nation/article...t-12505025.php

Quote:
Century after pandemic, science takes its best shot at flu

Spoiler:
WASHINGTON — The descriptions are haunting.

Some victims felt fine in the morning and were dead by night. Faces turned blue as patients coughed up blood. Stacked bodies outnumbered coffins.

A century after one of history’s most catastrophic disease outbreaks, scientists are rethinking how to guard against another super-flu like the 1918 influenza that killed tens of millions as it swept the globe.

There’s no way to predict what strain of the shape-shifting flu virus could trigger another pandemic or, given modern medical tools, how bad it might be.

But researchers hope they’re finally closing in on stronger flu shots, ways to boost much-needed protection against ordinary winter influenza and guard against future pandemics at the same time.

“We have to do better and by better, we mean a universal flu vaccine. A vaccine that is going to protect you against essentially all, or most, strains of flu,” said Dr. Anthony Fauci of the National Institutes of Health.

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Labs around the country are hunting for a super-shot that could eliminate the annual fall vaccination in favor of one everty five years or 10 years, or maybe, eventually, a childhood immunization that could last for life.

Fauci is designating a universal flu vaccine a top priority for NIH’s National Institute of Allergy and Infectious Diseases. Last summer, he brought together more than 150 leading researchers to map a path. A few attempts are entering first-stage human safety testing.

Still, it’s a tall order. Despite 100 years of science, the flu virus too often beats our best defenses because it constantly mutates.

Among the new strategies: Researchers are dissecting the cloak that disguises influenza as it sneaks past the immune system, and finding some rare targets that stay the same from strain to strain, year to year.

The somber centennial highlights the need.

Back then, there was no flu vaccine. It wouldn’t arrive for decades. Today, vaccination is the best protection, and Fauci never skips his. But at best, the seasonal vaccine is 60 percent effective. Protection dropped to 19 percent a few years ago when the vaccine didn’t match an evolving virus.

If a never-before-seen flu strain erupts, it takes months to brew a new vaccine. Doses arrived too late for the last, fortunately mild, pandemic in 2009.

Lauran Neergaard is an Associated Press writer.


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  #344  
Old Yesterday, 11:22 PM
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Apparently the manufacturers of IV saline bags (almost all US supply is manufactured in Puerto Rico) are finally back on the power grid. I'm not sure how long it will take to reverse the shortage, though. It's unbelievable that it's taken 4 months, and such a basic medical product has had to be rationed.
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