Daily Kos

Reid Weighs In On Pandemic Flu

Thu Sep 29, 2005 at 08:18:44 PM PDT

Update [2005-9-29 23:46:3 by DemFromCT]:: Reid and Frist are on Nightline together tonight. The flu amendment passed by unanimous consent.

Actions speak louder than words. Pandemic flu, as many of you know, is a very real concern right now. These very preparedness issues have been brought up at Daily Kos before by myself, Page and many others;  in fact, posts on pandemic flu can be found all over the Internets across the political spectrum. Indeed, the potential threat of pandemic flu is now in the mainstream, as this National Geographic cover story can attest to. And as of Wednesday, Harry Reid's comments on pandemic flu signal an attempt by the Senate to address some of the ongoing issues in a substantive way:

"Given the very real possibility of an outbreak, its potentially severe consequences, and our relative lack of preparedness, we need to take immediate action on several fronts to prepare this nation and the American people for a potential outbreak and to reduce its impact should it occur.

"Among the steps necessary are:

  • Improve surveillance and international partnerships so we may detect a new flu strain early;
  • Prepare for a pandemic by finalizing, implementing, and funding pandemic preparedness and response plans;
  • Protect Americans through the development, production, and distribution of an effective vaccine;
  • Plan Ahead for a pandemic by stockpiling antiviral medications, medical and other supplies;
  • Strengthen our public health infrastructure;
  • Educate Americans by increasing awareness and education about pandemic flu;
  • Finally, and perhaps most importantly, we need to commit to protecting Americans by devoting adequate resources to pandemic preparedness.
  • ::
In addition to Sen. Reid, Sen. Frist in an August speech has made the following suggestion:
So what must we do?

I propose an unprecedented effort -- a "Manhattan Project for the 21st Century" -- not with the goal of creating a destructive new weapon, but to defend against destruction wreaked by infectious disease and biological weapons.

I speak of substantial increases in support for fundamental research, medical education, emergency capacity, and public health infrastructure. I speak of an unleashing of the private sector and unprecedented collaboration between government and industry and academia. I speak of the creation of secure stores of treatments and vaccines and vast networks of distribution.

...

I call for the creation of the ability to detect, identify, and model any emerging or newly emerging infection, present or future, natural or otherwise -- for the ability to engineer the immunization and cure, and to manufacture, distribute, and administer what we need to get it done and to get it done in time.

Both of these statements  (in their entirety, if you wish) are terrific. In fact, there's almost nothing to disagree with in either one. You might even argue that the two leaders agree on many substantive points. But as Ben Franklin said, "Well done is better than well said."

And what has our government actually done? Not nearly enough at this point. There is no working vaccine and no crash program to change our 1940's era vaccine manufacturing methods and capacity. Many states have yet to commit to a pandemic plan that is simple, workable and understandable, and when those plans are announced they are likely at this point to contain little more than rationing. There are shortages of the antiviral medications needed to contain a pandemic (and those shortages will likely affect the regular flu season this winter that is distinct and separate from pandemic flu). But the biggest need  and most important task is in assisting countries in Southeast Asia to combat epidemic avian flu at the source. That latter point takes money and commitment. Both were promised by President Bush in his speech to the UN.

The Democrats (Sens. Reid, Harkin, Kennedy, Obama, et. al.) are offering an amendment to the Defense Appropriations Bill to get some money where it needs to go - quite a bit of money, actually.

This amendment would provide $3.913 billion to the Centers for Disease Control and Prevention (CDC) for the stockpiling of antivirals and necessary medical supplies; global surveillance; increase vaccine capacity; grants to state and local public health agencies for emergency preparedness and hospital surge capacity; and risk communication and outreach.

It remains to be seen whether the Republicans and Frist will agree. If they don't, and don't offer something substantive, and soon, we may find ourselves too late to do anything about the coming pandemic. The worry is that it's already too late. And since the Lord helps those who help themselves, we offer Flu Wiki and Pandemic Flu Awareness Week (Oct 3-9) to help achieve the goal Harry Reid articulated and "educate Americans by increasing awareness and education about pandemic flu".

Follow this story closely. Something's happening in Indonesia that bears watching. Leadership on both sides of the aisle are aware, as is the WH, and you'll be hearing more on this in the media as word gets out.

Education is the first step, although Sens. Reid and Frist have outlined others. These steps will take both money and political will, both in short supply in a post-Katrina world. Lets just hope the multiple DC scandals don't get in the way of the work of the Congress.

Tags: avian flu, tamiflu, pandemic preparedness, flu, Bill Frist, Harry Reid, disaster preparedness (all tags) :: Previous Tag Versions

Permalink | 127 comments

  •  Tell me again (none / 0)

    which party in the Senate has an MD as leader?
  •  We need to do something (none / 0)

    I think the average awareness about pandemics is woeful. there seems to be some sort of wilfull ignorance on the public's part, also.

    "Many people did not care for Pat Buchanan's speech; it probably sounded better in the original German," Molly Ivins, 1992

    by jeffinalabama on Thu Sep 29, 2005 at 08:23:01 PM PDT

    •  National Geographic again? (none / 0)

      The same magazine that had an article about what a catastrophic flood would do in New Orleans?  I hope it's not a jinx.  

      It does seem that a stock answer to a "Who could imagine that..." comment would be "National Geographic imagined it, in color."

      We're all pretty strange one way or another; some of us just hide it better. "Normal" is a dryer setting.

      by david78209 on Thu Sep 29, 2005 at 11:18:21 PM PDT

      [ Parent ]

  •  Finland is going to vaccinate everyone (none / 0)

    In response to a recommendation by the World Health Organization, according to which the avian influenza pandemic threat is real, Finland is preparing to vaccinate its entire population against the disease.

    In the second supplementary budget for 2005, released by the Ministry of Finance on Wednesday, it was proposed that a total of EUR 20.8 million be allocated to finance the acquisition of 5.2 million bird flu vaccine doses.

    A paper from Helsinki

    I'm not going anywhere. I'm standing up, which is how one speaks in opposition in a civilized world. - Ainsley Hayes

    by jillian on Thu Sep 29, 2005 at 08:23:40 PM PDT

  •  get out of my head, you! (4.00 / 5)

    i just wrote a diary on this subject, too!

    that's the fun part of it.  the less-than-fun part of it is that the virus could hit iraq.

    "Government, like dress, is the badge of lost innocence; the palaces of kings are built upon the ruins of the bowers of paradise." Thomas Paine, Common Sense

    by Cedwyn on Thu Sep 29, 2005 at 08:23:46 PM PDT

    •  but (none / 0)

      yours was kind of snarky ( I was tempted to post that, yeah, so it's poor southeastern europeans, Iran, and the southernmost former ussr countries that will get NOLA'd--but who can pronounce these friggin names-just an impression that didn't sit well)

      Rome wasn't burnt in a day.

      by Miss Devore on Thu Sep 29, 2005 at 08:33:00 PM PDT

      [ Parent ]

    •  you're listed right there in the story! (none / 1)

      see 'other' and click the link.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by DemFromCT on Thu Sep 29, 2005 at 08:46:23 PM PDT

      [ Parent ]

  •  What? Us worry? (none / 1)

    Hey! W has a war going on...and two hurricane aftermaths...and lots of real legislation to get passed.

    He doesn't have time for this!

    If you're worried about the flu, stock up on chicken soup and hot water bottles!  Don't bother W with stuff like this!

  •  Ummm.. (none / 1)

    this is an environmental issue...what is it doing on the front page?!?

    oh wait!  Environmental issues have to do with people and politics. Sorry, I forgot.

  •  ok call me crazy but (none / 0)

    if this thing does break out shut down schools trust me more problems will happen if they are open. During flu and cold season its bad enough but with this fuck that I will not go in with parents sending kids in who are sick to infect more kids and my underpaid ass. Sorry I like kids but I did not sign up to be on the front lines of a pandemic.
  •  It Wouldn't Hurt If We Could Some Day (none / 0)

    actually make some vaccine ourselves.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Thu Sep 29, 2005 at 08:26:10 PM PDT

    •  Hey, thats what the conservatives think (none / 0)

      we should do....make our own, you know, like in our bathtubs...can't go around depending on the government for everything, you know.
      •  Silly Me! (none / 0)

        I was doing that liberal thing and thinking "we" meant the United States. I forgot Personal Responsibility® -- "we" means each of us individually.

        We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

        by Gooserock on Fri Sep 30, 2005 at 12:11:46 AM PDT

        [ Parent ]

      •  We can't be making flu vaccines in our bathtubs... (none / 0)

        ... because that's where Grover Norquist is busy drowning the federal government.

        "It is only for the sake of those without hope that hope is given to us." -- Walter Benjamin

        by quaderni on Fri Sep 30, 2005 at 10:19:23 AM PDT

        [ Parent ]

  •  Another thing we need to do to protect Americans (4.00 / 8)

    is to commit to protecting at-risk populations in the countries that are most susceptible to pandemic disease.
    Its the public health version of the cold war.  By assuming a forward defense posture in other countries, we protect ourselves.
    The other benefit is that every life we save in another country is a person or group of people who have something good to think about us.
    investing in public health infrastructure in the developing world also provides the best bang for the buck.  The US dollar buys more public health in Ho Chi Minh City and Shanghai than it does in Los Angeles or Seattle, and by so doing, saves more American lives in the long run.
    It makes economic sense.  It makes geopolitical sense.  It makes public health sense.

    Because it makes sense on so many levels, it is something that we can never realistically hope to see from either the Republican-controlled congress or white house.

    "I don't belong to an organized political party. I'm a democrat."--Will Rogers

    by soonergrunt on Thu Sep 29, 2005 at 08:26:13 PM PDT

  •  rubbing eyes (none / 0)

    Oh , so that's what leadership is.

    New Frame: McCain thinks he is entitled to the presidency, and will say anything to get what he thinks he is owed.

    by coigue on Thu Sep 29, 2005 at 08:27:51 PM PDT

  •  very important idea (none / 1)

    we need to use our knowledge and resources for prevention, or in worst case, alleviation of any suffering.

    that's what a progressive is: someone who thinks forward.

    the other alternative is to wring hands in the future and say "no one could have imagined a bird virus could cause this distaster."

    Rome wasn't burnt in a day.

    by Miss Devore on Thu Sep 29, 2005 at 08:27:59 PM PDT

  •  The upside of Katrina (none / 0)

    If there is ever a time to get funding for this program, it is now.
  •  Nightline will cover this (4.00 / 6)

    starting now on the east coast.

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by DemFromCT on Thu Sep 29, 2005 at 08:33:39 PM PDT

  •  Two problems (4.00 / 3)

    I appreciate the attention given to this topic. Nobody wants a killer swooping out of the sky and laying waste to our way of life.

    That said, it's not feasable to call for a vaccine, since human to human transmission has not been proven. Without identifying the strain, there can be no vaccine. The strain so far as we know, does not yet exist. I'm all for vigorous vaccination funding, but as far as avian flu goes, development of a vaccine is about the only thing that's NOT behind schedule in terms of preparedness.

    Also I think the term pandemic has attained emotional weight that may not be warranted. Here are the stages of pandemic as defined by the WHO:

    Interpandemic period

    Phase 1: No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

    Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

    Pandemic alert period

    Phase 3: Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.

    Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

    Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).

    Pandemic period

    Phase 6: Pandemic: increased and sustained transmission in general population.

    Right now there is no evidence that avian flu is past Phase 3 or 4, from what I've read, though I don't claim exhaustive knowledge. And you'll notice that even Phase 6, which means a pandemic is upon us, means increased and sustained in the general population.

    That's a little different than cataclysmic scenarios of disease spreading like the plague or Ebola, killing all it touches. The doomsday scenarios are great for garnering attention, but it's also proper in my view to say that, as of yet, there is not a case to be made that human to human transmission has been found. Nor is there anyway to assess how virulent or lethal the virus will be should a variant adapted to humans develop. Most influenzas that don't kill probably started out in birds or other animals. There's no question that we should be scared shitless of a virus that has already killed and shown resistance to the human immune system. For me, I'd rest easier if we were pouring money into the effort to locate and isolate outbreaks, and also if  we were doing something to pay back the rural poultry farmers for all the birds they are going to have to slaughter. After all we need them to cooperate and be the canaries in the world's coal mine of disease.

    •  good summary, but... (4.00 / 2)

      ...here's evidence we might be at phase 5 right now.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by DemFromCT on Thu Sep 29, 2005 at 08:37:49 PM PDT

      [ Parent ]

      •  Awwwwww F!!!!ck! (none / 0)

        H5 will clearly be resident in humans worldwide.

        The resulting major pandemic appears to be accelerating in Indonesia at this time.

        That's just great

        Where did you say you can get Tamiflu?

        If honesty were suddenly introduced into American life, the whole system would collapse - George Carlin

        by brenda on Thu Sep 29, 2005 at 09:59:18 PM PDT

        [ Parent ]

    •  The problem is... (none / 0)

      creation of a vaccine now takes about 18 months from start to production in useful quantities.

      This is not much use against a lethal pandemic flu; by the time we've identified the virus and created the vaccine, it will be too late to save lives.

      The key passage in Reid's speech is this:

      I call for the creation of the ability to detect, identify, and model any emerging or newly emerging infection, present or future, natural or otherwise -- for the ability to engineer the immunization and cure, and to manufacture, distribute, and administer what we need to get it done and to get it done in time.
      In time.

      That requires re-inventing the whole vaccine process. Reid is calling for a massive research and development project to find new, much faster, ways of producing the needed vaccine.

      It's a terrific idea. I can't think of a better place to spend government research dollars.

      Folly is fractal: the closer you look at it, the more of it there is.

      by Canadian Reader on Thu Sep 29, 2005 at 08:58:29 PM PDT

      [ Parent ]

      •  that's exactly right (none / 0)

        anyone who can watch should see Nightline tonight... all of this was discussed.

        But this is a long term investment to change the way we do things. This is one time where Reid and Frist's speeches are more than bombast.

        That doesn't help us right now. For right now, we're talking rationing and planning to do without.

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by DemFromCT on Thu Sep 29, 2005 at 09:02:11 PM PDT

        [ Parent ]

      •  and not to mention (none / 0)

        the standard technique for culturing vaccines uses egg yolk in the medium.  since this virus is highly deadly to birds, this is a damn sticky wicket.

        "Government, like dress, is the badge of lost innocence; the palaces of kings are built upon the ruins of the bowers of paradise." Thomas Paine, Common Sense

        by Cedwyn on Thu Sep 29, 2005 at 09:51:40 PM PDT

        [ Parent ]

  •  Avian flu hates America and our freedoms! n/t (none / 0)

    Everything is funny as long as it is happening to somebody else. --Will Rogers

    by groggy on Thu Sep 29, 2005 at 08:35:49 PM PDT

  •  What the fuck is wrong with us? (none / 0)

     It's not like we have no experience with what a real pandemic can do. It isn't like we don't stare down the barrel of flu every year. A commitment to dealing with this will take money, and I'm afraid we already spent it all.

    There still are two Americas. I live in the other one. John McSame wants me to stay there.

    by high uintas on Thu Sep 29, 2005 at 08:37:27 PM PDT

  •  Reid and Frist are on Nightline together (4.00 / 2)

    and the amendment passed by unanimous consent.

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by DemFromCT on Thu Sep 29, 2005 at 08:38:29 PM PDT

  •  Total Bullshit..day late, dollar short (none / 0)

    The government, house and senate and HHS and DHS have known about the flu danger for a long time and the UN and the WHO have been telling them and telling them and telling them.

    If you want to know who to blame for the fact that the US is not prepared look no further than DHS and their evil twin the DOD...

    DHS gets $40.2 billion  for the "BioShield" program. $400 million of that amount is suppose to maintain and augment a stockpile of vaccines in the event of a biological-weapons attack.
    The rest they have given to drug companies as "an incentive to manufacture" the "next generation" of medications.

    Quote:....."The lack of advanced planning up until the moment in the United States, in the sense of not having a huge stockpile I think your citizens deserve, has surprised me and has dismayed me," he admits.  (UN offical)

    Quote:....When asked why the United States did not place its orders for Tamiflu sooner, Leavitt  replied, "I can't answer that. I don't know the answer to that." (DHS)

    Hypocrisy in anything may deceive the cleverest and most penetrating man, but the least wide-awake of children recognizes it....

    by Cal45 on Thu Sep 29, 2005 at 08:41:20 PM PDT

  •  George Bush can't imagine a pandemic... (none / 0)

    So, that means the Administration can't do ANYTHING about it. Sorry...

    It's just so hard for this administration to imagine anything...

  •  Republican response (none / 0)

    Let's not forget that among the suggestions that were made recently by House Republicans for cutting federal spending so they can throw money at the Gulf states without endangering the tax cuts for the super-rich: the Centers for Disease Control and Prevention (CDC)

    Need anymore proof that they either don't get it, or get it and just don't care? Oh yeah, and they also thought it would be a good idea to cut funding for Medicare prescription drug benefits and first-responder grants that help local governments prepare for terrorism.

    I'm starting to see a comedy sketch form in my head about how Republicans would have behaved on the Titanic...

  •  This nation, since Reagan on, (none / 0)

    has been systematically dismantling the very notion of public health.  I don't see that damage being reversed.

    Are you speaking "bat?" Is that what bat sounds like?

    by jazzmaniac on Thu Sep 29, 2005 at 08:50:44 PM PDT

    •  but that's exactly what has to happen (none / 0)

      and it's one of our tasks to point those who don't get it in the right direction.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by DemFromCT on Thu Sep 29, 2005 at 08:53:08 PM PDT

      [ Parent ]

    •  One Too Many Words-- (none / 1)

      "has been systematically dismantling the very notion of public."

      We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

      by Gooserock on Fri Sep 30, 2005 at 12:13:22 AM PDT

      [ Parent ]

  •  Ted Stevens Wants to Kill the Bill (none / 0)

    A group of Senate Democrats on Thursday sought to add nearly $4 billion to the U.S. fight against the deadly avian flu, with most of the money to be used to stock up on an anti-viral drug.

    But a Senate vote on the measure might be delayed until next week and an influential Republican, Sen. Ted Stevens of Alaska, said he would try to kill the effort.

    Reuters

    I'm not going anywhere. I'm standing up, which is how one speaks in opposition in a civilized world. - Ainsley Hayes

    by jillian on Thu Sep 29, 2005 at 09:00:50 PM PDT

    •  Frist and Reid jointly said it was adopted (none / 0)

      by unanimous consent. I await tomorrow's papers.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by DemFromCT on Thu Sep 29, 2005 at 09:03:07 PM PDT

      [ Parent ]

      •  O/T, sort of (none / 0)

        So in all of your study of flu, do you know what are the implications for caretakers of someone with an extremely suppressed immune system getting a flu shot?

        "There is danger from all men. The only maxim of a free government ought to be to trust no man living with power to endanger the public liberty." - John Adams.

        by mcjoan on Thu Sep 29, 2005 at 09:08:45 PM PDT

        [ Parent ]

        •  flu vaccine isn't live va a shot (none / 1)

          if you get a shot you can't spread virus to someone who is immunocompromised. Caretakers should avoid the nasal spray vaccine, which is live (called Flu Mist).

          Obviously the best advice is to talk to your doctor about it.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by DemFromCT on Thu Sep 29, 2005 at 09:13:03 PM PDT

          [ Parent ]

          •  Cool (none / 0)

            I know I should talk to my doc, but you were handy, so....

            Thanks!

            "There is danger from all men. The only maxim of a free government ought to be to trust no man living with power to endanger the public liberty." - John Adams.

            by mcjoan on Thu Sep 29, 2005 at 09:15:03 PM PDT

            [ Parent ]

    •  Fuck Ted Stevens with a chainsaw (4.00 / 2)

      I despise that guy and his fucking bridges to nowhere.  I know there's no chance he'll get defeated at the polls, but it'll be a sweet day when he's in the minority party in the Senate.

      -AG

      "Watching George Bush trying to govern is like
      watching a monkey trying to f**k a football."
      I'm a libertarian, pro-2A capitalist Democrat.

      by AlphaGeek on Thu Sep 29, 2005 at 09:08:56 PM PDT

      [ Parent ]

    •  Kill The Bill? friggin Stevens; does (none / 0)

      he want to kill The Johnny, The Anna, The Tom and The Tiffany too? huh, does he?
  •  You da MAN, DemFromCT! (none / 1)

    I'd bet my last dollar that Harry Reid and/or his staff has seen your articles and the work on the FluWiki.

    If only we could get a few Senators and Congressmen (*cough*Alaska*cough*) to give up some pork to offset that $4B...

    -AG

    "Watching George Bush trying to govern is like
    watching a monkey trying to f**k a football."
    I'm a libertarian, pro-2A capitalist Democrat.

    by AlphaGeek on Thu Sep 29, 2005 at 09:05:54 PM PDT

    •  LOL I'm still laughing at your sig.... (none / 1)

      here's the AP trying to spread the word...

      New Flu Pandemic Could Kill 150 Million

      By THE ASSOCIATED PRESS
      Published: September 29, 2005

      And we're trying to be so rational...

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by DemFromCT on Thu Sep 29, 2005 at 09:08:02 PM PDT

      [ Parent ]

      •  BiPM was on a roll that night (none / 0)

        I think he'd pretty much finished off a fifth of Bacardi by the time he posted that one.

        Had a word with the wife about the threat of a flu pandemic the other night.  We've got a basic plan worked out, but I'm concerned about access to medication.  Specifically, I'm concerned about the ethical implications of proactively obtaining prescriptions for Tamiflu.

        Thoughts?

        -AG

        "Watching George Bush trying to govern is like
        watching a monkey trying to f**k a football."
        I'm a libertarian, pro-2A capitalist Democrat.

        by AlphaGeek on Thu Sep 29, 2005 at 09:26:01 PM PDT

        [ Parent ]

        •  tough one (none / 0)

          if everyone gets some, there won't be enough for those that need it.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by DemFromCT on Thu Sep 29, 2005 at 09:27:15 PM PDT

          [ Parent ]

        •  i've been thinking about this (none / 1)

          I don't judge anyone who does get tamiflu for their family, but I think I've decided not to, at least for now.

          I figure there's only a limited supply, and it seems somehow wrong for me to keep it on my shelf when I and my family might never have the flu -- while other people may need it and not be able to get it.

          Also it's not like tamiflu is a magic bullet, or it will be clear how and when to administer it.

          I think instead I'm focused on prevention. How I could pull out of urban life, getting stocked with N95 masks and gloves, and prepared for periods of relative isolation.

          But I may be wrong.

          •  I would agree with you (none / 0)

            If I thought that the government would wisely use what little resources it has. But..do you really think that's what will happen? Your dose of tamiflu will go to Brownie's Mistress' dog.

            If honesty were suddenly introduced into American life, the whole system would collapse - George Carlin

            by brenda on Thu Sep 29, 2005 at 10:35:25 PM PDT

            [ Parent ]

            •  i understand (none / 0)

              What you're saying and of def. don't trust this government but the truth is the illness will come in waves -- other areas of the country could be hard-hit before it even comes to my area. I and my family could be fine. I'm not saying it's Bad, but it doesn't seem like it's a community-oriented response.
          •  We're holding off for now as well (none / 0)

            Although we're going to talk to the family doctors ASAP to lay the groundwork for a phone-in request for Tamiflu.

            The family plan would be for everyone but me to go under "house arrest", while I set up camp in the garage workshop.  I'll act as the go-between for grocery shopping, pickup of lesson plans and materials from school, and so forth.  Needless to say, there won't be any hugs for Daddy from the small people for quite a while if this comes to pass.

            -AG

            "Watching George Bush trying to govern is like
            watching a monkey trying to f**k a football."
            I'm a libertarian, pro-2A capitalist Democrat.

            by AlphaGeek on Thu Sep 29, 2005 at 10:36:01 PM PDT

            [ Parent ]

            •  The interesting thing (none / 0)

              is when do you go into "house arrest?"

              After the first human-human case is documented in Asia (perhaps already happening?) or the first case in the U.S. or the first case in your local area? Or when it's clearly epidemic and hundreds are dying? At what point do the kids stay out of school?

              •  first case nearby (none / 0)

                waiting til many die is too late. One makes rings of quarantine, ever-widening if needed.

                "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                by DemFromCT on Fri Sep 30, 2005 at 09:13:08 AM PDT

                [ Parent ]

          •  "N95 masks will give you a false sense... (none / 0)

            ....of security if you use them against H5N1 or any virus for that matter."

            According to Oregon Digital, distributors of NanoMask

            •  N95 masks (none / 0)

              You may want to consider that Oregon Digitals opinion might be a bit biased towards thier own product and profit. Real world flu experience:
              N95 masks and prophylactic treatment with antiviral drugs were used to protect thousands of poultry workers and cullers during an outbreak of highly pathogenic H7N7 avian influenza in the Netherlands in 2003. During that outbreak, nearly 30 million poultry were destroyed. Although avian influenza virus caused mild illness in 89 poultry workers and members of their families, the single death in that outbreak occurred in a veterinarian who was not adequately protected. (World Health Organization)

               

              The opposite of war is not peace, it's creation --Jonathan Larson

              by MaggieEh on Thu Sep 29, 2005 at 11:15:12 PM PDT

              [ Parent ]

              •  N100 masks are also available (none / 0)

                The 3M 8233 is a disposable N100 mask with an exhale valve and adjustable upper and lower straps.  At US$6 to $8 each it's a fair bit more expensive than N95 disposables (US$1.75 ea for the good ones) but worth considering.

                I have a small number of 8233 masks in my preparedness kits, along with a larger number of Draeger N95 disposables.

                -AG

                "Watching George Bush trying to govern is like
                watching a monkey trying to f**k a football."
                I'm a libertarian, pro-2A capitalist Democrat.

                by AlphaGeek on Thu Sep 29, 2005 at 11:30:04 PM PDT

                [ Parent ]

                •  They would be nice.. (none / 0)

                  If they were the same price I would go the N100, but for me this one's on the edge of the reasonably prepared vs that's-too-expensive line.

                  And partly I actually use the N95's for sanding etc. as I have a small nose/bridge that makes those clunky oval guy masks pretty useless.

                  I didn't actually realize that these were the same masks used by health care workers until SARS hit here in Canada and my Lee Valley catalogue order for masks got delayed for weeks.

                  The opposite of war is not peace, it's creation --Jonathan Larson

                  by MaggieEh on Fri Sep 30, 2005 at 12:04:31 AM PDT

                  [ Parent ]

                  •  preparedness that could be used for other things (none / 1)

                    makes the most sense. Here in CT, blizzards can knock out power for 3 days. Everyone has a 3 day supply of 'stuff'.

                    So if it never snows, maybe it's a rainstorm that knocks out your power.

                    Don't stock up for a year on stuff that goes bad. But be sensible about a minimal amount of things, and/or have a plan.

                    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                    by DemFromCT on Fri Sep 30, 2005 at 03:58:54 AM PDT

                    [ Parent ]

                •  Where do you get these? (none / 0)

                  Where are these N100 and N95 masks obtained from? Medical supply companies?  
                  thanks!
                  •  masks (none / 0)

                    Try any hardware store for the N95 kind, they usually stock them for paint sanding and insulation work. Masks that meet rating specifications like N95 will have this prominently on the packaging.

                    I like Lee Valley here in Canada, but I know Home Depot usually carries some versions too.

                    The opposite of war is not peace, it's creation --Jonathan Larson

                    by MaggieEh on Fri Sep 30, 2005 at 09:33:05 AM PDT

                    [ Parent ]

            •  Given That Hand Washing (none / 0)

              protects against so much infection, I wonder if almost any mask wouldn't be statistically better than nothing.

              Don't the biggest number of these pathogens travel on rather large moisture drops and dust particles etc. ? I'd think that a million ordinary carpenters' dust masks would save a lot of transmissions in routine civilian life even though it would require highly sophisticated equipment to protect health workers who were in constant close contact.

              We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

              by Gooserock on Fri Sep 30, 2005 at 12:18:18 AM PDT

              [ Parent ]

        •  Planning suggestions to share? (none / 0)

          Loved your preparedness series, gave a preparedness presentation at our quarterly safety meeting today and "borrowed" some of your stuff.

          I'd really appreciate any suggestions. Keep thinking about the book, "Earth Abides". Ever read that?

          Thanks

          •  Hmm... (4.00 / 2)

            The first thing you can do is get in the habit of never touching your face with your bare hands.  This is very difficult, but worth it.  Also, wash your hands -- a LOT.  Everybody in the house should be washing their hands very frequently.

            In the event of an outbreak, minimize contact between your household and the outside world.  If you aren't exposed to a disease you can't catch it.

            If possible, designate a single member of your household as the go-between to interact with the outside world for necessary tasks such as grocery shopping.  If practical, isolate that person from the rest of the household.  (See my post above.)

            Wear disposable protective gear if you need to go out in public.  Nitrile gloves and an N95 or better disposable respirator are excellent choices.  (The 3M 8233 with exhale valve is my personal choice, althought it's on the expensive side for a disposable.  Cheaper than dying, thought.)  Don't be afraid to look funny wearing a respirator, and seriously consider wearing eye protection.

            Wash and/or disinfect all goods brought into the household.  Ultraviolet is good for killing bugs on paper; from what I've heard, flu-type viruses can't survive an hour of direct sunlight.  For hard surfaces (e.g. canned food) and general disinfection I keep a couple of containers of PDI Sani-Cloth HB Wipes around.  This stuff is also handy during regular flu/cold season for doorknobs, bathrooms, etc.

            Talk to your doctor before anything bad happens.  

            That's all I've got for now, hope this helps.

            -AG

            "Watching George Bush trying to govern is like
            watching a monkey trying to f**k a football."
            I'm a libertarian, pro-2A capitalist Democrat.

            by AlphaGeek on Thu Sep 29, 2005 at 11:05:10 PM PDT

            [ Parent ]

            •  Last Time I Flew Cross Country (none / 0)

              I wore an ordinary carpentry dust mask, about 1 grade above super cheap, at all times on the plane and in close quarters, and it was the first trip I've made in memory that didn't give me a cold or flu.

              I don't fly often enough to build up immunity as some people suggest can happen.

              I was the only person in sight taking any precaution.

              We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

              by Gooserock on Fri Sep 30, 2005 at 12:20:50 AM PDT

              [ Parent ]

              •  I'm with you (none / 1)

                I've been reticent to do so in the past, but from now on I'm going to be wearing a nice, comfortable N95 mask with an exhale valve when I have to fly.

                I've seen a fair number of Asians on intercontinental flights wearing masks.  It's easy to write them off as germ-phobic (and many Asian cultures are germ-phobic) but that doesn't mean they're wrong.

                The dry, recirculated air found aboard jet planes is a killer for propagating infectious diseases.  I'll be wearing a mask from now on.

                -AG

                "Watching George Bush trying to govern is like
                watching a monkey trying to f**k a football."
                I'm a libertarian, pro-2A capitalist Democrat.

                by AlphaGeek on Fri Sep 30, 2005 at 01:02:37 AM PDT

                [ Parent ]

            •  Thanks! (none / 0)

              Given that the current fatality rate is somewhere between 40 and 70%, what are the implications for infrastructure if we have a full-blown epidemic in the US? As in Earth Abides, is it reasonable to expect that utilities might be disrupted due to lack of skilled persons to operate the controls?
              •  now you're getting the point (none / 1)

                30% of the utility company is sick... what happens if a line comes down?

                Multiply that for every public utility...

                more on that topic and others at flu wiki.

                "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                by DemFromCT on Fri Sep 30, 2005 at 07:01:10 AM PDT

                [ Parent ]

      •  150M (none / 1)

        ... Nat'l Geog projects 180 million to 360 million.  If we get a nifty new flu equivalent to the Spanish flu of 1918-19 (which killed 50-100 million).

        It killed them over an extended period (slower international transportation spread it more slowly) of about two years (I've seen references to deaths into 1920).

        The 1968 "minor" flu pandemic ran it's planetary course in just under a year.

        The projections for today are 180 days.  

        So a comparably fatal flu today would be killing more people (absolute numbers) in a shorter period.  Figure roughly three times as fast... and 4-5 times as many because of denser populations.

        We're looking at ~12-15 times as many people in any given place dying in a given period of time from the flu as did in the Spanish flu epidemic.

        That's going to hit the medical system like a tsunami.  And the economic system, too.

        People are going to simply freak out when there are 100 deaths in their community (think SARS)....

        We need not think alike to love alike -- Ferenc Dávid

        by ogre on Thu Sep 29, 2005 at 10:31:18 PM PDT

        [ Parent ]

        •  that's worst case, but yeah (none / 0)

          and if we never prepare it's worse.

          If we prepare and it doesn't happen, so what?

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by DemFromCT on Fri Sep 30, 2005 at 04:02:09 AM PDT

          [ Parent ]

  •  Time also to consider the source (none / 0)

    of the problem.  Joel Makower at HuffPost connects the agribusiness vs. environment dots:

    http://www.huffingtonpost.com/joel-makower/factory-farming-meets-the_b_8053.html

    We are soiling our own nest.

    Are we still routinely torturing helpless prisoners, and if so, does it feel right that we as American citizens are not outraged by the practice? -Al Gore

    by soyinkafan on Thu Sep 29, 2005 at 09:10:51 PM PDT

  •  Krugman's piece today mentions avian flu as well (4.00 / 2)

    Last week three men were arrested in connection with the gangland-style murder of Mr. Boulis. SunCruz, after it was controlled by Mr. Kidan and Mr. Abramoff, paid a company controlled by one of the men arrested, Anthony "Big Tony" Moscatiello, and his daughter $145,000 for catering and other work. In court documents, questions are raised about whether food and drink were ever provided. SunCruz paid $95,000 to a company in which one of the other men arrested, Anthony "Little Tony" Ferrari, is a principal.

    Iraq's oil production remains below prewar levels. The Los Angeles Times reports that mistakes by U.S. officials and a Halliburton subsidiary, which was given large no-bid reconstruction contracts, may have permanently damaged Iraq's oilfields.

    Tom DeLay, who stepped down as House majority leader after his indictment, once called Mr. Abramoff "one of my closest and dearest friends." Mr. Abramoff funneled funds from clients to conservative institutions and causes. The Washington Post reported that associates of Mr. DeLay claim that he severed the relationship after Mr. Boulis's murder.

    Public health experts warn that the U.S. would be dangerously unprepared for an avian flu pandemic.

    As Walter Cronkite used to say, That's the way it is.

    I guess it's a hot topic, this flu thing.

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by DemFromCT on Thu Sep 29, 2005 at 09:22:39 PM PDT

  •  more... (4.00 / 2)

    Senate approves $3.9 billion for bird flu
    By TODD ZWILLICH

    WASHINGTON, Sept. 29 (UPI) -- The Senate approved more than $3 billion in spending to bolster national defenses against avian flu late Thursday, though it remained unclear whether the money would survive a conference with the House.

    The measure, attached to a military funding bill, spends $3.08 billion to increase federal stockpiles of anti-viral medications, including Tamiflu, made by Gilead Pharmaceuticals. The drug can ease flu symptoms and may cut the chances of transmitting the disease.

    The amendment also spends $125 million to boost domestic production of an avian flu vaccine, though it does not specify where the money will be spent.

    The Bush administration signed a contract in August with Sanofi-Pasteur to begin producing initial doses of a vaccine against H5N1, the virus causing avian flu.

    Public-health experts both inside and outside the government have sounded alarm bells about the danger of an avian flu pandemic. Humans have no natural immunity to the virus, meaning if it spreads, it could cause widespread illness and death.

    An estimate by the Centers for Disease Control and Prevention in Atlanta predicts widespread human-to-human transmission could kill as many as 200,000 people in the United States.


     

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by DemFromCT on Thu Sep 29, 2005 at 09:29:59 PM PDT

  •  Go online and buy Tamiflu (none / 0)

    Seriously.  Your doc probably won't just write you a prescription just to have it "in case."  Go online to get a supply for yourself and your family.  

    Do you honestly want to depend on this fucked-up government of ours to protect you?  Based on Katrina, we'd all be dead if the avian flu hit here.

    The US is now a corporatist-fascist society where Blackwater rules. I'm neither a christian, nor a capitalist, so where do I fit in?

    by HillaryGuy on Thu Sep 29, 2005 at 09:39:57 PM PDT

    •  Expensive stuff (none / 0)

      Yes, I know, cheaper than dying... but the cheapest I can find a full course of Tamiflu is $60.  Multiply that by 5 to cover my whole family, and that's a nice chunk of change.

      That's assuming, of course, that I could get our family doctors to write prescriptions for that much Tamiflu.  The no-prescription-needed places have the highest rates of substandard and fake medication every time there's a study, on top of being much more expensive.

      -AG

      "Watching George Bush trying to govern is like
      watching a monkey trying to f**k a football."
      I'm a libertarian, pro-2A capitalist Democrat.

      by AlphaGeek on Thu Sep 29, 2005 at 10:42:13 PM PDT

      [ Parent ]

    •  Already done. (none / 0)

      Currently trying to source some N100 masks too.

      Paranoid? Maybe. But I have the money and I can't think of a better way to spend it than to provide a superior chance of survival for my family if the proverbial shit hits the fan.

      On a slightly darker note, I should also remind my lovely wife to renew her firearms cert.

      --
      Plot your political compass scores at KosCompass

      by Hatamoto on Sat Oct 01, 2005 at 04:58:25 PM PDT

      [ Parent ]

  •  Given that the Bush (none / 0)

    Family has a history of support for euthanasia and the stellar performance of Gee Dubya in the aftermath of Katrina. I'd say we're f!cked.

    Maybe I'm just paranoid, I mean, they wouldn't want to get embarrassed again would they?

    Sarcastically yours

    If honesty were suddenly introduced into American life, the whole system would collapse - George Carlin

    by brenda on Thu Sep 29, 2005 at 09:41:20 PM PDT

  •  National Geographic Subscriptions 4 the President (none / 0)

    I'm telling you, that obscure journal National Geographic needs to find its way to the White House somehow. First they predict the New Orleans fiasco, then this bird flu thing.

    I encouraged folks a while back to send Michael Brown a subscription, but now that he's gone, clearly the man at the top is in need.

    The subscription URL is:

    http://shop.nationalgeographic.com/shopping/product/detailmain.jsp?itemID=217&itemType=PRODUCT&a mp;iMainCat=105&iSubCat=669&iProductID=217

    Enter in as a gift recipient George W. Bush, 1600 Pennsylvania Avenue NW, Washington DC, 20500.

    Let's see if we can get 1000 DailyKos Subscriptions entered in. That way, the White House staff will be able to leave one in every room of the White House, Camp David, the ranch at Crawford, and the compound at Kennebunkport (barely).

    Look at it this way: at least your money will support the work of this incredibly obscure organization whose publications apparently are very hard to get.

    Disclaimer: I have nothing to do with either National Geographic or George W. Bush. I just care.

    Call me any ugly name you choose --
    The steel of freedom does not stain.
    -- Langston Hughes

    by TheCrank on Thu Sep 29, 2005 at 11:15:59 PM PDT

  •  "...all over the Internets..." (none / 1)

    I see that George Bush's mischoice of words is being normalized through repetition. Or is it still possible to stop eroding the language in the service of stale snark? "The Internet" is a world-uniting concept worth keeping perfectly clear.

    "C'mon -- if THAT were true, you wouldn't be getting the news from some crazy email forwarded by your brother-in-law!"

    by technopolitical on Thu Sep 29, 2005 at 11:17:16 PM PDT

    •  BTW, great diary! [n/t] (none / 0)

      "C'mon -- if THAT were true, you wouldn't be getting the news from some crazy email forwarded by your brother-in-law!"

      by technopolitical on Thu Sep 29, 2005 at 11:39:36 PM PDT

      [ Parent ]

      •  my use of Internets and strategery is deliberate (none / 0)

        and will not change until Bush is out of office. ;-)

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by DemFromCT on Fri Sep 30, 2005 at 04:03:55 AM PDT

        [ Parent ]

    •  You haven't been keeping up with the latest. (none / 0)

      There's currently a tousle regarding world (via UN) vs. the US over maintenance of root domain name services (DNS).

      The world says "Give up control of the root servers so there's no single choke point."

      The US says "Go Cheney yourself."

      The world says "Fine. Either play ball or we make our own root servers and sucks to be you, bitches."

      So yes, there is a serious potential to have "The Internet" turn into "The Internets", if you properly consider name resolution to be the glue that provides a common access method to various resources.

      --
      Plot your political compass scores at KosCompass

      by Hatamoto on Sat Oct 01, 2005 at 05:02:49 PM PDT

      [ Parent ]

  •  correction (none / 0)


    "Indeed, the potential threat of pandemic flu is now in the mainstream..."

    Shouldn't that read "political threat"?

    Also, is it time to duck tape our houses for this cuz I've been waiting a while to use that frikin' gross of duck tape that I got at Costco the last time the government tried to scare the crap out of me.

    •  I understand (none / 0)

      We tend to discount threats when they are presented the way they are sometimes. We sorta get desensitized to them and then we tend to ignore warnings becuae we've already be warned many times and we think they are just crying wolf.

      Ask the residents of New Orleans how well that works in the long run.

      Seriously, what we need to do is to evaluate the information we have and make a choice based on our own experience and knowledge.

      I live in Minnesota and we get a few tornados here in the summer. Do I run to the basement everytime there is a tornado warning? Nope. But I am more alert and if there are other cues I head for cover. I don't take chances and I try to use my head.

      I used to work at the Mayo Clinic, I was just a paramedical but many of my friends were med students years back and I felt I had to hold my end of the conversation. Ummm...it really looks like H5, bird flu, is making the leap. If that is true, that's if, then it will run like wildfire through Indonesia. It'll spread faster than the WHO can find it.

      What can you do? Take care of yourself. Get a good nights sleep, exercise, eat a balanced diet. Those three things right there will boost your immune system quite a bit. Reduce stress in your life, so maybe its time to pick up some meditation classes, also a proven immune booster.

      And fer crying out loud, wash your hands before you eat.

      There are seven billion people on this planet. Too many, Gaea is planning to shake a few off. It's not like we weren't warned about thirty years ago.

      If honesty were suddenly introduced into American life, the whole system would collapse - George Carlin

      by brenda on Fri Sep 30, 2005 at 12:33:44 AM PDT

      [ Parent ]

  •  Best thing you could do... (none / 1)

    WASH YOUR HANDS!

    Not just put them under water for 5 seconds.  I'm talking two full minutes of scrubbing with soap and water, a few times a day.  Soap doesn't work instantly.  Really, really wash your hands, and you'll do wonders in preventing -- and passing along -- illness.

    •  you can use the alcohol-based nonsoap (none / 1)

      washes as well... and cough in the crook of your arm if you don't have a tissue and a sink. That way, you don't spread it to surfaces.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by DemFromCT on Fri Sep 30, 2005 at 05:26:05 AM PDT

      [ Parent ]

  •  The 1918 flu - question (none / 0)

    I've read only a bit about the subject of avian flu, but I haven't seen any rationale as to why it would strike younger people and children other than that the 1918 flu did.  Is there any proof that "pandemic" flus strike younger people, or is everyone proceeding solely on the logic that because the 1918 flu was a pandemic flu, and because it struck younger people, then all pandemic flues (is that the plural?) strike younger people?

    Also, consider that the world's population was considerably younger then, many fewer old people proportionally - I wonder if that was statistically figured in, I suppose it was.

    •  last question first (none / 0)

      I wonder if that was statistically figured in

      It was. The problem is that young (20-29 year old, specifically) people in 1918-9 died in disproportionate numbers. Usually it is the very young and very old.

      Several reasons: it was during the Great War, and many younf soldiers were housed together in barracks. The government and the Army refused to adjust (isolation and quarantime) because it would hurt the war effort. But even back home, young folks died. It's suspected they died froma severe pneumonia called Adult respiratory Syndrome or ARDS. Even today, the cure rates in ICUs are not much better for ARDS (also known as shock lung or Da Nang lung), which is the body's reaction to severe injury or insult. And it seems to happen in healthy young people from a mechanism known as 'cytokine storm', where your immune system overreacts. Not much is known about this, or how to treat it.

      Although there are small numbers, many of the SE Asian deaths have had similar ARDS symptoms, and contributed to the high death rate (50%) currently seen with H5N1.

      Given the above, you can understand the concern.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by DemFromCT on Fri Sep 30, 2005 at 05:24:24 AM PDT

      [ Parent ]

  •  This is clearly related to terrorism preparedness (none / 1)

    One of the idiotic things about the Katrina response and government perceptions of that response is that people seem to think response was poor because the government has been focusing on preparedness for terrorism, not hurricane.

    Well, hello. Many of the same problems associated with Katrina and Rita (example: panicky evacuations, runs on supplies, health concerns) might surface in the event of earthquakes, biological, nuclear or chemical attacks. Natural disaster preparedness is terrorism preparedness. If we're not prepared for Katrina or Rita, we're not prepared for Al Qaeda.

    Similarly, the heart of flu preparedness are the sorts of things we would need if we faced a major, man-made biological attack, or maybe certain kinds of chemical attacks. The big challenge is that, noramlly, we now need fewer hospital beds than we have. But, if a bad flu hits, we need to be able to set up huge numbers of temporary hospitals that, at a minimum, can provide IVs full of fluids and some help with breathing.

    We also need some kind of reasonably bipartisan, thoroughly debated set of rules on quarantines. What do we do to quarantine people who are sick, and what about people who might be in some kind of incubation stage or other people who might be carriers? Do we put them in certain neighborhoods, or tent cities, or what?

    Finally, we need some kind of national consensus on what level of support people should expect to get in the event of a disaster, and maybe, frankly, we should make it clear that survivors of bigger disasters get less support than survivors of smaller, more manageable disasters.

    Maybe the brutal reality is that, essentially, we can provide $1 billion, $10 billion or $50 billion pots of individual relief for enormous disasters, and that's it. Maybe we can guarantee people access to food, water and emergency care for about a week, or a few weeks, but maybe for a disaster that displaces 1 million people, we can offer small emergency aid packages plus some major community-rebuilding/reconstruction efforts. Of course, each of the 1 million people hit affected by a nuclear attack would deserve $1 million in aid apiece, but maybe that generosity is just not realistic. On the other hand, if we can afford to help survivors by, for example, bringing back the estate tax or increasing taxes on gas-guzzling cars a little bit more, then we have to use those resources to help people.

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