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  • Comonly asked question: why close schools aggressively? We don't for seasonal flu.

    When you have a novel virus that everyone can catch, you treat it differently than seasonal flu, which many people have at least partial immunity to. Typically, schools close at ~10% to ~20% sick. But if you want to stop community spread you have to close the schools at 1% sick or you lose the effect. So with a virus you want to stop, you are proactive rather than reactive. More here about legal aspects

    Schools play a critical role in protecting the health of their students, staff, and the community from highly contagious, infectious diseases such as seasonal or pandemic influenza. Modeling and analyses conducted by CDC and others indicate, for example, that community-wide school closures may mitigate the incidence of pandemic influenza, thereby reducing its impact on individuals, groups, healthcare providers, public health systems, and the economy. The public health premise is that closing schools limits the spread of influenza (or other communicable conditions) consistent with social distancing theories.

    This brief article notes that policy is different from state to state. Does it work? Models say yes, it should.

  • Good summary:

    Aside from testing procedures, assessment and management of 2009 H1N1 (swine) flu should largely mimic that for seasonal flu, the CDC says.

    For now. And remember, like seasonal flu, cases can grow in a hurry.

    A hundred cases of swine flu in the U.S.? Health officials say there are likely more. Just how many is not important, they say. As the world faces a potential pandemic, swamped labs are not testing all possible cases. Getting an exact tally has taken a back seat to finding new outbreak hot spots or ways to limits its spread, health officials said.

    "The specimens are coming in faster than they can possibly be tested," said Dr. Jeffrey P. Davis, state epidemiologist in Wisconsin, where a lab helped spot the nation's first known case, in a 10-year-old boy from San Diego.

    But you knew that.

  • We'll have a pandemic, but not just yet.

    More countries will get to stick their fingers in this pie because the virus is spreading rapidly. Lab-confirmed cases are up to 236 from 148 yesterday; and three more European countries have joined the list: the Netherlands, France (with a probable case), and Switzerland. Peru and Costa Rica are now flu zones, too. Even a member of President Barack Obama’s security team is suspected of catching swine flu during a recent visit to Mexico with the president. Because of this spread, Angus Nicoll, head of ECDC’s influenza program, said today that it’s "inevitable" that WHO will raise the alert level from pandemic phase 5 to 6, and "it’s just a question of when that will happen." But WHO said the situation hasn’t changed yet: "There is nothing that epidemiologically suggests today that we should be moving towards phase 6," said Keiji Fukuda, WHO’s assistant director-general for health security and environment, in a briefing.

    "There’s a backlog of several thousand specimens that need to be tested," said Fukuda.

    We wrote about a high-throughput laboratory here. Keiji Fukuda's comment shows why we need one.

  • Another good summary of epidemiologists and ID docs.
  • Media Matters:

  • Trust for America's Health (TFAH) today re-issued a series of It's Not Flu As Usualguides on pandemic flu preparedness for families, businesses, medical providers, and community groups.

    "Worry and fear will not protect us -- knowing the facts and planning ahead will," said Jeff Levi, PhD, Executive Director of TFAH.  "All of us want to do the right things to protect ourselves and our families in the event of a health emergency. These guides provide information that can help prepare for not just for a potential pandemic flu outbreak, but also for many other types of health emergencies."

  • Want to talk H1N1 risk communication? These people do it for a living.
  • Are we writing too much about influenza? Public health expert Cervantes at Stayin' Alive thinks so.

    So why do we spend so much attention here to pandemic flu and so little to what public health is really all about? That’s an interesting question which I will address anon- assuming anybody cares.

    Me, I think we can multitask. But if you agree with either one of us, donate to the people who watch for emerging diseases all over the world. The International Society for Infectious Diseases runsProMED mail, the internet sentinal site, and they could use the help.

  • WaPo:

    The Democratically controlled Congress yesterday easily approved a $3.4 trillion spending plan, setting the stage for President Obama to pursue the first major overhaul of the nation's health-care system in a generation along with other far-reaching domestic initiatives.

  • The Hill:

    A new public insurance plan is an essential part of reforming the U.S. healthcare system, 16 Democratic senators declared in a letter to two powerful committee chairmen Wednesday.

    The letter was addressed to the two senators expected to shape healthcare reform legislation; Senate Health, Education, Labor and Pensions Committee Chairman Edward Kennedy (D-Mass.) and Senate Finance Committee Chairman Max Baucus (D-Mont.).

Originally posted to Daily Kos on Fri May 01, 2009 at 06:20 AM PDT.

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Comment Preferences

  •  Closing schools... (17+ / 0-)

    for a short period (just longer than the incubation period) is actually a great, proactive public health action. The cycle of infection gets cut off, and it can sometimes nip an "epidemic" (using the term colloquially, not scientifically) in the bud.

    A few days of school in Texas can be made up. Just breaking the infection chain is really effective. Unfortunately, today's parents seldom have emergency child care provisions, and there is some collateral danger for children who are left alone or in the care of barely-mature siblings.

    But I've been surprised at people who think that closing schools is some Macchiavelian action. It's just a tool to break an infection chain, and often works like a charm.

    Quidquid latine dictum sit, altum viditur.

    by MrMichaelMT on Fri May 01, 2009 at 06:23:09 AM PDT

  •  any real conclusive science yet (1+ / 0-)
    Recommended by:

    on the alleged Smithfield Farms-flu connection?

    I've been following science blogs and haven't seen any yet.

    (0.12, -3.33) who what where why how when. think.

    by terrypinder on Fri May 01, 2009 at 06:24:19 AM PDT

  •  Great info, but the spellcheck police have a (1+ / 0-)
    Recommended by:

    minor nit:

    It's "commonly", not "comonly". It wouldn't be worth mentioning, but it's literally the first thing you see, and I imagine this summary will get passed along and seen by a lot of people.

    "It's not enough to be right. You still have to use your nice voice." -said by my then six-year-old daughter; "Love binds us all."-willb48

    by be the change you seek on Fri May 01, 2009 at 06:26:20 AM PDT

  •  I'm all for closing schools where cases have been (9+ / 0-)

    confirmed. However, yesterday on our local news, a school was closed and the parents organized a football game for the kids! So here we have just what the district was trying to prevent with large gatherings of students. So, closing a school alone doesn't cut it, parents need to be educated about precautions to take while the school is closed.

    He's with stupid, I'm with THAT ONE.

    by expatinparis on Fri May 01, 2009 at 06:26:25 AM PDT

  •  Do you know how happy this paragraph makes me? (12+ / 0-)

    The Democratically controlled Congress yesterday easily approved a $3.4 trillion spending plan, setting the stage for President Obama to pursue the first major overhaul of the nation's health-care system in a generation along with other far-reaching domestic initiatives.

    Key words:

    • "Democratically controlled Congress"
    • "setting the stage"
    • "first major overhaul of the nation's health-care system in a generation"
    • "far-reaching domestic initiatives"

    Yes, I realise that's pretty much everything but the verbs and articles, but so be it!

    •  Yes we do want (6+ / 0-)

      what they have in Canada, Great Britain, France, Japan, and the rest of the civilized world - some form of Universal Health care under a single payer system.

      Looking back through the Bush years for his Positive Accomplishments is, for me, like picking through my toddler's diaper for the undigested corn. - Thers

      by MadRuth on Fri May 01, 2009 at 06:38:18 AM PDT

      [ Parent ]

    •  I'm happy too (0+ / 0-)

      I'm almost as happy to read this article as when I heard Barack Obama's remarks on March 4, 2009.  He made the remarks to open the healthcare summit.  Here's a link to the text of his remarks:

      He said that healthcare reform will happen THIS YEAR.  Yeah!

    •  There is that troubling $3.4 trillion part. (0+ / 0-)

      INflation can kill retirement savings as surely as Wall Street.

      Free speech? Yeah, I've heard of that. Have you?

      by dinotrac on Fri May 01, 2009 at 06:56:00 AM PDT

      [ Parent ]

      •  what retirement savings? (2+ / 0-)
        Recommended by:
        samddobermann, dinotrac

        For many middle-class Americans, retirement savings are already gone.  I'm in my 50s and I can remember the advice given to my age cohorts in our 20s and 30s.  Retirement will be based on: 1/3rd company-provided pensions; 1/3rd savings (a combination of your house plus investments in the stock market); and 1/3rd Social Security.  Well, company provided pensions are disappearing; even individuals who retired with company pensions are finding their pensions zeroed out (see: airline retirees as a large example).  The 401K's that replaced company provided pensions have dramatically reduced in value.  Same thing for your house and for your own personal investments.  The only leg left on the stool is Social Security .... and the Republicans have had their eye on destroying Social Security since its inception in the 1930s.  I don't think Obama and the Democrats will harm Social Security; however, Social Security is not enough to live a middle class retirement on.

        Meanwhile, my life, and, more importantly my medically needy son's life, depends on access to the healthcare system, an access that becomes more tenuous every year.  If it takes $3.4 trillion dollars, so be it.  I'm sure this nation has spent far more than $3.4 trillion on warmaking.  We can certainly afford to spend some money to keep our citizens alive.

        •  I don't have any either, but... (1+ / 0-)
          Recommended by:

          I'm in my 50s, too, so I undertand your predicament, but
          I remember the 1970s and have no desire to return to high inflation.

          I also have kids who may one day have kids of their own.  i would prefer not to lay land-mines at every corner.  Just because things haven't turned out well for me, I see no reason to chop my kids off at the knees.

          Free speech? Yeah, I've heard of that. Have you?

          by dinotrac on Fri May 01, 2009 at 07:10:47 AM PDT

          [ Parent ]

  •  Way overblown (2+ / 0-)
    Recommended by:
    freakofsociety, karmsy

    There are a lot of people in this country that are so excited about this I would bet that sales of lube and kleenex are way up over the last week.  This flu doesn't appear to be particularly contagious or we would be hearing of an exponentially increasing number of cases (like in the tens of thousands).  It also appears that this version of the flu is relatively mild in most people.  If we overreact to this, we run the risk of having people not take you seriously when a real pandemic does hit.

  •  Honestly, it isn't this one I'm worried about. (4+ / 0-)

    I'm more worried about this flu being a "dud" in the US, and then another one popping up that no one has had. (H5N1 for example)
    The worry comes that everyone will shrug that one off, and later on really wish they hadn't as it ravages the ignorant population. (A case of Peter yelling 'wolf!' once and then not listened to as the real wolf comes down to the village for a snack).

    Yes, Wingnuts. We ARE out to get you. (Preferable into the newly opened sanitariums that the mental health budgets will cover for).

    by RElland on Fri May 01, 2009 at 06:29:17 AM PDT

  •  Overexposure? (1+ / 0-)
    Recommended by:
    Abra Crabcakeya


    But the reason it's getting more play than chronic diseases that are actually more harmful is because of the novelty -- it's getting the news media blitz for the same reason a school shooting does while numerous homicides all over the country go mostly ignored.

  •  Will McCain suspend his campaign? (9+ / 0-)

    The Republican brand: "Consequences, schmonsequences, as long as I'm rich"

    by D in Northern Virginia on Fri May 01, 2009 at 06:34:45 AM PDT

  •  cheers to the Rays! Bulls!Boston Teams losing! (0+ / 0-)

    I er this is cheers and jeers right?

    oh excuse me, my bad O:

    i was just soooo excited from last night

    "Its the name on the front of the jersey that matters most, not the one on the back." Joe Paterno

    by surfdog on Fri May 01, 2009 at 06:35:08 AM PDT

  •  Pandemic (3+ / 0-)
    Recommended by:
    elfling, PsychoSavannah, raincrow

    A pandemic of the H1N1 virus may be a good thing....and with a very big IF.  If the strain is as mild as some virologists think, and I have read that it actually may be milder than the usual seasonal strain, then a pandemic will yield immensely valuable information on how a pandemic starts, spreads and the value of various mitigation efforts.  We are going to be hit by a mega killer pandemic sooner or later and the lessons learned in a mild pandemic will save many more lives later.  

  •  Yesterday, I saw some terrified little soul (3+ / 0-)

    wearing a surgical mask in public (!) here in Oakland. I thought, "I bet he watches Fox News."

  •  Gee, maybe if pandemic preparedness funding (5+ / 0-)

    had made it into the stimulus package, these labs would have been more, you know, prepared to handle the extra caseload. I wonder if Susan Collins would agree.

    Does this internet make me look fat?

    by pattyp on Fri May 01, 2009 at 06:45:00 AM PDT

  •  We dodge a bullet (2+ / 0-)
    Recommended by:
    samddobermann, Pris from LA

    We dodged a huge bullet in the past few days when it comes to the healthcare reform debate. President Obama gave an interview in the New York Times magazine a few days ago where he talked about end of life issues. He talked about his grandmother during the waning months of her life and how she needed a hip replacement even though doctors said that the hip replacement might bring on heart failure. Then he talked about the huge costs associated with caring for the chronically ill and those at the end of their life and then said this:

    Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

    I am amazed that the right wing hasn't picked up this interview. Ever since I saw this interview, I've been really worried that Republicans would demagogue what he said to take down healthcare reform. Remember how divisive the Terri Schiavo debacle was? I've been watching Fox News especially to see if anyone was talking about it and so far nothing. They seem more preoccupied with torture, the swine flu, Miss California, Arlen Specter and now David Souter's retirment. So again we dodged a real bullet that could have started the healthcare reform debate on a bad footing IMHO!!!

    I really want healthcare reform to succeed and I know how difficult it is going to be so anything controversial like this, I get really worried. Call me paranoid if you want, but I vaguely remember 1993-1994...

    •  But what he said was perfectly true (2+ / 0-)
      Recommended by:
      raincrow, Egalitare

      if being realistic will sink health care reform then there's no hope.

      Let the circular firing begin!

      by Grass on Fri May 01, 2009 at 06:54:26 AM PDT

      [ Parent ]

    •  We CANNOT successfully get REAL (3+ / 0-)
      Recommended by:
      samddobermann, raincrow, Pris from LA

      and meaningful Health Care reform if we attempt to dodge that issue. Every Western European Healthcare system has some body - either government employees or more commonly appointed recognized experts in the field - which designates or very strongly suggests "best practices."

      Does that mean that music or art therapy might not make the cut for authorized cancer treatment? Depends on if it is the primary treatment or a wholistic supplement to a broader treatment regime. Or that elective cosmetic surgery is going to be everyone's "right?" Most probably not.

      My point is we shouldn't pretend that hard choices and absolutes are not going attend real and meaningful Universal Health Care. The well-to-do will be able to pay out of pocket for any crazy "treatment" that they desire, and frankly we shouldn't suggest that everyone will get liposuction on demand. I'm more interested in creating a structure where every citizen and resident (legal or otherwise) is guaranteed to see a primary physician, a dentist and a optometrist as often as is recommended by generally accepted norms 'cause that ain't happening right now.

      Single Payer...NOW!!!

      by Egalitare on Fri May 01, 2009 at 08:09:36 AM PDT

      [ Parent ]

  •  Not lethal? (0+ / 0-)

    I saw something yesterday (a video -- can't find it now) saying that the new flu looks more or less like the old flu, and that it lacks an amino acide common to lethal flus.

    Apparently, it looks a lot like a 1957 flue, which might mean old-timers like yours truly have at least partial immunity.

    What is the current thinking, or does it change by the minute?

    Free speech? Yeah, I've heard of that. Have you?

    by dinotrac on Fri May 01, 2009 at 06:50:58 AM PDT

    •  I try to read up on this (3+ / 0-)
      Recommended by:
      samddobermann, Fabian, dinotrac

      on the flu blogs, etc, and my impression is that nobody knows for sure yet. The wheels of accurate study turn slowly. In the meantime, a lot of the ideas floating around are interesting but not necessarily evidence-based.

      Oops! I'm gonna need a whole new sig!

      by sillia on Fri May 01, 2009 at 07:09:57 AM PDT

      [ Parent ]

    •  Immunity (1+ / 0-)
      Recommended by:

      People who appear to know a lot about this insist that there is no immunity to this strain in the general population.  I have not seen data to support that assertion.  One of the articles linked in the diary indicates this strain has a common factor with the 1918 pandemic bug that could make it more dangerous for young people.  I think the current level of response is probably beyond appropriate, but I can understand why the CDC is concerned.

    •  thiat factoid does not mean (0+ / 0-)

      1957 flu (H2N2) has anything to do with this flu. it doesn't.

      if a yugo has a muffler like a BMW, they ain't the same car.

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

      by Greg Dworkin on Fri May 01, 2009 at 09:19:40 AM PDT

      [ Parent ]

  •  Sorry... (4+ / 0-)

    I just don't buy it-- 30,000 people die each year from the flu- a few people die from a new strain and we're in apocolyptic lockdown?  

    My worry is that we really WILL have a serious communicable illness and next time people won't believe its serious and follow recommendations- because it was such BS this time.

    Sorry- but that's how I see it.

  •  Closing schools but not halting flights out of (3+ / 0-)
    Recommended by:
    DeeDee001, ziggydove, dark daze

    Mexico is the clue to the hypocrisy.  Closing schools doesn't lead to economic loss so that's OK and good.  Grounding planes costs the airlines money so that's not OK.  And yet planes force folks to breath the same air for hours, schools can at least open windows.

    We're all one heartbeat away from Forever.

    by KS Rose on Fri May 01, 2009 at 06:56:51 AM PDT

  •  The kids in our house are throwing up (10+ / 0-)

    wish us luck.

    Freedom isn't free, but don't tax me. Fox 527 on your dial.

    by 88kathy on Fri May 01, 2009 at 07:00:40 AM PDT

  •  World Flu Center: Mild strain, "seasonal" type. (4+ / 0-)

    BBC report also provides good explanation of flu strains. Much better media coverage by BBC. More info, less panicked "ambulance chasing" tone than US media.  BestFlu Tracking Map.

    Analysis done so far suggests what they are dealing with is a mild virus and nowhere near as dangerous as the H5N1 avian flu strain that has caused scientists so much concern over the past decade.

    Northwestern University "worst case" computer simulation of 1700 total US cases looks to be accurate based on relatively slow spread of H1N1/2009.

    The flu panic by US media may hurt public reaction should the more dangerous H5N1 flu strain break out.  People won't take precautions as quickly while the virus will be both more contagious and more virulent.

    •  but but (0+ / 0-)

      but its sweeps week and cable news is hurting for advertising, they desperately need national inquirer type bullshit to play on the idiots out there who still believe anything people say on TV.

      This just in, .. Bad shit is happening all the time, 24/7 ,you either accept it and go on with your life, or you become a cowering irrational human.  Take your pick.

      (regarding the bank mess) They want to cure the patient but not deal with the disease.

      by dark daze on Fri May 01, 2009 at 07:17:45 AM PDT

      [ Parent ]

      •  US media is "Hallmark media". (4+ / 0-)

        Self created events like "The First Hundred Days" or "Flu Pandemic" or "Cute white child is (fill in terrible blank)".

        US media is almost pure sensationalism, little information.

        Best example is the BBC coverage of the flu vs. US. BBC had a tracking map up based on WHO confirmed H1N1/2009 cases. It was quickly clear from the map and the WHO hard data that the flu was behaving like typical seasonal flu, not very virulent nor contagious.

        US media and right wing politicians were calling for closing Mexican border.

        Watch, soon the US media will be criticizing US health officials for "over reacting" when it was the US media that over reacted as it always does due to its poor journalistic ability and sensationalist, commercial nature.

    •  US media never understands public health.. (7+ / 0-)

      .. so it shouldn't be a surprise.

      Stuff like this happens, and public health workers (as is our job) start to scurry around like a disturbed anthill.  

      Then, all of the sudden, the media notices the activity, like a baby noticing a jingling set of car keys..

      "OOOO ... look ... what's going on over there..?"

      And all hell breaks loose, making our job harder beause half the population panics ("it's the end of the world!"), and the other half gets totally dismissive ("it's all a conspiracy to keep us down!").

      Did I mention I love my job???  :)

      REAFFIRMED as a second-class citizen since Nov 4, 2008!

      by Timoteo on Fri May 01, 2009 at 07:29:42 AM PDT

      [ Parent ]

    •  An Important Statement About Overreacting (1+ / 0-)
      Recommended by:

      Several here have cautioned that people may not listen when there is a really serious outbreak.  If the current response turns out to be overreaction, IT COULD DO MORE HARM THAN GOOD.

    •  most flu professionals (1+ / 0-)
      Recommended by:

      caution you on models. check science insider from AAAS.

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

      by Greg Dworkin on Fri May 01, 2009 at 09:23:09 AM PDT

      [ Parent ]

  •  Props to DemFromCT... (10+ / 0-)

    ... absolutely doing a stellar job at keeping on top of this.

    And it makes me grin to see him quoting former and current public health colleagues in DK frontpage articles!

    This isn't a public health over-reaction ... it's public health working the way it is supposed to work!

    Thank god we weren't facing this epidemic 12 months ago.  I hate to think how the 'leadership' at the federal level would have responded.

    REAFFIRMED as a second-class citizen since Nov 4, 2008!

    by Timoteo on Fri May 01, 2009 at 07:19:11 AM PDT

  •  I think that is the only thing I've ever agreed (0+ / 0-)

    w/ Scarborough about.

    Those other commentators are disgusting filth.

    Why do Hannity, Beck and Limbaugh hate America?

    by NYCgrl on Fri May 01, 2009 at 07:22:19 AM PDT

  •  Taking Public Health Departments for granted (5+ / 0-)

    Remember when the Utah State Legislature considered getting rid of the public health department?

    Well, well.  Isn't THIS a teachable moment.

    But for a man who says one of his top goals is raising the profile of public health -- and who fended off a short-lived challenge by some lawmakers this year to dismantle his department -- the emerging threat is in some ways welcome.

    "It might sound weird, but I'm kind of glad we periodically have challenges like this because it makes people appreciate [the job of public health] and not take it for granted," Sundwall said Tuesday in his office before taking a call from Gov. Jon Huntsman Jr. and heading to his now-daily telephone swine flu briefing with the federal Centers for Disease Control and Prevention.

    Damn Straight.

  •  Swine flu isn't kosher. (5+ / 0-)

    There's been some weird talk about how calling swine flu swine flu insults Jews and Mulsims. Well, it shouldn't. Flu isn't kosher to begin with.

  •  On the Hill piece re: public option-- (2+ / 0-)
    Recommended by:
    samddobermann, Pris from LA

    I am sick to death (no, not literally!) of using the "liberal" label to describe anything that's uh, popular and sensible, like cheaper, more accessible effective healthcare.

    You know who's on that list?

    * Jay Rockefeller. Liberal? Oh, yeah, standard-bearer for the liberal wiretapping plank in the Democratic party platform, from liberal Mecca West Virginia.

    *And Kirsten Gillibrand! You know, from NY-20, the reddest district in NY, which the Democrat won by a few hundred votes (not a few percentage points, like you'd expect in a "liberal" stronghold). Unless Michael Steele's fail is so contagious it retroactively turned her into Barbara Boxer on the way into the Senate, Gillibrand is a pro-business, gun-friendly Senator like her colleagues.

    Hell, if they wanted to be honest, they would have called it a "leftist" policy, since it has Bernie Sanders on board. Sanders isn't a liberal at all--them's fighting words! He's a socialist.

    Coal-fired media = fail.

    Republican "party": Party like it's 1929.

    by noabsolutes on Fri May 01, 2009 at 07:33:38 AM PDT

  •  Finance Committe CUTS Medicare. No reform in 2009 (1+ / 0-)
    Recommended by:
    Pris from LA

    In a clear signal that we will likely not get any health care reform in 2009, Senators Baucus (D) and Grassley (R) of Senate Finance Committee announced CUTS in Medicare services.

    Under guise of "reform" Senate conservatives are doing what they have done for the last 30 years, cut Medicare services by cutting payments for services to health care providers, doctors, hospitals, nursing care facilities.

    If Obama administration allows Senate Finance Committee to cut Medicare vs. the needed drastic expansion, then health care reform is dead in 2009. Even if Obama allows a "public option", health care providers will shun those who have it and will, as required by cuts, provide fewer services to "public option" clients.

  •  I agree that we can multitask (0+ / 0-)

    My complaint is, we aren't actually doing it.  Yet another health care Friday devoted entirely to influenza.  


  •  Without a doubt, DemFromCT.... (3+ / 0-)
    Recommended by:
    elfling, samddobermann, KimD

    ....your healthcare diaries and swine flu diaries are the very best.  It is incredible how much information and knowledge you can impart in one short diary.  If you compare what you write to the pages and pages of drivel we get in the see that your posts are the best.

  •  Damn panic-mongering pig flu cheerleaders... (1+ / 0-)
    Recommended by:


  •  Hey, uprate this story on MSNBC on Flu racism (1+ / 0-)
    Recommended by:
    Pris from LA

    it's well written and quite blunt about the xenophobia spreading faster than the flu. Right now their little article rating system is showing a low rating, likely because of what the story is writing about...

    see bottom of article to rate. Don't need to be signed in.

  •  Brochures not available from Trust for America's (0+ / 0-)

    Health website.  "doc not found."

  •  After reading a couple of the heated exchanges (4+ / 0-)

    within threads in this diary's comments , I wonder when the pandemic of shitty mental health is going to be addressed.Swine flu ,hell, something like mad cow disease seems more prevalent.

    •  sorry, I couldn't help myself ;-) (2+ / 0-)
      Recommended by:
      Fabian, Abra Crabcakeya

      (0.12, -3.33) I prefer facts and real science. conspiracy theories will be mocked :)

      by terrypinder on Fri May 01, 2009 at 07:51:10 AM PDT

      [ Parent ]

      •  I went back & read your comments - nothing crazy (3+ / 0-)
        Recommended by:
        samddobermann, Fabian, terrypinder

        about suggesting that someone read reputable sources of usually accurate information instead of revelling in their own ignorance. Can't fault you there , TerryP. Yesterday I went to(damn , may have been the day before , actually , can't give out false info and bullshit the public , can we?)the small business owned by a friend and sat chewing the fat for a while. He is devoutly religious , yet told me that he hoped people would have enough sense to keep themselves and their kids home from church if "this flu thing does look to get pretty bad".This fellow is an x chief of police , a Republican , and , devout Southern Baptist , yet otherwise dislays uncommonly good sense about most everythnig.He has the right idea , most likely.Same as with lesser evils , such as local outbreaks of gutbugs.Don't spread it.

        •  it seems to me the only people really (5+ / 0-)

          freaking out are

          1. the people on the blogs demanding the closure of borders and grounding of flights (or the round of of immigrants, or the arrest of Smithfield Farms CEOs, or the end of NAFTA, etc.)
          1. the people who are misunderstanding (Egypt killing all its pigs)
          1. the people freaking out over the freakout

          everyone else seems to have some common sense about them. In our office, we prefer you stay home if you're sick, period even though the official rules are to conserve your sick time. The nice payout you might get from conserving that sick time isn't worth infecting your co-workers with whatever bug you might have. I did that once and never heard the end of it. I mean stuff needed to get done but in hindsight, we weren't shorthanded and I probably should have just stayed home. Now, whenever I'm sick, I stay home. No one else needs my cold.

          (0.12, -3.33) I prefer facts and real science. conspiracy theories will be mocked :)

          by terrypinder on Fri May 01, 2009 at 08:14:34 AM PDT

          [ Parent ]

  •  The link to TFAH works. (0+ / 0-)

    But the links to the various brochures/pages are dead ends.

    The real enemy of the good is not the perfect, but the mediocre.

    by Orange County Liberal on Fri May 01, 2009 at 08:23:09 AM PDT

  •  Apparently the Mexican Gvt has dropped in half... (2+ / 0-)
    Recommended by:
    Fabian, Pris from LA

    The number of suspected Pig Flu deaths to about 84...saying the others were caused by other ailments. They have now apparently ceased providing likely death figures under pressure because their numbers are unreliable...


    Simple math tells you there are large numbers of people who have contracted the virus and simply did not go to the doctor, probably because their symptoms were not severe enough. There is no other way to explain the number of people here and abroad, returning from Mexoco, who have come down with it.

  •  Yay for the public option letter! Thanks Sens... (1+ / 0-)
    Recommended by:
    Pris from LA

    A big thank you to the following Senators who drafted and/or signed the letter to Senators Baucus and Kennedy in support of the public option:

    - John Rockefeller

    - Sherrod Brown

    - Dick Durbin

    - Chuck Schumer

    - Tom Harkin

    - Daniel Inouye

    - Carl Levin

    - Jack Reed

    - Debbie Stabenow

    - Bernie Sanders

    - Bob Casey

    - Jim Webb

    - Sheldon Whitehouse

    - Jeff Merkley

    - Ted Kaufman

    - Kirsten Gillibrand

    Democratic Senators from all over the spectrum are on record in support of the public option. Let's keep fighting for its inclusion in this year's Health Care Reform bill!

    Special thanks to my Senator, Jeff Merkley. Keep making us Oregonians proud, Jeff! (BTW, where's Ron?)

    Check out Future Roots for organic rock'n'roll goodness from Oregon...

    by ozretiro on Fri May 01, 2009 at 09:19:19 AM PDT

  •  The bright side of H1N1 (at least so far) (1+ / 0-)
    Recommended by:

    Looks like H1N1 flu is not particularly more virulent or destructive than seasonal flu. Unless we start seeing extremely dangerous/virulent mutations, I think we're going to come away from this feeling very, very lucky to have had another opportunity to mull over lessons learned, tighten up our response to epidemics, and increase general public knowledge about such matters.

    At the risk of speaking too soon, it seems that this could have been much, much worse.


    On a slightly different tack, I heard a CDC representative discuss how flu vaccination, over several years, helps recipients develop immunity to many molecular components of our seasonal flu strains, and that this gives people partial protection even to novel mutations of seasonal flu.

    If this is the case, now that it's plain we'll increasingly be exposed to bird and pig flu viruses, should we not begin incorporating bird and pig flu virus components into our annual seasonal flu shots and begin building up at least some degree of protection in anticipation of future outbreaks such as the current one?

    •  some assumptions there (1+ / 0-)
      Recommended by:

      theory of cross-protection not matched this year by in vitro results. But those discussions are avctive and ongoing. Single H1N1 vaccine or incorporate? How much antigen do you need to ge ta good response? with or without adjuvant (extra special sauce added to boost immune response to the vaccine)?

      Good points!

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

      by Greg Dworkin on Fri May 01, 2009 at 12:29:00 PM PDT

      [ Parent ]

      •  I should have done some surfing before (0+ / 0-)

        posting (not atypical for moi) -- looks as if there are some promising vaccine candidates based on 2 conserved internal virus proteins, synthetic DNA sequences, extra special sauces, etc. We might be fairly close to a pan-year, somewhat "broad-spectrum" influenza vaccine...

  •  May 5th : Sen. Max Baucus Round Table (1+ / 0-)
    Recommended by:


       Testimony of David U. Himmelstein, M.D. before the Health, Employment, Labor, and Pensions Subcommittee, at the hearing on "Ways to Reduce the Cost of Health Insurance for Employers, Employees, and Their Families," 23 April 2009

    Mr. Chairman, members of the Committee.  My name is David Himmelstein.  I am a primary care doctor in Cambridge, Massachusetts and Associate Professor of Medicine at Harvard.  I also serve as National Spokesperson for Physicians for a National Health Program.  Our 15,000 physician members support non-profit, single payer national health insurance because of overwhelming evidence that lesser reforms will fail.


    On Tuesday May 5th Sen. Max Baucus will host a roundtable discussion on Capitol Hill titled "Expanding Health Care Coverage."

    Max has invited 15 people to testify.


    Blue Cross Blue Shield.

    America’s Health Insurance Plans – the private health insurance industry lobby.

    The Business Roundtable.

    The Heritage Foundation.

    The Chamber of Commerce.

    And then anti-single payer inside the beltway corporate liberals like Ron Pollack, Andy Stern, Len Nichols, and AARP.

    •  Shit. We need to bombard Baccus with calls and (0+ / 0-)

      emails. I am so tired of this shit.

      I am also furious my 2 senators, NM, didn't sign on to the letter.

      We are in a time where it is risky NOT to change. Barack Obama 7-30-08

      by samddobermann on Fri May 01, 2009 at 11:37:02 AM PDT

      [ Parent ]

      •  resource (0+ / 0-)

        Tell Congress:
        Include Single-Payer in Health Reform Debate

      •  MONDAY: Dr. Howard Dean (0+ / 0-)

        Excerpt from Email:

        Dear MoveOn member,

        Urgent update on health care: Next week, Congress will begin making the actual decisions about what'll be in a health care reform bill.

        Meanwhile, conservative groups have launched a new assault on the president's proposal, including a million-dollar ad campaign claiming that health care will be rationed and "bureaucrats" will "decide the treatments you receive."1

        If real people like us don't get involved in this health care fight now, it could all fall apart. So we're holding an emergency online briefing on Monday night at 9 p.m. ET with Dr. Howard Dean to make sure we're all ready for the fight ahead, called "What we all need to know to win on health care this year."

        If fixing our health care system is important to you, this is an event you shouldn't miss. All you need to join in is a computer with an internet connection. Can you join us?

        Here are the details:

        What: Emergency Online Briefing with Dr. Howard Dean (Organized by MoveOn and Democracy for America)

        When: Monday, May 4, 9 p.m. ET/ 8 CT/ 7 MT/ 6 PT

        Where:'s web site

    •  Amazing (0+ / 0-)

      That he didn't invite the AHA spokesperson as well.

      I bet Obama smells like warm cookies, fresh from the oven.

      by dancerat on Fri May 01, 2009 at 07:06:39 PM PDT

      [ Parent ]

  •  Ummmm, DemFromCt, sweety, dear, dahling, maybe (1+ / 0-)
    Recommended by:

    you could change your sig line? Just for a while? Huh?

    Much as I appreciate both you and Groucho, that quote just kinda grates right now.

    We are in a time where it is risky NOT to change. Barack Obama 7-30-08

    by samddobermann on Fri May 01, 2009 at 11:51:51 AM PDT

  •  Ya know, I have been listening (3+ / 0-)
    Recommended by:
    DemFromCT, samddobermann, paxpdx

    to people complain about the media coverage of this Swine Flu.

    I will speak as a mother of young germ hosts.  I think this has been handled very well.  The heightened awareness is a beautiful thing from my POV.  

    As a mother who gets those letters in her daughters' homework folders stating a child in your class has tested positive for xyz.  As a mother who has been filled with dread knowing this letter is probably too late and I am going to have 1 maybe 2 sick children to care for in the next few day, I applaud what has been done.

    We are all in tune to our children right now.  They sneeze we send them to go wash their hands.  They cough and every adult within 20 yards of that child say, Cover your mouth.

    This is good stuff and it will probably and has probably  stopped this from being a much, much larger and serious problem.
    Not to mention we probably will not have to arm wrestle each other for Tamaflu and THAT is a VERY good thing.

    •  may i jst say (0+ / 0-)

      this has been, will be, and should be geared for parents.

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

      by Greg Dworkin on Fri May 01, 2009 at 12:25:58 PM PDT

      [ Parent ]

      •  Can I ask you? (0+ / 0-)

        You mean the structure of the WHO, CDC etc.'s information?

        It would make complete sense to me.  Children to me, would seem to be the least controllable variable (left to independent devices and judgement) in an epidemic or pandemic.

  •  Closing the schools (0+ / 0-)

    What's good for the goose is good for the gander.  If closing schools makes sense now, even though no one of school age has yet reportedly died, because schools are such highly efficient engines of mass transmission, eventually, to those who are at risk, then it would make sense to keep down the attack rates every flu season.  Since it is unlikely that this swine flu will even get close to the >30,000 death toll we expect from annual flu, more lives are at risk, and could be saved, by applying this measure to annual flu than to this swine flu.

    The cost would be less for a predictable annual closing, from say December to March, because parents would have had the opportunity to make alternate care arrangements. There would essentially be no recurring costs beyond what we already incur by having the schools close from June to September, a time interval that does not have the added benefit of throwing a wrench into flu's cycle.  But this unplanned closure would be highly disruptive, and carry considerable social costs.

    The idea that this swine flu would have more of a wrench thrown into it by school closure than annual flu, or is more dangerous, and so there would be more benefit to throwing a wrench into it, is not convincing.  Look, annual flu has already solved the attack rate rate problem created by adaptive, mnestic immunity in its hosts.  It seems odd to worry that we need to take the benefit of school transmission away from swine flu, because it will notionally be expected to have a higher attack rate because our population hasn't seen it before, but don't need to do so for annual flu, when the latter routinely hits a phenomenal 20% attack rate.  Annual flu has mastered this trick of cycling its antigenic glycoproteins to get under our adaptive immune system's defenses, and we get the dominant strain every year based on what antigenic combination doesn't have much adaptive immunity in the host population.  Annual flu already has whatever attack rate advantage is conferred by population naivete, and is hobbled in comparison to human flu strains by not being adadpted to, you know, humans.

    There also seems to be this idea that naivete in the host population will also, in addition to higher attack rates, likely lead to a higher case-fatality rate, or in general to higher morbidity of each case.  Some notional cross-immunity is thought to be why annual flu is less deadly than this swine flu has been, at least in Mexico, or the 1918 flu was.  But such a mechanism is just a theory.  And the pattern of higher mortality in this swine flu in Mexico, and the 1918 event, where the 20-40 year olds are affected, not just in addition to the older and younger, as we might see if the mechanism was just generally higher virulence, but actually in preference to these groups with less overall immune reactivity.  This suggests that it's the immune system itself, in its response to swine flu, that is doing the killing.  The disparity between the mortality seen in Mexico in the 20-40 age group, vs the one death in a more typical age group here in the US, reinforces the suspicion of an auto-immune problem as the mechanism.  Perhaps there are some HLA types common in Mexico that present this swine flu's antigens in ways that provoke an immune attack on the lungs.  I trust that part of the search for answers includes HLA-typing the fatal cases.

    At an rate, I don't see why the harping on the differences between this event and annual flu, as if there were some population health advantage to be gained in emphasizing differences.  To the contrary, I think that public concern over this event, that I think all of us should admit will probably fizzle at levels of morbidity and mortality insufficient to maintain the public's prurient interest, should be channeled whenever possible to getting some permanent good done for annual flu.  I offer the suggestion that we close the schools every year for annual flu, by moving "summer" vacation to winter, not as some sort of reductio ad absurdam, as if to say, "Well, we don't shut schools for annual flu, so why do it now?", but rather as something that is likely well worth doing.  Maybe this swine flu will fail to fizzle so epically that it won't turn out to have been a false alarm to close the schools now.  We won't know until it's over.  But it seems to me that this event is extremely unlikely to even get close to the 36,000 fatalities that we can count on every year from the much more predictable annual flu.  Emphasizing the connnection of the risk-benefit analysis of closing schools for this event, with the analysis for doing the same for annual flu, would, it seems to me, not only at least potentially, especially if this event does turn out to be bigger than I think likely, get the school vacation moved to a time where it will help frustrate the annual flu, but also act as corrective and modulator of the inevitable backlash if we do close schools now, and the thing does turn out to be Swine Fizzle.

    The annual flu's death toll is plenty enough to convince me that we should do anything reasonable, like move school vacation, and like vaccinating everyone, not just high case-fatality groups, for flu every year, and not just as some crisis-management response to one-of events that will probably never cause a fraction of the annual toll.  I can't see throwing any opportunity to help move the ball on that front under the bus in some attempt to convince people that this event is categorically different.  And it seems to me a teachable moment to make this point to a public that has managed to get itself all worked up over 100 deaths, but every year swallows whole the camel of 36,000 deaths.

    The presidency must be destroyed.

    by gtomkins on Fri May 01, 2009 at 05:52:31 PM PDT

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