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  • Argentina's got a flu problem.

    “We are facing a grave problem here,” said Dr. Jorge Yabkowski, the president of the Federation of Health Professionals of Argentina. “Hospitals here have very limited capacity to deal with this epidemic.”

    On Wednesday, emergency rooms that normally receive 200 patients had to attend to 1,000, and in Buenos Aires Province the minister of health, Claudio Zin, said about 40 percent of health care workers were not showing up, either because they were ill or were concerned about catching the virus. The province had called up retired doctors and medical students to help out.

    See Disasters, Surge and Pandemics. This could be us in the fall.

  • Last Friday, I participated in a flu summit at NIH/National Library of Medicine. The all-day summit archive is on line here.
  • A further WH and cabinet level summit will take place at NIH on July 9.

    “Scientists and public health experts forecast that the impact of H1N1 may well worsen in the fall – when the regular flu season hits, or even earlier, when schools start to open – which is only five or six weeks away in some cases,” Secretary Sebelius said. “The goal of the Summit is to launch a national influenza campaign by bringing federal, state and local officials, emergency managers, educators and others together with the nation's public health experts to build on and tailor states' existing pandemic plans, share lessons learned and best practices during the spring and summer H1N1 wave, and discuss preparedness priorities.”

    We'll see what comes out of it, but there's no question the fall will be a difficult time, and preparing now for potential school closures is prident and necessary. From CIDRAP:

    Pandemicflu.gov and various health departments offer checklists on what individuals and families can do to get ready for a pandemic. They include:

    · Learn about pandemic H1N1 influenza, its symptoms, how it spreads, and how to prevent infections.

    · Stock up on water and non-perishable food. Although the recommendations vary from days' to months' worth, most experts agree it's important to have extra key supplies on hand.

    · Ensure you have a supply of your prescription medicines.

    · Keep other emergency and health supplies handy such as flashlights, manual can openers, face masks, and painkillers.

    · Make a list of people who are willing to help and can be contacted in case of emergencies.

    · Make plans for potential disruptions at work, curtailed social gatherings, and school closures (for example, is it possible to work from home if you are unable to go into work?).

    Other useful skills for pandemic preparedness include learning how to care for the sick at home, rehydration therapy, and isolation measures, said, Joy Alexiou, public information officer for the Santa Clara Department of Public Health in California.

    "Get things in order. Have the supplies in hand so you are not surprised when you go to the store and it's not there," said Alexiou, noting that in the first days of the HINI outbreak, some stores ran out of hand sanitizer.

    Fall will be here in just a few short weeks.

  • CNN:

    The new president of the American Medical Association, which represents the interests of the nation’s doctors, said Wednesday the group is open to a government-funded health insurance option for people without coverage.

    Dr. J. James Rohack told CNN that the AMA supports an “American model” that includes both “a private system and a public system, working together.”

    In May, the AMA told a Senate committee it did not support a government-sponsored public health insurance option.

    However, Kossack wbramh notes that the AMA's position is not so clear.

  • Ezra on the HELP bill:

    This goes back to my point the other day: For health reform in general and the public plan in particular, the composition of the health insurance exchanges is arguably the single most important policy question. The larger the exchanges, the more people who will have access to a competitive insurance market (including the public plan). But the easier you make it for employers to access the exchanges, the more health reform costs because more people use government subsidies, and the more people "lose" their current coverage because their employer buys into the exchange option.

  • Kaiser.orgon Schumer and the public option:

    Sen. Charles Schumer, D-N.Y., a member of the key Senate Finance Committee and advocate for a government-run health insurance plan, said yesterday he would abandon all other possible compromises in favor of immediately creating a public plan that "would operate on 'a level playing field' with private insurers," CongressDaily reports. Other proposals have included a plan that would establish health insurance co-ops with government seed money or "trigger" the creation of a public plan only if private insurers fail to meet certain targets for containing costs and improving access.

Originally posted to Daily Kos on Fri Jul 03, 2009 at 06:16 AM PDT.

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Comment Preferences

  •  Effect Measure on H1N1 animal research (6+ / 0-)

    It's unlikely this will be like a 1918 flu virus. But it doesn't have to be to cause a major problem. Constantly comparing it to 1918 isn't the point. The point is that this is an influenza pandemic, and that's bad enough

    http://scienceblogs.com/...

    "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 Jul 03, 2009 at 04:40:19 AM PDT

    •  to illustrate the point (2+ / 0-)
      Recommended by:
      terabytes, Curiosity

      translation re Argentina:

      [Interview with Hugo Amor, the president of the Association of Health Professionals from the Province of Buenos Aires (CICOP-CTA).]

      Do you agree with the closure of schools?

      The suspension of those classes that have been suspended is a correct measure it cuts the chain of infection, especially by pointing out what might come after, which is the transfer of contingents of students traveling at the end of classes to provinces have have few cases. This [closure] prevents the spread.


      What measures should complement the formal decision?

      This provision would be supplemented with other measures such as standardizing the treatment that was implemented in Chile. In Argentina we have the protocols but they were not implemented due to lack of antivirals. The treatment [protocol] indicates that anyone suspected of suffering from flu and fever persists should be treated with antivirals and their close contacts. This is not being met because the amount of drugs, at least in many places, is not what is needed. [snip]

      What is the status of the hospitals?

      Hospitals are overwhelmed. If they usually work at capacity [then] in an epidemic situation they are totally collapsed. The therapies [treatment rooms?] are filled, no places for the patients and obviously there are delays in care.

      http://www.newfluwiki2.com/...

      "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 Jul 03, 2009 at 04:42:30 AM PDT

      [ Parent ]

      •  The main problem in Argentina (0+ / 0-)

        is not influenza, but influenza panic.  The vast majority of those people undoubtedly do not need to go to the ER, and obviously the health care providers should be showing up for work. And it is not appropriate to treat everybody with flu like symptoms, and their close contacts, with antivirals.  They don't have enough to do what they shouldn't be doing anyway.

        Argentina would have far less of a problem if they just weren't grossly overreacting.  That's the bottom line here.

        •  this moderate category 2 pandemic (4+ / 0-)
          Recommended by:
          CalifSherry, stitchmd, BlueSue, terabytes

          will likely lead to 3-5 times the usual number of deaths with seasonal flu, and in contrast to seasonal flu (usually over 65), the deaths will predominantly be in young adults. Attributing all the flu problems in the world to panic is not only inappropriate but counterproductive to proper preparations for the US.

          Overreacting is also counterproductive, but it's hard to see where that's actually happening, since no one in the US that doesn't work for CNN is actually panicking.

          We'll see if next week's WH conference can hit the sweet spot.

          "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 Jul 03, 2009 at 07:18:42 AM PDT

          [ Parent ]

          •  What leads you to believe this... (0+ / 0-)

            The morbidity rate so far is quite in line with seasonal flu, perhaps less. And WHO says there is no evidence so far the virus is mutating...

            Is this an estimate based on a presumption the virus will mutate to make it more lethal?

            Also, would you recommend folks get the pneumonicoccal(sp) vaccine to mitigate potential problems with pneumonia should they get the flu?

          •  Or are you assuming a larger number infected... (0+ / 0-)

            With the rate being the same

            •  a larger number will be infected (0+ / 0-)

              because of lack of pre-existing immunity, and ferret studies show higher morbidiy, similar infectivity (one study shows less infectivity than seasonal flu, others are similar). The WHO working group suggests parallels to 1957.

              "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 Jul 03, 2009 at 07:59:52 AM PDT

              [ Parent ]

      •  The status of hospitals is what worries me (2+ / 0-)
        Recommended by:
        CalifSherry, terabytes

        Hospitals are overwhelmed. If they usually work at capacity [then] in an epidemic situation they are totally collapsed.

        We have no excess capacity in our hospitals any more, not that we ever had much. We do not have enough nurses nor enough beds. In Baltimore, where we have 2 (some say 3) major medical centers and multiple other hospitals, emergency departments go on diversion all the time because of a lack of beds. This does not bode well.

        If anyone needs any elective procedures, don't put them off if you can do them now - they will be the first thing to get postponed or canceled if hospitals need the beds.

        Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

        by stitchmd on Fri Jul 03, 2009 at 07:08:12 AM PDT

        [ Parent ]

  •  Better send Gov. Sandford down there. (3+ / 0-)
    Recommended by:
    lirtydies, terabytes, Curiosity

    .
    He's already got the lay of the land.

    He might even pay his own way.

    He's going Air Lingus. It's like air guitar.

    What's more, ELVIS VS. DUBYA!!!
    .

  •  Interesting worldwide mapping of H1N1 Swine Flu (1+ / 0-)
    Recommended by:
    CalifSherry

    on FluTracker

    For NYC, Channel 13 (WNET) is covering it here: Swine Flu H1N1 Virus News Updates and Information

  •  Argentina, huh? (0+ / 0-)

    $5 says Sanford brought it there.


    We need to get back to bedrock American values like torture and secession. - Josh Marshall

    by AlyoshaKaramazov on Fri Jul 03, 2009 at 06:37:17 AM PDT

  •  Looks like I'll be getting a flu shot soon! (0+ / 0-)

    And thanks DemFromCT for putting this together. It's interesting to read this news. I didn't know that Argentina was experiencing this epidemic right now. Your postings, as always, keep me well informed. We appreciate your hard work here. Peace!

    Please support equality in California: http://www.couragecampaign.org

    by Curiosity on Fri Jul 03, 2009 at 06:38:41 AM PDT

  •  Any chance for a flu vaccine before the fall? (0+ / 0-)

    It would be wonderful if we had a vaccine before schools are back in session.  

    •  nope (1+ / 0-)
      Recommended by:
      stitchmd

      and when it comes, it will be in short supply and rationed.

      "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 Jul 03, 2009 at 07:19:34 AM PDT

      [ Parent ]

      •  which means, of course, (0+ / 0-)

        that you and I will likely be the "guinea pigs," right?

        Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

        by stitchmd on Fri Jul 03, 2009 at 07:21:09 AM PDT

        [ Parent ]

        •  you got it (0+ / 0-)

          and I am most interested in whether the vaccine will be adjuvant or straight up.

          if adjuvants like squaline or MF-59 are added, you can stretch supply, but add risk for reactions.

          "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 Jul 03, 2009 at 07:27:38 AM PDT

          [ Parent ]

      •  Actually (0+ / 0-)

        we probably will have a vaccine in mass production by the end of summer. The main issue will be concern over its safety. The 1976 vaccine (the last time this flu strain was a major threat) had a rare but dangerous side effect in that it could cause a paralytic condition. So the question will be how many people forgo the vaccine out of a fear of  repeat of that.

      •  From what I have seen this is not yet set... (0+ / 0-)

        There may be a large vacccination campaign for late in the fall. It seems several companies have successfully produced vaccine and one or two have advanced the technology allowing them to produce it at an accelerated rate.

        Seems like the debate is how health agenices are going to handle the overwhelming demand.

        •  one of several debates (0+ / 0-)

          it won't all come on line at once, so:

          do we use it at all?

          who gets it? and who gets it first?

          one shot or two?

          how do we give it? It will not be through your doc's office (can't handle demand, some don;t have insurance)

          "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 Jul 03, 2009 at 08:02:30 AM PDT

          [ Parent ]

      •  I'm not allowed to take 'flu shots any more (1+ / 0-)
        Recommended by:
        CalifSherry

        Having experienced a severe allergic reaction in 2007, I'm forbidden by my doctor to have any more 'flu shots.  So what can I do to protect myself?  I'm retired, which is one good thing--less exposure to public places.  I'm pretty housebound during the week because I take care of my granddaughter while her parents work.

        Should I boost my immunity by eating even better than I normally do?  (Lots of fruit and vegetables, little meat, some chicken and fish.)  Should I start eating yogurt every morning instead of just occasionally?  My granddaughter was born in February of this year.  She spends 95 percent of her time either here or at her parents' house--how much danger is she in?

        Equal "rites" for ALL Americans!

        by Diana in NoVa on Fri Jul 03, 2009 at 08:19:57 AM PDT

        [ Parent ]

  •  My concern about insurance exchanges (3+ / 0-)
    Recommended by:
    CalifSherry, Andiamo, Abra Crabcakeya

    ... is that, if participation is optional, they will become the more expensive risk pool. If an employer can get a better deal on the private market -- and with younger, healthier workers they usually can -- then the cost of participating in the exchange may keep it yet again out of reach of the very people who are uninsured today. Those people aren't necessarily less healthy, but they are the self-employed, those working for small businesses, and the inadvertently unemployed.

    And remember: If you don't like the news, go out and make some of your own. - Scoop Nisker, the Last News Show

    by North Madison on Fri Jul 03, 2009 at 06:41:10 AM PDT

    •  adverse selection.. (1+ / 0-)
      Recommended by:
      CalifSherry

      Thats what you're talking about, and yes, it is THE big worry that everyone has about insurance plans that attract sick people but then become increasingly too expensive for the healthy as they raise rates.

      The whole thing about more people being cheaper only works if those more people are healthy.

      More sick people does NOT equal cheaper, it eaquals more expensive.

      Healthcare should NOT be expected to "show a profit" when it deals with the sick.

      "Rationally, single payer is the best system","our system is the worst, most expensive and least effective." - Ex-President Bill Clinton

      by Andiamo on Fri Jul 03, 2009 at 07:06:10 AM PDT

      [ Parent ]

  •  Would you please keep the hype in check (0+ / 0-)

    Dear Demfromct,

    I thought Avian flu was supposed to be the big, scary pandemic? What happened? Remember? That was the strain of flu that the last I checked had not even verifiably killed a single bird, much less a person on the North American continent. I guess the utility of the using the avian flu for extracting public funds  for boondoggle measures just petered out.

    According to the CDC, 36,000 people die every year of the flu in the US. I checked this morning and the CDC is saying 172 people have died from Swine flu so far in the US.

    My guess is that the appearance of swine flu hasn't made a statistically significant difference in either flu mortality or morbidity yet you keep on banging the drum that this is a significant health threat.

    Now we are buying hundreds of millions of doses of an untried vaccine that has not been tested for efficacy or safety. And at a cost of billions.

    The last time we had a swine flu hysteria in the Carter administration a rushed vaccine program ended up killing more people than the disease.

    And from what I read the swine flu vaccine will contain mercury, a vaccine ingredient the USPHS and the AAP said should come out of vaccines as soon as possible back in the Clinton administration. I also read that in will contain MF-59 as an adjuvant. MF-59 has been linked to Gulf War Syndrome and a wide range of adverse reactions. And has never been used in a recommended vaccine in the US before.

    On what basis are we dispensing with the safety procedures that took decades of struggle to get in place? Are you concerned that millions of people will be used essentially as guinea pigs for no demonstrable benefit?Aren't you even the least bit concerned that a lot of this is motivated by making a quick buck by the drug firms that are already reaping huge, no risk rewards from all this hype?

    Do you really think this is the best use of scarce public health dollars?

    •  This isn't the most dangerous phase (2+ / 0-)
      Recommended by:
      CalifSherry, stitchmd

      This particularly virus, historically, has a one-two punch.  The first is a light jab, the second a knockout.

      Whether the threat materializes or not, the system created to respond to it is still a good investment because it can be used to deal with other threats, including some that materialize suddenly.

      However, it is important to be very clear and accurate in describing threats, to avoid the "cry wolf" response, whereupon the public becomes so jaded that they fail to take any warnings seriously.

      •  He's right on that.. (1+ / 0-)
        Recommended by:
        CalifSherry

        Thats what happened in 1918

        "Rationally, single payer is the best system","our system is the worst, most expensive and least effective." - Ex-President Bill Clinton

        by Andiamo on Fri Jul 03, 2009 at 07:09:25 AM PDT

        [ Parent ]

      •  On the other hand... (0+ / 0-)

        It is not responsible to only present one side of the potential track of the disease. So far the mobidity rate is equal to or smaller than seasonal flu. And there is just as good a chance that there won't be a significant second wave. It doesn't happen with every pandemic.

        Comparisons to the 1918 flu without context are also irresponsible. Conditions are far different now than they were then, and it is a different virus. It is just as, or more, likely this virus will track to the 1968 pandemic.

        •  actually you are wrong on your facts (2+ / 0-)
          Recommended by:
          CalifSherry, Deep Harm

          all 4 of the last pandemics had subsequent wqaves. No guarantee, but highly likely we will see this as well.

          And this is not the same morbidity as seasonal flu. it's not only worse, it hits a younger cohort.

          "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 Jul 03, 2009 at 07:56:52 AM PDT

          [ Parent ]

          •  How can you say that? (1+ / 0-)
            Recommended by:
            CalifSherry

            What is the morbidity rate of the current virus?

            We have about 250 deaths in the US with over 1 million infections...if the estimates are to be believed...

            How does that compare to previous pandemics...

            •  that's what the data suggests (0+ / 0-)

              Swine flu caused more-severe illness in ferrets than seasonal flu, according to two studies in the journal Science that help explain why the H1N1 virus causes symptoms not seen in regular flu such as nausea and vomiting.

              The H1N1 swine flu virus went further into the ferrets’ lungs, and also penetrated the gastrointestinal tract while seasonal flu stayed in the nasal cavity, researchers from the U.S. and the Netherlands found. Ferrets are affected by flu viruses much as humans are, the researchers said.

              http://www.bloomberg.com/...

              Modeling studies suggest similarity to 1957.

              "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 Jul 03, 2009 at 08:15:10 AM PDT

              [ Parent ]

              •  But Ferrets are not people... (0+ / 0-)

                I know they are used due to thier similarity...but so far these predictions are not borne out in actual rates among those infected...

                Again if the estimate of infections is close to accurate...

                •  cfr (case fatality rate) is 0.46% in the US (0+ / 0-)

                  and close to 1 in Mexico and higher in Argentina. Globally it is 0.44%

                  see chart.

                  http://www.pandemicflu.gov/...

                  "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 Jul 03, 2009 at 09:32:42 AM PDT

                  [ Parent ]

                  •  I'm sorry I don't understand... (0+ / 0-)

                    THere ae about 250 confirmed deaths related to H1N1 in the US last I saw...

                    CDC is esitimating over 1 million infections so far

                    That is a .025 rate...

                    The chart you linked is not tracking actual cases but an estimate based on infection rates...

                    •  the cfr is based on known cases (0+ / 0-)

                      and estimates from CDC and WHO. You can't make up a number and decide your own cfr. Doesn't work like that.

                      Only when the event is over do modeling data give us better estimates. We don't know the actually cfr now, but that's part of the deal.

                      We are starting to see the estimated R0, which gives us an idea of infectivity. It's in line with other pandemics. But those are guesses as well.

                      The point is to prepare for that which you are not sure of, not to wait until you are sure (too late, then.)

                      "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 Jul 03, 2009 at 10:30:13 AM PDT

                      [ Parent ]

    •  Of course we need safe vaccines. (0+ / 0-)

      I don't know anything about the safety of the vaccine that's in the works right now. The problem is that we've had ideological politicians who aren't interested in honesty, logic, or science.  As a result, public health has sometimes been sacrificed to profits.  I hope this is changing, and changing fast.  I need to see Obama get passionate about something, and I'm still waiting.   He was so inspirational during the primaries, so what's happened to him?  He doesn't look very happy or enthusiastic about anything.    We need that in a leader.  I wonder if he has any health problems or what.  FDR was in a wheelchair, but that didn't stop him from shouting out his plans and putting his enemies in their proper place.  Of course, he made his mistakes too, but one might hope that we've learned from his and don't have to repeat them.  Please read Krugman today.

    •  Just one question.... (0+ / 0-)

      What if you are wrong?

    •  Not hype, not a conspiracy (2+ / 0-)
      Recommended by:
      terabytes, Abra Crabcakeya

      Avian flu in fact did kill many birds and killed people, although as you said it didn't kill anyone in North America.

      The flu virus is an interesting little bugger. Influenza viruses have 3 main hosts: pigs, birds, and humans. Most of the viruses are unique to the species, but sometimes they cross species. The reason they can then become a threat to the other species is that the receiving critter has no natural immunity. The factors that you then look at are how serious an infection the virus causes in the new host (for avian flu, very serious, high case-fatality rate; for swine flu, lower, at least so far) and whether it can be transmitted easily from individual to individual in the new species (for avian flu, very, very low transmission rate; for swine flu, it's clear it's very easily transmitted.)

      The problem becomes when you have a high lethality virus that is transmitted easily from person to person. The great worry is that the H1N1 virus, already easily transmitted, could become one that causes a more serious disease. The concern with the H5N1 was that it could develop the ability to be transmitted from human to human easily. Fortunately that hasn't happened, and the virus may have run its course in its native species.

      What safety procedures are you saying are being dispensed with? In fact, it's been the decimation of our public health system and keeping the hospital systems without any excess capacity that is likely to be the greatest risk if this does turn into a serious problem. That damage has already been done, almost deliberately over the last 30 years.

      Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

      by stitchmd on Fri Jul 03, 2009 at 07:19:36 AM PDT

      [ Parent ]

      •  If this isn't hype what is? (0+ / 0-)

        if you want investment in the public health care system then make a case for it without these mindless scare tactics that have been used for SARS, avian flu and now swine flu.

        Far more people have been killed by lightning strikes this year than avian flu. I have yet to see any explanation of why this flu strain is any different than the other strains that appear every year. Despite earlier claims,  H1N1 appears to be no more lethal than most flu strains.

        And the safety procedures being dispensed with are concocting an H1N1 vaccine containing new and untested ingredients, like MF-59, and some, like mercury, we already have expended great effort to try and get rid of. So we are taking a step backward.

        I believe that the avian flu vaccine will also be cultured on cell tissue lines derived from aborted fetal tissue, which will obviously present serious moral problems for a great many people. I am not sure that was a wise choice if the goal is to maximize acceptance of a vaccine.

        More and more people are beginning to think, with good reason, that the credibility of the public health establishment is squandering its credibility on this overstated flu scares. He have far more serious health issues than the flu that are almost completely ignored.

        •  um, (0+ / 0-)

          yeah, lightning strikes kill more people than avian flu, I tried to explain why above. We're not talking about avian flu, H5N1. We're talking about swine flu, H1N1.

          Mercury has already been shown to not be a problem. Given your user name, I'm not going there further, I'm not into a futile discussion this morning.

          And where in the world did you get the idea that flu vaccine is cultured on aborted fetal tissue? Flu vaccine is cultured in eggs.

          DemFromCt already mentioned the potential risks of using additives to expand a possible low supply of the vaccine. And as I said to him, it will be us health workers who will be the front line for the new vaccine, we will be the guinea pigs as it were. So if there's a risk, we'll see it first.

          Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

          by stitchmd on Fri Jul 03, 2009 at 08:25:15 AM PDT

          [ Parent ]

    •  Minor quibble (1+ / 0-)
      Recommended by:
      stitchmd

      The last time we had a swine flu hysteria in the Carter administration a rushed vaccine program ended up killing more people than the disease.

      This happened before Carter was president, during the Ford administration.

    •  at current rate and prediction of category 2 (0+ / 0-)

      around 90K-450K will die in the US (mostly younger patients) before it's over, unless we take steps to mitigate the illness. Your limited description of pandemics is incomplete. This flu will be with us for the next year, so you can't judge now.

      "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 Jul 03, 2009 at 07:49:08 AM PDT

      [ Parent ]

  •  Did Sanford go to Mexico then Argentina (0+ / 0-)

    Did he see one girlfriend in Mexico then go to Argentina to see another, is he to blame for the H1N1 breakout. How many other girlfriends in different countries did he visit.
    Hey Sanford stay home and you wouldnt be in the dog house and maybe the H1N1 flu wouldnt be so bad.

  •  Huge thanks for the summit link (1+ / 0-)
    Recommended by:
    terabytes

    and for all of the updates, a real feather in the cap of Daily Kos.

  •  Interesting to hear about Schumer (0+ / 0-)

    I'm on Twitter so if you'd like to follow my tweets, please do!

    by slinkerwink on Fri Jul 03, 2009 at 06:57:56 AM PDT

  •  n-acetylcysteine (0+ / 0-)

    reduces the severity of influenza if you get it, somewhat..

    Its a good thing to take.

    Its an "over the counter" supplement. You can buy it at GNC, etc.

    It also helps people who have allergies breathe somewhat.

    "NAC"

    "Rationally, single payer is the best system","our system is the worst, most expensive and least effective." - Ex-President Bill Clinton

    by Andiamo on Fri Jul 03, 2009 at 07:02:36 AM PDT

  •  Speaking of avoiding large public gatherings..... (0+ / 0-)

    there are elections this fall.

    Who will be there to wipe down/sterilize the electronic voting machines...

    Just wondering.

  •  Thanks for keeping us up to date on this - (1+ / 0-)
    Recommended by:
    DemFromCT

    surprisingly large numbers of commentors were making "much ado about nothing " remarks a couple of months back about influenza and the Fed Guv's reports. My viewpoint is from that of a retiree from public health , with 20 years' experience in service. You start getting to know when the noises being made indicate there is indeed a fire and it's time to wet down the roof.

  •  We have more to fear from (0+ / 0-)

    the media.  Not to undermine the seriousness of the virus, the media went way overboard with this the first time around and  scaring the hell out of people, and that was only with a few dozen cases initially.  Now, with more cases around the country and planet, the word "swine flu/H1N1" are rarely heard over the "breaking" Michael Jackson is still dead news.  I just wonder what will happen when it really does become a health emergency.  How will the media handle that?  If you guessed wall to wall fear coverage, you are probably not far from the truth.

    Keep your head up and be hopeful. Just remember to look at what you are stepping in once in a while...

    by trekguy66 on Fri Jul 03, 2009 at 07:19:05 AM PDT

  •  About the AMA...... (1+ / 0-)
    Recommended by:
    lirtydies

    The new president of the American Medical Association, which represents the interests of the nation’s doctors

    Didn't I read that only 25% of the nation's doctors are members of the AMA?  

    The vast majority of Americans think that the vast majority of doctors are AMA members, as if they truly speak for all American doctors.  

    I'm so glad that CNN continues to not surprise me by not doing any real reporting and perpetuating the myth of the AMA's actual influence.  

  •  Am I reading that right about Schummer. (0+ / 0-)

    Is he abandoning the Public Option in favor of a trigger option?

    If they put through a triggered co-op they will loose me forever.  Talk about stupid politics.  Why not just hand over the win to the Pubic Hairs in 2012?
    Tie it up with BOW.

    •  I don't think that's it. (2+ / 0-)
      Recommended by:
      CalifSherry, polar bear

      What's noticeable about Schumer is that he's putting his public option plan forward as an amendment in the Senate Finance Bill mark-up process. It means they're including the co-op plan in the main bill, and accepting amendments. Any Democrat that votes against the Schumer amendment should be targeted by us.

      I'm on Twitter so if you'd like to follow my tweets, please do!

      by slinkerwink on Fri Jul 03, 2009 at 07:47:50 AM PDT

      [ Parent ]

  •  "Stock up on water"? (0+ / 0-)

    Really?  Why would my faucets stop working in an outbreak?  I have the same question about flashlights.  Why would there be blackouts?

    I'm not anti-environmentalism, I'm anti-colonialism.

    by sneakers563 on Fri Jul 03, 2009 at 07:41:34 AM PDT

    •  Power generation facilities and public water (0+ / 0-)

      supply treatment plants do not run themselves. Both are in constant states of maintenance and repair,adjustment and human intervention.Any disease outbreak that has potential for even temporarily incapacitating as much as 30% of a population will severely impact the delivery of services.

      •  Highly, highly unlikely.... (0+ / 0-)

        Even if you go with the category 2 prediction. 30% of the population will not be sick all at the same time...

      •  I can't imagine (0+ / 0-)

        that power plants would be allowed to fail. That's got to be one of the last things that would be abandonned, about the same time they open the jails and shut down the hospitals-- and that would only be in an epidemic of such lethality that even the Black Death would look like an outbreak of psoriasis. To be sure, natural disasters like hurricanes and earthquakes (and ice storms etc.) do devastate the power grid so it is a good idea to have backup in case the lights go out for an extended time, but I don't see that being a danger in an epidemic unless we facing Stephen King's "The Stand".

    •  The idea is to (1+ / 0-)
      Recommended by:
      Abra Crabcakeya

      be able to stay out of public places - like grocery stores - for 10 days from the time you think you have a problem.

    •  if 30-40% of personnel are ill (3+ / 0-)

      critical infrastructure becomes vulnerable. water and electricity only work because it is constantnly being repaired. if the repair people are ill, expect outages and shortages.

      "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 Jul 03, 2009 at 08:17:56 AM PDT

      [ Parent ]

      •  Were there electrical and water disruptions (1+ / 0-)
        Recommended by:
        CalifSherry

        In 1957?

        •  estimates of vulnerablilty (1+ / 0-)
          Recommended by:
          Abra Crabcakeya

          come from DHS and the electric companies, not made up.

          http://uaelp.pennnet.com/...

          http://www.pandemicflu.gov/...

          "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 Jul 03, 2009 at 09:13:08 AM PDT

          [ Parent ]

          •  Well that wasn't really an answer... (0+ / 0-)

            The article you linked uses the 1918 pandemic as an example to illustrate the potential of disruptions...there is no indication we are headed to that type of situation...

            And I have to say, Dr. Osterholm is consistently the most "alarmist" about pandemic flu. Not that his viewpoints are not valid, but he seems nearly always to be on that end of the spectrum

            And of couse Homeland security plans for it...hat is their job...to plan for worst case scenarios...

            It is impssible for the average person to maintain a high level of alert all the time.

            My point is, if this pandemic tracks to the 1957 outbreak as you believe it will...I would like to know what disruptions occurred in 1957. Certainly that experience would be instructive now.

            •  the biggest disruption wouyld be to the medical (0+ / 0-)

              system, which has little surge capacity, but there would be spot disruptions of goods and services due to ill people.

              http://www.upmc-biosecurity.org/...

              Pandemic Flu Preparedness: Lessons from the Frontlines PDF

              Jeffrey Levi, Thomas V. Inglesby, Laura M. Segal, Serena Vinter
               

              This analysis by Trust for America’s Health (TFAH), the Center for Biosecurity, and the Robert Wood Johnson Foundation (RWJF) finds that the initial response to the H1N1 outbreak showed strong coordination and communication and an ability to adapt to changing circumstances from U.S. officials, but it also showed how quickly the nation’s core public health capacity would be overwhelmed if an outbreak were more severe or widespread. The brief includes 10 early lessons, 10 recommendations for addressing core vulnerabilities in U.S. pandemic flu preparedness, and financing options for creating surge capacity.

              Read the press release on TFAH’s website | Download the full report as PDF

              I don't think you are 'getting' that the more significant cases need to be planned for, rather than dismissed as 'oh, I can see a milder case happening and there's a range, so i needn't be concerned with worse scenarios'. That's just wrong headed thinking. Even something as simple as increased tamiflu resistance (beginning to be reported in Hong Kong, Japan and Denmark) makes things significantly worse. So would unpredictable changes in the virus.

              I also don't think you are 'getting' that this interdependent just-in-time world isn't 1957 and is more subject to disruption. In cities, for example, there's only 24 h of food in stores, and coal delivery is dependent on 24 hour coal trains, particularly in the midwest. The implication is obvious.

              I am sorry, but it was an answer. it's simply one you didn't like. But all of these scenarios have been modeled and studied from the World Bark to whO to CDC, not just by Mike Osterholm.

              "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 Jul 03, 2009 at 10:28:00 AM PDT

              [ Parent ]

              •  Of course they need to be planned for... (0+ / 0-)

                But the nature of the commentary here and elsewhere makes the base assumption that they will happen..

                And the advice to average folks is to assume they will happen...

                I'm not sure there is an appreciation for the level of stress that comes with constantly being on alert for the worst to happen. Eventually, rather than prepare, people are just going  to throw up their hands and figure there is nothing that can be done...and so won't prepare at all

                Pandemic flu is not the only potential crisis brewing, and it probably isn't even be the worst.

                The reason I push back on here is because I think there needs to be a better balance in how this stuff is presented to people and a more realistic representation made as to what can likely be expected.

                Certainly there is a possibility of disruption in electrical and water services...but a better presentation as to the likelihood of this happening needs to be made. The likelihood is not high if your assumption of a 1957 type pandemic is accurate.

                If it is assumed that every conceivable negative consequence of a pandemic will happen, there is no way the average person can physically or emotionally prepare for that.

                •  well, I don't agree with your characterization (1+ / 0-)
                  Recommended by:
                  Abra Crabcakeya

                  of how it's been presented by me, nor how you've been presenting your POV, which has been unhelpfully and diffusely negative. Not much of a "public service" on your part. I'd challenge you on your attitude whether it was hurricane prep or flu prep. "people can't handle it' is bullshit. Of course they can, so long as you tell them why.

                  I am not presenting only the worst case, or even the worst case at all, for that matter. This isn't 'sky is falling' stuff. I am advocating flexibility and prudent planning.

                  The reason for two weeks recommendation of supply is an all-hazard approach that everyone should do for reasons beyond flu prep. But the specific reason is that if a family member becomes ill, you don't want to go out and infect everyone else while you take care of them or yourself. Have what you need and stay home. if you have less than two weeks, you won't explode in a cloud of green smoke. But you will be ahead of the game, and better prepared for the next nor'easter and the next blizzard. And there's really no reason why people can't or why they shouldn't.

                  At the same time, we have already seen disruptions locally because of school closures. makes more sense to plan for them than to ignore the likelihood they will happen in the fall. That means planning for alternate child care. Good idea, regardless of why schools close.

                  I didn;'t bring up critical infrastructure as a "it's going to happen" but there's no question that it might. None. That's why it's being planned for.

                  "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 Jul 03, 2009 at 10:55:46 AM PDT

                  [ Parent ]

                  •  Interesting... (0+ / 0-)

                    I'm not sure I cursed once in any of my posts...I don't believe I have insulted you, said you were wrong in your analysis, or denigrated you in any way...

                    I'm absolutely sure you do not believe the way I have characterized yours (and other)recommendations is accurate...I differ..

                    I'm not sure why you should be insulted by that...certainly this topic does not lend itself to cut and dried analysis or conclusions...but if you are I apologize. Insulting you or denigrating the sevice you are providing was not my intent.

                    •  than I apologize to you in return (0+ / 0-)

                      there's a lot worth debating here, and much is not only unknown but unknowable. But planning ard preparation is necessary. We, as a nation and as a society at a local level, need to do these things. The issues are very real, and with only a few precious weeks left before fall, putting preparations off any longer is not a good thing to do.

                      Are we certain that there will be another wave? Never say never or always, but it is highly likely. Can we even count on the virus going away this summer? No. That's unheard of for seasonal flu, but this is not seasonal flu.

                      There's no such thing as a mild pandemic (that's an oxymoron). Act accordingly.

                      "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 Jul 03, 2009 at 11:28:40 AM PDT

                      [ Parent ]

  •  Obama has to take on Healthcare's "AXIS OF EVIL" (3+ / 0-)
    Recommended by:
    CalifSherry, Blutodog, polar bear

    Put simply, (1)the insurance industry, (2)big pharma, (3)the AMA, and (4)the GOP are allied in derailing real healthcare reform:

    http://www.mikemalloy.com/...



    These are the forces Obama is up against.            

  •  CBO's estimate of the revised HELP Committee bill (1+ / 0-)
    Recommended by:
    polar bear

    draft is now available to the public (.PDF):

    http://www.cbo.gov/...

    •  If there is a "Mandate" (0+ / 0-)

      prices will go UP, not down, as they have in Massachusetts.

      "Much of title I addresses health insurance coverage. Among other things,
      that title would: require all legal residents to have insurance; establish
      insurance exchanges (called "gateways") through which individuals and families could"

      i.e. would HAVE to, even if they do not even cover their costs adequately and affordably.

      "purchase coverage; set certain minimum requirements regarding the availability, pricing, and actuarial value of policies; and
      provide federal subsidies to substantially reduce the cost of coverage for some enrollees...."

      "Rationally, single payer is the best system","our system is the worst, most expensive and least effective." - Ex-President Bill Clinton

      by Andiamo on Fri Jul 03, 2009 at 09:13:33 AM PDT

      [ Parent ]

  •  Swine Flu Britain 100,000 cases a day (1+ / 0-)
    Recommended by:
    CalifSherry

    I was shocked to read this today in the British press:

       

    Swine flu to infect 100,000 a day by autumn

       SWINE flu is spreading so rapidly across Britain that there could be 100,000 new cases a day by the end of next month.

       The virus can no longer be contained, UK Health Secretary Andy Burnham said as he issued the alarming projection.

       It also emerged the virus could take five years to stamp out and that healthy young people could eventually die from swine flu.

    I wonder if we'll hear something similar after the summit.

  •  Public Plan and Ins. Industry (2+ / 0-)
    Recommended by:
    CalifSherry, porchdog1961

    I've been trying for at least several months, ever since I first saw it mentioned, to figure out just exactly why in the world I would give a shit if the entire insurance industry should wind up going broke because it "can't compete" with a government-sponsored Public Plan.  So far, nothing; I can't come up with a single solitary reason that I should worry the matter at all, at any level whatsoever.  Conclusion: reasons to be concerned do not exist. There are none. Period.

    •  When loggers and millworkers get displaced (0+ / 0-)

      by limits on logging or changes in technology, there are generous retraining plans available. If these insurance companies fold, I guess these folks are gonna have to suck it up and move on.

  •  Meanwhile, across the pond (1+ / 0-)
    Recommended by:
    peace voter

    British Health Secretary says Swine flu 'cannot be contained'
    From BBC World Service

    The rising numbers of swine flu cases mean trying to contain the virus is no longer an option, the government says.

    Ministers said the emergency response would now move to a new "treatment" phase across the UK as there may soon be 100,000 new cases a day.

    It means anti-flu drugs will no longer be given to the close contacts of those infected nor will lab testing be done to confirm cases.

    The move has been made to relieve the pressure on the health service.

  •  The Big Picture arguments about the health bill.. (2+ / 0-)
    Recommended by:
    CalifSherry, this is only a test

    I can't bring myself to care about them. I know it will be better for us all in the long run if we maximize the cost benefits. I know it will be better for the nation if we can maximize the number of people being covered. I know doing it right matters, because we won't likely get another chance for a long time.

    I just don't care.

    I'm unemployed and uninsured. All I care about right now is getting decent insurance that I know isn't going to drop me right when I need it the most.

    •  to clarify... (1+ / 0-)
      Recommended by:
      CalifSherry

      I was referring to Ezra's criticisms. They're noteworthy, to be sure, but I wanted to point out that while criticizing the proposal where justified is certainly helpful to the process, we shouldn't let it get in the way of actually getting this done.

      Schumer has it right. We're going to have a public plan, period.

    •  I agree with you 100% (0+ / 0-)

      To me, it's bizarre that we're putting so much energy into whether or not there is a public option to be offered at some point in the distant future, and nobody's talking about the fact that the whole health reform bill doesn't start until 2013!  That's ridiculous, and it's what progressives should really be upset about.  Bad politics, bad policy.  We need to get help to people now, and I don't care if it's a public option, a private option, or an alien option run by the spaghetti people.

      •  2013? (0+ / 0-)

        LOL. oh sure Pres. Palin is really going to go for that. NOT! If it starts in 2013 it's just so much mental masturbation these klowns are putting everyone through. They had NO problem passing the Constitution destroying Patriot act that had been written by some RT. wing think tank and arrived whole cloth 5 mins. after 9/11. Hell these cowards didn't even read the damn thing! But, Health care Reform none of them want to touch it with a 10 ft. pole. 2013?? LOL! What joke on us!

        "It's better to die on your feet then live on your knees" E. Zapata

        by Blutodog on Fri Jul 03, 2009 at 09:03:50 AM PDT

        [ Parent ]

  •  new webinar (1+ / 0-)
    Recommended by:
    CalifSherry

    Learning to Live in a World with the H1N1 Pandemic
    http://smtp01.kff.org/...

    The CSIS Global Health Policy Center and the Henry J. Kaiser Family Foundation, in partnership with the Congressional Global Health Caucus, sponsored a briefing on the current H1N1 flu outbreak.

    The event featured two leading experts, Dr. Harvey Fineberg, president of the Institute of Medicine, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, discussing the current outbreak and the critical policy decisions that lie ahead, as the U.S. government, the World Health Organization, and other institutions attempt to ensure adequate preparedness.

    A podcast is also available.

    "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 Jul 03, 2009 at 08:30:41 AM PDT

  •  19 House Democrats threaten Pelosi (0+ / 0-)

    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 Fri Jul 03, 2009 at 08:59:12 AM PDT

  •  PO level playing field? (1+ / 0-)
    Recommended by:
    Abra Crabcakeya

    Schumers idea of a Public Option on a level playing field is nuts. The whole pt. is that such an option gives people a real choice not just another over priced        "bad option" A Robust PO would allow for a huge Public Pool to be formed giving this Option enormous bargaining power. Any PO that is forced to be just another bad Ins. policy is stupid. Schumer thinks he's being cute. He knows such a PO would be nothing more then a shell game. He's just protecting the Private Ins. guys with this non-plan. He thinks he can fool people with an Orwellian PO.

    "It's better to die on your feet then live on your knees" E. Zapata

    by Blutodog on Fri Jul 03, 2009 at 08:59:26 AM PDT

  •  the number of deaths attributed to Influenza (0+ / 0-)

    The CDC’s efforts and that of the nation’s health care system have made a concerted effort to cut the number of cases of influenza in the US. Influenza and Pneumonia, during the last decade, represented the 8th greatest cause of death in the US — 72,507 deaths out of 2,425,901 in 2006. Over the course of the last decade, the rate of deaths from all types of the influenza and pneumonia has steadily reduced from 23.4 deaths per every 100,000 people in 1999 to 18.8 in 2006.

    Lacey
    http://www.project.org

    •  it's a wonderful thing (thanks!) (0+ / 0-)

      though this next year may well take a statistical hit. Rebuilding surveillance and (especially) state and local public health (where the work is done) is key to further improvement.

      "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 Jul 03, 2009 at 03:17:24 PM PDT

      [ Parent ]

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