Swine Flu Cases Widen Reach With ‘Epidemic Curve’ (Update2)
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By Tom Randall and Lisa Rapaport
May 7 (Bloomberg) -- Swine flu may spread to at least one- third of the world’s population within the next year and a full- fledged pandemic remains possible, the World Health Organization said.
In two weeks, the flu jumped from isolated reports in the U.S. and Mexico to a widening circle of infections in Central America, South America, Europe, the Middle East, Asia and New Zealand. The disease has been confirmed in 2,371 people in 24 countries, with 44 deaths, the WHO reported today.
A panel of the Geneva-based agency will meet May 14 to decide whether drugmakers should begin producing hundreds of millions of doses of a vaccine against the new illness, a form of H1N1 influenza. Keiji Fukuda, the WHO’s assistant director- general of health, security and environment, said in a video broadcast from Geneva to Asian ministers in Bangkok today that more of the world’s 6 billion people will fall ill.
“Even if the illnesses appear relatively mild at the individual level, the global population level adds up to enormous numbers,” Fukuda said.
Fukuda declined to say how many deaths there might be in a full pandemic.
In the U.S., an outbreak in Illinois led to a jump in the number of confirmed cases to at least 896, the U.S. Centers for Disease Control and Prevention said today on its Web site. The cases include two U.S. deaths and may represent a fraction of those infected, officials said.
Not ‘Petering Out’
Illinois cases totaled 204, the agency said. Most of the surge is attributable to the state’s new testing capability, Illinois officials said. Before this week, only the CDC lab in Atlanta could definitively identify U.S. cases of swine flu. Test kits were delivered May 5 to laboratories in all 50 states.
“As we look at the data so far, we’re not seeing any sign that this is petering out,” Richard Besser, the acting director of the CDC, said today on a conference call. “We’re still in the upswing of what we call the epidemic curve. We see ongoing transmission and we expect that to continue.”
Hong Kong, which confirmed its first case of swine flu on May 1, and China are today releasing some people who were isolated after they were found to be on the same flight as an infected patient.
A 58-year-old Polish woman, that country’s first confirmed swine flu case, is recovering and the passengers on her May 2 flight from New York to Warsaw are being monitored for symptoms, Pawel Wierdak, a spokesman for the Polish mission to the United Nations in New York, said yesterday in an interview.
World Impact
Disease trackers are monitoring 88 cases in Spain and 34 in the U.K. to determine whether the virus has established itself outside North America. Such a finding would prompt the WHO to declare a pandemic, the first since 1968, the agency said.
The WHO panel next week will determine whether to go ahead with production of a swine flu shot and may later ask companies to stop making seasonal flu vaccines in order to free manufacturing capacity, said Marie-Paule Kieny, director of WHO’s initiative on vaccine research, at a news conference in Geneva yesterday.
“We are very early in the epidemic,” Kieny said. “We have recommended for all manufacturers to put everything into place to be able to start manufacturing the vaccines.”
Younger Patients
Data so far suggest that the virus affects youth more than seasonal influenza, and that younger patients are entering hospitals, Besser said yesterday. Few with swine flu are older than 60, and the median age is 16. It’s possible that older people have greater immunity or that younger people spread the disease on spring break vacation trips to Mexico, he said.
The CDC reversed U.S. school-closure recommendations that shut 468,000 students out of classes this week, saying schools should reopen and sick children should stay home. About 103,000 students returned to school yesterday, and it will take several days for most schools to reopen, the U.S. Education Department said.
The virus is milder than originally thought and has already rooted itself in communities across the country, making containment impossible, Besser said, explaining the school policy reversal. Even if symptoms remain mild, the ease with which the new virus spreads makes it a threat, he said.
The three main seasonal flu strains -- H3N2, another form of H1N1, and type B -- cause 250,000 to 500,000 deaths a year globally, according to the WHO. The new flu’s symptoms are similar: aches, coughing and fever.
Mexico City
Mexico City’s government planned to reduce its emergency alert level for swine flu today to “yellow,” or medium alert, from “orange,” or elevated warning, said Carolina Pavon, a spokeswoman for the city. The change could allow businesses such as bars, gymnasiums and theaters to reopen under the city’s sanitary guidelines.
Hong Kong has isolated 386 people under a seven-day quarantine imposed after they had contact with a 25-year-old man who flew in from Mexico by way of Shanghai and was tested positive for swine flu. The city released 28 people with no swine flu-like symptoms from the Lady MacLehose Holiday Village, Thomas Tsang, controller at Hong Kong’s Centre for Health Protection, said today.
China started allowing about 110 passengers on the same flight as the Mexican man to leave their hotels today after holding them under quarantine for seven days, the official Xinhua News Agency said, citing some of the people.
South Korea today confirmed its third case of swine flu.
Affected Countries
In addition to the U.S. and Mexico, swine flu has been confirmed in Austria, Canada, Colombia, Costa Rica, Denmark, El Salvador, France, Germany, Guatemala, Hong Kong, Ireland, Israel, Italy, the Netherlands, New Zealand, Poland, Portugal, South Korea, Spain, Sweden, Switzerland and the U.K.
The virulence of the swine flu may reveal itself when the Southern Hemisphere faces its influenza season beginning this month through September, Besser said. Scientists will watch the virus to see whether it becomes the dominant flu strain or mutates into a deadlier illness.
WHO determined that a swine flu shot would have to be made in separate plants from the seasonal flu version. The swine flu vaccine may also require a follow-up booster shot to be effective because it is an entirely new strain, Kieny said. The single-shot seasonal flu vaccine itself acts as a booster, reinforcing natural antibodies from previous flu exposures, health authorities said.
Vaccine Makers
Sanofi-Aventis SA of Paris, Baxter International Inc. of Deerfield, Illinois, and GlaxoSmithKline Plc of London are talking with world health authorities about producing shots, the agency said.
Baxter received a sample of the virus from the WHO and is taking steps to produce a vaccine, Chris Bona, a company spokesman, said today in an interview.
The U.S. Food and Drug Administration yesterday licensed Sanofi’s new vaccine plant in Swiftwater, Pennsylvania, the agency and the company said in separate statements. Sanofi said the new plant can produce 100 million doses of seasonal flu vaccine when it is operating at full capacity and the company’s Sanofi-Pasteur unit can produce another 50 million doses at its older Swiftwater facility.
Authorities advised hand washing, hygiene and staying home if sick as the most effective ways to control the outbreak. The WHO and CDC said closing borders or killing animals are costly steps that wouldn’t slow the spread of flu.
Friday, May 8, 2009
Friday, May 1, 2009
Mandatory Mass Vaccination in an event of Pandemic
1918 flu WAS preceded by mass vaccinations with typhoid shot and the people who got vaccinated were those who ended up getting sick with 'flu'.
Mass Vaccination Drill gives real shots
The Santa Clara County Public Health Department offered free flu shots as a way to test years of planning for a real-life medical emergency.
"This could be for anything where we really have to bring in large numbers of people and get them vaccinated or give them antibodies in a very short amount of time," public health officer Marty Fenstersheib said.
In Alameda County, a similar drill was carried out for first responders - police, fire and medical workers.
Government template for mass vaccination
It’s called “ring vaccination” or “traced vaccination” — a round ‘em up and vaccinate program forced on the population by the government. DHS and FEMA have plans in place to accomplish this, as D. H. Williams wrote for the Daily Newscaster in February. An Indiana county municipal official in the vicinity of Chicago revealed a plan to “vaccinate the entire population within 48 hours” as part of a Hazard Mitigation Plan (YouTube clip below).
During the legally mandated meetings held with FEMA and DHS different disaster scenarios were reveled to county officials:
• Every county in the nation would be required to prepare a Hazard Mitigation Plan.
• The county should prepare a plan to vaccinate the entire population within 48 hours and practice the plan several times.
• FEMA inquired to where mass graves could be placed in the county and would they accept bodies from elsewhere.
• The sheriffs department via the state sheriff association was told that no .223 ammunition rounds would be available as the military would be purchasing all stocks.
• The county was asked to make plans for hardening of police and fire stations, putting in hardened bunker type buildings around town.
• The county was asked to make plans for the possibility of up to 400,000 refugees from Chicago.
In 2006, a pastor came forward and told Alex Jones about a nationwide FEMA program designed to train religious leaders on how to pacify their flocks in the event of a national crisis. In addition to a declaration of martial law, property and firearm seizures, and forced relocation, the FEMA program envisions mass vaccinations. “In the event of an outbreak or a bio-terrorist attack, there’d be a mass vaccination… they have a program nationwide ‘Pills in People’s Palm In 48 Hours’,” an anonymous pastor told Jones.
In 2004, the Kansas Department of Health and Environment, along with ten county health departments, organized a series of exercises designed to assist local health department officials to exercise plans to mass vaccinate entire communities. It was dubbed “Flu-X” and it encouraged participants to get a flu shot.
Now we have a “template” to be used for mass vaccination. In a document released by the Regional Counter Terrorism Task Forces, “specific dispensing site operational plans and standard operating procedures” for mass vaccination are put forward:
The dispensing of medications/vaccine is a core function of the Strategic National Stockpile (SNS) plan and preparedness. It is the most complex and challenging of all the functions since large numbers of persons must be provided medication/vaccine in just a few days when an event occurs. The key to survival for most people is to provide antibiotics/vaccine as soon as possible and/or before an individual begins to show any clinical symptoms. This plan describes the dispensing of medications to a large number of people for prophylaxis(vaccination) of asymptomatic individuals as well as treatment of symptomatic persons.
Time Magazine Preps Americans For Mandatory Vaccinations
Says public should “trust” government when it institutes draconian measures to deal with pandemic
Time Magazine’s coverage of the swine flu scare has a noticeable subplot - preparing Americans for draconian measures to combat a future pandemic as well as forcing them to accept the idea of mandatory vaccinations.
In an article entitled How to Deal with Swine Flu: Heeding the Mistakes of 1976, the piece discusses how dozens died and hundreds were injured from vaccines as a result of the 1976 swine flu fiasco, when the Ford administration attempted to use the infection of soldiers at Fort Dix as a pretext for a mass vaccination of the entire country.
Despite acknowledging that the 1976 farce was an example of “how not to handle a flu outbreak,” the article still introduces the notion that officials “may soon have to consider whether to institute draconian measures to combat the disease.”
Later we discover exactly what this will entail, namely “when to institute mass vaccination programs,” according to Howard Markel, director of the Center for the History of Medicine at the University of Michigan and a historical consultant to the CDC on flu pandemics.
Markel notes that the less politically combustible situation in America today compared to the post-Watergate era of Ford would make such draconian measures more achievable.
“Even so, he says, citizens still need to trust that the government is working for the greater good,” adds the article. “The American public has to be forgiving and patient and do [their] part too,” according to Markel.
Americans would indeed have to be very trustworthy and ultimately forgiving in taking a vaccine by government decree manufactured by a company that was been caught red-handed contaminating their vaccines with far deadlier viruses than swine flu.
As we reported yesterday, Baxter International confirmed over the weekend that it is working with the World Health Organization on a potential vaccine to curb the deadly swine flu virus that is blamed for scores of deaths in Mexico and has emerged as a threat in the U.S., reports the Chicago Tribune.
As reported by multiple sources last month, including the Times of India, vaccines contaminated with deadly live H5N1 avian flu virus were distributed to 18 countries last December by a lab at an Austrian branch of Baxter.
Since the probability of mixing a live virus biological weapon with vaccine material by accident is virtually impossible, this leaves no other explanation than that the contamination was a deliberate attempt to weaponize the H5N1 virus to its most potent extreme and distribute it via conventional flu vaccines to the population who would then infect others to a devastating degree as the disease went airborne.
These are the people we are supposed to “trust” and “forgive” according to Time Magazine and Markel when the federal government breaks down our door, guns drawn and dripping needle in hand.
Markel says the political climate in the U.S. is much less combustible today than in the post-Watergate era, when Ford faced a skeptical public. Even so, he says, citizens still need to trust that the government is working for the greater good. He says, "The good news is that our surveillance, methodology and public health professionals have never been better. But we are human and mistakes may be made — as happened with the 1976 swine flu affair — and we may jump the gun in the hope of preserving life. The current outbreak is a situation in flux. The American public has to be forgiving and patient and do [their] part too."
An example of the Emergency Planning:
Pennsylvania Department of Health
Pandemic Influenza
· Treatment and Prevention: Vaccine
o Vaccine takes 6-8 months to produce following the emergence of a new virus.
o Supplies will be limited, if available at all.
o Establish priority groups for use of limited vaccine.
§ Two federal advisory committees provided recommendations on the use of vaccines and antiviral drugs in an influenza pandemic.
§ The Advisory Committee on Immunization Practices (ACIP)
§ The National Vaccine Advisory Committee (NVAC)
o 2nd dose after 30 days will likely be required.
o Need to monitor vaccine safety and efficacy.
Vaccine and Medication Distribution Workgroup
· Pandemic Influenza Planning incorporates the use of PODs
o PODs are a location the population will go in the event of needing to perform mass prophylaxis or mass vaccination
·
o Assumes enough vaccine or antiviral medication has been provided for the entire population
Confirmed larger then normal vaccine dose needed for immune response
Time is a critical factor.
Volunteer staffing in a POD (Point of Administration) to administer an antiviral/vaccine to the total population in 48-hours.
Mass Vaccination Drill gives real shots
The Santa Clara County Public Health Department offered free flu shots as a way to test years of planning for a real-life medical emergency.
"This could be for anything where we really have to bring in large numbers of people and get them vaccinated or give them antibodies in a very short amount of time," public health officer Marty Fenstersheib said.
In Alameda County, a similar drill was carried out for first responders - police, fire and medical workers.
Government template for mass vaccination
It’s called “ring vaccination” or “traced vaccination” — a round ‘em up and vaccinate program forced on the population by the government. DHS and FEMA have plans in place to accomplish this, as D. H. Williams wrote for the Daily Newscaster in February. An Indiana county municipal official in the vicinity of Chicago revealed a plan to “vaccinate the entire population within 48 hours” as part of a Hazard Mitigation Plan (YouTube clip below).
During the legally mandated meetings held with FEMA and DHS different disaster scenarios were reveled to county officials:
• Every county in the nation would be required to prepare a Hazard Mitigation Plan.
• The county should prepare a plan to vaccinate the entire population within 48 hours and practice the plan several times.
• FEMA inquired to where mass graves could be placed in the county and would they accept bodies from elsewhere.
• The sheriffs department via the state sheriff association was told that no .223 ammunition rounds would be available as the military would be purchasing all stocks.
• The county was asked to make plans for hardening of police and fire stations, putting in hardened bunker type buildings around town.
• The county was asked to make plans for the possibility of up to 400,000 refugees from Chicago.
In 2006, a pastor came forward and told Alex Jones about a nationwide FEMA program designed to train religious leaders on how to pacify their flocks in the event of a national crisis. In addition to a declaration of martial law, property and firearm seizures, and forced relocation, the FEMA program envisions mass vaccinations. “In the event of an outbreak or a bio-terrorist attack, there’d be a mass vaccination… they have a program nationwide ‘Pills in People’s Palm In 48 Hours’,” an anonymous pastor told Jones.
In 2004, the Kansas Department of Health and Environment, along with ten county health departments, organized a series of exercises designed to assist local health department officials to exercise plans to mass vaccinate entire communities. It was dubbed “Flu-X” and it encouraged participants to get a flu shot.
Now we have a “template” to be used for mass vaccination. In a document released by the Regional Counter Terrorism Task Forces, “specific dispensing site operational plans and standard operating procedures” for mass vaccination are put forward:
The dispensing of medications/vaccine is a core function of the Strategic National Stockpile (SNS) plan and preparedness. It is the most complex and challenging of all the functions since large numbers of persons must be provided medication/vaccine in just a few days when an event occurs. The key to survival for most people is to provide antibiotics/vaccine as soon as possible and/or before an individual begins to show any clinical symptoms. This plan describes the dispensing of medications to a large number of people for prophylaxis(vaccination) of asymptomatic individuals as well as treatment of symptomatic persons.
Time Magazine Preps Americans For Mandatory Vaccinations
Says public should “trust” government when it institutes draconian measures to deal with pandemic
Time Magazine’s coverage of the swine flu scare has a noticeable subplot - preparing Americans for draconian measures to combat a future pandemic as well as forcing them to accept the idea of mandatory vaccinations.
In an article entitled How to Deal with Swine Flu: Heeding the Mistakes of 1976, the piece discusses how dozens died and hundreds were injured from vaccines as a result of the 1976 swine flu fiasco, when the Ford administration attempted to use the infection of soldiers at Fort Dix as a pretext for a mass vaccination of the entire country.
Despite acknowledging that the 1976 farce was an example of “how not to handle a flu outbreak,” the article still introduces the notion that officials “may soon have to consider whether to institute draconian measures to combat the disease.”
Later we discover exactly what this will entail, namely “when to institute mass vaccination programs,” according to Howard Markel, director of the Center for the History of Medicine at the University of Michigan and a historical consultant to the CDC on flu pandemics.
Markel notes that the less politically combustible situation in America today compared to the post-Watergate era of Ford would make such draconian measures more achievable.
“Even so, he says, citizens still need to trust that the government is working for the greater good,” adds the article. “The American public has to be forgiving and patient and do [their] part too,” according to Markel.
Americans would indeed have to be very trustworthy and ultimately forgiving in taking a vaccine by government decree manufactured by a company that was been caught red-handed contaminating their vaccines with far deadlier viruses than swine flu.
As we reported yesterday, Baxter International confirmed over the weekend that it is working with the World Health Organization on a potential vaccine to curb the deadly swine flu virus that is blamed for scores of deaths in Mexico and has emerged as a threat in the U.S., reports the Chicago Tribune.
As reported by multiple sources last month, including the Times of India, vaccines contaminated with deadly live H5N1 avian flu virus were distributed to 18 countries last December by a lab at an Austrian branch of Baxter.
Since the probability of mixing a live virus biological weapon with vaccine material by accident is virtually impossible, this leaves no other explanation than that the contamination was a deliberate attempt to weaponize the H5N1 virus to its most potent extreme and distribute it via conventional flu vaccines to the population who would then infect others to a devastating degree as the disease went airborne.
These are the people we are supposed to “trust” and “forgive” according to Time Magazine and Markel when the federal government breaks down our door, guns drawn and dripping needle in hand.
Markel says the political climate in the U.S. is much less combustible today than in the post-Watergate era, when Ford faced a skeptical public. Even so, he says, citizens still need to trust that the government is working for the greater good. He says, "The good news is that our surveillance, methodology and public health professionals have never been better. But we are human and mistakes may be made — as happened with the 1976 swine flu affair — and we may jump the gun in the hope of preserving life. The current outbreak is a situation in flux. The American public has to be forgiving and patient and do [their] part too."
An example of the Emergency Planning:
Pennsylvania Department of Health
Pandemic Influenza
· Treatment and Prevention: Vaccine
o Vaccine takes 6-8 months to produce following the emergence of a new virus.
o Supplies will be limited, if available at all.
o Establish priority groups for use of limited vaccine.
§ Two federal advisory committees provided recommendations on the use of vaccines and antiviral drugs in an influenza pandemic.
§ The Advisory Committee on Immunization Practices (ACIP)
§ The National Vaccine Advisory Committee (NVAC)
o 2nd dose after 30 days will likely be required.
o Need to monitor vaccine safety and efficacy.
Vaccine and Medication Distribution Workgroup
· Pandemic Influenza Planning incorporates the use of PODs
o PODs are a location the population will go in the event of needing to perform mass prophylaxis or mass vaccination
·
o Assumes enough vaccine or antiviral medication has been provided for the entire population
Confirmed larger then normal vaccine dose needed for immune response
Time is a critical factor.
Volunteer staffing in a POD (Point of Administration) to administer an antiviral/vaccine to the total population in 48-hours.
Thursday, April 30, 2009
The Swine Flu Pandemic and Vaccine– Fact or Ploy?
As soon as Homeland Security declared a health emergency, 25 percent -- about 12 million doses -- of Tamiflu and Relenza treatment courses were released from the nation's stockpile. However, beware that the declaration also allows unapproved tests and drugs to be administered to children. Many health- and government officials are more than willing to take that chance with your life, and the life of your child. But are you?
Remember, Tamiflu went through some rough times not too long ago, as the dangers of this drug came to light when, in 2007, the FDA finally began investigating some 1,800 adverse event reports related to the drug. Common side effects of Tamiflu include:
* Nausea
* Vomiting
* Diarrhea
* Headache
* Dizziness
* Fatigue
* Cough
All in all, the very symptoms you're trying to avoid.
More serious symptoms included convulsions, delirium or delusions, and 14 deaths in children and teens as a result of neuropsychiatric problems and brain infections (which led Japan to ban Tamiflu for children in 2007). And that's for a drug that, when used as directed, only reduces the duration of influenza symptoms by 1 to 1 ½ days, according to the official data.
But making matters worse, some patients with influenza are at HIGHER risk for secondary bacterial infections when on Tamiflu. And secondary bacterial infections, as I mentioned earlier, was likely the REAL cause of the mass fatalities during the 1918 pandemic!
Where did This Mysterious New Animal-Human Flu Strain Come From?
Alongside the fear-mongering headlines, I've also seen increasing numbers of reports questioning the true nature of this virus. And rightfully so.
Could a mixed animal-human mutant like this occur naturally? And if not, who made it, and how was it released?
Not one to dabble too deep in conspiracy theories, I don't have to strain very hard to find actual facts to support the notion that this may not be a natural mutation, and that those who stand to gain have the wherewithal to pull off such a stunt.
Just last month I reported on the story that the American pharmaceutical company Baxter was under investigation for distributing the deadly avian flu virus to 18 different countries as part of a seasonal flu vaccine shipment. Czech reporters were probing to see if it may have been part of a deliberate attempt to start a pandemic; as such a "mistake" would be virtually impossible under the security protocols of that virus.
The H5N1 virus on its own is not very airborne. However, when combined with seasonal flu viruses, which are more easily spread, the effect could be a potent, airborne, deadly, biological weapon. If this batch of live bird flu and seasonal flu viruses had reached the public, it could have resulted in dire consequences.
There is a name for this mixing of viruses; it's called "reassortment," and it is one of two ways pandemic viruses are created in the lab. Some scientists say the most recent global outbreak -- the 1977 Russian flu -- was started by a virus created and leaked from a laboratory.
Another example of the less sterling integrity of Big Pharma is the case of Bayer, who sold millions of dollars worth of an injectable blood-clotting medicine to Asian, Latin American, and some European countries in the mid-1980s, even though they knew it was tainted with the AIDS virus.
So while it is morally unthinkable that a drug company would knowingly contaminate flu vaccines with a deadly flu virus such as the bird- or swine flu, it is certainly not impossible. It has already happened more than once.
But there seems to be no repercussions or hard feelings when industry oversteps the boundaries of morality and integrity and enters the arena of obscenity. Because, lo and behold, which company has been chosen to head up efforts, along with WHO, to produce a vaccine against the Mexican swine flu?
Baxter!11 Despite the fact that ink has barely dried on the investigative reports from their should-be-criminal "mistake" against humanity.
According to other sources,12 a top scientist for the United Nations, who has examined the outbreak of the deadly Ebola virus in Africa, as well as HIV/AIDS victims, has concluded that the current swine flu virus possesses certain transmission "vectors" that suggest the new strain has been genetically-manufactured as a military biological warfare weapon.
The UN expert believes that Ebola, HIV/AIDS, and the current A-H1N1 swine flu virus are biological warfare agents.
In addition, Army criminal investigators are looking into the possibility that disease samples are missing from biolabs at Fort Detrick -- the same Army research lab from which the 2001 anthrax strain was released, according to a recent article in the Fredrick News Post.13 In February, the top “biodefence” lab halted all its research into Ebola, anthrax, plague, and other diseases known as "select agents," after they discovered virus samples that weren't listed in its inventory and might have been switched with something else.
Factory Farming Maybe Source of Swine Flu
Another theory as to the cause of Swine Flu might be factory farming. In the United States, pigs travel coast to coast. They can be bred in North Carolina, fattened in the corn belt of Iowa, and slaughtered in California.
While this may reduce short-term costs for the pork industry, the highly contagious nature of diseases like influenza (perhaps made further infectious by the stresses of transport) needs to be considered when calculating the true cost of long-distance live animal transport.
The majority of U.S. pig farms now confine more than 5,000 animals each. With a group of 5,000 animals, if a novel virus shows up it will have more opportunity to replicate and potentially spread than in a group of 100 pigs on a small farm.
With massive concentrations of farm animals within which to mutate, these new swine flu viruses in North America seem to be on an evolutionary fast track, jumping and reassorting between species at an unprecedented rate.
Should You Accept a Flu Vaccine -- Just to be Safe?
As stated in the New York Times14 and elsewhere, flu experts have no idea whether the current seasonal flu vaccine would offer any protection whatsoever against this exotic mutant, and it will take months to create a new one.
But let me tell you, getting vaccinated now would not only offer no protection and potentially cause great harm, it would most likely be loaded with toxic mercury which is used as a preservative in most flu vaccines..
I've written extensively about the numerous dangers (and ineffectiveness) of flu vaccines, and why I do not recommend them to anyone. So no matter what you hear -- even if it comes from your doctor -- don't get a regular flu shot. They rarely work against seasonal flu...and certainly can't offer protection against a never-before- seen strain.
Currently, the antiviral drugs Tamiflu and Relenza are the only drugs that appear effective against the (human flu) H1N1 virus, and I strongly believe taking Tamiflu to protect yourself against this new virus could be a serious mistake -- for all the reasons I already mentioned above.
But in addition to the dangerous side effects of Tamiflu, there is also growing evidence of resistance against the drug. In February, the pre-publication and preliminary findings journal called Nature Precedings published a paper on this concern, stating15:
The dramatic rise of oseltamivir [Tamiflu] resistance in the H1N1 serotype in the 2007/2008 season and the fixing of H274Y in the 2008/2009 season has raised concerns regarding individuals at risk for seasonal influenza, as well as development of similar resistance in the H5N1 serotype [bird flu].
Previously, oseltamivir resistance produced changes in H1N1 and H3N2 at multiple positions in treated patients. In contrast, the recently reported resistance involved patients who had not recently taken oseltamivir.
It's one more reason not to bother with this potentially dangerous drug.
And, once a specific swine flu drug is created, you can be sure that it has not had the time to be tested in clinical trials to determine safety and effectiveness, which puts us right back where I started this article -- with a potential repeat of the last dangerous swine flu vaccine, which destroyed the lives of hundreds of people.
Topping the whole mess off, of course, is the fact that if the new vaccine turns out to be a killer, the pharmaceutical companies responsible are immune from lawsuits -- something I've also warned about before on numerous occasions.
Unfortunately, those prospects won't stop the governments of the world from mandating the vaccine -- a scenario I hope we can all avoid.
How to Protect Yourself Without Dangerous Drugs and Vaccinations
Watch the video above to see ridiculous 1976 commercials promoting Swine Flu shots.
For now, my point is that there are always going to be threats of flu pandemics, real or created, and there will always be potentially toxic vaccines that are peddled as the solution. But you can break free of that whole drug-solution trap by following some natural health principles.
I have not caught a flu in over two decades, and you can avoid it too, without getting vaccinated, by following these simple guidelines, which will keep your immune system in optimal working order so that you're far less likely to acquire the infection to begin with.
Optimize your vitamin D levels. As I've previously reported, optimizing your vitamin D levels is one of the absolute best strategies for avoiding infections of ALL kinds, and vitamin D deficiency is likely the TRUE culprit behind the seasonality of the flu -- not the flu virus itself.
This is probably the single most important and least expensive action you can take. I would STRONGLY urge you to have your vitamin D level monitored to confirm your levels are therapeutic at 50-70 ng. ml and done by a reliable vitamin D lab like Lab Corp.
For readers who are in the U.S., we [original writers of the article] hope to launch a vitamin D testing service through Lab Corp that allows you to have your vitamin D levels checked at your local blood drawing facility, and relatively inexpensively. We hope to offer this service by June 2009.
If you are coming down with flu like symptoms and have not been on vitamin D you can take doses of 50,000 units a day for three days to treat the acute infection. Some researchers like Dr. Cannell, believe the dose could even be as high as 1000 units per pound of body weight for three days.
However, most of Dr. Cannell's work was with seasonal and not pandemic flu. If your body has never been exposed to the antigens there is chance that the vitamin D might not work. However the best bet is to maintain healthy levels of vitamin D around 60 ng/ml.
BUT to keep this in perspective the regular flu, not the swine flu, has killed 13,000 in the US since January. But there is strong support that these types of figures are grossly exaggerated to increase vaccine sales. However, the fact remains that the regular flu at this point in time is FAR more dangerous than the swine flu and were you worried about the regular flu before the media started talking this up?
Avoid Sugar and Processed Foods. Sugar decreases the function of your immune system almost immediately, and as you likely know, a strong immune system is key to fighting off viruses and other illness. Be aware that sugar is present in foods you may not suspect, like ketchup and fruit juice.
Get Enough Rest. Just like it becomes harder for you to get your daily tasks done if you're tired, if your body is overly fatigued it will be harder for it to fight the flu. Be sure to check out my article Guide to a Good Night's Sleep for some great tips to help you get quality rest.
Have Effective Tools to Address Stress . We all face some stress every day, but if stress becomes overwhelming then your body will be less able to fight off the flu and other illness.
Exercise. When you exercise, you increase your circulation and your blood flow throughout your body. The components of your immune system are also better circulated, which means your immune system has a better chance of finding an illness before it spreads. You can review my exercise guidelines for some great tips on how to get started.
Take a good source of animal based omega-3 fats like Krill Oil. Increase your intake of healthy and essential fats like the omega-3 found in krill oil, which is crucial for maintaining health. It is also vitally important to avoid damaged omega-6 oils that are trans fats and in processed foods as it will seriously damage your immune response.
-- Wash Your Hands. Washing your hands will decrease your likelihood of spreading a virus to your nose, mouth or other people. Be sure you don't use antibacterial soap for this -- antibacterial soaps are completely unnecessary, and they cause far more harm than good. Instead, identify a simple chemical-free soap that you can switch your family to.
-- Eat Garlic Regularly. Garlic works like a broad-spectrum antibiotic against bacteria, virus, and protozoa in the body. And unlike with antibiotics, no resistance can be built up so it is an absolutely safe product to use. However, if you are allergic or don't enjoy garlic it would be best to avoid as it will likely cause more harm than good.
-- Avoid Hospitals and Vaccines. In this particular case, I'd also recommend you stay away from hospitals unless you're having an emergency, as hospitals are prime breeding grounds for infections of all kinds, and could be one of the likeliest places you could be exposed to this new bug. Vaccines will not be available for six months at the minimum but when available they will be ineffective and can lead to crippling paralysis like Guillain-Barré Syndrome just as it did in the 70s.
Remember, Tamiflu went through some rough times not too long ago, as the dangers of this drug came to light when, in 2007, the FDA finally began investigating some 1,800 adverse event reports related to the drug. Common side effects of Tamiflu include:
* Nausea
* Vomiting
* Diarrhea
* Headache
* Dizziness
* Fatigue
* Cough
All in all, the very symptoms you're trying to avoid.
More serious symptoms included convulsions, delirium or delusions, and 14 deaths in children and teens as a result of neuropsychiatric problems and brain infections (which led Japan to ban Tamiflu for children in 2007). And that's for a drug that, when used as directed, only reduces the duration of influenza symptoms by 1 to 1 ½ days, according to the official data.
But making matters worse, some patients with influenza are at HIGHER risk for secondary bacterial infections when on Tamiflu. And secondary bacterial infections, as I mentioned earlier, was likely the REAL cause of the mass fatalities during the 1918 pandemic!
Where did This Mysterious New Animal-Human Flu Strain Come From?
Alongside the fear-mongering headlines, I've also seen increasing numbers of reports questioning the true nature of this virus. And rightfully so.
Could a mixed animal-human mutant like this occur naturally? And if not, who made it, and how was it released?
Not one to dabble too deep in conspiracy theories, I don't have to strain very hard to find actual facts to support the notion that this may not be a natural mutation, and that those who stand to gain have the wherewithal to pull off such a stunt.
Just last month I reported on the story that the American pharmaceutical company Baxter was under investigation for distributing the deadly avian flu virus to 18 different countries as part of a seasonal flu vaccine shipment. Czech reporters were probing to see if it may have been part of a deliberate attempt to start a pandemic; as such a "mistake" would be virtually impossible under the security protocols of that virus.
The H5N1 virus on its own is not very airborne. However, when combined with seasonal flu viruses, which are more easily spread, the effect could be a potent, airborne, deadly, biological weapon. If this batch of live bird flu and seasonal flu viruses had reached the public, it could have resulted in dire consequences.
There is a name for this mixing of viruses; it's called "reassortment," and it is one of two ways pandemic viruses are created in the lab. Some scientists say the most recent global outbreak -- the 1977 Russian flu -- was started by a virus created and leaked from a laboratory.
Another example of the less sterling integrity of Big Pharma is the case of Bayer, who sold millions of dollars worth of an injectable blood-clotting medicine to Asian, Latin American, and some European countries in the mid-1980s, even though they knew it was tainted with the AIDS virus.
So while it is morally unthinkable that a drug company would knowingly contaminate flu vaccines with a deadly flu virus such as the bird- or swine flu, it is certainly not impossible. It has already happened more than once.
But there seems to be no repercussions or hard feelings when industry oversteps the boundaries of morality and integrity and enters the arena of obscenity. Because, lo and behold, which company has been chosen to head up efforts, along with WHO, to produce a vaccine against the Mexican swine flu?
Baxter!11 Despite the fact that ink has barely dried on the investigative reports from their should-be-criminal "mistake" against humanity.
According to other sources,12 a top scientist for the United Nations, who has examined the outbreak of the deadly Ebola virus in Africa, as well as HIV/AIDS victims, has concluded that the current swine flu virus possesses certain transmission "vectors" that suggest the new strain has been genetically-manufactured as a military biological warfare weapon.
The UN expert believes that Ebola, HIV/AIDS, and the current A-H1N1 swine flu virus are biological warfare agents.
In addition, Army criminal investigators are looking into the possibility that disease samples are missing from biolabs at Fort Detrick -- the same Army research lab from which the 2001 anthrax strain was released, according to a recent article in the Fredrick News Post.13 In February, the top “biodefence” lab halted all its research into Ebola, anthrax, plague, and other diseases known as "select agents," after they discovered virus samples that weren't listed in its inventory and might have been switched with something else.
Factory Farming Maybe Source of Swine Flu
Another theory as to the cause of Swine Flu might be factory farming. In the United States, pigs travel coast to coast. They can be bred in North Carolina, fattened in the corn belt of Iowa, and slaughtered in California.
While this may reduce short-term costs for the pork industry, the highly contagious nature of diseases like influenza (perhaps made further infectious by the stresses of transport) needs to be considered when calculating the true cost of long-distance live animal transport.
The majority of U.S. pig farms now confine more than 5,000 animals each. With a group of 5,000 animals, if a novel virus shows up it will have more opportunity to replicate and potentially spread than in a group of 100 pigs on a small farm.
With massive concentrations of farm animals within which to mutate, these new swine flu viruses in North America seem to be on an evolutionary fast track, jumping and reassorting between species at an unprecedented rate.
Should You Accept a Flu Vaccine -- Just to be Safe?
As stated in the New York Times14 and elsewhere, flu experts have no idea whether the current seasonal flu vaccine would offer any protection whatsoever against this exotic mutant, and it will take months to create a new one.
But let me tell you, getting vaccinated now would not only offer no protection and potentially cause great harm, it would most likely be loaded with toxic mercury which is used as a preservative in most flu vaccines..
I've written extensively about the numerous dangers (and ineffectiveness) of flu vaccines, and why I do not recommend them to anyone. So no matter what you hear -- even if it comes from your doctor -- don't get a regular flu shot. They rarely work against seasonal flu...and certainly can't offer protection against a never-before- seen strain.
Currently, the antiviral drugs Tamiflu and Relenza are the only drugs that appear effective against the (human flu) H1N1 virus, and I strongly believe taking Tamiflu to protect yourself against this new virus could be a serious mistake -- for all the reasons I already mentioned above.
But in addition to the dangerous side effects of Tamiflu, there is also growing evidence of resistance against the drug. In February, the pre-publication and preliminary findings journal called Nature Precedings published a paper on this concern, stating15:
The dramatic rise of oseltamivir [Tamiflu] resistance in the H1N1 serotype in the 2007/2008 season and the fixing of H274Y in the 2008/2009 season has raised concerns regarding individuals at risk for seasonal influenza, as well as development of similar resistance in the H5N1 serotype [bird flu].
Previously, oseltamivir resistance produced changes in H1N1 and H3N2 at multiple positions in treated patients. In contrast, the recently reported resistance involved patients who had not recently taken oseltamivir.
It's one more reason not to bother with this potentially dangerous drug.
And, once a specific swine flu drug is created, you can be sure that it has not had the time to be tested in clinical trials to determine safety and effectiveness, which puts us right back where I started this article -- with a potential repeat of the last dangerous swine flu vaccine, which destroyed the lives of hundreds of people.
Topping the whole mess off, of course, is the fact that if the new vaccine turns out to be a killer, the pharmaceutical companies responsible are immune from lawsuits -- something I've also warned about before on numerous occasions.
Unfortunately, those prospects won't stop the governments of the world from mandating the vaccine -- a scenario I hope we can all avoid.
How to Protect Yourself Without Dangerous Drugs and Vaccinations
Watch the video above to see ridiculous 1976 commercials promoting Swine Flu shots.
For now, my point is that there are always going to be threats of flu pandemics, real or created, and there will always be potentially toxic vaccines that are peddled as the solution. But you can break free of that whole drug-solution trap by following some natural health principles.
I have not caught a flu in over two decades, and you can avoid it too, without getting vaccinated, by following these simple guidelines, which will keep your immune system in optimal working order so that you're far less likely to acquire the infection to begin with.
Optimize your vitamin D levels. As I've previously reported, optimizing your vitamin D levels is one of the absolute best strategies for avoiding infections of ALL kinds, and vitamin D deficiency is likely the TRUE culprit behind the seasonality of the flu -- not the flu virus itself.
This is probably the single most important and least expensive action you can take. I would STRONGLY urge you to have your vitamin D level monitored to confirm your levels are therapeutic at 50-70 ng. ml and done by a reliable vitamin D lab like Lab Corp.
For readers who are in the U.S., we [original writers of the article] hope to launch a vitamin D testing service through Lab Corp that allows you to have your vitamin D levels checked at your local blood drawing facility, and relatively inexpensively. We hope to offer this service by June 2009.
If you are coming down with flu like symptoms and have not been on vitamin D you can take doses of 50,000 units a day for three days to treat the acute infection. Some researchers like Dr. Cannell, believe the dose could even be as high as 1000 units per pound of body weight for three days.
However, most of Dr. Cannell's work was with seasonal and not pandemic flu. If your body has never been exposed to the antigens there is chance that the vitamin D might not work. However the best bet is to maintain healthy levels of vitamin D around 60 ng/ml.
BUT to keep this in perspective the regular flu, not the swine flu, has killed 13,000 in the US since January. But there is strong support that these types of figures are grossly exaggerated to increase vaccine sales. However, the fact remains that the regular flu at this point in time is FAR more dangerous than the swine flu and were you worried about the regular flu before the media started talking this up?
Avoid Sugar and Processed Foods. Sugar decreases the function of your immune system almost immediately, and as you likely know, a strong immune system is key to fighting off viruses and other illness. Be aware that sugar is present in foods you may not suspect, like ketchup and fruit juice.
Get Enough Rest. Just like it becomes harder for you to get your daily tasks done if you're tired, if your body is overly fatigued it will be harder for it to fight the flu. Be sure to check out my article Guide to a Good Night's Sleep for some great tips to help you get quality rest.
Have Effective Tools to Address Stress . We all face some stress every day, but if stress becomes overwhelming then your body will be less able to fight off the flu and other illness.
Exercise. When you exercise, you increase your circulation and your blood flow throughout your body. The components of your immune system are also better circulated, which means your immune system has a better chance of finding an illness before it spreads. You can review my exercise guidelines for some great tips on how to get started.
Take a good source of animal based omega-3 fats like Krill Oil. Increase your intake of healthy and essential fats like the omega-3 found in krill oil, which is crucial for maintaining health. It is also vitally important to avoid damaged omega-6 oils that are trans fats and in processed foods as it will seriously damage your immune response.
-- Wash Your Hands. Washing your hands will decrease your likelihood of spreading a virus to your nose, mouth or other people. Be sure you don't use antibacterial soap for this -- antibacterial soaps are completely unnecessary, and they cause far more harm than good. Instead, identify a simple chemical-free soap that you can switch your family to.
-- Eat Garlic Regularly. Garlic works like a broad-spectrum antibiotic against bacteria, virus, and protozoa in the body. And unlike with antibiotics, no resistance can be built up so it is an absolutely safe product to use. However, if you are allergic or don't enjoy garlic it would be best to avoid as it will likely cause more harm than good.
-- Avoid Hospitals and Vaccines. In this particular case, I'd also recommend you stay away from hospitals unless you're having an emergency, as hospitals are prime breeding grounds for infections of all kinds, and could be one of the likeliest places you could be exposed to this new bug. Vaccines will not be available for six months at the minimum but when available they will be ineffective and can lead to crippling paralysis like Guillain-Barré Syndrome just as it did in the 70s.
Pandemic Influenza Planning Scenarios issued by NZ Ministry of Health
Issued by NZ Ministry of Health
http://www.med.govt.nz/upload/27552/planning-guide.pdf
Appendix 2: Pandemic Influenza Planning Scenarios
These scenarios are produced for planning purposes only. Scenarios deliberately represent extremes and are not predictions.
Scenario 1 – Pandemic Disease Recognised Overseas
It is a Friday before a holiday weekend, with fine weather forecast over the whole country.
For several weeks there have been many rumours and unconfirmed reports of large clusters of person-to-person spread of H5N1 in two south-east Asian countries – Sealand and Beeland. The situation in neighbouring countries is quiet, but in some regions the situation is unknown, with a total communications blackout from some provinces. The World Health Organisation (WHO) is intensively investigating, but has not yet confirmed person-to-person spread of H5N1 in any region, although the level of suspicion is high and increasing all the time. Nothing much else is happening in the world, so there has been intense and increasing interest in these developments from the world and New Zealand media.
Intensive surveillance in New Zealand has not found any evidence of H5N1 among the influenza-like illnesses that are normally present at low levels in the general population.
The Ministry of Health (MoH) has been monitoring the situation and has informed the health sector of the domestic and overseas situations through Code White (information) messages to District Health Boards (DHBs).
At 1200 on Friday, MoH receives information from the WHO in Manila that H5N1 influenza appears to have been responsible for a number of sudden deaths among Beeland citizens in the large capital city, Beeville. The people who died had no known exposure to infected poultry, or connection with the areas where H5N1 spread is suspected.
From Southern Beeland, there are unconfirmed reports of the sudden deaths of three German tourists who recently took a bus trip to the interior, and of influenza-like illnesses among other tourists. Some tourists are thought to have flown to Singapore or other regional destinations while unwell.
At 1230, while the MoH is attempting to verify the information received, CNN reports that “pandemic influenza has broken out in Beeland, and is causing many deaths in the slums of Beeville and the villages in the interior. Tourists have died, and many are ill”. The report also says that the Beeland government has denied that pandemic influenza is present.
MoH assembles its crisis team and identifies people for Co-ordinated Incident Management System (CIMS) team roles. By 1430 a Code Yellow (standby/warning) message has gone out to the health sector informing them of the situation. Also by this time, the WHO in Manila has confirmed the information received earlier that 120 people are ill in hospital, a further 30 are thought to have died of a new form of influenza and an unknown but “large” number are thought to be affected. It adds that a pandemic declaration will be made at 1600 New Zealand time.
Advice from the Australian Health Disaster Management Committee states that Australia has closed borders to all incoming flights.
MoH issues a Code Red message (pandemic alert) to the health sector at 1615, following the WHO declaration.
At 1630 the MoH national controller issues the first pandemic advice to the government.
The advice is:
. • To enable an effective response to be mounted, the Minister of Health should immediately unlock the special powers available to Medical Officers of Health, in the Health Act; and
. • To immediately close the border, for an indefinite period, to all incoming flights.
At 1800, the Government’s Ministerial-level Domestic and External Security Committee accepts all the Ministry of Health’s recommendations and directs the appropriate agencies to action them immediately.
Outline of likely Health Sector Actions
After unlocking of powers, Medical Officers of Health (MOoHs) have a wide range of special powers available to detain, quarantine or isolate people who have, or may have, infectious diseases.
At the time the border was closed there were 7 aircraft in the air enroute to New Zealand. For safety reasons they may land in New Zealand if the Captain decides that it is inappropriate to divert or turn back. All elect to continue, with 5 to land in Auckland and 2 for Christchurch.
Using the MOoH’s special powers, incoming passengers and aircrew will be held at the airports until health services carry out risk assessments and decide the most appropriate actions.
Outcomes could include:
1. 1. Encouragement of incoming foreign nationals to leave on the next available aircraft without entering New Zealand.
2. 2. Release of some low-risk incoming New Zealanders, with medication as required and arrangements for intensive follow-up by Public Health Units.
3. 3. Quarantine all the remaining passengers and aircrew for 8 days before allowing entry to New Zealand.
Planners should assume that it might take up to 24 hours, and possibly longer, to complete the processing of the people held at the airport, and/or make the necessary arrangements and dispositions. Health services will also review the health declarations of all passengers arriving from South East Asian airports within the last 4-5 days to assess the risks to New Zealand.
Passenger and contact tracing will be done if there are any grounds for suspicion. Surveillance will be stepped up to the highest possible state, especially in communities close to airports and on the normal tourist pathways.
MoH will make supplies of anti-viral medication available to assist with border management operations. Health staff resources will be made available by the appropriate District Health Board(s).
Scenario 2 – Cluster(s) in New Zealand
It is Mid-February. H5N1 influenza is now spreading person-to-person in Western Sealand. The virus is not yet an efficient spreader so there is no widespread outbreak, although several thousand people have been infected. The case fatality rate is very high, at about 20%. Many of the fatalities collapse and die within a short time of becoming symptomatic, mostly with cyanotic mottling and/or subcutaneous haemorrhage. WHO and the Sealand government are making strenuous efforts to contain the situation, with internal travel restrictions in place and draconian penalties for non-compliance with government directives.
H5N1 is known to exist in birds in many other parts of Asia, but intensive surveillance of these regions has not provided evidence of person-to-person spread. It appears the pandemic strain is contained in Sealand. WHO has not yet issued a world pandemic alert, although it has issued a regional alert for South East Asia and Sealand.
New Zealand borders are closed to Sealand nationals except for those who demonstrate that they are from unaffected regions, pass an exit screening examination in Sealand, and undergo health assessments on arrival in New Zealand. These people are mostly students, business people, and those with family in New Zealand. The flow of people from Sealand is low, because of Sealand government restrictions.
General tourist traffic from Asia is substantially reduced from normal because of uncertainties associated with the pandemic situation. Tourists from Asian countries other than Sealand are not undergoing health assessments at the border, although all aircraft are now required to inform authorities of the health status of people on board before arrival in New Zealand.
In New Zealand there is intensive surveillance concentrated on regions surrounding airports and the normal tourist trails.
On a Saturday afternoon, a Medical Officer of Health (MOoH) of Crossville (in the North Island) contacts the MoH. Two people of Asian extraction turned up at a local GP medical centre on Friday with influenza-like illnesses. They were assessed and swabs taken. They were provided with advice and then discharged.
At about 1100 on Saturday morning, one of these people was found dead in their motel. The hotelier rang the police as part of normal process. The other person cannot be found, and the car in which they came is missing, not having been seen since the night before. The two people had been in the motel for two days since arriving in the country.
The MOoH has seen the body, and noted cyanotic mottling and the fact that the person had been dead for some hours. He is very concerned. He has directed that the unit be sealed for the time being until full infectious disease precautions can be provided for the removal of the body to the morgue.
MoH assembles a CIMS team and informs the Minister of developments. As a number of conditions could be involved, it is decided to wait until results from swabs and a post-mortem become available before making any decisions. MoH liaises
with Police about the missing person and advises that if found, the person should be treated as infectious and appropriate precautions taken. MoH also alerts all DHBs and PHUs via a Code Yellow message.
During Sunday, several people present at a nearby Emergency Department (ED) had influenza-like illnesses. Most are itinerant market garden workers and backpacking tourists, living in various hostels and similar accommodation. None require admission. ED is taking full infection control precautions on MoH recommendation.
MoH also recommends that the after-hours surgery takes full infection control precautions, but can only recommend this, as primary care is essentially private business. MoH learns that about a dozen people have turned up at the after-hours surgery with flu-like symptoms, an unusual number for this time of year.
At 2300 on Sunday, the MOoH contacts the Ministry again. After complaining of being unwell in the early evening a receptionist from a local GP medical centre collapsed and died on arrival at the ED. During an attempted resuscitation, infection control precautions were inevitably less than perfect. Another person, whom relatives state went to the after-hours surgery earlier in the day because of the ‘flu’, is now seriously ill in intensive care.
The Ministry re-convenes its CIMS team. In conversations with the local hospital the MoH learns that at around midnight, two more patients turned up at the ED with respiratory and circulatory collapse. At 0300 on Monday morning, the team advises the government that:
. • An unknown disease causing respiratory collapse and death is present in the district;
. • It may be H5N1 pandemic influenza, but this cannot yet be confirmed;
. • The Ministry will put regional DHBs on full pandemic alert through Code Red messages;
. • Local hospital staff and facilities, and other medical staff and facilities in the area have probably been exposed;
.• The Ministry recommends that:
a. o The Minister unlocks the special powers available to Medical Officers of Health under the Health Act;
b. o That the Medical Officer of Health in charge establishes travel restrictions for the area;
c. o Until appropriate medical screening arrangements can be made, no people or goods should be allowed to move into or out of the area without the express permission of the Medical Officer of Health in charge;
d. o Public gatherings in the area should be prohibited until further notice;
e. o Schools, kindergartens, crèches, play-centres, educational campuses of all kinds, public libraries, video stores, game arcades and casinos in the area should not open on the Monday morning, and may be required to remain closed for an indefinite period; and
o All possible efforts are made to find the missing Asian person, and to track anybody who is known to have left the area since Saturday.
The Government accepts all the Ministry’s recommendations and expects them to be actioned immediately by the appropriate agencies.
Outline of Health Sector Actions
After a declaration of a national Health Emergency, Medical Officers of Health (MOoHs) have a wide range of powers available to detain, quarantine or isolate people who have or may have infectious diseases.
MoH will immediately issue a Code Red pandemic alert message, informing all health practitioners of the situation.
MoH, through their Regional Co-ordinators, will direct relevant DHBs to prepare for the release of PPE to identified hospitals, primary health care centres and first responders
No hospital-to-hospital transfers will be made from the Hospital to places outside the infected area. Surveillance will be stepped up to the highest possible state, both in the area and in the rest of the country.
Intensive investigations of the cases in the Hospital will be made, with rapid PCR investigations to confirm or rule out H5N1 avian influenza. Initial results are likely to be available within 12 hours.
MoH will make ready-use supplies of anti-viral medication available to assist with the management of the situation.
MoH’s CIMs team will advise the government on appropriate courses of action as the situation develops.
Scenario 3 – Severe Pandemic in New Zealand
It is mid-July. About eight weeks ago, H5N1 pandemic influenza achieved an explosive breakout from South East Asia, appearing in Europe, North and South America, Africa and India within a couple of weeks. The disease is impacting heavily on all age groups, but particularly on younger adults. The case fatality rate is about 2% over all age groups but up to 8-10% for people under 30. The pandemic disease has a high reproductive rate and spreads very rapidly once the first few cases have appeared in any country or region. International trade and travel is more or less at a standstill as all impacted countries attempt to adjust to the new situation. Very limited amounts of airfreight are still moving, but flights are arranged more or less as required, rather than to a timetable, and even so it is very difficult to find aircrew willing to fly to some countries. Very few passengers are being carried. Merchant ships at sea on the way to New Zealand when the pandemic broke out, have either turned around and gone home, have berthed and are unable to leave, or are remaining offshore, waiting to assess the onshore situation before berthing. One of the ships that turned around was a tanker carrying a large shipment of petrol, and there has not been a petrol delivery at Marsden Point for over six weeks now. Despite strenuous border control efforts, pandemic influenza appeared suddenly in one urban area a bit over four weeks ago. Efforts at containment were abandoned, as many other cases were reported throughout the country over the next week. Health authorities shifted efforts to attempt to ameliorate the impacts of the pandemic. Medical Officers of Health have directed all crèches, kindergartens, schools, colleges, universities, public libraries, video stores, game arcades and casinos to close indefinitely. Public gatherings are prohibited, and people are advised to avoid crowded places as much as possible. Wherever practical, people are working from home, or have taken leave – either paid or unpaid. So far, the epidemiology of the disease in New Zealand appears much the same as in other countries, with the heaviest impact on young adults. Over 100,000 people have become ill since the development of the pandemic in New Zealand, and nearly 3,000 have died. About 2,000 of these are under the age of 30. Case numbers are still increasing very fast. Initial forecasts indicate that this wave could involve up to 40% of the population, implying that there may be another 1.5 million people becoming ill over the next six weeks or so, with a peak in about another 2-3 weeks. Given the current epidemiology, this may result in between 30,000 – 35,000 deaths in total. The Ministry of Health has directed DHBs to release their PPE supplies to hospitals, the primary health care sector (in previously agreed locations), and to local services to support first responders.
The Ministry of Health has released the national reserve of anti-viral medication for use. The medication is being distributed through about 80 special temporary facilities. It is strictly prioritised to people who meet clinical criteria for influenza and time since onset of symptoms. After several incidents at the distribution stations the Ministry asked for Police or Defence Force assistance with security as civilian security firms could not manage this. Anti-viral medication has been allocated for all health services, Police and Defence Force, and staff from some other organisations providing direct pandemic responses. This guarantees treatment for any staff from these services that become ill. Despite this, there is a degree of absence in both the health sector and Police force that is not related to direct illness. Between 10%-15% of the Police force is not available for duty. The overall absence rate is still increasing, and may reach about 40%-50% in a few weeks time – around the expected peak of the current pandemic wave. The Army has about 10% of its troops not available for duty from illness, and the Air Force about the same. The Navy has one frigate on its way back from the Persian Gulf, and doesn’t have enough crew available to man the other, currently moored in Auckland. Navy volunteers are assisting health services in Auckland. Primary health services in most districts are shifting priorities, as case numbers climb, and are mostly still functioning although increasingly in a directive and support role. Secondary hospitals and DHBs in most affected areas are moving to a coordination
and logistic supply role for primary and volunteer groups while attempting to maintain hospital services as much as possible. Hospitals are hampered by very high rates of sickness and absences among their staff, and are down to between 50% and 60% of their normal capacity. Hardly any influenza patients are being admitted to hospitals. It is probable that things will get worse for hospitals before they get better. Health services in the most affected urban area and much of the surrounding region are no longer functioning in a co-ordinated manner. Here, the primary and secondary health workforce has been very heavily impacted, with only about 40% of the normal staff available for duty. The pandemic is developing very fast in some population sub-groups, and there have been a large number of deaths. A number of very young children have been orphaned by the deaths of both their parents. Several hundred bodies are in freezer storage in the district, and more containers are being brought in. People of all ages who live alone, and solo parents with small children, are especially vulnerable, as the disease comes on suddenly and is extremely incapacitating. Sufferers can do very little for themselves for several days. People who have few supplies or resources at home, or who have no support, are quickly in dire straits. Some very young children are attempting to look after their sick parents with little or no support. A number of people have died alone in their homes, and it is feared that many more may follow.
In all affected areas people are at home looking after sick children and spouses, and in many cases friends and neighbours in their homes. Some areas have quickly organised networks to support this initiative, but in others people are working as individuals with little co-ordination or support. Many people in the most affected urban area have moved to rural areas. Rapidly increasing case numbers are being reported from these districts. Health service capacity in these areas is very limited, and cannot manage anything remotely approaching the demand now being experienced. Availability of supplies varies across the country, but everywhere there are shortages of fuel and some foodstuffs, partly as a result of people buying up large quantities of basic foods in the early days. Anybody with reserve food or petrol is hoarding it for an uncertain future. Telephone, text and email communication is heavy as people try to keep in touch with each other and keep checking on their friends and relatives in New Zealand and overseas. So far, water, electricity, gas and sewerage systems are still operating, although some are becoming more vulnerable to breakdown and interruptions because of unusual demand patterns and a progressive lack of routine maintenance, as staff availability dwindles. Postal services have stopped providing daily deliveries because so many staff are absent, and courier services are severely handicapped by shortages of fuel. Many New Zealand citizens and residents overseas are stranded, unable to return to New Zealand. People who were overseas on holiday have run out of money, and businessmen overseas are in great difficulty as their incomes have often dried up completely. They are appealing to the government for assistance. About 150,000 tourists and other transient people are stranded in this country. Many are out of money, or their currencies now have virtually no value. International electronic banking is still mostly operating, as are telecommunications and media links. However currency fluctuations are extreme and nobody knows what their money will be worth tomorrow. Many of the tourists and transients are living more or less on the goodwill of moteliers and accommodation suppliers, who are now vociferously demanding the government “do something” to help the critical business situation developing in the sector from both the downturn in normal business and accommodating people with no funds. Around 100,000 overseas students are likewise stuck. Although most have enough money to last a while, they are mostly not normally eligible for publicly funded health services in New Zealand, although they are in an age group that is being heavily impacted.
Outline of Health Sector Actions
Generally, the health sector is shifting from provision of direct care to the coordination, direction, logistic support and assistance of care provision by volunteers, community groups and individuals caring for sick family members.
Nation-wide, direction of release of PPE to primary and secondary sectors occurs when Code Red alerts are issued.
The health sector will be providing direct care to only a very small proportion of all people who get sick.
Anti-virals will be released to the general population early in the wave, but there will not be sufficient to provide treatment for everybody who gets sick in a large wave. It is possible more stringent prioritisation may be adopted (in this case likely to be age-based), which may exacerbate issues around the distribution of the medication.
http://www.med.govt.nz/upload/27552/planning-guide.pdf
Appendix 2: Pandemic Influenza Planning Scenarios
These scenarios are produced for planning purposes only. Scenarios deliberately represent extremes and are not predictions.
Scenario 1 – Pandemic Disease Recognised Overseas
It is a Friday before a holiday weekend, with fine weather forecast over the whole country.
For several weeks there have been many rumours and unconfirmed reports of large clusters of person-to-person spread of H5N1 in two south-east Asian countries – Sealand and Beeland. The situation in neighbouring countries is quiet, but in some regions the situation is unknown, with a total communications blackout from some provinces. The World Health Organisation (WHO) is intensively investigating, but has not yet confirmed person-to-person spread of H5N1 in any region, although the level of suspicion is high and increasing all the time. Nothing much else is happening in the world, so there has been intense and increasing interest in these developments from the world and New Zealand media.
Intensive surveillance in New Zealand has not found any evidence of H5N1 among the influenza-like illnesses that are normally present at low levels in the general population.
The Ministry of Health (MoH) has been monitoring the situation and has informed the health sector of the domestic and overseas situations through Code White (information) messages to District Health Boards (DHBs).
At 1200 on Friday, MoH receives information from the WHO in Manila that H5N1 influenza appears to have been responsible for a number of sudden deaths among Beeland citizens in the large capital city, Beeville. The people who died had no known exposure to infected poultry, or connection with the areas where H5N1 spread is suspected.
From Southern Beeland, there are unconfirmed reports of the sudden deaths of three German tourists who recently took a bus trip to the interior, and of influenza-like illnesses among other tourists. Some tourists are thought to have flown to Singapore or other regional destinations while unwell.
At 1230, while the MoH is attempting to verify the information received, CNN reports that “pandemic influenza has broken out in Beeland, and is causing many deaths in the slums of Beeville and the villages in the interior. Tourists have died, and many are ill”. The report also says that the Beeland government has denied that pandemic influenza is present.
MoH assembles its crisis team and identifies people for Co-ordinated Incident Management System (CIMS) team roles. By 1430 a Code Yellow (standby/warning) message has gone out to the health sector informing them of the situation. Also by this time, the WHO in Manila has confirmed the information received earlier that 120 people are ill in hospital, a further 30 are thought to have died of a new form of influenza and an unknown but “large” number are thought to be affected. It adds that a pandemic declaration will be made at 1600 New Zealand time.
Advice from the Australian Health Disaster Management Committee states that Australia has closed borders to all incoming flights.
MoH issues a Code Red message (pandemic alert) to the health sector at 1615, following the WHO declaration.
At 1630 the MoH national controller issues the first pandemic advice to the government.
The advice is:
. • To enable an effective response to be mounted, the Minister of Health should immediately unlock the special powers available to Medical Officers of Health, in the Health Act; and
. • To immediately close the border, for an indefinite period, to all incoming flights.
At 1800, the Government’s Ministerial-level Domestic and External Security Committee accepts all the Ministry of Health’s recommendations and directs the appropriate agencies to action them immediately.
Outline of likely Health Sector Actions
After unlocking of powers, Medical Officers of Health (MOoHs) have a wide range of special powers available to detain, quarantine or isolate people who have, or may have, infectious diseases.
At the time the border was closed there were 7 aircraft in the air enroute to New Zealand. For safety reasons they may land in New Zealand if the Captain decides that it is inappropriate to divert or turn back. All elect to continue, with 5 to land in Auckland and 2 for Christchurch.
Using the MOoH’s special powers, incoming passengers and aircrew will be held at the airports until health services carry out risk assessments and decide the most appropriate actions.
Outcomes could include:
1. 1. Encouragement of incoming foreign nationals to leave on the next available aircraft without entering New Zealand.
2. 2. Release of some low-risk incoming New Zealanders, with medication as required and arrangements for intensive follow-up by Public Health Units.
3. 3. Quarantine all the remaining passengers and aircrew for 8 days before allowing entry to New Zealand.
Planners should assume that it might take up to 24 hours, and possibly longer, to complete the processing of the people held at the airport, and/or make the necessary arrangements and dispositions. Health services will also review the health declarations of all passengers arriving from South East Asian airports within the last 4-5 days to assess the risks to New Zealand.
Passenger and contact tracing will be done if there are any grounds for suspicion. Surveillance will be stepped up to the highest possible state, especially in communities close to airports and on the normal tourist pathways.
MoH will make supplies of anti-viral medication available to assist with border management operations. Health staff resources will be made available by the appropriate District Health Board(s).
Scenario 2 – Cluster(s) in New Zealand
It is Mid-February. H5N1 influenza is now spreading person-to-person in Western Sealand. The virus is not yet an efficient spreader so there is no widespread outbreak, although several thousand people have been infected. The case fatality rate is very high, at about 20%. Many of the fatalities collapse and die within a short time of becoming symptomatic, mostly with cyanotic mottling and/or subcutaneous haemorrhage. WHO and the Sealand government are making strenuous efforts to contain the situation, with internal travel restrictions in place and draconian penalties for non-compliance with government directives.
H5N1 is known to exist in birds in many other parts of Asia, but intensive surveillance of these regions has not provided evidence of person-to-person spread. It appears the pandemic strain is contained in Sealand. WHO has not yet issued a world pandemic alert, although it has issued a regional alert for South East Asia and Sealand.
New Zealand borders are closed to Sealand nationals except for those who demonstrate that they are from unaffected regions, pass an exit screening examination in Sealand, and undergo health assessments on arrival in New Zealand. These people are mostly students, business people, and those with family in New Zealand. The flow of people from Sealand is low, because of Sealand government restrictions.
General tourist traffic from Asia is substantially reduced from normal because of uncertainties associated with the pandemic situation. Tourists from Asian countries other than Sealand are not undergoing health assessments at the border, although all aircraft are now required to inform authorities of the health status of people on board before arrival in New Zealand.
In New Zealand there is intensive surveillance concentrated on regions surrounding airports and the normal tourist trails.
On a Saturday afternoon, a Medical Officer of Health (MOoH) of Crossville (in the North Island) contacts the MoH. Two people of Asian extraction turned up at a local GP medical centre on Friday with influenza-like illnesses. They were assessed and swabs taken. They were provided with advice and then discharged.
At about 1100 on Saturday morning, one of these people was found dead in their motel. The hotelier rang the police as part of normal process. The other person cannot be found, and the car in which they came is missing, not having been seen since the night before. The two people had been in the motel for two days since arriving in the country.
The MOoH has seen the body, and noted cyanotic mottling and the fact that the person had been dead for some hours. He is very concerned. He has directed that the unit be sealed for the time being until full infectious disease precautions can be provided for the removal of the body to the morgue.
MoH assembles a CIMS team and informs the Minister of developments. As a number of conditions could be involved, it is decided to wait until results from swabs and a post-mortem become available before making any decisions. MoH liaises
with Police about the missing person and advises that if found, the person should be treated as infectious and appropriate precautions taken. MoH also alerts all DHBs and PHUs via a Code Yellow message.
During Sunday, several people present at a nearby Emergency Department (ED) had influenza-like illnesses. Most are itinerant market garden workers and backpacking tourists, living in various hostels and similar accommodation. None require admission. ED is taking full infection control precautions on MoH recommendation.
MoH also recommends that the after-hours surgery takes full infection control precautions, but can only recommend this, as primary care is essentially private business. MoH learns that about a dozen people have turned up at the after-hours surgery with flu-like symptoms, an unusual number for this time of year.
At 2300 on Sunday, the MOoH contacts the Ministry again. After complaining of being unwell in the early evening a receptionist from a local GP medical centre collapsed and died on arrival at the ED. During an attempted resuscitation, infection control precautions were inevitably less than perfect. Another person, whom relatives state went to the after-hours surgery earlier in the day because of the ‘flu’, is now seriously ill in intensive care.
The Ministry re-convenes its CIMS team. In conversations with the local hospital the MoH learns that at around midnight, two more patients turned up at the ED with respiratory and circulatory collapse. At 0300 on Monday morning, the team advises the government that:
. • An unknown disease causing respiratory collapse and death is present in the district;
. • It may be H5N1 pandemic influenza, but this cannot yet be confirmed;
. • The Ministry will put regional DHBs on full pandemic alert through Code Red messages;
. • Local hospital staff and facilities, and other medical staff and facilities in the area have probably been exposed;
.• The Ministry recommends that:
a. o The Minister unlocks the special powers available to Medical Officers of Health under the Health Act;
b. o That the Medical Officer of Health in charge establishes travel restrictions for the area;
c. o Until appropriate medical screening arrangements can be made, no people or goods should be allowed to move into or out of the area without the express permission of the Medical Officer of Health in charge;
d. o Public gatherings in the area should be prohibited until further notice;
e. o Schools, kindergartens, crèches, play-centres, educational campuses of all kinds, public libraries, video stores, game arcades and casinos in the area should not open on the Monday morning, and may be required to remain closed for an indefinite period; and
o All possible efforts are made to find the missing Asian person, and to track anybody who is known to have left the area since Saturday.
The Government accepts all the Ministry’s recommendations and expects them to be actioned immediately by the appropriate agencies.
Outline of Health Sector Actions
After a declaration of a national Health Emergency, Medical Officers of Health (MOoHs) have a wide range of powers available to detain, quarantine or isolate people who have or may have infectious diseases.
MoH will immediately issue a Code Red pandemic alert message, informing all health practitioners of the situation.
MoH, through their Regional Co-ordinators, will direct relevant DHBs to prepare for the release of PPE to identified hospitals, primary health care centres and first responders
No hospital-to-hospital transfers will be made from the Hospital to places outside the infected area. Surveillance will be stepped up to the highest possible state, both in the area and in the rest of the country.
Intensive investigations of the cases in the Hospital will be made, with rapid PCR investigations to confirm or rule out H5N1 avian influenza. Initial results are likely to be available within 12 hours.
MoH will make ready-use supplies of anti-viral medication available to assist with the management of the situation.
MoH’s CIMs team will advise the government on appropriate courses of action as the situation develops.
Scenario 3 – Severe Pandemic in New Zealand
It is mid-July. About eight weeks ago, H5N1 pandemic influenza achieved an explosive breakout from South East Asia, appearing in Europe, North and South America, Africa and India within a couple of weeks. The disease is impacting heavily on all age groups, but particularly on younger adults. The case fatality rate is about 2% over all age groups but up to 8-10% for people under 30. The pandemic disease has a high reproductive rate and spreads very rapidly once the first few cases have appeared in any country or region. International trade and travel is more or less at a standstill as all impacted countries attempt to adjust to the new situation. Very limited amounts of airfreight are still moving, but flights are arranged more or less as required, rather than to a timetable, and even so it is very difficult to find aircrew willing to fly to some countries. Very few passengers are being carried. Merchant ships at sea on the way to New Zealand when the pandemic broke out, have either turned around and gone home, have berthed and are unable to leave, or are remaining offshore, waiting to assess the onshore situation before berthing. One of the ships that turned around was a tanker carrying a large shipment of petrol, and there has not been a petrol delivery at Marsden Point for over six weeks now. Despite strenuous border control efforts, pandemic influenza appeared suddenly in one urban area a bit over four weeks ago. Efforts at containment were abandoned, as many other cases were reported throughout the country over the next week. Health authorities shifted efforts to attempt to ameliorate the impacts of the pandemic. Medical Officers of Health have directed all crèches, kindergartens, schools, colleges, universities, public libraries, video stores, game arcades and casinos to close indefinitely. Public gatherings are prohibited, and people are advised to avoid crowded places as much as possible. Wherever practical, people are working from home, or have taken leave – either paid or unpaid. So far, the epidemiology of the disease in New Zealand appears much the same as in other countries, with the heaviest impact on young adults. Over 100,000 people have become ill since the development of the pandemic in New Zealand, and nearly 3,000 have died. About 2,000 of these are under the age of 30. Case numbers are still increasing very fast. Initial forecasts indicate that this wave could involve up to 40% of the population, implying that there may be another 1.5 million people becoming ill over the next six weeks or so, with a peak in about another 2-3 weeks. Given the current epidemiology, this may result in between 30,000 – 35,000 deaths in total. The Ministry of Health has directed DHBs to release their PPE supplies to hospitals, the primary health care sector (in previously agreed locations), and to local services to support first responders.
The Ministry of Health has released the national reserve of anti-viral medication for use. The medication is being distributed through about 80 special temporary facilities. It is strictly prioritised to people who meet clinical criteria for influenza and time since onset of symptoms. After several incidents at the distribution stations the Ministry asked for Police or Defence Force assistance with security as civilian security firms could not manage this. Anti-viral medication has been allocated for all health services, Police and Defence Force, and staff from some other organisations providing direct pandemic responses. This guarantees treatment for any staff from these services that become ill. Despite this, there is a degree of absence in both the health sector and Police force that is not related to direct illness. Between 10%-15% of the Police force is not available for duty. The overall absence rate is still increasing, and may reach about 40%-50% in a few weeks time – around the expected peak of the current pandemic wave. The Army has about 10% of its troops not available for duty from illness, and the Air Force about the same. The Navy has one frigate on its way back from the Persian Gulf, and doesn’t have enough crew available to man the other, currently moored in Auckland. Navy volunteers are assisting health services in Auckland. Primary health services in most districts are shifting priorities, as case numbers climb, and are mostly still functioning although increasingly in a directive and support role. Secondary hospitals and DHBs in most affected areas are moving to a coordination
and logistic supply role for primary and volunteer groups while attempting to maintain hospital services as much as possible. Hospitals are hampered by very high rates of sickness and absences among their staff, and are down to between 50% and 60% of their normal capacity. Hardly any influenza patients are being admitted to hospitals. It is probable that things will get worse for hospitals before they get better. Health services in the most affected urban area and much of the surrounding region are no longer functioning in a co-ordinated manner. Here, the primary and secondary health workforce has been very heavily impacted, with only about 40% of the normal staff available for duty. The pandemic is developing very fast in some population sub-groups, and there have been a large number of deaths. A number of very young children have been orphaned by the deaths of both their parents. Several hundred bodies are in freezer storage in the district, and more containers are being brought in. People of all ages who live alone, and solo parents with small children, are especially vulnerable, as the disease comes on suddenly and is extremely incapacitating. Sufferers can do very little for themselves for several days. People who have few supplies or resources at home, or who have no support, are quickly in dire straits. Some very young children are attempting to look after their sick parents with little or no support. A number of people have died alone in their homes, and it is feared that many more may follow.
In all affected areas people are at home looking after sick children and spouses, and in many cases friends and neighbours in their homes. Some areas have quickly organised networks to support this initiative, but in others people are working as individuals with little co-ordination or support. Many people in the most affected urban area have moved to rural areas. Rapidly increasing case numbers are being reported from these districts. Health service capacity in these areas is very limited, and cannot manage anything remotely approaching the demand now being experienced. Availability of supplies varies across the country, but everywhere there are shortages of fuel and some foodstuffs, partly as a result of people buying up large quantities of basic foods in the early days. Anybody with reserve food or petrol is hoarding it for an uncertain future. Telephone, text and email communication is heavy as people try to keep in touch with each other and keep checking on their friends and relatives in New Zealand and overseas. So far, water, electricity, gas and sewerage systems are still operating, although some are becoming more vulnerable to breakdown and interruptions because of unusual demand patterns and a progressive lack of routine maintenance, as staff availability dwindles. Postal services have stopped providing daily deliveries because so many staff are absent, and courier services are severely handicapped by shortages of fuel. Many New Zealand citizens and residents overseas are stranded, unable to return to New Zealand. People who were overseas on holiday have run out of money, and businessmen overseas are in great difficulty as their incomes have often dried up completely. They are appealing to the government for assistance. About 150,000 tourists and other transient people are stranded in this country. Many are out of money, or their currencies now have virtually no value. International electronic banking is still mostly operating, as are telecommunications and media links. However currency fluctuations are extreme and nobody knows what their money will be worth tomorrow. Many of the tourists and transients are living more or less on the goodwill of moteliers and accommodation suppliers, who are now vociferously demanding the government “do something” to help the critical business situation developing in the sector from both the downturn in normal business and accommodating people with no funds. Around 100,000 overseas students are likewise stuck. Although most have enough money to last a while, they are mostly not normally eligible for publicly funded health services in New Zealand, although they are in an age group that is being heavily impacted.
Outline of Health Sector Actions
Generally, the health sector is shifting from provision of direct care to the coordination, direction, logistic support and assistance of care provision by volunteers, community groups and individuals caring for sick family members.
Nation-wide, direction of release of PPE to primary and secondary sectors occurs when Code Red alerts are issued.
The health sector will be providing direct care to only a very small proportion of all people who get sick.
Anti-virals will be released to the general population early in the wave, but there will not be sufficient to provide treatment for everybody who gets sick in a large wave. It is possible more stringent prioritisation may be adopted (in this case likely to be age-based), which may exacerbate issues around the distribution of the medication.
Dr Horowitz: Mexican”Swine” Flu Made in Lab
Author of Emerging Viruses: AIDS And Ebola: Nature, Accident or Intentional?, Horowitz says the swine-bird-human flu strain, reported to be found first in Mexico in late-March 2009, could have only come from Dr James S. Robertson and his colleagues in association with the US Centre for Disease Control and vaccine manufacturer Novavax, Inc, which was ready to profit from the release he says. Nobody else takes H5N1 Asian-flu infected chickens, takes them to Europe, extracts their DNA, combines their proteins with H1N1 viruses from the 1918 Spanish flu isolate, additionally mixes in some swine-flu genes from pigs, then reverse engineers them to infect humans, he said.
A report in Medical News Today revealed that Novavax was working on a vaccine for an avian flu pandemic in 2005 and an article at News-Medical.net mentioned they began human clinical testing of a pandemic flu vaccine in August 2007. Also, in a news release dated the 14th of April 2009, shortly after the first reported case of “swine flu”, their vaccine was being touted as being able to protect against the “highly pathogenic H5N1 avian influenza strain.” Stated the Vice President of Vaccine Development for Novavax in this report, the vaccine “has significant implications for both pre-pandemic and pandemic preparedness.”
A report in Medical News Today revealed that Novavax was working on a vaccine for an avian flu pandemic in 2005 and an article at News-Medical.net mentioned they began human clinical testing of a pandemic flu vaccine in August 2007. Also, in a news release dated the 14th of April 2009, shortly after the first reported case of “swine flu”, their vaccine was being touted as being able to protect against the “highly pathogenic H5N1 avian influenza strain.” Stated the Vice President of Vaccine Development for Novavax in this report, the vaccine “has significant implications for both pre-pandemic and pandemic preparedness.”
1918 Swine Flu outbreak
'Mother of pandemics'
But, during the last century, the virus has shown a deadly ability to change beyond recognition.
In 1918, an influenza pandemic started that became a global disaster - eventually killing more people than the Great War.
Estimates of the death toll from the 1918 outbreak of Spanish flu range from 20 million to 40 million. Some historians argue it could have been as high as 100 million.
"There was a mild wave in the spring, but the very serious, lethal wave was in the autumn to the winter," says Professor Markel. "Then a third wave in January to April 1919, and a fourth wave in the winter of 1920."
This tendency for "waves" of infection and re-infection makes the virus yet more unpredictable.
New vaccines for circulating strains are now designed every year
At the time the medical consensus was that the disease was caused not by a virus, but by a bacterium called Haemophilus influenzae.
So some countries, including the US and UK, distributed vaccinations against the wrong disease-causing agent.
"Another problem was that the authorities stuck their heads in the sand," says Mr Honigsbaum.
"Their priority was the war and they didn't have the resources to deal with the health crisis.
"There's an argument that if they'd been more proactive, and diverted doctors and nurses from the front to civilian needs, they could have saved more lives."
Dr Morens refers to the 1918 H1N1 strain as "the mother of all pandemics".
"In the category of Influenza A, which is the category of virus that has caused all human epidemics and pandemics, every virus circulated since 1918 has been a descendent of this virus in one way or another," he says.
"Descendants of the 1918 pandemic are still infecting human beings, but they have mutated again and again and again to be able to survive."
Hybrids and mutants
The 1918 influenza pandemic gripped a vulnerable, unprepared human population, but its ability to "reassort" - or exchange its genes with other viruses - was what made it "dangerously novel".
We had two lineages of the disease, both of which have persisted
David Morens
National Institute of Allergy and Infectious Diseases
"Every species has its own flu - when those species live together, and they can transmit their flu to different species, the virus itself changes its structure," says Professor Markel.
Since our immune systems recognise and respond mainly to the H and N part of the molecule, scientists suspect that pandemics arise when a strain emerges with a big change in the structure of one of these proteins.
But how exactly the virus adapts to enable it to attach to receptors on the cells of a different species, is an "unanswerable" question, says Dr Morens.
"With only four pandemics in over 100 years, our sample size is too small to say, but it seems that a new H [on the surface of the virus] has been the major factor," says Dr Morens.
"We don't know where the 1918 virus came from, but the evidence is that it was a new virus.
"At the same time that it infected humans, it also infected pigs. And at that point, we began to have two lineages of that disease - the human virus, and the pig virus, which persisted too," he adds.
The progeny of the 1918 influenza strain evolved and mutated as they were transmitted from one host to another.
And on two further occasions, these strains incorporated completely new genes and spread globally once again.
Controlled outbreak
"That's what happened in 1957 and 1968 - a hybrid formed of the 1918 virus with genes that were never part of it before," says Dr Morens.
In the case of the 1957 Asian flu outbreak, a human H2N2 virus combined with the genes of a strain found in wild ducks.
The pandemic killed an estimated one million people worldwide.
An outbreak of H3N2 Hong Kong flu in 1968, when avian and human virus genes combined once again, claimed another million lives.
In both cases, the impact was minimised by health authorities, who identified the virus, and made vaccines available.
"Now, every year, around summer time, a group of flu experts get together and see what strains are circulating so they can design an appropriate vaccine," says Dr Markel.
And in the last few years, principally because of the global concern about avian flu, anti-viral drugs that target influenza, such as Tamiflu, have been introduced.
The emergence of a virus that crosses a species barrier is extremely rare
But Professor Markel points out that, despite having reached new levels of medical preparation, "we live in a world of emerging infectious diseases".
"We have learned to take avian flu very seriously, and we have learned to take the animal kingdom very seriously," he says.
But in the rare event that a virus does develop that is able to cross the species barrier, he points out that the close proximity of domestic farm animals to humans provides an opportunity for human infection.
"Human beings travel farther and faster than ever before. All of this means that we are set up for a potential epidemic or pandemic," concludes Professor Markel.
"We learn more every time, but the story of flu pandemics is still very much a story in progress."
But, during the last century, the virus has shown a deadly ability to change beyond recognition.
In 1918, an influenza pandemic started that became a global disaster - eventually killing more people than the Great War.
Estimates of the death toll from the 1918 outbreak of Spanish flu range from 20 million to 40 million. Some historians argue it could have been as high as 100 million.
"There was a mild wave in the spring, but the very serious, lethal wave was in the autumn to the winter," says Professor Markel. "Then a third wave in January to April 1919, and a fourth wave in the winter of 1920."
This tendency for "waves" of infection and re-infection makes the virus yet more unpredictable.
New vaccines for circulating strains are now designed every year
At the time the medical consensus was that the disease was caused not by a virus, but by a bacterium called Haemophilus influenzae.
So some countries, including the US and UK, distributed vaccinations against the wrong disease-causing agent.
"Another problem was that the authorities stuck their heads in the sand," says Mr Honigsbaum.
"Their priority was the war and they didn't have the resources to deal with the health crisis.
"There's an argument that if they'd been more proactive, and diverted doctors and nurses from the front to civilian needs, they could have saved more lives."
Dr Morens refers to the 1918 H1N1 strain as "the mother of all pandemics".
"In the category of Influenza A, which is the category of virus that has caused all human epidemics and pandemics, every virus circulated since 1918 has been a descendent of this virus in one way or another," he says.
"Descendants of the 1918 pandemic are still infecting human beings, but they have mutated again and again and again to be able to survive."
Hybrids and mutants
The 1918 influenza pandemic gripped a vulnerable, unprepared human population, but its ability to "reassort" - or exchange its genes with other viruses - was what made it "dangerously novel".
We had two lineages of the disease, both of which have persisted
David Morens
National Institute of Allergy and Infectious Diseases
"Every species has its own flu - when those species live together, and they can transmit their flu to different species, the virus itself changes its structure," says Professor Markel.
Since our immune systems recognise and respond mainly to the H and N part of the molecule, scientists suspect that pandemics arise when a strain emerges with a big change in the structure of one of these proteins.
But how exactly the virus adapts to enable it to attach to receptors on the cells of a different species, is an "unanswerable" question, says Dr Morens.
"With only four pandemics in over 100 years, our sample size is too small to say, but it seems that a new H [on the surface of the virus] has been the major factor," says Dr Morens.
"We don't know where the 1918 virus came from, but the evidence is that it was a new virus.
"At the same time that it infected humans, it also infected pigs. And at that point, we began to have two lineages of that disease - the human virus, and the pig virus, which persisted too," he adds.
The progeny of the 1918 influenza strain evolved and mutated as they were transmitted from one host to another.
And on two further occasions, these strains incorporated completely new genes and spread globally once again.
Controlled outbreak
"That's what happened in 1957 and 1968 - a hybrid formed of the 1918 virus with genes that were never part of it before," says Dr Morens.
In the case of the 1957 Asian flu outbreak, a human H2N2 virus combined with the genes of a strain found in wild ducks.
The pandemic killed an estimated one million people worldwide.
An outbreak of H3N2 Hong Kong flu in 1968, when avian and human virus genes combined once again, claimed another million lives.
In both cases, the impact was minimised by health authorities, who identified the virus, and made vaccines available.
"Now, every year, around summer time, a group of flu experts get together and see what strains are circulating so they can design an appropriate vaccine," says Dr Markel.
And in the last few years, principally because of the global concern about avian flu, anti-viral drugs that target influenza, such as Tamiflu, have been introduced.
The emergence of a virus that crosses a species barrier is extremely rare
But Professor Markel points out that, despite having reached new levels of medical preparation, "we live in a world of emerging infectious diseases".
"We have learned to take avian flu very seriously, and we have learned to take the animal kingdom very seriously," he says.
But in the rare event that a virus does develop that is able to cross the species barrier, he points out that the close proximity of domestic farm animals to humans provides an opportunity for human infection.
"Human beings travel farther and faster than ever before. All of this means that we are set up for a potential epidemic or pandemic," concludes Professor Markel.
"We learn more every time, but the story of flu pandemics is still very much a story in progress."
swine flu could jump start new drugs
More from Fortune
Swine flu could jump start new drugs
True obsessions
When will the economy recover?
FORTUNE 500
Current Issue
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NEW YORK (Fortune) -- The rush to respond to the swine-flu outbreak could provide an opportunity for vaccine and antiviral developers to showcase new biotechnologies sooner than expected.
There's no vaccine for the exact strain of swine flu yet, so the immediate course of action lies with currently available flu antivirals. The Centers for Disease Control and Prevention have 50 million treatment courses of such drugs as Tamiflu and Relenza. The agency says lab tests show the swine flu virus is "sensitive" to those treatments. The Department of Homeland Security has asked for $1.5 billion from the government to "acquire antivirals and invest in a vaccine," though officials haven't decided whether to produce a vaccine yet. The pharma maker Roche had $530 million in Tamiflu sales last year while GlaxoSmithKline (GSK) had sales of $105 million for Relenza.
The availability of flu-specific vaccines has a lag time, typically four to six months after a new strain appears, because scientists must grow millions of copies of the virus strain in chicken eggs. But several pharmaceutical and biotechnology companies are experimenting with quicker ways to produce vaccines, cutting the incubation period down to as little as 10 weeks.
These newer vaccines are far from reaching the market, with many of them still in clinical trials and unapproved by the Food and Drug Administration. But investors seem ready to bet on their potential. Since the swine flu hit, the stocks of some anti-flu drugmakers soared; Roche and GlaxoSmithKline saw boosts because of Tamiflu and Relenza, while smaller vaccine creators like Novavax (NVAX) and BioCryst (BCRX) saw share prices rise more than 70% in one day.
Here's a look at a few of the up-and-coming potential medicines and technologies that could help with swine and other types of flu strains in the future.
Baxter International: The drug giant, based in suburban Chicago, requested a sample of the swine flu from the World Health Organization to develop a candidate vaccine through vero-cell cultures, which creates the vaccine by growing the virus in animal cells instead of eggs.
Baxter (BAX, Fortune 500) used this method to develop Celvapan, a bird-flu vaccine that could be used if the WHO declared such a pandemic. It has already received approval for use in Europe and is awaiting approval in the U.S. A Baxter spokesman says a swine-flu vaccine made through vero-cell technology could take only 13 to 16 weeks to provide initial doses.
Novavax: Using technology based on recombinant virus-like particles, the same method used to develop Gardasil, the women's HPV vaccine, Novavax is developing treatments for seasonal and bird flu. CEO Rahul Singhvi says the company could make a vaccine for swine flu within 10 to 12 weeks using VLP technology because scientists need only the genetic sequence of the virus (the swine flu sequence was released last week), instead of the virus itself, to create the vaccine.
"It's a proven technology with Gardasil," Singhvi says. "Therefore it's not a leap of faith that we could test one for swine flu." Singhvi estimates it would cost $100 million to create a vaccine and says Novavax has offered its services to the government.
BioCryst Pharmaceuticals: Instead of a vaccine, BioCryst is developing a flu antiviral that's currently in clinical trials in Japan and the U.S. The medicine, which would differ primarily because it would be taken orally or inhaled (like Relenza), could prevent a "broad range of strains," according to a spokesman. The 80-person company is developing the antiviral, called Peramivir, through a $103 million research grant from the U.S. Department of Health and Human Services.
First Published: April 30, 2009
Swine flu could jump start new drugs
True obsessions
When will the economy recover?
FORTUNE 500
Current Issue
Subscribe to Fortune
NEW YORK (Fortune) -- The rush to respond to the swine-flu outbreak could provide an opportunity for vaccine and antiviral developers to showcase new biotechnologies sooner than expected.
There's no vaccine for the exact strain of swine flu yet, so the immediate course of action lies with currently available flu antivirals. The Centers for Disease Control and Prevention have 50 million treatment courses of such drugs as Tamiflu and Relenza. The agency says lab tests show the swine flu virus is "sensitive" to those treatments. The Department of Homeland Security has asked for $1.5 billion from the government to "acquire antivirals and invest in a vaccine," though officials haven't decided whether to produce a vaccine yet. The pharma maker Roche had $530 million in Tamiflu sales last year while GlaxoSmithKline (GSK) had sales of $105 million for Relenza.
The availability of flu-specific vaccines has a lag time, typically four to six months after a new strain appears, because scientists must grow millions of copies of the virus strain in chicken eggs. But several pharmaceutical and biotechnology companies are experimenting with quicker ways to produce vaccines, cutting the incubation period down to as little as 10 weeks.
These newer vaccines are far from reaching the market, with many of them still in clinical trials and unapproved by the Food and Drug Administration. But investors seem ready to bet on their potential. Since the swine flu hit, the stocks of some anti-flu drugmakers soared; Roche and GlaxoSmithKline saw boosts because of Tamiflu and Relenza, while smaller vaccine creators like Novavax (NVAX) and BioCryst (BCRX) saw share prices rise more than 70% in one day.
Here's a look at a few of the up-and-coming potential medicines and technologies that could help with swine and other types of flu strains in the future.
Baxter International: The drug giant, based in suburban Chicago, requested a sample of the swine flu from the World Health Organization to develop a candidate vaccine through vero-cell cultures, which creates the vaccine by growing the virus in animal cells instead of eggs.
Baxter (BAX, Fortune 500) used this method to develop Celvapan, a bird-flu vaccine that could be used if the WHO declared such a pandemic. It has already received approval for use in Europe and is awaiting approval in the U.S. A Baxter spokesman says a swine-flu vaccine made through vero-cell technology could take only 13 to 16 weeks to provide initial doses.
Novavax: Using technology based on recombinant virus-like particles, the same method used to develop Gardasil, the women's HPV vaccine, Novavax is developing treatments for seasonal and bird flu. CEO Rahul Singhvi says the company could make a vaccine for swine flu within 10 to 12 weeks using VLP technology because scientists need only the genetic sequence of the virus (the swine flu sequence was released last week), instead of the virus itself, to create the vaccine.
"It's a proven technology with Gardasil," Singhvi says. "Therefore it's not a leap of faith that we could test one for swine flu." Singhvi estimates it would cost $100 million to create a vaccine and says Novavax has offered its services to the government.
BioCryst Pharmaceuticals: Instead of a vaccine, BioCryst is developing a flu antiviral that's currently in clinical trials in Japan and the U.S. The medicine, which would differ primarily because it would be taken orally or inhaled (like Relenza), could prevent a "broad range of strains," according to a spokesman. The 80-person company is developing the antiviral, called Peramivir, through a $103 million research grant from the U.S. Department of Health and Human Services.
First Published: April 30, 2009
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