WHO Can Stop an Epidemic
- Posted by: Nina Hachigian
- on January 13, 2009 at 6:21 pm
According to the New York Times, this season’s particular flu virus doesn’t respond—at all—to the standard flu medicine, Tamiflu. I admit to shivering when I hear medical experts saying things like “It’s quite shocking” and “We’ve never lost an antimicrobial this fast. It blew me away.” Thirty six thousand Americans die every year from the flu, so it’s no joke. But the last paragraph of the Times piece is particularly chilling:
“And while seasonal flu is relatively mild, the Tamiflu resistance could transfer onto the H5N1 bird flu circulating in Asia and Egypt, which has killed millions of birds and about 250 people since 2003.”
That is disturbing because the LA Times reports last week that, after a two-year lull, avian flu is back and killing people again. In the past, pandemic health experts have warned that this “H5N1″ avian flu virus could well become transmissible from human to human, and then we’d be in big trouble. The flu from the turn of the 20th century, also an avian flu, killed the percentage equivalent today of two million Americans. Its victims turned blue and coughed up blood.
Areas reporting confirmed occurrences of H5N1 avian influenza in poultry and wild birds since 2003, status as of December, 15, 2008. From the WHO See the full size version here.
In response to the outbreaks of avian flu, public health agencies around the world have been stockpiling Tamiflu. So the idea of an avian flu virus that cannot be treated with Tamiflu is, well…yikes.
All of this makes me wonder why the World Health Organization is virtually unheard of in the U.S (and it has only 1,203 fans on Facebook compared to, say, over 600,000 fans for Red Bull). The WHO tracks global epidemics like avian flu and another nightmare pathogen, Ebola. It also more or less eradicated polio and helps developing countries with their healthcare systems.
The rules are that if there is an outbreak of contagious disease in your country, you have to share samples of the virus with the WHO That way, the WHO can get scientists to track and analyze the bug (and ideally develop a vaccine), and it can help coordinate a response among public health officials to prevent the spread. No other group can do this—if Washington asked for those samples, many countries would refuse.
The WHO is an encouraging, and too rare, example of countries getting over their differences to solve a common problem. The WHO is underfunded and needs reform, but it stands between us and some lethal future pandemic. President Obama, Secretary of State Clinton and Obama’s pick for healthcare czar—Senator Tom Daschle—should be sure to support it, talk it up and push to make it as effective an organization as it can be.
Guest blogger Nina L. Hachigian is a Senior Fellow at the Center for American Progress.
DISCUSSION: 7 Comments
Get better informed – (or is this deliberate spin on your part? Given your background you should know better) there was never “a lull” in H5N1 deaths – and, nations have been refusing to report cases within 24 hours (Pakistan didn’t admit to one outbreak in late 2007 until after someone flew from NYC to the funerals and back) , been refusing to share virus samples (or like China, picking one once in a while to show), lying about test results -with impunity. (Indonesia says they’ll update case numbers evey 6 months- and- they are just lying about “official” results at this point; to keep that number down to “not hurt tourism”) The dangerous H5N1 strains come from China. The WHO has not been ’supportable’ since Dir.Gen Lee dropped dead at work right after the Karo h-h-h cluster and China got Chan in as WHO Dir.- the Pandemic Alert Phase was never raised (it was unplugged early 2006 -ignore it- the WHO has been Responding to Contain increased threats and delay pandemic start without raising the Alert Phase,”due to political and economic pressures”. The delays were supposed to buy us all time to prepare for long-forseen supply chain and infrastructure disruptions, and system-overwhelming viral impacts. Are you ready? Their Olympics were not impacted by the public hearing about ongoing cluster Continaments, nor any travel bans or other 2005-definition Phase 4 action items. Who benefits most if the world and the US is unprepared? Not us. This piece also reads as if you never heard of (thank your officials) the site supposedly to warn Americans, up since Oct. 2005, paid for with tax dollars: pandemicflu.gov (Why didn’t you tell your readers about it?) See left sidebar “Planning and Response” read pages for “Individuals” and Community – incl. “Mass Medical Care with Scarce Community resources”. Do not, public, volunteer for groups who have not obtained BSL-3 PPE and have not warned your community about Pandemic Flu year Alert, and have hidden Pandemic plans-on-paper in their “all-hazards” cabals, and pretend to know nothing about current H5N1 cases and that virologists say H5N1 can go pandemic at current “unprecedented” fatality rate. (Not the “biological attack” people think of? The future is never a do-over of the past. We are not in a “Spanish Flu” alert- sure they “don’t know” what the exact panflu strain(s) will look like – but, look at science facts- and real worst-case and prep for that, or we’re just “planning to fail”.) Stop the panflu virus at the N.American border, and every border thereafter; we need to slow and mitigate the impact; it Is the “gravest” threat we face, not just the UK -though at least they said it in public.Go read the “US State Dept H5N1 factsheet” original went up July 2006 -travellers are likely to be stranded by Pandemic start and will get No food, water, nor medical care from US embassies. Are business and schools and travel agencies sending people abroad without disclosing this?Every state and community and school, and power company and water dept, and funeral home and cemetery, and truck driver and farmer, and hospital and family of a of responder is already supposed to be ready for a pandemic flu year that can start “at any time“: in 2006 HHS had a Summit with every state; Leavitt said, (Dec 2005 -pity it wasn’t a PSA)”Any state, any community, any citizen that failed to prepare, assuming that the federal government could take care of them during a pandemic, would be tragically wrong.”Officials tell themselves informing the public will cause “panic” – obviously Not informing the public we need to try and reduce debt and become more resilient and get educated about pandemic Mitigation strategies only Delays “panic” – unless you call asking questions in an alarmed or aggrieved tone and wanting accountability, and, a part in shaping workable local contingency preparations (see pandemicflu.gov State/Local planning checklist First Task: UnDone) and changing local and state spending priorities to take H5N1 pandmeic alert into account “panic”. Be more worried about being unable to meet critical needs, or loved ones dying the system can’t save; That kind of panic. Look at the “Moral hazard” -the people the public trusted to warn them – the WHO, the CDC their own elected or appointed officials – thought their lives would be easier- short-term, to Not tell your neighbors. It wasn’t even a campaign issue – while the cases and deaths and cluster Containments and animal culls continued – they are still happening right now. Anyone thought we still had a free press? Get “input” aboutthe ethics of vaccine rationing of patient triage, but ignore how unethical is was to not inform the public they are in an H5N1 panflu year alert? Yet, some govt employees got told in 2006, keep 12 weeks of suppplies and prepare for total infrastructure collapse? Officials are trying to fill MRC quotas without full and fair disclosure, and without supplies. Local “plans say, come pandemic, churches will then be asked to feed the hungry, nurse the sick and bury the dead- responders will be told it is their “duty” to respond to work. We don’t send soldiers unarmed to battle, nor force firefighters into wildfires, nor censor incoming Hurricane data to the public. Why does public health keep repeating past mistakes?You have it correct: “ the idea of an avian flu virus that cannot be treated with Tamiflu is, well…yikes“ Try not to get infected. High CFR panflu -well, N.American had been virtually depopulated before; read “1491″?”Brisbane strains” are already killing some young healthy people in the US (the CDC has not released full sequences on any of those flus) and one of the 3 vax strains is not a match for what is circulating in the US- get a flu shot, get a pneumonia shot if you can, make sure your other vaccine boosters are up to date, do not touch your face outside of home unless you sanitize your hands first. Stay away from sick people and stay home if you’re sick. None of the other medical interventions will be functioning normally during a pandemic; if communities aren’t careful, they will lose people to the epidemics their grandparents or great-grandparents had, and of course, storms and disasters will still happen during pandemic, without normal outside aid “possible”. “Yikes”.What is their Plan B? We have no vaccine, too many clades of H5N1 and I have no idea how many subclades and strains - it mutates fast; like HIV, we lack vaccine manufacturing capacity for current population, and, the federal plan was to Not buy antivirals for 75% of the public. (How did you like that? Everyone is at risk from a panflu; no point using “seasonal flu” AR in “planning”. Some states didn’t even try to buy antivirals - despite H5N1 being fatal without treatment at symptom onset) -now it would be easy for a panflu to be Tamiflu resistant, and there are other gene snips around from use of other antivirals getting into the ecosystem abroad.
What is your state/local plan? Give up? Dump it on the military – who already said they can’t pick up all the slack? Well, we can’t give up. “Continuity of Govt”? That’s nothing unless “Continuity of the People” is as important. Re-read the Declaration of Independence.First things first; there Are things people can do, steps they can take, and they come in useful – these ‘preps’ get used more often than your fire insurance does- we rely too much on outside aid, but we have no experince with contagious-before-symptoms (that’s why influenza gets around so well -it is also airborne-contagious) epidemics, and we haven’t had a severe panflu in most of our lifetimes – even reading about the “Spanish flu” accounts should be enough reason to get better prepared at home. Better safe than sorry.Even the WHO never said they could stop a Pandemic – in fact Containment to delay start had never been attempted before – and if we hadn’t had an effective antiviral -it would not have worked, and, at some point, a case or contact will be missed, or a strain will fail to be stopped by the Tamiflu. By the time you know Pandemic started, Preparation time will have just ended. Make a start now to become better prepared; so you won’t be part of the problem, first thing. Nature doesn’t think you have a “non-negotiable lifestyle” (neither does the Chinese govt) (nor do your own govt pandemic plans; read around) See PFI Pandemic Flu Information Forum for past and current News, too.Free preparedness resource, hosted by the emergency managers in one county in Idaho, made with concerned citizen collaborations, pick a piece you can do a little something about, maybe a different issue every week could you have coped at home in some of the storms the nation has had lately? We need grassroots, sustainable preparedness, as the “new normal” for so many reasons: See GetPandemicReady.org
While the length and tone of “Anonymous’s” posting are far from ideal, he/she is correct overall. There never was a lull in H5N1 outbreaks, simply a lull in media attention. WHO is a membership organization, of nations. Under its charter design WHO serves the needs of member countries. If countries decide to ignore WHO, or fail to comply with WHO dictates, there is almost nothing the agency can do to penalize them. As a result, outbreaks of all sorts of microbes — including H5N1 — go unreported. It is for that reason that Google is creating its own disease surveillance system, that the Federation of American Scientists set up ProMED, and that a tiny staff inside WHO uses database on line searches to get clues regarding hidden epidemics. Overall, I would agree with “Anonymous” that your posting is rife with inaccuracies, and reflects a rather superficial level of knowledge and understanding of the pandemic and, in particular, H5N1 situations. Sorry, but true.
H5N1 never had a “lull” – two-years-long or otherwise. Apparently the media has lost interest, but the virus is alive and spreading. The virus is already transmissible from person to person. That transmission may not “easy” or “extended” but there is person-to-person transmission nevertheless. To say otherwise is to mislead the public.
The 1918 pandemic flu virus did kill the percentage equivalent of two million Americans. That virus had an approximate 2% fatality rate. The H5N1 virus has a fatality rate worldwide of over 60% – with antiviral medication. That fatality rate has been increasing, and it will not necessarily go down when the virus causes a pandemic. Perhaps the “rules” are that countries share samples of virus with WHO, but it is not being done. It is well known that Indonesia (as well as other countries) is not sharing H5N1 samples with WHO.
We won’t have vaccine for pandemic flu – it will take at least 6 months after a pandemic begins to have the first batches of vaccine. Why isn’t the public being told this so that they can prepare to avoid the virus during this time? WHO does not stand between us and a potential pandemic. Public health officials do not stand between us and a potential pandemic. The only thing that stands between us and a pandemic are the preparations that we make for ourselves. Where are the public service announcements telling the public to gather nonperishable food, water, over the counter medication, baby food, diapers, pet food, respirators, gloves, cleaning products, etc. Unfortunately our government is not willing to warn the public about pandemic flu and to provide information about what families can do now to prepare.
Why isn’t this information being given to the American public? We are in a Pandemic Alert Period. Why doesn’t every American know this? We’re seeing commercials every day about preparation for the switch to digital TV. Why aren’t we seeing commercials about preparation for pandemic flu? Supporting WHO does nothing to prepare our country for a pandemic. Unfortunately our federal, state and local governments aren’t preparing us either. We are on our own, and most of our population hasn’t a clue.
For information on how to prepare for a potential pandemic go to http://www.GetPandemicReady.org .
Thanks for the comments. From 2003 to 2006, the human cases of H5N1 reported increased dramatically each year. Then in 2007 and 2008, the numbers, thankfully, dropped–that is what I mean by a “lull.” But the more important point is that H5N1 is highly lethal and highly contagious and could lead, many say WILL lead, to a major pandemic. Not enough people are paying attention, including in my national security community—you rarely hear avian flu cited as a threat to national security, which I consider it to be. Of course, domestic preparedness is critical—I certainly didn’t meant to suggest otherwise. Here is another site that tells people what they can do. http://www.avianflu.gov/plan/individual/index.html.
That all said, even though it is flawed and even though countries shirk the rules, which I would never deny, the WHO is playing a very important role in attempting to detect and help coordinate the containment of avian flu outbreaks. It creates a forum where countries can pressure those who have not complied. Our approach should be to make it work better, not throw our hands up. As you know, fighting a pandemic at EVERY stage is critical and only an international coordinating body can hope to halt the spread of outbreaks, whereever on the globe they occur.
“Then in 2007 and 2008, the numbers, thankfully, dropped–that is what I mean by a “lull.” That “lull” was what most people call a “Lie”. Even a “Big Lie”. “Enron-ing” reality doesn’t make it so. Why are you thankful the reporting got censored since then? If you thought domestic preparedness was critical, you’d admit the federal site has been deliberately under-marketed to the public. You’re pointing to pandemicflu.gov to the wrong crowd if you’re addressing the commentors; we knew about the H5N1/panflu year threat even before that got online. The public isn’t hearing about the site, and the feds saying, in 2005, “two weeks” of supplies has derailed any action on the public’s part; they think they already have that at home - they think after that, the govt will meet their needs, pandemic be over, or, vaccine be here; otherwise they would have been told to stockup for far longer. “All-hazards” cabals are still ignoring panflu year alert at all -censoring the media coverage isn’t helping- and they are still only telling the public they need “72 hours” of supplies “for emergencies”. “Health” officials are still answering questions about pandemic by saying their community, “can request aid from the SNS in emergencies” when we know we aren’t getting our critical needs met in panflu.
You also wrote: “only an international coordinating body can hope to halt the spread of outbreaks” – the WHO has certainly not halted the spread of outbreaks to date – the viruses spread themselves; though the WHO may have helped Contain each human outbreak -the reported ones anyway.The WHO under Chan is compromised, and has a stopped clock (or Trojan horse) of a Pandemic Phase Alert now; that has done more harm than good. The “National Security community” would have paid better attention if the Phase had been raised to 2005-definiton 4 after Karo in early 2006, and state local and private preparedness would have been more advanced. Now Phase 3 = Now and then next thing anyone will hear will be Pandemic, but too many people don’t know that. No commentor so far is throwing in the towel, but there are other ways to safeguard the people on the globe from disease outbreaks, since the WHO kowtows to, “political and economic pressures”. You didn’t even post your readers a map with nations that have had “officially-confirmed” Human H5N1 cases. I’d like to see a map with all the Rapid Response and Containment Zone circles to date drawn on it, too.” Globalization” has been bad for “children and other living things” – When the WHO stops working to safeguard us, and puts the world at risk as it has, regarding this “unprecedented” killer flu virus out of the PRC, then it is past time to turn to more honest and more effective organizations for our “good guards”. What we do Not need is One New World Order; not financially, and not in disease surveillance; the “flaws” and “skipping the rules” are going to get too many people in too many deliberately under-warned and under-prepared countries killed. Who benefits?
…”A spokeswoman for the World Health Organisation’s Beijing office, Nyka Alexander, said yesterday that the WHO had no plan to send experts to investigate the cases or demand virus samples. ” (SCMP.com)(Helblindi at PFI) “Whatever has been left of WHO’s credibility, is now gone.”
The WHO does not stand between the US and an, “at any time” lethal pandemic from this Chinese viral threat; it is part of the problem, and the US should make ”Better safe than sorry” -or -”Better ’safe’ than, ‘tragically wrong’” preparedness decisions on its own best judgement; for our citizens and our national security. Non-pharmaceutical Interventions are all we’ve got; the public needs to be informed now and made ready to make avoiding infection possible.