Let's take it seriously
 

Remember those child hood stories?
The one about the big bad wolf and the three little pigs. The facts are.......
The big bad wolf said "I'll huff and i'll puff and I'll blow your house down!!!!
To which the little pig replied "Piss off wolf, or I'll sneeze on you"

You can't actually break the law by passing on contagions if you don't know that you have them.

Anyone who thinks that this is going to be contained by "quarantining" after people exhibit the symptoms is naive in the extreme.
Most people will have effectively spread the virus LONG before they get developed symptoms and of course those people cross infected will do likewise.

As the Chief Health minister said, "It may be better to simply treat this the same as the seasonal flu".

Unfortunately, just like the "Global warming" hysteria, there are those that think that we as humans can actually do something about a phenomena that's completely out of our control.

As George Carlin would have put it "It's the ultimate arrogance of our species" :=

you can reasonably suspect whether you have them or not when you simply trace your steps backwards for a week, have you been to a high risk countries in the list of 44 publish by the government? Are you starting to feel fatigue? Is your throat not feeling usual? simple steps like that can slowly narrow it down to whether you are a suspect or not.

however your team manager will laugh it off and say until I see you in a stretcher, hauled to the nearest hospital, I do not think it is anything to worry about, in that case, I think you need to slap them with the law and contact the NSW health department.

Don't let your employer bully you into not taking this seriously through scare tactics.

And yes such is the arrogance of the human species.

So still worried about this mild version of flu are we fellas?

Any bets on what the next 'pandemic' scare campaign will be?

I still don't get how they can call it a f#%king pandemic.....

Sure, the criteria for a pandemic is 'sustained community level transmission..' in more than a couple of countries, but the step down to the phase at the end of a pandemic is a reduction to seasonal infection levels.... which the current 'pandemic' (swine.... really?) flu is WELL below already.

So... was it ever really a pandemic?


Edit: Unprecedented typo on PPRUNE

A bit in the US papers yesterday estimated that over a million US citizens had now been infected by swine flu.

You are joking, aren't you?

It's a flu, for christ sake.

The only reason we know about it is because it's shoved in our faces every day by the media.

The mis-information that is reported as fact is diabolical.

So far, we have had 4 Swine Flu deaths. But then you read the small print and discover that the victims didn't actually die from Swine Flu. They just happened to have it at their time of death, but it wasn't the cause of death!

It's just a flu!

Of course the pharmaceutical companies are making a killing with their sales of Tamiflu medications. (Not to mention the companies who make those stupid little paper masks)

Wake up people, can't you tell when you're being conned, or do you all just blindly believe everything that you read in the paper or see on TV?

Some news
 

<QUOTE>

Swine flu: to every thing there is a season : Effect Measure


Early returns on what is happening in the southern hemisphere suggest that novel H1N1 is crowding out the expected seasonal strains, something that pandemic strains have usually done. In 1918 there was a pandemic with the H1N1 subtype that settled down as the dominant seasonal flu virus until the "Asian flu" pandemic of 1957 when it was bumped by H2N2. That subtype ruled the seasonal flu roost for only 9 years when a new subtype, H3N2 took its place in the Hong Kong flu pandemic of 1968. Both pandemics were much less severe than 1918 but still resulted in millions of excess deaths globally. In 1977 the pattern was interrupted with the return of H1N1, which didn't take the place of H3N2 but co-circulated with it. Since then we've seen mixtures of H3N2 and H1N1 each flu season, with sometimes one subtype much more prevalent, sometimes the other (a hybrid H1N2 made a sporadic appearance in 2002 but never gained a foothold and didn't represent a novel appearing virus to the population). Sometimes H1N1 and H3N2 would switch places at some point in the flu season, but those two, along with influenza B have made up seasonal influenza since 1977.

Now we have a novel H1N1 added to the mix. While novel H1N1 and seasonal H1N1 have the same subtype designation, the swine origin of the new virus means that the hemagglutinin (H) and neuriminidase (N) proteins on its surface are sufficiently different from the human adapted counterparts that it looks like a very different flu virus to most of the population. Despite its swine origin it is infecting humans and being easily transmitted from person to person. It is also continuing to circulate in the northern hemisphere at a time when most seasonal flu is at a very low level. The seasonal flu strains are essentially gone up north, almost all flu A being novel H1N1. Is this just because seasonal flu went away by itself (and we emphasize, again, the reasons for flu's seasonality remains a mystery)? Will they return, with or without novel H1N1 during next flu season up north?

We are looking to what is happening in the southern hemisphere for some clues. Australia is one of the most hard hit countries and also has a well functioning influenza surveillance system similar to one in the US. And it appears the new virus is pushing out the seasonal strains that were expected to be the main circulating flu viruses:

Tests on 138 type-A flu samples collected by a network of doctors confirmed 60 cases of the new A/H1N1 variant and only five of seasonal influenza in the eight weeks ended June 21, according to a report today by the Victorian Infectious Diseases Reference Laboratory in Melbourne.

[snip]

“We are seeing a big increase compared to the same stage of the flu season last year, and the increase is predominantly in 5- to 16-year-olds,” Kerry Chant, chief health officer for New South Wales, said in a statement today. Two children are in intensive care and two other people hospitalized, she said.

The eastern state, Australia’s most populous, has 653 confirmed cases of swine flu, the second highest number in the nation after neighboring Victoria state.

Health officials in Victoria have recorded 1,509 cases from laboratory tests and stopped analyzing specimens from patients with mild disease earlier this month as part of the state’s response to the virus.

[snip]

Victoria’s influenza sentinel surveillance network diagnosed flu-like illness in 21.9 of every 1,000 patients seen in the week ended June 21, the report showed. That’s up from 17 per 1,000 a week earlier.

The network comprises 87 general practitioners across the state who test a portion of their patients for flu to give authorities an indication of flu activity in the community.

Unlike seasonal flu, from which the elderly suffer the most death and disease, the new bug is targeting the young and causing potentially fatal complications in otherwise healthy people aged 30 to 50, pregnant women and those with asthma, diabetes and obesity, according to the WHO. (Jason Gale, Bloomberg)

Not only is the virus taking the place of the seasonal strains, it is acting like a pandemic strain usually acts, moving the age distribution to the left (younger age groups). So while the virus is not clinically very different from seasonal flu, it is epidemiologically different.

So what will happen? The most likely outcome in our view is that henceforth flu season will be dominated by a single viral lineage, the current swine origin H1N1. That may take a couple of seasons and during the transition we could have some very unpleasant flu seasons, with lots more illness than usual and increased morbidity and mortality among younger members of the population. That epidemiological difference will make this flu virus seem different and more frightening. But I'm guessing.Flu never does what we expect it to, so there are many other possibilities, some much nastier.

Over at Avian Flu Diary Mike Coston also reflects on this. He's an astute flu observer and always worth reading, no less so this time.

<UNQUOTE>

Cheers,
Brad

If you think it isn't worth your caring .. then don't
 

Here's a quote you might find apt:

<QUOTE>
In short - living your life by the news is like driving using only the rear view mirror. Both only show a selective part of the past - not the future. Please post your feelings about the future. A good idea or skill should not be kept to oneself.
<UNQUOTE>

It is from this thread: Pandemic prep teachable moment : Effect Measure


These snippets may also be of interest but the whole thread is worth reading if you are after a balanced view of the real professionals instead of what you are fed in MSM.

<QUOTE>
Far as I can tell, the public health authorities across most of North America have used this "teachable moment" to assure people that the flu is mild, that the "pandemic" is more a technical than a real problem, and that everything that needs to be done is being done.

In consequence of our don't-worry-about-it messaging, we have achieved a high level of disinterest in, and complacency about, the pandemic. Published polls show this to be true. For example, see:

Despite ?Pandemic,? Swine Flu Worry Dwindles

If/when we need to actually motivate people to take steps to protect themselves, and if/when we need to start talking up complicated and problematic community level interventions, then we will no doubt be seen by many as, and accused of, once again, being either a) scaremongers, or b) Pollyannas who failed to tell people earlier about the risk.

Which is to say I think we have failed to communicate in a manner consistent with known principles of effective risk communications. The practical result of this may well be that our eventual management of this outbreak will be less effective than it should be.

As in: more people will die than would be the case if we were leveling with people now about what may be coming down later.

German authorities warn of swine flu mutation risk | Health | Reuters
<UNQUOTE>

And if you want some deeper info on Flu etc please go to this page:
biology : Effect Measure


Cheers,
Brad

And once again:
 

For those too busy to research before posting but are interested in the facts here is a quick primer on pandemic influenza :
It is cut/paste from a blog <http://afludiary.*************/2009/06/new-pandemic-primer.html> that I can't seem to link to from here:

<QUOTE>


Six week and nearly 300 essays ago - when the Swine Flu story was just hitting the news wires - I put together a primer on pandemics for first-time visitors to Flublogia (our little corner of the Internet that specializes in influenza) .



Today, with the declaration of a pandemic apparently imminent, I’ve updated that piece to include some of the information we’ve learned about the H1N1 swine flu virus over the past 6 weeks, and am running it again.


The HHS rates Pandemics like Hurricanes. Category 1-5

The 1918 Spanish Flu was a CAT 5 Pandemic.


While my regular readers are no doubt familiar with the basics of pandemics, it is probably a good time for a review.


Don’t worry, I’ll be gentle.



First, you need to know that scientists have been expecting another pandemic (global spread of a novel virus) to come around for years.


Influenza viruses, you see, are notorious for being unstable.

They mutate constantly, which is why we need a new flu shot every year. The changes from year to year are often minor, but even a tiny antigenic shift or drift in the virus can render your last flu shot useless.

Every once in awhile, we see a major change in an influenza virus. It can jump species to humans (as we believed happened in 1918), or it can acquire genetic material (reassortment) from another flu virus and create a new hybrid.

<image>

<Fig.> Birds, humans, and Pigs are all susceptible to Influenza

In either event, you can end up with a new (novel) virus to which humans have little or no immunity.

If the virus is also easily transmissible, and it produces illness in humans, you have the ingredients for a pandemic.

The term `pandemic’ describes the geographic spread of a novel virus, not the severity.

Roughly every 30 to 40 years for at least the past 3 centuries the world has seen an influenza pandemic. Usually these pandemics are mild or moderate, but on rare occasions they can be horrific.

The last true pandemic was in 1968, and the culprit was the H3N2 Hong Kong Flu.

As pandemics go, it was pretty mild. It probably only killed a million people or so, and perhaps 30,000 in the US.

Before that, you only had to go back 11 years, to 1957 and the H2N2 Asian Flu. A more lethal pandemic than 1968, the Asian Flu killed between 2 and 4 million people worldwide, and nearly 70,000 Americans.

The Granddaddy of flu pandemics occurred in 1918, and that was the H1N1 Spanish flu. Somewhere between 50 and 75 million people are estimated to have died over an 18 month period. The United States saw about 675,000 deaths from this flu.

We’ve also had `close calls’, such as the Swine Flu Scare of 1976, the Liverpool Flu of 1951, and the pseudo-pandemic of 1947.


In 1977, the H1N1 virus returned after an absence of 20 years, possibly due to an accidental release from a laboratory in the former Soviet Union.

It is also likely that we’ve been close to a pandemic other times, and simply were oblivious to the fact.

For the past 10 years we’ve been watching the H5N1 `Bird Flu Virus’ as it has moved out of Central China, to the Middle East, Indonesia, and parts of Europe.



The H5N1 virus has `pandemic potential’, but luckily hasn’t acquired the ability to spread from person to person easily.

You should know that despite the fact that the press has lost interest in it, the Bird Flu threat has not gone away, and the emergence of the H1N1 swine flu pandemic does not eliminate H5N1 as a threat.

The novel H1N1 `swine’ flu virus that has unexpectedly thrust us towards a pandemic is a distant relative of the seasonal H1N1 virus that has been in circulation – off and on – since at least 1918.

It has picked up genetic material from hosts (pigs) over the years (including some avian genes), that makes it unique enough that most humans have little or no immunity to it.

The good news (at least so far) is that this virus doesn’t appear to have the virulence (severity) that some pandemic strains have demonstrated in the past.

None of this is to suggest that this virus is benign. It isn’t. It is fully capable of producing serious, even fatal, illness in some small percentage of its victims.

For now, the WHO is calling this virus `moderate’ – not mild.

Early studies have suggested that it may be roughly equivalent to the 1957 `Asian Flu’ in virulence, but it is probably too soon to say with any certainty.


And the virulence of any influenza virus can change over time. The flu that we see this summer, or even this fall, may not be the same flu we see next winter or the following year.

And something else you should know; a pandemic is not a short-term event, like a hurricane or a flood. They can last for months – even a year or longer.

This is something we are likely to be dealing with in 2010 as well.


<image>


In late April, in response to the emergence of the novel H1N1 virus, the WHO began raising the pandemic alert level – from Phase 3 – where it has sat for several years, to Phase 4 and then to Phase 5.

It is anticipated that the WHO will declare a Level 6 Pandemic Phase later today. If that happens, it is simply official recognition of what has been going on for several weeks; the global spread of this novel virus.

We don’t know right now how seriously this pandemic will affect our society, our healthcare delivery system, and our economy. The impact could range from minor to severe – and since the virus could mutate, the effects could change over time.

It is unlikely that the vast majority of Americans will see a vaccine before 2010, meaning most of us will have to go through this winter without the protection of a H1N1 flu shot.

Certain high risk individuals, either due to their profession or due to falling into a medical high risk group, may see a vaccine late in the fall.

The HHS wants you, and your business, and your community to take this pandemic threat seriously. And that means being proactive, and taking steps now to prepare for this pandemic.

If you have not done so, go to Ready.gov. Get A Kit, Make A Plan, and Be Informed.

<image>

You should also visit pandemicflu.gov, and read and follow the advice provided on their Plan and Prepare page.

A pandemic may bring societal disruptions, such as prolonged school closures in the fall. You need to be figuring out now how you will handle it if your child is forced to stay home for weeks at a time.

You may also find that your regular employment is affected by a pandemic. There may be supply chain interruptions, personnel shortages, and possibly even some public health ordinances that interfere with your ability to work – at least temporarily.

And of course, during a pandemic there is a strong likelihood that you could contract the virus. For most people, this will simply mean spending a miserable week or two at home. The vast majority of people will recover without incident.

But some people, particularly those at higher risk, may experience serious, even life threatening illness.

You need to be prepared to care for yourself, and your loved ones, in your home. Dr. Grattan Woodson's Home Treatment of Influenza is as good a reference for the treatment of influenza as you are likely to find, and it’s free.

Hospitals and clinics are likely to be overrun with flu cases during a pandemic wave, and medical care will probably be difficult to obtain – even in developed countries.

Lastly, you need to be thinking about how you can help your neighborhood, and greater community, get through a crisis.

It can be something as simple as volunteering to be a `flu buddy’ for a neighbor or friend – being willing to fetch medicines, food, or render medical assistance in the event that they are unable to help themselves.

If you are able, you might consider volunteering with the Red Cross or, CERT, or the Medical Reserve Corps. There will also probably be opportunities to help with your local school, church, or hospital.

The important thing is that we react – not overreact – to this crisis.

If we retreat into our homes, refuse to work, or are afraid to help our neighbors and community we will only compound the effects of a pandemic.

And we risk putting a stake through the heart of an already staggering economy.

The pandemic of 2009 will make the third pandemic in my lifetime. It probably won’t be my last.

As Michael Leavitt, former Secretary of the HHS liked to say, “Pandemics happen.”

Now it’s our task to deal with it.



<UNQUOTE>

Cheers,
Brad

Blimey Bradley, I am exhausted from reading your post. Are you a pilot or a quack, you sound like one of those horribly ernest young S/O's who regale you for hours about some drival or personal problems they might have, ( I still shudder when I think of one young man who spent the entire night trying to convert me to Buddhism) anyway old chap, you cannot go thru life with a hot water bottle and parachute strapped to your side, and having bottles of dettol in your nav bag, carefully wiping hotel doors ( I flew with one of them too) eat well, exercise, relax, and if you do get the dreaded lugey, you will be equipped to fight it, live each day mate, stop worrying about it, next year it will be something else!

.....great post Theresa.

I haven't had a laugh like this from pprune for ages:D

You're right though. Pig Flu, Swine Flu ,H1N1, Hep A, Hep B & C, the world is full of nasties.

Many moons ago ......me and a mate back packed from Capetown to Cairo........and guess what.... survived. Its all a numbers game -just as the dudes who won last nights lotto and got $50m each.:{

Paranoia will get you know where.

The only way to avoid all this is to lock yourself in a bubble on a sterile IV drip.:hmm:

I figured out stubby with 25,000 hrs in my log, that means I must have eaten at least 12,000 crew meals, now mate, that should be enough to kill a herd of elephants, I reckon crew are miles ahead in the infections stakes, if they have survived x amount of crew meals, not much else could possibly kill them, and old blokes like me have survived, the threat of TB, Polio, Hepatitis, Asian flu, AIDS, mad cow disease, Ross River fever, to say nothing of mumps, chicken pox, and measles, and like most blokes I personally hope I die "on the job" if not I will be quite happy to be buried in a old DC9 with my arm around one of her beautiful little donks and sent to the nearest aircrew bar in the sky, meanwhile I am dammed if I am going to worry about some flu, pig, goat or otherwise, I am far more interested in catching my next Barra, and so should the rest of you.

I am sure Brad has some stakeholding in Tamiflu or the likes??

Anyway on a side note I had a mate get the dreaded Swine Flu, he had a fever and was bed bound for a day, then a week later I got some flu symptoms, got tested but it was just another strain of flu! Well I shouldn't say just I got slammed and bed bound for 4 days! I know which one I would have preferred to get! The Swine is just another strain that has appeared along with heaps of others in the past which have transferred from avian and swine origins!
:)

(Sigh) the problem is not the virulence of pandemic flu, it is going to be the number of cases that have the capacity to overwhelm the health system.

Teresa et al,

Loathe as I am to rebut the sniping and sarcasm that is a regular feature of PPRuNe, I'd just like to make 2 things perfectly clear:

1. I have no interest in any business associated with this or any other pandemic or medical interest. The purpose of my posts is to share with my profressional colleagues the information of which I have become aware through a personal interest in the virology and epidemiology of Influenza A.

2. The information I post is relayed from the worlds acknowledged authorities on Flu A as well as sources well outside the MSM you so decry every time they beat up an aviation issue. Perhaps that experience should make you wary of blindly accepting what you are fed on the telly or your daily rag of choice. The recent posts which you find so tedious are all direct quotes with attriibutions stated as best I can within the link posting limitations of PPRuNe.

You are welcome to add me to your ignore list, not read the posts or exercise your free will in any other way so so desire. Personally I'd prefer if you all played the ball and not the man ie. stick to the facts and do some reasearch.

Cheers with the best intent,

Brad

I say again.

It's just a flu! :ugh:

Latest from popular media website:From the article:
That last sentence is a hint that it might be a little more serious than i previously thought...

Any updates about the current flu situation/ (and fatalities) from those that post on this forum with a knowlege about all things?

No need to panic over flu deaths'

Sydney Morning Herald

July 8, 2007


A FLU outbreak in NSW was unlikely despite the deaths of three young children in Western Australia in the past few days, authorities said yesterday.

But NSW Health said it was not too late to be vaccinated against the respiratory illness.

NSW Health director of communicable diseases Dr Jeremy McAnulty said the annual flu season had arrived in NSW but there was no data to suggest anything more serious than usual. "It's so far shaping up like a regular old flu season but we will be monitoring it over the coming weeks," he said.

While most people get over the flu without problems, young children, the over-55s, Aborigines over 50 and people with existing medical conditions should take extra care, he said.

People with diabetes, heart problems and respiratory conditions were particularly at risk from complications, such as pneumonia, brought on by flu.

Dr McAnulty urged people in those groups, who had not already been vaccinated, to visit their GP and receive the flu shot, which takes about a week to take effect.

People struck down by flu should stay at home and recuperate, rather than go to work or school and risk spreading the illness, he said.

Dr McAnulty said it was also important to remember basic hygiene, such as coughing into a tissue and regular hand-washing, to reduce the spread of flu.

"Many hundreds of people in NSW, maybe thousands across Australia, are hospitalised from flu each year," he said.

"There's probably several hundred deaths across Australia, usually elderly people but sometimes small children . . . fortunately it's pretty uncommon."

Hundreds of concerned parents have fronted up to hospital emergency departments across Perth following an influenza warning from health authorities. Their action was prompted by a call from Western Australia's Department of Health urging parents to seek early medical attention for young children showing signs of respiratory illness.

The department's warning followed the deaths of three children, all aged under five, in the Perth metropolitan area in recent days.

It has been confirmed they died from the A strain of the influenza virus, which can be controlled by vaccination.

Two died after suffering complications after falling ill in a Perth hospital. The third did not receive hospital treatment.

OK Kiddies, lets move on to the next sensationalistic journalism piece, surely there must be another apocolypse due soon :ugh:

Quote from Effect Measure - A blog by US Public Health Officials:

Pediatric complications and deaths with swine flu

Category: Swine flu
Posted on: July 24, 2009 7:54 AM, by revere

Yesterday CDC's Morbidity and Mortality Weekly Report (MMWR) carried an a note about neurologic complications in children with swine flu. Central nervous system effects -- seizures, encephalitis, encephalopathy, Reye syndrome, and other neurologic disorders -- are known to occur with seasonal influenza in children, but whether they are more or less common with the swine flu variant is unknown at the moment. The MMWR reports four cases from Dallas County, more as a reminder that these kinds of complications can occur and should be considered whenever a child with influenza-like illness (ILI) presents with unexplained seizure or mental status changes. It's also a reminder of something else. That influenza, whether seasonal or pandemic varieties, presents different clinical pictures in different age groups, but pandemic flu shifts the age distribution of ill cases towards the younger age groups. The difference is not necessarily a clinical difference but an epidemiological one. First, the clinical picture:

This is the first report describing patients with neurologic complications associated with novel influenza A (H1N1) virus infection. The severity of the neurologic disease in the four patients described in this report was less than the typical disease described in two studies of neurologic complications associated with seasonal influenza (1--2), which included reports of severe static encephalopathy and death. Only two of the four patients described in this report had seizures, and none died or had neurologic sequelae at discharge. Considering that clusters of influenza-associated encephalopathy in children have been reported during previous community outbreaks of seasonal influenza and that children appear to be infected with novel influenza A (H1N1) virus more frequently than adults, additional neurologic complications in children are likely to be reported as the pandemic continues. Clinicians should consider influenza associated encephalopathy in the differential diagnosis of children with ILI and seizures or mental status changes, and remain aware of the potential for severe neurologic sequelae associated with seasonal or novel influenza A (H1N1) virus infection. (MMWR, CDC [cites omitted])

If that sounds vague reassuring, it is important to remember that influenza infection is always potentially dangerous. Seasonal flu kills mainly those over 65, but pandemic flu targets the young, and while most "just have a case of flu" (in itself potentially nasty as the cases reported above show), every year children die and this year's flu season was no exception. For several years CDC has been trying to keep track of pediatric flu mortality and the striking thing about this year is the appearance of pediatric swine flu as a distinct second season. Here is a chart from last week's CDC surveillance report where it is easy to see that this year's pediatric mortality from seasonal flu looks very much like the three previous years (although last year was a very bad flu year), but that in addition pediatric deaths are occurring this year during weeks when there are no, or almost no, pediatric deaths in the previous seasons. This is another key marker of an influenza pandemic:

IPD27.jpg

Source: CDC, Influenza-associated pediatric mortality

Of the 90 pediatric deaths this year (there were 88 last year), 23 are from swine flu. Not all of the children had specimens collected, but of the 40 that did (all deaths, not just swine flu), about a third (15) had bacterial co-infections that contributed to their deaths, and Staph aureus was the organism in 9 of them (60%). Of these 9, 5 were MRSA, i.e., antibiotic resistant (see our post of the other day). This year, as in past years, the children with bacterial co-infections have been the older ones, most over 5 and two-thrids over 12 years old. Of the 9 swine flu fatal cases in children where specimens from normally sterile sites were obtained to see if there was bacterial co-infection, only one had a positive bacterial culture. It is still too early to say if this difference is a real difference in the likelihood of bacterial co-infection because no specimens were obtained from the majority (14 of 23) of the fatal swine flu cases.

The swine flu pandemic continues to be described in some quarters as "mild." In our view, "mild" is not a word that should be used in connection with influenza outbreaks, whether seasonal or pandemic.

To Prep or not to Prep?
 

Another Quote from Effect Measure:

<snip>
The swine flu prepping controversy

Category: Pandemic preparedness • Public health preparedness • Swine flu
Posted on: July 21, 2009 7:09 AM, by revere

The reaction to our post on Sunday about preparing for the ongoing flu pandemic was mixed. Some thought it was right on target while others expressed dismay over what was perceived as minimizing the possible effects, especially as we have been talking for well over four years about the potentially pervasive nature of widespread absenteeism. Still others thought we had retreated to a narrow view focused on the pressure on the health care system while neglecting what might happen in the wider world. There is some truth to all these perceptions, but we didn't take this tack because we changed our mind. We took it for pragmatic reasons relating to the urgency of the problem. We'd like to explain because we wish to make a few points (again).

1. We are out of time. Yesterday's post about prioritizing vaccine efficacy and safety studies applies also to pandemic preparation. For years we have been advocating a broad approach to pandemic preparedness through strengthening the public health and social service infrastructures. Since the Reagan era, both Republicans and Democratic Presidents and Congresses have systematically dismantled and in other ways crippled public health and social services in the US. Both are a shadow of what they were before Reagan. It was our belief, based on four decades in medicine and public health, that service infrastructure investment was the best way to protect us against an influenza pandemic and many other hazards as well. If a pandemic didn't happen, there would still be manifold benefits.

But we didn't do it and now it's too late. Fortunately the pandemic that is evolving is not the one we feared most. It may change character, but in terms of preparing as a community we've only got a 10 foot dike, so it won't matter if the flood crests at 15 feet or 20 feet. We should be getting ready to be inundated, but we're not even doing that. The focus on vaccine availability we cited on Sunday and again yesterday is "planning for the best" (the availability of a vaccine that works). When it comes to planning for the (more likely) worst, we have to be realistic and pragmatic about how bad an event we can prepare for. We still have time to get ready for the kind of pandemic they are seeing in the southern hemisphere and which we have had twice in the last century (1957 and 1968), but not much more. The planning corollary to the perfect being the enemy of the good, is the horrible is the enemy of the bad. There is too little emotional energy, money and people to do what we should have done over the years. The has clock ran out. So now we find ourselves talking about a much more restricted response than we wanted.

2. In this context, a calm, steady and rational approach will serve best. It is easy to anticipate the media images that will produce the opposite. Images of overwhelmed health services and out of stock necessities will make communication very difficult. Other effects will have less impact. School closings are a hardship but not a cause of panic. It is unlikely water will be unavailable, for reasons we outlined on Sunday (and we have professional experience regarding water system security). If there is interruption of electricity it is unlikely to come at the outset, very unlikely to be national or regional in scope and in any event can be fixed. If you live in an area prone to outages, take that into account, as you would normally. Remember that flu pandemics are irregular in time and space. They don't happen everywhere at once and some places are virtually untouched. The key issue is to instill a sense of empowerment and control by having objectives that are attainable, visible and rational. That was the subtext of our Sunday post.

3. The issue that seemed to provoke the most consternation was our implicit rejection of personal prepping as a solution. We plead guilty to this, so we feel obligated to explain why we have taken this position. The most obvious, and in some ways the most understandable explanation, is that this is a public health blog. Our professional object of interest and our point of application is a population or a community, not an individual. Individuals are the subject of clinical medicine, and while we are physicians, we are firmly fixed in the public health realm. Our intended audience is state, local, and national public health professionals and we know from our referrer logs we they are reading us regularly. Many others are drawn here by reason of personal interest and we welcome and often try to involve them in a public health approach. But we don't do personal prepping here mainly because it's not our subject matter.

But it's not just a subject matter issue. We have a philosophical bias. We think it's great if people take personal responsibility to prepare for whatever hazards might come, whether it's buying home owner's insurance or stashing away a couple of weeks of staples (contrary to what I have said, Mrs. R. informs me we have more than enough in the pantry to last a few weeks; shows you what I know). We are lucky. Most of the world cannot provide for daily needs, much less stock up a couple of days, weeks or months worth. Most of the world means most people, so we are not in favor of making self-reliance the centerpiece of preparation. It's irrelevant to most people in the world and therefore to us as public health professionals. I realize many preppers are also generous people who will share and help others. If people talked about neighborhood food pantries, we'd consider that very appropriate. Self-reliance, though, is not a topic here nor does it advance what we stand for. Our definition of public health is what we, as a community, choose to do for each other. As I said, it's a philosophical bias. If you are focused on individualism as a principle, you won't like our approach.

4. Our interest in flu at the outset was as a lens through which to look at public health from a progressive perspective. This is a political blog as well as a science blog. As we've said many times, public health has the word "public" in it and is inherently political, in the non-partisan sense. Public health as a profession and our progressive politics are joined by a desire to make a better world. That's a lifelong commitment for us that we've pursued at one time or other in dingy storefront offices, in the streets, in free clinics, in the classroom, in union halls and churches and auditoriums, with stethoscopes, petitions, typewriters, mimeomachines, xeroxes and computers. And now on the internet. Four and a half years ago, when we started this blog, one of our objectives was just to keep the lights on in a dark age. That moment has now passed and we aren't sure we are adding much to the conversation. We're weighing our options, looking to see if there is a better way we can be effective. But at the moment we are here.

The bottom line regarding the pandemic is that it is too late for the kind of overarching approaches we have been advocating. The train has already left the station. What remains is how to use the little time left to make things less bad. We'll muddle through. It's not the end of the world.

But we could have done so much better had we invested in public health as a common good, not just a technical fix for a pandemic. Maybe when this storm passes, we can again put our shoulders to the wheel to make that happen.

Blah blah blah blah blah

Duck and cover, and dont forget to cough into your sleeve! :}

Bump!

To be filed between Sasquatch and Tarot Cards (The "we're all doomed bit", anyway....) :)

GFC + Swine flu = flash in the pan.

Was a fantastic time to buy up in the share market. Its over now. It was the story of 08/09

Mr. Hat:

I don't think our European colleagues nor the medical profession, nor the Government share your assumption.

I hope you are right, but I urge you to get your 'Flu shot when it is available to you. I've already had mine.

So what happened to the Swine Flu this year?

I'm glad to see there was no major return. Or was there and it didn't make the mainstream media?

I've had it, Dad got it..lots of people I know had the same symptoms, bad productive cough..fever, tired painfull joints that takes ages to go away..

Doctor said the medical profession was told to tell people that they just had the flu..scaring people doesn't help the recovery and its just like any other bad strain that comes along every couple of years!

yep.......caught it in Victoria :yuk::yuk::yuk:

Left Cowra with a tickle in the talker, by YMOR feeling a bit off, by YAMB going downhill fast and by YCAB, was glad to throw the Retard Vehicle in tha hanger. By the time I drove home I was glad I was not flying, came over me that fast, in a couple of hours between YMOR and YCAB few days later back at work but 6 weeks later still have a raspy cough :yuk::yuk::yuk:.

OINK OINK :cool:

I know someone who had it while pregnant AND in the middle of the 'big scare' - Drs told her to go home and take a lie down for a few days.

It was just another strain of flew blown way out of proportion by morons with agendas.

As I stated earlier in this thread, 100s of thousands of people die of flu every year world wide. 150 died of this particular strain-which made it a damn site less virulent than garden variety flu.

People need to learn, or relearn, what is worth worrying about and what isn't. If some dildo is screaming "we're all doomed", especially a politician, it's almost certain that no problem exists.