Gaps In Bird Flu Plan
Leave US Vulnerable -
(What Plan?)
From Patricia Doyle, PhD

Hello, Jeff - Gaps in an avian influenza plan (story below)? I would say that there is almost NO plan at all.
The USDA leaves something to be desired when we talk about developing a 'comprehensive' plan and 'comprehensive' programs to monitor for bird flu. Gaps? More like huge, monstrous HOLES in what appears to be a slight semblence of a plan to monitor, diagnose and contain avian influenza.
We have no idea as to how much illegal poultry or pork products are entering the US daily, or even how many smuggled exotic birds or animals have made it into the country. Illegal imports is a MAJOR HOLE that needs to be plugged immediateley.
Another way for H5N1 to enter the country is via migratory birds. I would hope that there is a plan being implemented currently that monitors migratory birds - as bird migrations will account for bird flu entry. When we first heard about a suspected human-to-human transmission of H5N1 in a family cluster in Karo, Sumartra, Indonesia, there was NO monitoring of visitors to the US from Karo, Indonesia.
What IF the cluster case had turned out to be the pandemic strain? The next big gap in the plan would have been unmonitored entry into the US of visitors from Karo. This could have been one of the most serious faux pas.
Obviously, preventing travelers from entering the US is unpopular and not very condusive to the economy. However, it might just prevent a pandemic outbreak here at home. Once a pandemic strain is identified in a country, our borders must close before the virus escapes from the index country. IF we wait until the virus "escapes the fire break" it will be too late. Who knows how many infected people wouold have entered the country with the pandemic strain?
Some measures will be extremely unpopular and some will be costly. Businessmen will have to sit down and plan strategy for their individual companies. Individuals will have to sit down with family members and begin to plan on provisions and make other preparations. Don't wait for Uncle Sam to do it. George just won't do it. I, myself, must take care of me and mine. Period.
Hospitals are in worse shape and have the most gaps. Hospitals, ER docs - right down to kitchen staff and cleaners - won't have a clue, and when the pandemic starts, it will be too late.
The gaps should have been plugged a year or two ago. Federal, State, County and local governments should have coordinated their plans a couple of years ago. The financial resources should have been accounted for two years ago, or more. 2006 should have been the year of the "final touches."
What took place on May 22, 2006 - the deployment of part of the US stockpile of tamiflu (which has not been returned to our stockpile) - was an act of desperation on the part of the WHO and the US Health and Human Services agency.
The agencies were so scared that the Karo cluster was the dreaded pandemic strain that they paniced and began rounding up tamiflu. Let's examine this strategy. A suspected pandemic strain develops in Country X. The WHO panics and requests that the US send, x number of doses of tamiflu from the US stockpile. OK. The WHO begins prescribing tamiflu to the patients, hospital personnel, etc.
Then, all of a sudden, let's say Country Y reports a cluster of the same virus strain in country x, the pandemic strain. Woa! The fire break did not stop the virus from spreading via scared refugees from Country X to Country Y. The US, now in full panic, asks for the tamiflu stockpile back. What do you think the odds are we get it back...or any part of it? More than likely, Country X will simply say they used it and deployed some to
Country Y.
So, a few days later, the US reports its first cases of bird flu pandemic strain. Well, we have even less tamiflu and practically no pandemic plan. People go to work, school, shopping, etc and one by one, people begin to take ill. Hospitals are overwhelmed within 8 hours of treating their first case. Hospitals close down like dominoes and all sick patients are asked to report to Yankee stadium in NY City and various stadiums around the country. Make shift beds are set up in the stadiums where the sick are warehoused. The virus spreads in this situation like wildfire and people begin to get infected with different strains...bound to happen when people are warehoused. Doctors, nurses, EMTs treating patients become ill and die. Tamiflu, amantadine isn't working as it should. We did not have enough to treat everyone. Doctors, nurses etc have partial doses of it.
Resistant strains of H5N1 begin to develop therefore tamiflu and amantadine simply are useless. Relenza? Does not work. Maybe, some of the statins will work, however, people with liver problems really cannot use the drug.
The only thing that the government can do is to bury the dead quickly and try to cope with the ill in the various warehouses. Rumors of euthanesia abound and are probably true.
Many people flee their homes in the city and end up in government encampments which serves to spread the virus further.
The ones who have a chance for survival are those who have stored supplies, hidden them from the government and stay clear of the government. BTW, supplies are no guarantee of survival. IF the government learns that individuals have supplies, generators, gasoline, food, medications, pet supplies and plenty of guns and ammo to protect those supplies, etc, I am 100% sure the government will requisition them. Be sure the supplies are well-hidden and act as though you do not have any.
As was the case in 1918/19, the outbreak simply had to run its course. As with most pandemics, time enables the bird flu outbreak to run its course. Eventually people do build up resistance to the new virus and antibodies begin to help people fight infections.
The government should have been planning to
1. monitor for bird flu and prevent, as much as possible, it from entering the US.
2. Have a comprehensive plan for First Responders to treat bird flu victims without the crowded stadium type warehousing of victims and suspected flu victims.
3. The government should have a plan to assist people with supplies, perhaps a military-civilian supply chain of medical and food stuffs.
4. A comprehensive plan to take over utilities, and other vital entities. There also needs to be a plan with business to have debt forgiveness during the brunt of the outbreak when people are unable to work or even leave their home. Business should alo be included in government plans. Gasoline, food, medication, personal needs, clothing etc and all necessities need to be provided in some way. Business can attempt to set up some forms of business via at home workers. example:
A person who owns a blouse and shirt factory might be able to provide enough material and, sewing machines to homes so that seamstresses can continue to make product.
5. There needs to be safe, efficient and sanitary method of removing and burying the dead.
During this period of time it would be suggested that people learn first aid, even some very basic dentistry. If a pandemic does hit, we will have to be our own dentists, doctors, barbers, butchers, even our own veterinarians and farmers, etc.
The government "plan" has many gaps. Some states will have more gaps then others. It is up to the individual to try to survive a pandemic. Hopefully, I have given a few ideas as to how you can survive. Those gaps have to be filled by us.
If anyone has suggestions or advice, please contact me.
Patricia Doyle
Gaps In Bird Flu Plan Leave US Vulnerable
WASHINGTON (Reuters) - The U.S. Agriculture Department's failure to develop a "comprehensive" program to monitor for bird flu could leave the country unprepared if an outbreak happens, a bipartisan group of senators said on Friday.
In a letter to Agriculture Secretary Mike Johanns, six lawmakers said some states were not as prepared as they should be for the disease.
In order to better protect public health, they said, the department should provide states with a protocol for developing their own avian influenza response plan, rather than leaving that to the individual states.
The letter also expressed concern that the U.S. Agriculture Department has not done enough to prepare for an outbreak in multiple states or increase awareness among backyard poultry owners for symptoms of the virus.
"We need leadership from USDA in preparing for the arrival of avian flu," said Sen. Tom Harkin, an Iowa Democrat on the Senate Agriculture Committee.
"USDA's failure to develop a comprehensive monitoring program leaves us in the dark about areas of the country where better surveillance is needed. And USDA's inadequate assistance and cooperation with states and industry leaves our nation unnecessarily vulnerable," he said.
The letter also was signed by Democratic Sens. Harry Reid, Barack Obama, Hillary Clinton and Charles Schumer and Republican Charles Grassley.
Last month, USDA's inspector general said the United States did not have adequate measures in place to survey and monitor for avian influenza, including the deadly H5N1 strain.
The latest bird flu strain is known to have killed more than 130 people and forced hundreds of millions of birds worldwide to be destroyed.
H5N1 has remained largely an infection of birds as it has spread through Asia, Europe and Africa. This strain has not been found in the United States so far.
Some experts believe the H5N1 virus could mutate so that it could spread easily from person to person, potentially killing millions of people.
© Reuters 2006. All Rights Reserved.



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