H5N1

Dubai: 'They made a mockery of us'

Via Xpress, an unpleasant story about an Indian expatriate family's experience with H1N1: Flu trauma: 'They made a mockery of us'. Excerpt (but read the whole thing):

An Indian school teacher who came down with swine flu along with her three children in Dubai last week said that her family did not receive timely help at two hospitals. 

“They made a mockery out of us and I pray that no other family suffers our plight,” Nalini Fatima Gonsalves told XPRESS.

Mexico: Kids going to school hungry

Never mind the pandemic--this is bad on general principles, and the pandemic only makes it worse. Via Milenio.com: Niños van a la escuela sólo con un té en el estomago: Ernesto Cordero. [Children going to school with only tea in their stomachs] Excerpt, with my translation:

 El secretario de Desarrollo Social, Ernesto Cordero aseguró que aun cuando “mucha gente” lo acusa de “exagerado”, en México existen familias que dejaron de comer tres veces al día y niños que van a la escuela con “un té en el estómago y con una tortilla embarrada de frijoles”. 

Ernesto Cordero, Secretary of Social Development, said that even though "many people" accuse him of "exaggeration," Mexico has families that have stopped eating three meals a day and children who go to school "with nothing in their stomachs but tea and a tortilla with beans."

“La consecuencia de (la crisis) es que muchas familias se están saltando una comida y a lo mejor hacen dos o una comida al día. Los niños que van a la escuela con un té en el estómago, con una tortilla embarrada de frijoles, si bien les va”, dijo.

"The consequence of the crisis is that many families are skipping a meal and at best living on two or even one meal a day. Children who go to school with tea in their stomachs, and a tortilla with beans, are doing well," he said.

The crisis is not just the pandemic, but the global recession aggravated by the collapse of Mexico's tourism. This is where we face the consequences of our decisions in the last twenty years or so. We've "cut the fat" out of social services, asked those services to "do more with less," and in general tried as individuals to get our social services for nothing.

So the kids who die of H1N1 (and many other causes) are not just the victims of bad luck in meeting a nasty virus. We in the affluent world have chosen, as individuals and societies, to pass certain costs on to people like Mexican kids, or First Nations kids in Manitoba, who can pay only with their lives.

If you smell sulphur, that's the hole in Hell they're warming up for you.

Hong Kong: Bad news and good news

Via the Hong Kong government flu website: Update of clustering of HSI cases in paediatric ward in PYNEH. Excerpt:

Regarding an earlier announcement on three patients and three staff members of a paediatric ward in Pamela Youde Nethersole Eastern Hospital (PYNEH) presented with fever and flu symptoms, PYNEH announced the following updates today (September 30):      

Today there is one more male staff member in the ward presenting with flu-like symptoms. Viral test was arranged and the staff member was subsequently confirmed with Human Swine Influenza. The staff member is now on sick leave and is in stable condition.      

PYNEH has enhanced infection control measures of the concerned ward in accordance with the HA Infection Control Guidelines and will closely monitor the condition of affected patients and staff. Patient service remains normal in the ward.

Meanwhile, another government report offers relatively good news: only 397 new H1N1 cases, bringing the total in Hong Kong to 27,897.

Canada: "An epidemic of confusion"

Via the Globe and Mail, Caroline Alphonso writes: Provincial flu strategies all over the map. Excerpt:

Two provinces and a territory have split ranks with the rest of Canada's health authorities in their fall immunization plans, sowing public confusion and raising questions of whether Canadians are being offered the safest options. 

The hodge-podge of vaccination strategies comes after a controversial, unpublished study suggested that people under 50 are twice as likely to contract the H1N1 virus if they have received a seasonal flu shot compared to unvaccinated people. 

With no data revealing the optimal way of rolling out vaccines against the looming double threat of seasonal flu and the pandemic swine flu virus, the abrupt changes by provinces and territories could create disarray in inoculation programs, with fewer people turning up for either shot, potentially resulting in more cases of severe illness. 

New Brunswick's public health authorities, skeptical about the science behind the Canadian study, have moved up seasonal flu shots for all their residents to October before proceeding to the pandemic vaccine campaign. Meanwhile, Quebec and Nunavut are deferring their seasonal flu campaigns until after their H1N1 mass vaccination clinics. 

Other provinces and territories – Ontario, British Columbia, Saskatchewan, Manitoba, Prince Edward Island, Nova Scotia, Newfoundland and Labrador, Northwest Territories and Yukon – have decided on a three-step approach. 

They will offer seasonal shots next month only to the elderly, who are at low risk of catching H1N1, and residents of long-term care facilities; then they will roll out the swine flu vaccine when it becomes available in November, and resume seasonal flu shots in December or January. Alberta will announce its decision Thursday. 

“We'll know who's smarter at the end of the flu season,” said Ross Upshur, director of the University of Toronto's Joint Centre for Bioethics and a primary care physician. 

“What we assuredly have is an outbreak of unpublished research which is causing an epidemic of confusion.”

Non-Canadians may not understand that our provinces--in some areas--are effectively sovereign states. Education and health are two of those areas, where the federal government provides some money and guidance, but the provinces set their own terms.

In some ways this is just fine. But in the present emergency, we do look like Canadian humorist Stephen Leacock's gallant knight who dashed out of his manor house, leaped on his horse, and galloped off in all directions.

Spain: Over 80,000 Valencians get seasonal flu vaccination

Via LasProvincias.es: Más de 80.000 valencianos se vacunan contra la gripe común en sólo dos días. [Over 80,000 Valencians get seasonal flu shot in just two days] Excerpt, with my translation:

La afluencia de ciudadanos a los centros de salud para vacunarse contra la gripe común, la de todos los años, mantiene su ritmo creciente. Desde el lunes, cuando comenzó la vacunación, hasta ayer ya se ha administrado el antiviral a 84.607 pacientes en toda la Comunitat, según los datos facilitados por la Conselleria de Sanidad. 

The flow of citizens of all ages to health centers for seasonal flu vaccinations continues to grow. Between Monday, when vaccinations began, and yesterday, 84,607 residents have received the antiviral, according to the Health Council.

Los resultados están confirmando la previsión inicial. Las autoridades sanitarias advirtieron el pasado verano de que se esperaba que este año, dado el temor a la gripe A, el número de pacientes que se interesarían por la vacuna contra la patología común aumentaría.

The results confirm the initial preview. Health authorities said last summer that they hoped for a growth in the number of patients who would seek vaccination against the seasonal flu.

US: California's Santa Clara Country declares an emergency

Via KSBW.com: H1N1 Emergency Declared In Santa Clara County. Excerpt:

An H1N1 emergency has been declared in Santa Clara County following the deaths of eight people infected with the virus. 

The county will receive $500,000 for an emergency response to the H1N1 virus, which is also known as the swine flu. 

Health officials have told Santa Clara County supervisors that the number of hospitalizations in the county is now up to 155 patients who have the H1N1 virus. 

The Saint Louise Regional Hospital in Morgan Hill is witnessing an average of three to four H1N1 cases a day. The hospital said they expect a steady increase of patients in the future. 

"We have a plan for what we call a flu tent, which is a tent specially set up to help patients under symptoms of the flu," said Dr. Valerie Vigl, of the Saint Louise Regional Hospital. 

Vigl said the tent, which was first used in April, will allow patients to be rapidly evaluated and treated. The tent will also keep those with H1N1 from infecting the rest of the hospital's patient population.

At the Monday editorial meeting of The Tyee, I mentioned the use of tents in Austin, Texas to handle the surge of H1N1 cases. Vancouver, I said, would likely do the same. One of my colleagues asked: "Will we have the tents?"

You know, I'm not sure. I'm going to follow up on this.

US: Military to get mandatory swine flu shots soon

Via Stars and Stripes: Military to get mandatory swine flu shots soon | Stars and Stripes.

U.S. military troops will begin getting required swine flu shots in the next week to 10 days, with active duty forces deploying to war zones and other critical areas going to the front of the vaccine line, a top military commander said Tuesday. 

Air Force Gen. Gene Renuart also told The Associated Press that as many as 400 troops are ready to go to five regional headquarters around the country to assist federal health and emergency management officials if needed as the flu season heats up. 

The Pentagon has bought 2.7 million vaccines, and 1.4 million of those will go to active duty military. National Guard troops on active duty are also required to receive the vaccine, as are civilian Defense Department employees who are in critical jobs. 

As a result, the military is expected to provide health officials with an early assessment of the vaccine. 

“Because I can compel people to get the shots, larger numbers will have the vaccine,” said Renuart, commander of U.S. Northern Command. 

“They will, as a percentage of the population, be vaccinated more rapidly than many of us. So we may see some objective results, good or not, of the vaccinations.”

Indonesia: Two hospitals wrecked in earthquake

Via the Globe and Mail, an AP report: Destruction strikes city in Indonesian earthquake. Excerpt:

A powerful earthquake struck western Indonesia on Wednesday, triggering landslides and trapping thousands under collapsed buildings — including two hospitals, an official said. At least 75 bodies were found, but the toll was expected to be far higher. 

The temblor started fires, severed roads and cut off power and communications to Padang, a coastal city of 900,000 on Sumatra island. Thousands fled in panic, fearing a tsunami.

Indonesia's healthcare system is fragile enough without this kind of added disaster. And Sumatra has seen numerous outbreaks of human H5N1 in recent years. 

Are N95 masks worth it for healthcare workers?

Via the New England Journal of Medicine: Novel H1N1 Influenza and Respiratory Protection for Health Care Workers. Excerpt:

Your hospital has been seeing a large number of patients with influenza-like symptoms, many of whom turn out to be infected with the novel H1N1 influenza A virus. You have been asked to consult on the case of a 28-year-old woman who is in an isolation room because of an influenza-like presentation and shortness of breath. 

You put on a gown, carefully clean your hands with hand soap or an alcoholic gel, pull on gloves, and reach for a mask. Guidelines from the Centers for Disease Control and Prevention (CDC) recommend the use of an N95 filtering facepiece respirator. Some states and many professional groups have suggested that a standard surgical mask is satisfactory in this situation, except when a clinician is performing high-risk procedures, such as airway suctioning, in which case the N95 is still recommended. 

What should the hospital and its infection-control officer provide when you reach into the box for a respiratory protective device? What should be available to others who will enter this room, including nurses, respiratory technicians, cleaners, and food servers?

Jordan: 405 H1N1 cases

Via the Jordan Times: Swine flu total rises past 400. Excerpt:

The Ministry of Health registered 72 new H1N1 (swine) flu cases over the past week, raising the total number of confirmed cases in the Kingdom to 405. 

Sixty-five of the new cases are Jordanian, 30 of whom are students, while the rest are foreigners, according to the Health Ministry's weekly report, received by The Jordan Times on Wednesday. 

A total of 157 students from 74 public and private schools and 10 nurseries have been diagnosed with the disease since the beginning of the scholastic year in early September, the report stated. 

The majority of the new cases are being treated at Prince Hamzah Hospital, while one patient was admitted to the University of Jordan Hospital and another to the King Hussein Cancer Centre, it added. 

Meanwhile, Director of the Jordan Food and Drug Administration (JFDA) Mohammad Rawashdeh said the department is following up with pharmacies across the Kingdom to ensure they do not sell seasonal influenza vaccines as swine flu vaccines. 

Rawashdeh stressed that there are no pharmacies doing so at present. 

Earlier this month, the JFDA issued a circular warning the public against pharmacies and companies that claim to sell swine flu vaccines.