Were there companies that made money off this potential disaster, yes. I’m sure companies are making money off the Haiti Earthquake too. Nothing any of us can do about that.

Was the potential danger from H1N1 real? Absolutely. It was up to the virus itself on whether it would turn deadly or not. Even though it didn’t turn deadly, being prepared for it wasn’t wrong.

I am a disaster planning consultant, so I err on the side of being prepared rather than waiting to see what’s going to happen. If we wait too long, we will have no defenses. In April/May, the pandemic timebomb started ticking…..no one knew how big the explosion would be. It could have been a dud or it could have been nuclear. Fortunately, it was a dud, but that doesn’t mean we were wrong to be prepared.

And of course the drug companies are going to be first on the scene when a pandemic hits. That is only natural. It is their business, so not a big deal in my mind.

If you study past pandemics, you know that the first wave could be a dud and the second wave could become very deadly, just as happend in 1918 when 40-50 Million people died, most in 3 months. Being prepared with vaccine and anti-virals, masks and gloves, hand sanitizer, etc. is still required.

Keep getting prepared. There’s still a pandemic on the horizon.

Harlan Dolgin
Director of Continuity Services
Bick Group
Read the Article at HuffingtonPost

H1N1 is still spreading rapidly, although most of the media has given it very little attention lately. The World Health Organization’s (WHO’s) latest report indicates that over 25,000 people in 73 countries have been confirmed with the 2009 H1N1 influenza.

The WHO is reportedly reluctant to raise the Pandemic Alert Level from 5, where it is now, to 6 (signifying we are in a pandemic) because of the potential panic that might follow. Unfortunately, this delay is causing too little attention to be focused on this problem, which also is not good.

There are 25,288 confirmed cases, according to WHO’s latest update.  That is 3,348 more confirmed cases than the prior update just three days earlier.  Most of these confirmed cases were people in the United States.  I suspect that is because our system of medicine is better and we do a better job than many countries of identifying cases.  So far, 139 people have died from having the 2009 H1N1, and it’s only been in existence about two months.  

Compare that to Bird Flu (H5N1), which has been around since 2003 and has been responsible for  262 deaths.  It won’t be long, maybe another few months, before H1N1 surpasses H5N1 in total deaths.  Of course, it is the Mortality Rates (MR) that are most important, and fortunately, the MR for H1N1 if far, far, far below that of H5N1. 

 To calculate the MR, you simply divide the deaths by the number of cases.  The MR for H5N1 (Bird Flu) is 60.5%, which means that 60% of all people who contract H5N1 die from it.  Conversely, the MR for 2009 H1N1 flu is only .55%, meaning that 55 die out of every 10,000 people sick with this new flu.

More about this on my next blog.  Stay tuned…..

Hello Everyone,

It’s been a while since I’ve written a blog, as I’ve been busy working with PandemicPrep.Org since H1N1 broke out.  We’ve been making plans which I’ll share with you in a future blog.  We did hold a very successful Anti-viral Program and H1N1/H5N1 Update.  We had approx. 110 people and the response was overwhelmingly positive.  Thanks to Susan Cutler from Roche Laboratories for planning the event, and to Steven J. Lawrence from Washington University for being the keynote speaker.

The media hasn’t been reporting much about the H1N1 lately, but that doesn’t mean it has gone away.  The WHO on Saturday reported that there were 15,510 confirmed cases and 99 deaths.  We now have enough data to begin making a reasonable estimate of the Mortality Rate for what I’m calling the first wave of the 2009 H1N1 Influenza.

The CDC has developed a Severity Index similar to the one used for Hurricanes.  They allow us to label a pandemic based upon its mortality rates (MR) from Category 1 (MR less than .1%) to Category 5 (MR > 2.0%)

There have been three pandemics in the 20th Century, each with a corresponding Mortality Rate.

1918                       40-50 Million Deaths                          2-3% MR                Category 5
1957                      2 Million Deaths                                     .25% MR                Category 2  (see related article)
1968                      1 Million Deaths                                      >.1% MR                Category 2 (see related article)

By comparison, the Mortality Rates for the current H1N1 Influenza are as follows:

          Worldwide                    15,510 confirmed cases                 99 deaths             .638% MR    Category 3
          United States                 7,927 confirmed cases                 11 deaths             .139% MR     Category 2

The above facts mean that we could be in store for a Category 2 or Category 3 pandemic this fall, which could kill anywhere from 90,000 to 900,000 people in the United States alone, rather than the usual 36,000 per year that die of seasonal flu. 

It is possible that the H1N1 virus will mutate further, and that could change the mortality rate of the virus.  It is also possible that H1N1 could combine with H5N1 in some way, and that could significantly change the mortality rate for the worse, since H5N1 has a mortality rate of over 60%.

In any event, I’m predicting a bumpy ride this fall as flu season gets underway.

First, I’ve joined the Twitter community. I’ll have the link on this site by the time you see this. Please sign up to follow my Tweets.

Second, There is a lot of concern about the Bird Flu situation in Egypt, with the discovery of two more cases recently. That’s a total of 15 cases since the start of the year, making Egypt the worst location for H5N1 so far in 2009. It does appear that the virus has shifted in Egypt, which is a good thing because it is less deadly than it was previously. Of the 15 people that have come down with H5N1 this year in Egypt, NONE of them have died. There is some concern that it is more easily transferable from person to person, but if the mortality rate has gone down to zero, that is a significant and noteworthy development. WHO is sending a team to Egypt to study these latest cases, but they were delayed due to the holidays in Egypt. They should be there by now. Let’s see how long it takes them to report their findings.

Stay tuned…

Harlan

There is a guide for schools that will assist them in creating Business Continuity plans that says it will address All-Hazards. The document was created by the Agency for Healthcare Research and Quality. This agency is a branch of HHS. The document itself can be found at:

http://www.ahrq.gov/prep/schoolprep/school3.htm.

This is an excellent approach for most hazards. It is well thought out and incorporates many best practices that Business Continuity professionals use every day.

However, it is not quite an all hazards approach. It does not take into account the specific problems that will arise if schools are faced with a pandemic.

What if schools are asked to close during a pandemic? In Missouri, schools have a mandate that that need to teach, even though the physical buildings have been closed. This can be accomplished through use of e-mail and internet interactions between students and teachers. That has led to criticism that not all students have access to computers at home, but since an overwhelming majority of students do have home access to the internet, that may unfortunately be the best we can do. There may be a way to identify those that don’t have internet access, and develop a methodology of mailing assignments back and forth. This would be costly to invoke for all students, but might be easier to do if it were limited to those students that request it.

Pandemic preparedness in the schools means being prepared for school closures of 12 weeks at a time, as recommended by the CDC.

HHS published a document on Community Disease Control and Prevention during a pandemic. They identified school closures as one method they would use to curb the spread of a novel influenza virus. http://www.hhs.gov/pandemicflu/plan/sup8.html#_ftn3.

My last blog, I mentioned the State pandemic preparedness assessment performed by the Homeland Security Council.  I decided to take that data and try to make sense out of it all, to determine which states were the most prepared and which were the least prepared.

Giving each of the categories equal importance, I simply counted the number of cells for each state that were Fully Prepared, Mostly Prepared, etc, and gave each one a weight accordingly.  Each Fully Prepared received a 4, Mostly prepared received a 3, and so on.  The results are listed below.

The bottom line, there are some states are are VERY prepared, which is good to see, and some states that are HORRIBLY unprepared, so I guess the key is to hope you live in a state that is well prepared.  My condolences if you live in a state that doesn’t want to face the reality of the moment.

Here are the states that are best prepared, based upon my completely unscientific findings: 

Arizona, Wisconsin and Arkansas are in the best shape, all scoring 90 or above.  They are closely followed by Indiana, Delaware, Virginia, Alabama, California and Rhode Island.  (Missouri, the state I’m from,is 16th with a score of 78, so that’s not so bad….)

Now for the bad news (for somebody).  The states that have done almost nothing for a pandemic (at least according to the Homeland Security Council) are: North Carolina, Hawaii, Montana, Georgia, South Dakota, Nevada, Vermont, Mississippi and Kentucky.  I do find it sad that none of these states are as prepared as Puerto Rico is, although that’s good news for the people of Puerto Rico.

If your state wasn’t listed above, then you at least can take some comfort that you’ve got a partial plan in place.  If your state isn’t in the top list of prepared states, then you should consider contacting your political friends and ask them why.  Lives are at stake, and it is their job to make sure they are planning adequately for the pandemic we all know is coming.

This table was compiled from information provided in the link from my last blog.  Please refer to that link if you want to see the data.

Thanks.

Harlan Dolgin
www.dolginconsulting.com

Recently, the results of an analysis of State pandemic preparedness were released with very mixed results.  It was prepared for the Homeland Security Counsel in January 2009.  Below is a link to the full report.

http://pandemicflu.gov/plan/states/state_assessment.html

There are 27 Objectives broken down into three Strategic Goals that the Health and Human Services Department have identified.  States were then evaluated based upon their answers to questionnaires on how far they’ve gotten in each area over the last two years.

The three goals identified were:  A) Ensure Continuity of Operations of State Agencies & Continuity of State Government (with 6 objectives); B) Protect Citizens (14 objectives); and C) Sustain/Support 17 Critical Infrastructure Sectors and Key Resources (7 objectives).

The conlusion states in part:

The findings summarized above indicate that, in the aggregate, the States have made important progress toward preparing for their unique roles in combating an influenza pandemic but have much more to do. Most States have major gaps with respect to most of the 27 Operating Objectives.

This is troubling, given the fact that preparations have been going on since early 2006, and after three years of planning, we still have “major gaps” in our planning within each State of the union.  For example, Missouri has five areas where they have been graded as “Inadequate Preparedness”, and four of those occured within the strategic goal of Protecting Citizens.   They had two other objectives rated as Many Major Gaps (also in the area of Protecting Citizens) and eleven other objectives with a Few Major Gaps.  In only six of the 27 objectives was Missouri rated as No Major Gaps.

A quick review of Table 3 of the report, which identified the status of each State on each of the 27 objectives, indicates that Arizona was among the best prepared, with No Major Gaps in 19 of the 27 areas, and no area received a mark of Inadequate Preparedness.    On the other hand, Hawaii was one of the worst prepared states, with 21 marks of Inadequate Preparedness.

This is certainly an issue that bears closer scrutiny.  You should look up where your state lies on all these preparedness issues, and see if you can convince them to move faster to close all the gaps in planning that currently exist.

Thanks.

Harlan Dolgin
Dolgin Consulting, LLC

First, my last post talked about H5N1 found in Canada.  The last report I saw was that it was probably low pathegenic H5N1 and therefore not dangerous to people.  A very lucky break!

Now on to the current breaking pandemic news:  There were four outbreaks in the last 24 hours.  Three were animal outbreaks (Vietnam, India and Bangladesh), and one was a human infection (China).  This was reported by the Center for Infectious Disease Research and Policy (CIDRAP) at: 

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/feb0209birds-br.html

This highlights the fact that H5N1 is still very active in parts of the world, and is spreading and still has the potential to become the next pandemic.  The virus has been less active this winter than it was in the winter of 2006-2007, but it is still a grave threat.

I heard at a recent seminar that if we get to 2017 without experiencing a pandemic in the world, then it will be the longest we have gone in recorded history without experiencing a pandemic.  The last one was in 1968, over 40 years ago.  We are already overdue for a pandemic, as the experts often say, but if we go another 8 years without one, that will set a milestone for longevity between pandemics.  The likelihood is, therefore, that there will be a pandemic sometime in the next 8 years. 

We don’t know when it will happen for sure.  We also don’t know how severe it will be when it does occur, but we do know its coming, so please, please, please prepare for a pandemic in your community.

If you prepare, you have less to fear.  For more information on pandemic planning, see www.pandemicprep.org.

Thanks……….Harlan

Its a little premature to be too alarmed, but I just saw a news report from January 23 that said that Canada may have had its first outbreak of H5N1 on a Turkey farm in British Columbia.  See the link below for more details.

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jan2309avian-jw.html

IF it turns out to be true, and at this point it’s just suspected, then it may be a major turning point.  This will be the first case of high pathegin H5N1 in North America.  There was a case of low pathegin H5N1 in Virginia a few years ago, but low pathegin H5N1 is not dangerous to people.  High pathegin is the kind that is in the news, that can be deadly to people.

If it is confirmed to be high pathegin H5N1, then it may be just a matter of time before it makes its way into the U.S.  Experts have long thought that the migratory pattern of wild birds would bring H5N1 to the U.S. sooner or later, and the government checks many thousands of migratory birds every year to see if they have H5N1.  So far, they haven’t found any, but that may soon change. 

This is a wake up call that everyone needs to begin preparing for a pandemic.  At the least, people should start gathering extra food, water and medicine, learn and begin using proper hygiene, and consider how a pandemic might affect your family -  Will your job be affected?  Can you work from home?  What if schools close?  I’ll discuss all of this in a future blog, or feel free to e-mail me your questions at hdolgin@dolginconsulting.com to learn more.

Thanks.

Harlan Dolgin
Dolgin Consulting

There have been a few recent developments on the Pandemic front that I thought should be discussed.

First, last week CIDRAP reported new  H5N1 (Bird Flu) outbreaks in India (http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jan0509birds-jw.html) as well as China and Vietnam (http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jan0609humans-br.html).  Despite the fact that H5N1 gets almost no play with the media, it is still the biggest threat in the world of becoming the next pandemic.  The mortality rate, or death rate, is still a very high 63 percent of all people who contract H5N1.  393 have been infected by H5N1 since its inception in 2003, and of those, 248 have died.  Fortunately this is still only a small number of people. 

Some positive news, for a change.  There was a study released in December that shows a correlation between use of Personal Protective Equipment (PPE) and protection from viruses.  This study, conducted by researchers in the UK, was reported by the CDD and can be found at http://www.cdc.gov/eid/content/15/1/59.htm.     It concluded that “Incomplete use of personal protective equipment (PPE) was associated with conjunctivitis and influenza-like symptoms. Rigorous use of PPE by persons managing avian influenza outbreaks may reduce exposure to potentially hazardous infected poultry materials.”  It was not the most resounding affirmation, but it is significant that less illness was found when PPE was used effectively.

Last week, there was an article in the New York Times that the current seasonal influenza had developed a resistance to Tamiflu.  The seasonal flu is almost exclusively H1N1.  Unfortunately, H1N1 is now fully resistant to Tamiflu.  Fortunately, there are no other strains of flu that have developed the same resistance, so Tamiflu is still effective against all other flu strains.  Relenza is still effective so far as it is known.  The full article can be found at http://www.nytimes.com/2009/01/09/health/09flu.html?_r=1&hp. 

I hope this summary of recent developments has been helpful.