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Well, here we are.  The Swine Flu is sweeping over the country like an invisible Tsunami, or maybe like an invisible Katrina.  Several months ago the government – CDC etc  – promised that they were on top of the situation and there would be plenty of flu vaccine available.   “Brownie, you’re doing a heckuva job.” Doesn’t this seem sort of like deja vu all over again? I mean, during Katrina it was – at first anyway – difficult to tell whether the government just didn’t care or if they were just sublimely incompetent.  Now we know.

OK.  Now we have a new government in place. We all knew last spring that the Swine flu was spreading around the world and that it would be coming around here again in the fall. Well, it’s the fall.  Several months ago our government told us that there would be plenty of flu vaccine around, and remember, at the time no one knew whether the H1N1 flu would be morphing into something very deadly, like its cousin the 1918 flu pandemic that killed millions of people worldwide. So, there was a lot of concern and we were assured that there would be a lot of vaccine available.  But there isn’t.

As of today, the H1N1 flu is widespread in just about all the states. Meanwhile there is precious little vaccine available. It appears that the flu might even have peaked in some areas. So, how are things going at the CDC?  It seems they are confused. They thought they were going to have plenty of vaccine – but they don’t. So what happened? Did someone drop the eggs? How can we go from expecting maybe 100 million doses to be available to hoping for 42 million by mid-November? How can we be at the peak of the flu and have only 16 million doses available right now? There are 300 million people in this country.  And if you get a flu shot today, how long does it take before you have built up immunity to the flu? It doesn’t happen overnight.

There are only two conclusions that can be drawn from the H1N1 vaccine debacle – either our government doesn’t care or it is incompetent. There is an amazing similarity between the Katrina catastrophe and this – at least in the way the government has reacted. The primary difference is that the flu is not nearly as deadly as it might have been had it morphed – scant comfort, I suppose, to those whose children have already died from the H1N1.

One would have thought we had learned a lesson from Katrina, but it seems we didn’t – at least the elephantine U.S. government didn’t.  How could they not know there wouldn’t be sufficient supplies of vaccine? Were the manufacturers lying to them? Did anybody actually bother to do a calculation to see how much vaccine would be available on any given day? Have the people who work for the government ever heard of a spreadsheet?  Do they have any idea how to use a computer to project future supply and demand? I don’t think so.

We are simply at the mercy of an incompetent, uncaring assortment of Civil Servants who couldn’t care less if they rescue people from Hurricanes or germs or anything else for that matter. And where is the Presidential anger?  Where is the Presidential outrage at this gross incompetence? Where is my CHANGE? Why isn’t there any foresight, why no vision, why no imagination? Who is responsible for asking, “What if?” What if this had turned out to be a very deadly flu variant, as in 1918? It happened once – it will certainly – CERTAINLY – happen again. Don’t these people get it?

We lucked out this time. There are plenty of embarrassed, red faces in DC, but there should instead be plenty of embarrassed red faces out on the streets of DC.  But that will never happen because when you are a Civil Servant you have a job for life come Hell, High Water, or the Flu.  Nobody takes responsibility or gets blamed for anything – ever.

The problem is this: we have an incompetent government that is unable to protect the people of this country. It was demonstrated in Katrina and it has been demonstrated again with H1N1. Change is needed like never before, but it hasn’t come where it is needed most – inside the halls of government where intelligent, crucial, lifesaving decisions are supposed to be made, but they aren’t.

That is the lesson of the H1N1 vaccine debacle.

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I’m not talking about some third world country, I’m talking about the United States.  Approximately 50 million Americans have no health insurance and now face the prospect of being turned away from for-profit hospitals if they are in need of treatment for swine flu.  So why is that a concern?  Isn’t that also the way it is for these people if they break a leg or have a heart attack?  Don’t they just wind up at some overcrowded municipal hospital like always?  I suppose so, the only problem is that this time things might be different.

The World Health Organization has announced that there is now a severe form of the Pandemic H1N1 flu that goes straight to the lungs. It causes severe or fatal cases of the flu in young people who had been in good health.  While Americans have been enjoying the summer weather and their days at the beach, the people in the Southern Hemisphere have been battling the Pandemic as it has traveled from country to country and morphed along the way. A second wave if Pandemic H1N1 is about to sweep over the U.S. and the northern countries of the world and we are woefully unprepared.  Unlike Socialist Europe, we have no health care system in place to care for the general population.  We have no system for providing free flu inoculations for the general public. Even more of a concern is that we don’t have the capability to cope with treating the casualties of a severe pandemic, even for our wealthiest citizens.

The World Health Organization has reported that those people who contract the very severe form of Pandemic H1N1 require intensive care in order to survive.  How many of our uninsured poor will be provided intensive care in our for-profit hospitals?  None.  They are going to die.  How many of our uninsured citizens who already suffer respiratory diseases or cardiac disease or diabetes, and thus become very high risks, will be able to be treated in our intensive care units, even if they already pay for the best insurance in the land?  Very few.  The simple fact is that we are unprepared, as a nation, to begin to cope with a serious pandemic. We don’t have the intensive care facilities, we don’t have an emergency plan to deal with need for such mass treatments, and we have no intent on providing it to the general public in any case.

The World Health Organization has issued a worldwide warning about the coming pandemic.  It advises that the disease could have a devastating impact in those parts of the world where adequate health care cannot be obtained.  They are referring to the Third World, where first class medical care is  not available at any price. I guess they forgot about the 50 million – those Americans who also have no access to first class health care because they have no health insurance.

It’s coming soon.  Some of those Socialist European countires are about to begin mass inoculations for the flu.  The United States isn’t ready to do that yet.  Maybe in October.  And it will be done on a priority basis – which may not include you.  Of course, you’ll have to pay for your innoculation, and if you don’t have health insurance maybe you’ll just skip it, like you always do.  Welcome to the land of opportunity.  Welcome to the best health care in the world.  Welcome to North America’s Third World system of “medical care only for the insured and for those who can pay”.

You’re on your own.

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On June 11, 2009 the World Health Organization declared that the A (H1N1) Swine Flu had become a pandemic.  There is now no question that the disease will spread throughout the world.  It is expected that this influenza virus will revisit the U.S. in the fall, as most influenzas do, and the number of cases will be far higher than what was experienced earlier this year.  There are now a couple of questions that come to mind. 1) Is our government taking any steps to protect the population from the spread of this disease? 2) What will our government do if the virus mutates (as they often do) into a form that is resistant to any vaccines that might have been prepared in advance?

In 1918-1919 a very deadly pandemic influenza spread throughout the world, killing between 30,000,000 and 50,000,000 people worldwide.  More people died from that flu than died in World War I.  An estimated 675,000 Americans died from the flu during that pandemic.  At the time there was nothing that could be done to prevent the spread of the disease. Flu vaccines were unknown.  The coming pandemic may well spread as far and wide as the 1918-1919 pandemic, maybe more since we have a much more densely populated world now.  Right now, the current pandemic flu virus is not as deadly as the 1918 one. But does that mean we are safe?  What if it mutates? What is our government doing about the situation?

According to John O. Brennan, the President’s advisor on Homeland Security, the government is planning to have a flu vaccine available for voluntary vaccinations by mid-October. Which is a little late. The flu season usually starts before then.  He doesn’t say how many doses are being created, nor does he say how much they will cost – but they will be voluntary – if you can get one. Let’s take a moment and compare our American response to the problem with that of a country that has a national health insurance program. Hmmm…I winder what Ireland is doing about the flu? On July 4th the government of Ireland announced that they will provide free flu vaccinations to the entire population of the country this autumn. Aren’t you glad we don’t suffer from a national health program like those poor Europeans?

Oh, there is this one other detail – you know, the one about the virus mutating.  What do we do if the virus mutates into a really deadly virus?  That’s what happened in 1918.  If the mutation is major then the vaccines we are making in the U.S. will probably have no effect – and we also won’t be able to make enough of a new version of the vaccine in time.  That’s because we grow our vaccines in eggs, and that just takes a lot of time and lots of eggs too.  After all, our drug companies can’t make the vaccine in batches of a million eggs at a time.  So, to put it succinctly, we’ll just be out of luck.

On the other hand, there is another way to make a vaccine – synthetically.  Synthetic vaccines using techniques that already exist could build up our supply 100 times or more faster than using eggs. But our government is not pushing this technique. After all – we don’t have a national health system, do we?  It’s up to our private, profit-making, drug companies to develop such a vaccine and, of course, the real issue is this: does it make economic sense? Can they recoup their investment dollars? Who’s going to pay for all the development costs? So, while some companies say they already can make such a vaccine synthetically, as a country, we really don’t have much capability at the moment.  And of course, if the flu suddenly mutates, it’ll be a little late to create the capability won’t it?

So, what is the answer to my question? Can our government save us from the pandemic that the World Health Organization says is certain to come? Sure, if the virus doesn’t mutate and still only produces very mild cases of flu. But do we really need saving from that? And what if the virus turns deadly. That’s when we really will need our government to save us.  So far, however, it doesn’t look good. Right now the profit picture, probabilities of mutation, investment risk, and so forth is sort of keeping our major drug manufacturers on the bench  with regard to the synthetic vaccine thing.  Remember, the key issue here is profit.  Aren’t you glad we don’t have a government health program?

By the way, if you like reading medical thrillers (and you like my blog), you might also like my novel about a pandemic. It’s called The Viral Epiphany and its available on Amazon.  You’ll need a Kindle reader though, because it’s only available for digital downloads for now. You can take a look at it and order it here.

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Yesterday, the World Health Organization (WHO) announced that we are now at threat level 5 for a flu pandemic. A level 5 warning means that a worldwide flu pandemic is imminent. The WHO has never before issued a Level 5 pandemic warning.  It seems logical then to expect that we will soon have a Level 6 warning from WHO indicating that we are immersed in a worldwide pandemic.  While these high level warnings serve to get everyone’s attention, they don’t really do much to protect us, as individuals, from contracting the flu.  While the U.S. and world governments (not to mention the news media) have been quick to warn us of the imminent danger, there doesn’t seem to be much the governments are doing to prevent us from getting the flu.

One might think that the government would quickly order the pharmaceutical companies to ramp up production of a vaccine for the new flu virus. The problem is that even if they did, the companies could not respond quickly enough. That’s because our method of vaccine production, using eggs as incubators, is much too slow. Besides that, the companies just don’t have enough capacity to produce millions or billions of vaccine doses in a few weeks. A timely vaccine is simply out of the question.

OK, so how about distributing anti-viral drugs like Tamiflu or Relenza to the general population today or tomorrow?  Wouldn’t that work?  It probably would. There is, however, only one problem. There isn’t enough of either drug available. There are about 50 million courses of anti-viral medication in the U.S.  That should cover about 15% of the population. Worldwide, there are about 500 million doses available. Currently, there are 6.7 billion people in the world, so we can protect about 7% of the world population.  It doesn’t look promising does it? It appears that the government knows there is a potential for panic and strong public demand for these antiviral medications.  The supplies that we do have are being pre-positioned in all the states – under armed guard.

So, what can the average person do? It’s pretty clear that, no matter how well intentioned the Obama administration is, the government does not have the capability to protect U.S. citizens from this disease.  We are on our own.  A worldwide pandemic is inevitable. The only thing we don’t know is how deadly it will be. So far it doesn’t seem to be as lethal as the 1918 pandemic that killed 50 million people worldwide.  On the other hand, our usual fall and winter seasonal flu kills about 36,000 Americans every year – and we usually have vaccines for those viruses! With this new H1N1 flu, no one in the world will be vaccinated.  It is therefore likely that the death toll will exceed the 36,000 number in the U.S. by quite a bit.  We can only begin to imagine the toll this disease will also take on the worldwide economy as people avoid travel, shopping, public events, and so forth. The economic effect could be significant.

Meanwhile, we are told to wash our hands and avoid crowds.  Both are good advice, but the government will have to do more if the pandemic really takes off. At some point it might be necessary to ban public gatherings, like sports events and concerts.  I haven’t heard anything about quarantine measures, but I wouldn’t be surprised if they are being considered.  Our only defense against the disease is reducing person to person contact and keeping our hands clean until the virus burns itself out.  The flu viruses can survive on surfaces, like door knobs, for many hours, so it is important to not only wash your hands but to keep them away from your face. Just touching a mucous membrane with your hand can help a virus on your hand enter your body.  It probably wouldn’t hurt to buy increased quantities of food and stockpile it at home in order to minimize shopping trips.  It’s also probably a good idea to avoid traveling to places that have major outbreaks of the disease. I don’t know if there is much else we can do…..

On a related note – About a year ago I finally finished my first novel.  My book, The Viral Epiphany, deals with a pandemic situation very much like the one we are now facing (OK, maybe a lot, lot worse).  How’s that for a coincidence?  If you have a Kindle Reader, it is available on Amazon for digital download here. Sorry, it is not currently available in hard copy form.  The Viral Epiphany is, of course a novel, but it might make you think about how we do things, and perhaps it might also provide a few hours of entertainment while you sit in your home and wait for the flu to pass by.  The book is also Part 1 of a planned thriller trilogy.

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