Effect Measure

Bhutto, birdflu and WHO bashing

Former Pakistani Prime Minister Benazir Bhutto, despite a bevy of bodyguards, was assassinated yesterday. Pakistan is a dangerous place, especially for pro-American politicians or those thought to be pro-Western officials. It’s something to think about when you read that WHO and the US reference laboratory NAMRU-3 each sent teams to the politically unstable and hostile-to-the-West northern regions of Pakistan to gather information about the recent cluster of bird flu cases. WHO’s team was in Peshawar, north of Islamabad. Here’s what Middle East expert Juan Cole said about Peshawar the other day:

Speaking of chaos, guerrillas bombed a mosque in northern Pakistan, killing 50 persons, on Saturday. Barnett Rubin explains this horrific event as part of a concerted plan by al-Qaeda and the neo-Taliban in Pakistan to cut off and surround the northern city of Peshawar. (Juan Cole, Informed Comment),

The “horrific event” referred to was the bombing a week ago at Charsadda (lots of sad details at the link inside the pull quote), just northeast of Peshawar. Both Peshawar and Charsadda are close to the Afghan border, an area that is a Taliban stronghold. There are reports that members of NAMRU-3 went outside of Peshawar to villages where some of the cases occurred, although I could not confirm this. Either way, this is a dangerous place and the bombing happened within a day or two of the visits.

WHO has offered an Update in which they support their belief there was limited human to human transmission in at least one case. Here’s the text:

The first case of human infection with H5N1 avian influenza has been confirmed in Pakistan. Laboratory tests conducted by the WHO H5 Reference Laboratory in Cairo, Egypt and WHO Collaborating Center for Reference and Research on Influenza, in London, United Kingdom have confirmed the presence of avian influenza virus strain A(H5N1) in samples collected from one case in an affected family. Additional laboratory analysis, including gene sequencing, is ongoing.

At the request of the Pakistan Government, a WHO team traveled to Pakistan to participate with national authorities in the ongoing investigations of several suspected cases of human H5N1 infections. The following conclusions have been made accordingly:

  • The preliminary risk assessment found no evidence of sustained or community human to human transmission.
  • All identified close contacts including the other members of the affected family and involved health care workers remain asymptomatic and have been removed from close medical observation.

The Ministry of Health in Pakistan has taken timely steps to investigate and contain this event including case isolation, contact tracing and monitoring, detailed epidemiological investigations, increasing the availability of personal protective equipment, dedicating hospital facilities for any new suspected cases, and other infection control measures. In addition, agricultural authorities, including the Ministry of Food, Agriculture and Livestock and FAO, have been active technical partners for the effective control of this limited outbreak. (WHO)

A story by Helen Branswell indicates that tests for H5N1 on the other cases initially thought to be positive have not been confirmed by reference laboratories but that follow-up testing for convalescent antibodies is being done to rule out false negatives. But apparently the fact tthat WHO and NAMRU3 have so far not able to confirm further instances of human to human transmission or even infection has angered some (for a particularly egregious example, see this comment). Such people are either so terrified that any attempt at reason is fruitless or so intent on justifying their own fear they are glad when the news is bad and angry when the pandemic they have so far warned must happen has not yet occurred.

Admittedly WHO has risked this kind of reaction by clumsy attempts to spin information in the past. But spinning isn’t covering up and it isn’t outright lying. People can disagree on interpreting the evidence but I have no reason to believe now or in the past evidence was altered or suppressed or that in this case they are releasing false information.

I mention this because I am frankly upset with irresponsible comments about WHO from people tapping away at their keyboards in the safety and security of their living rooms thousands of miles away from the action. If I a loved one of mine were traveling in these areas I would worry for their safety every second. I’ve been quite critical of WHO here (I hope fairly), but when they and other public health professionals risk their lives to gather urgent public health information, they most certainly get the benefit of the doubt from me.

Comments

  1. #1 karen
    December 28, 2007

    Well put Revere. I know I wouldn’t want to be in Peshawar right now.

  2. #2 Tom DVM
    December 28, 2007

    With respect to the World Health Organization, it is all about false assurances and a lack of scientific integrity…and I believe I have the track record and scars to substantiate the comment…

    …one of many examples…is their use of the 3-7 million mortality (only) figures fraudulently lifted from a CDC model in 2005, stated as such in the limitations section of the experiment…and my local health department and Governments at all levels in Canada are still using these numbers to downplay the potential threat.

    I happen to believe they remain a political agency without regulatory or scientific ‘guts’…

    …I am patiently waiting for them to prove me wrong.

  3. #3 Tom DVM
    December 28, 2007

    It’s all about faith really…if you have ‘the faith’… good for you.

    I have already been on a WHO train wreck called SARS…and I will be on another in the near future.

  4. #4 The Blind Bugmaker
    December 28, 2007

    Agreed, WHO scientists are putting their necks on the line searching for bird flu sources under dangerous conditions. Insults of “rotten bastards” and “criminals” are bending the stick too far.

    But revere here is guilty of two misdirections:
    1. Bashing WHO policy means bashing WHO frontline scientists.
    2. Serious critiques of WHO practices other than those from revere’s keyboard (in Boston, thousands of miles from any bird flu front) are in the same league as posted flames.

  5. #5 Nick
    December 28, 2007

    Revere,
    Thanks for putting this in perspective. The region where WHO/NAMRU-3 are was a bad place to be before Bhutto’s assassination and now it just getting worse. An example of what is going on there can be found here (http://monitor.asigroup.com/) note the U.S. Embassy’s warning.

    This just serves as a good reminder for all those monitoring H5N1 around the world, that a lot of the field work is being done in places that are less than ideal for field work. These men and women routinely risk much to bring “us” tidbits of information.

  6. #6 Stan
    December 28, 2007

    “….Such people are either so terrified that any attempt at reason is fruitless or so intent on justifying their own fear they are glad when the news is bad and angry when the pandemic they have so far warned must happen has not yet occurred.” – Revere

    I couldn’t have said it better myself and Tom DVM has yet again provided a perfect and timely example. As time continues to tick by without an H5N1 pandemic, Tom and the rest of the pff crowd will become more angry and their attacks on the WHO or any group they perceive as generating “good news” will likely continue to get more vicious. Just reflect on Tom’s musings over the past 2 years as an example.

    Unfortnately these irresponsible, self servers tend to reflect on good people like Revere and cost them credibility, which ultimately impacts the general publics’ willingness to listen when important information is provided. This isn’t lost on the likes of Tom, niman and others, they simply don’t care.

    Thanks again Revere for the excellent piece and saying what many of us are thinking.

  7. #7 revere
    December 28, 2007

    Tom: You and I have been over this before. WHO is NOT a regulatory agency. They cannot be under the international system. Their one departure was SARS where they put your country under a travel advisory. Your country slammed them for it. Talk to them about that.

    BB: I do not think critiques other than mine are flames. I do think that critiques should be more nuanced and informed than too many are. WHO has done many things wrong (although their budget is minisucule and they do many other things right; bird flu is only a fraction of their activities, although it may be the one most important to you). If someone “bends the stick too far” they should be held accountable.

  8. #8 Helblindi
    December 28, 2007

    What is the situation like with WHO and Indonesia? How much co-operation are they getting? I’m asking this because Indonesian media *seem to be suggesting* the avian flu virus has already mutated into a H2H-capable form there.

  9. #9 M. Randolph Kruger
    December 28, 2007

    And the region is about to get a whole lot worse. Tom DVM has it nailed down pretty good. On one hand they send these guys out to do a job that they were trained for and they know the risks. On the other we have a super political body that is their support mechanism and supposed to be charged with world health that cant even force Indonesia to account for one crap load of money. Another blue beret program that produces nothing but animous. We are there not because we give one rat shit about the Paki’s but more for what it might do to us. Please lets just cut to the chase scene here. The WHO is even more political than the UN.

    Those guys on the front lines ARE the WHO. The rest of them are politicians that demand money from countries, they use it for dubious projects and programs, all with no accountability. No one is bashing the intent of the WHO, only the people who run it. People like Auntie Margaret who delayed the response to SARS because it was the same initials as the Special Administrative Region of the PRC. Good singer though. Just what we need right now.

    Those tidbits come at a huge price? Well folks I cant find any WHO worker being killed by the locals in the last 10 years. If someone has a reference then by all means post it. But the assertion is correct. You send a Westerner into an Islamic zone, you might not come back. Want to be a Bulgarian in Libya?

    BTW-Before we all go Bhutto over this, be advised it was under her tutelage that they developed the “Islamic Bomb”. She was Western in many ideas but not enough and passed the program on to Zia who popped the cap. Even Al-Baradei said that the Iranians were getting help from “outside sources” and that was Mr. Khan, an avowed Western hater.

    WHO spin is part of transparency. No transparency means spin. It would be better if they said nothing rather than this horsecrap. If we have the bug runnning amok in Pakistan then they should say so. Limited human to human? Dont pass out 300,000 tamiflu packs to the Paki’s and then tell me not to be alarmed. Thats Pan Level 4 stuff and we all know it. Prophylaxis of a population. Feel free to look up the pandemic levels and tell me what level of action this is.

    I am not slamming anyone here. They have to be sure but err on the side of caution. Dont sit back and say there is no need for alarm. Fact is that it has made a key status… confirmed human to human transmission. It means the bug has adapted. Will it go further? IHTFN! I would expect this infobull from the Chinese but not a world organization. Raise the Titanic and the Pandemic Level 4 so we can get these people moving before its too late. They will kill far more from inaction than lack of action.

  10. #10 SusanC
    December 28, 2007

    revere,

    Thank you for saying what needs to be said. I wouldn’t have said it the way you said it, but it’s just a temperament thing, I guess. ;-)

  11. #11 ColdClimatePrepper
    December 28, 2007

    Thanks Revere,
    This has been getting to me a lot too lately.

    Well earned and specific criticism of WHO’s actions is fine, especially if expressed with some respect. Personal attacks and name calling is destructive and reflects poorly on this community which is concerned about this topic. That damages credibility and is more apt to encourage folks to dismiss us as an unreasonable bunch who need not be listened to.

  12. #12 ssal
    December 28, 2007

    Stan –
    Wow! Reading the middle two paragraphs you wrote above, it looks to me you have the makings of truly great Republican speech writer. Do you agree?

  13. #13 Phila
    December 28, 2007

    BTW-Before we all go Bhutto over this, be advised it was under her tutelage that they developed the “Islamic Bomb”. She was Western in many ideas but not enough

    Is this supposed to mean that if she’d been more Western, Pakistan wouldn’t have developed the bomb, despite India’s 1974 bomb test?

    A pretty odd assertion, if so.

    Beyond that, Pakistan started work on its bomb in 1976 under Zulfikar Ali Bhutto, and tested it in 1998 under Nawaz Sharif, who was in power for most of the nineties. Benazir Bhutto served for barely two years in the late eighties, and for barely three years in the early nineties. Even allowing for your usual hyperbole, it’s a bit of a stretch to say that the bomb was developed “under her tutelage.” Do you have any actual evidence for your claim?

  14. #14 herman
    December 28, 2007

    “What is the situation like with WHO and Indonesia? How much co-operation are they getting? I’m asking this because Indonesian media *seem to be suggesting* the avian flu virus has already mutated into a H2H-capable form there.”
    Please read the above paragraph very slowly and very calmly, and please think about it for a second.
    In Indonesia they are now giving detailed reports on recent human bird flu infections in the media. Please note these reports, after very complete investigations by the authorities, can find no evidence of the presence of infected birds.
    What does that mean? It means human to human transmission may now be sustained in Indonesia. That means stage 4 should be declared now. To wait will be too late.
    Please read carefully Randy’s comments. He makes me feel very humble, because he shows a dedication to a very sincere search for answers to the bird flu threat that I do not have. But he is very aware as to how close we are to a pandemic, and I agree with him.
    Governments and WHO have done their best to conceal the danger for economic reasons, but it appears the government officials in Indonesia may be face to face with massive death from a pandemic now, not at some distant point in the future. Therefore they no longer blame birds. What good would it do if human to human transmission is now at stage 6, efficient human to human contagion? I sincerely hope I am wrong, because it the virus has now adapted completely to humans, death will now be our constant companion.

  15. #15 Monotreme
    December 28, 2007

    revere, I’ll have to agree with The Blind Bugmaker that you are conflating criticisms of the Director-General of the WHO, Margaret Chan, with attacks on people who risk their lives getting important data. Further, the comment you chose is from someone with a past history of making outrageous statements which are intended to make members of Flublogia look like loons, imo. This approach is similar to planting violent rowdies in the middle of peace march in order to discredit the protesters.

    For the record, I have nothing but praise for public health workers who go into hot zones to collect data and have said this a number of times in Forums. However, their bravery does not transfer to political hacks like Margaret Chan. Carlo Urbani, who was working for WHO at the time, warned the world about SARS and gave his life treating patients. At the same time, Margaret Chan was a public health official in Hong Kong. Her incompetent handling of this challenge, attributed by many in Hong Kong to her sycophantic relationship with the mainland government, was publicly criticised in a board of enquiry conducted in Hong Kong.

    Carlo Urbani is dead and Margaret Chan is Director-General of the WHO.

    What a world.

  16. #16 AnnieRN
    December 28, 2007

    It appears to me that the problem is that WHO has an imperfect scale which probably should have been changed a long time ago, when there was little to no risk of a pandemic of any type. The time to change the rules is when things are quiet, and the scale could have been changed at that point to reflect the smaller nuances of a possible future outbreak. There is no “level 3.5″, and it appears that some mid-range number would now be appropriate. I don’t think that people are sitting around in their living rooms hoping that a pandemic occurs, and becoming angry at WHO if it doesn’t happen. I just think that people are frustrated with the inaccurate use of one level (3)–which appears outdated–and the “apparently-but-not-quite-there” use of level 4, which on the surface appears appropriate. AnnieRN

  17. #17 revere
    December 28, 2007

    Mono: Yes, I was very irritated by the comment and may have “lost it” as a result. OTOH, there is a “natural” tendency to discount (and make unwarranted critiques) of news that doesn’t accord with what one thinks should be the case. IMO there is too much of it on flu sites. It isn’t any better than the opposite tendency which you and we have criticized.

    Whether Chan is a “hack” or not is something we will only know when future historians go over the record, public and non public. I was not a fan of hers and thought she was a bad choice (and said it here several times) but I have an open mind now that she is DG. The claims she mismanaged SARS is contested by many and I don’t have an opinion about it (I seem to be the only one). I’ve read about it and have spoken to some doctors who were in the midst of the HK outbreak but I don’t have any clear evidence one way or another about it. After I read China Syndrome I didn’t get a sense from that of malfeasance. What are your sources that make you certain she screwed it up? (This is not a challenge but a genuine request for information).

    The DG job today is extremely difficult. Some of Chan’s recent predecessors were quite bad and she is an improvement (this is not strong praise considering the competition). I think people do not understand WHO’s limited resources and major constraints. They think WHO is a regulatory agency (it isn’t and cannot be) or that it is supragovernmental (also not possible in the given international system).

    The extreme anger directed at WHO is curious, misplaced and unconstructive, IMO. I understand others legitimately disagree. But there’s a lot of work to do. We should try to do it together. That means, to me, we should try to help WHO, not try to make their job more difficult.

  18. #18 M. Randolph Kruger
    December 28, 2007

    Phila-Sure, here it is.

    http://www.globalsecurity.org/wmd/world/pakistan/nuke.htm

    And she indeed stated that it was an “Islamic Bomb” that they were developing. So was she playing us for idiots or was it to ensure balance in the Muslim world? Or was it defence against India. Probably both. 6 months ago I posted up that Al Qaeda and the Taliban were actively trying to destabilize Pakistan with the help of Iran. Seems that I was pretty much right here.

    But B. Bhutto during her tenure was actively pursuing both spent fuel for plutonium bombs and finally settled on the uranium one at the urging of Khan. Most people though are not dumb enough to spill their guts about it in interviews. She reveled in it and we increased the aid to stop them. They didnt. A buy off that didnt work. On the other hand she did try to keep those extremists in line and that likely was what got her whacked.

    Here is my next prediction. They topple Mussharif and then we invade Pakistan and/or we capture the facilities holding their nukes. Aint no way in Hell we are going to let those weapons fall into terrorist or anyone far left or right of centers hands. They will use them in the name of God and kick off WWIV. Remember they hate the Ruskies as much as they hate us.

    Everyone thinks we should use diplomacy and just leave Iraq. This is a prime reason that we cant leave. We have now Syria on the left flank, Iran on the right and a questionable Pakistan on the other that could close the Straits of Hormuz. Moscow is just about within the range of Pakistans missiles, but Israel is for sure along with Turkey, Mombai, Saudi Arabia and everything in between.

    So how do we deal with it? We continously, constantly and relentlessly keep hammering at the terrorist bases and keep them running. The Iranians figured it out and are now supporting the attacks in Pakistan, but they aint Persians and thats whats stopping this from going over right now. They dont like Iran in Pakistan too terribly much.

    Annie… We are actually kind of under the US system here which is 3.1 and that entails the use of “antivirals” in the interdiction of the bug. You can find it here.

    http://www.pandemicflu.gov/plan/pdf/cikrpandemicinfluenzaguide.pdf on page 17.

    Then on the subsequent pages you can see that there are actions that bump this into level 4 automatically for what is being done. So for everyone concerned that is why I am jumping jack pissed off because the WHO is violating their own procedures and not calling this pan 4. We are in the use of prophylaxis… Level 4 stuff!

    Sorry if anyone thinks I am sticking it to the WHO. I am. But not the ground guys. I am talking about those pricks in the crystal palaces in the various offices around the world that are members of the WHO and no one, not one is calling the organization on it. It may be misconstrued as frustration. Its not. Its pure bullshit and Tom DVM is one of the FEW who will call a spade a spade and on his own say Pan 4. With my accolades of course.

  19. #19 paiwan
    December 28, 2007

    Monotreme: What a world.

    The world of appeasement to China partly is accountable for WHO performances. Compromise or improve?

    Virus is telling the world how far we can go. Olympics, or pandemics?

  20. #20 anon.yyz
    December 28, 2007

    ssal,

    I happen to agree with what Stan said, and I couldn’t have expressed it better. I take it you agree with what he said too, with what a great compliment you gave him. As for Republican, I have no idea. Good writing is good writing, straight talk with no platitudes.

  21. #21 Phila
    December 28, 2007

    Phila-Sure, here it is.

    http://www.globalsecurity.org/wmd/world/pakistan/nuke.htm

    I’m not going to take up EM’s valuable space arguing over this off-topic topic, but I don’t think the link you provided really bears out your apparent claim that BB was somehow more responsible for the bomb than her father or her successor (let alone that repudiating nukes is somehow “Western.”

    Here is my next prediction. They topple Mussharif and then we invade Pakistan and/or we capture the facilities holding their nukes. Aint no way in Hell we are going to let those weapons fall into terrorist or anyone far left or right of centers hands.

    Some of us were actually predicting that before the Iraq War, believe it or not. Unfortunately, it seems that none of us worked for the White House. Such is life!

  22. #22 Phila
    December 28, 2007

    Much as I want to be a gracious guest, I can’t let this go:

    But B. Bhutto during her tenure was actively pursuing both spent fuel for plutonium bombs and finally settled on the uranium one at the urging of Khan.

    The link you provided says that that thanks to Khan, the uranium decision was made in 1975. It also quotes BB to the effect that Pakistan may’ve had a bomb as early as 1977.

    Seriously…did you even read it?

  23. #23 Monotreme
    December 28, 2007

    revere,

    I’m afraid I don’t understand why that particular comment caused you to “lose it”. That person has been posting the same kind of stuff, and worse, for years here. No-one who reads that gibberish for more than a short time takes that person seriously. I am amazed that you do. Certainly you know that his offal is a very poor example of what people who criticise the WHO write. Quoting him as your example of people who criticse the WHO is analogous to quoting Lyndon LaRouche to criticise the Democratic party (he ran for President as a Democrat 7 times). Frankly, its insulting.

    My source that Margaret Chan screwed up is the “Report of the Select Committee to inquire into the handling of the Severe Acute Respiratory Syndrome outbreak by the Government and the Hospital Authority” which was convened by Hong Kong lawmakers.
    http://www.legco.gov.hk/yr03-04/english/sc/sc_sars/reports/sars_rpt.htm

    See also:

    “HONG KONG (AFP) Protestors and concern groups called for senior Hong Kong health officials to be punished after an inquiry criticised their handling of the SARS crisis which killed nearly 300 people.

    Secretary for Health, Welfare and Food Yeoh Eng-kiong, ex-health director Margaret Chan Fung Fu-chun and Hospital Authority chief Leong Che-hung were among five key figures slammed by the report for their handling the outbreak.”
    http://findarticles.com/p/articles/mi_kmafp/is_200407/ai_n6845409

    As far as the the extreme anger directed against the WHO, it would be more accurate to say the extreme anger directed against the Chinese government as personified by their puppet at the WHO – Margaret Chan.

    Many of us feel that the Chinese government is responsible for covering up early outbreaks of H5N1, at the least, and hence putting their immediate neighbors in mortal danger. This cover up likely resulted in the deaths of many children in Thailand and Viet Nam. That alone justifies extreme anger, in my book.

    I have read every situation report that the WHO has put out. In my opinion, these have been deliberately manipulated to leave out key data, notably symptom onset dates for a number of key clusters. If these situation reports were publications and I was a reviewer, I would send a note to the editor indicating that I thought the author was providing incomplete and misleading information. I would not sign off on publication without correcting the omissions. This is my professional opinion.

    Our criticism is not misdirected. Only the Director-General of the WHO can raise the alert level to phase 4, something that many of us feel is more than justified by the current situation. Indeed it was justified over a year ago. Serious preparedness steps only kick in at phase 4. I believe that DG Chan does not want to do this because it would result in damage to the Chinese economy and her masters in Beijing cannnot have that.

    Its SARS all over again.

  24. #24 revere
    December 28, 2007

    mono: You are of course entitled to your opinion about WHO and the DG (and thank you for the links). Regarding your taking offense at my criticism, I suggest you read the post again, carefully. It did not issue a blanket condemnation of those critical of WHO (I noted I have been critical as well) but it took aim at some who have criticized it irresponsibly. I gave an example, which you choose to consider an outlier. His comments are indeed beyond the pale but they often acquire agreement from others and they have echoes elsewhere. The fact that you and your cohorts have decided he is a crank and atypical is your judgment. But I don’t know why you should then feel affronted when I go after a crank. In other words, I am asking you the same pointed question you (justifiably) asked me: why are you reacting so badly?

    What are the serious preparedness steps you expect at Stage 4? And if the situation doesn’t change for a year or two from what it is now, how do you expect things to be different? You might be right about your suggested course of action (whatever it is) and you might not be. What I am struck by is your absolute certainty about a lot of things many of us who also follow this are uncertain about. I don’t think you realize how difficult a task this is and the answers are not as easy as you appear to think. That doesn’t mean that WHO is taking the best course of action. I don’t know if they are. But I don’t get a sense you appreciate what is involved with these decisions. Clearly we disagree but we can still talk (I hope).

  25. #25 Monotreme
    December 28, 2007

    revere,

    you wrote “I mention this because I am frankly upset with irresponsible comments about WHO from people tapping away at their keyboards in the safety and security of their living rooms thousands of miles away from the action.”

    Could you list those who you think are making irresponsible comments, besides the person you link to? Who is making responsible comments about WHO?

    The person you cite is way more than an outlier, he is mocking us and has been for a long time. Anyone who goes back and reads his comments with his current identity and his previous one(s) will see that. At the least, I hope we can agree that he writes poorly. If you suggest that his style of writing is typical of those who criticise the WHO, I will most definitely be offended ;-)

    I am expressing my opinions, as you do, about things I believe. I don’t think I say the things I feel strongly about with any more certainty than the things you feel strongly about. History will record which of us is right.

    If you wish, I can provide a long list of actions that kick in at phase 4. The US government, US state governments, and countries all over the world have yoked their preparedness actions to the WHO phase alert status. One thing that would occur is travel restrictions to affected areas, which would include parts of China.

    A rise in the alert status to phase 4 would give ammunition to those of us pushing for more concrete preparedness steps. There are many benefits to increasing preparedness that would flow even if a pandemic never materialised. I can list these in detail if you wish. To be brief, hardening the Grid, stockpiling food, fuel and critical medicines would make every country more resilient in the face of any disruption of the current (precarious) global order. Encouraging individuals to prepare for self-sufficiency would improve personal health and save them money.

    It should be noted that phase 4 is not phase 6. We have been at phase 3 for several years and no one has suggested that moving to this phase was a mistake. Phase 4 means small clusters. We have small clusters. I would be very surprised if we did not continue to have, at the least, small clusters for the forseeable future.

    I understand the need for diplomacy, I really do. But what is going on at the WHO is more than diplomacy. I believe that Margaret Chan is carrying out an agenda that is designed in Beijing. Why else would they use a huge amount of political capital to install their candidate in a position not normally desired by a Great Power?

    From Bloomberg:

    “Chan’s nomination by China for the top job two months after Lee’s death is cited by Harvard’s Murray and others as a prime example of how nationalism is also, increasingly, becoming an issue for the global agency.

    In pushing Chan, who led Hong Kong’s battle against the 2003 epidemic of severe acute respiratory syndrome, or SARS, China violated an unwritten rule among the UN’s Security Council nations, Murray said. Security Council member nations normally don’t nominate officials to become UN agency heads, said Murray, who worked at the WHO until 2003.

    China has been criticized for its responses to both SARS and avian flu, and may have nominated Chan because of the prominence of the issue, Murray said.”

    [Christopher Murray, a former WHO official who is now director of Harvard University's Global Initiative for Public Health.]

    http://www.bloomberg.com/apps/news?pid=20601082&sid=ay4zFaF4H4Nw

    Yep, we can still talk.

  26. #26 Stan
    December 28, 2007

    “revere, I’ll have to agree with The Blind Bugmaker that you are conflating criticisms of the Director-General of the WHO, Margaret Chan, with attacks on people who risk their lives getting important data.” – monotreme

    May I call bullsh&t here? The criticisms of the WHO by Tom & company (including monotreme) definitely preceded Margaret Chan. Some of us clearly remember your unrelenting attack posts on Flu Wiki during the pre-Dr. Chan days complaining that the WHO’s reports/updates on the H5N1 situation were not nearly dire enough. Guess what, they were more right than you then and they are more right than you now. Nice try though…..

  27. #27 Monotreme
    December 28, 2007

    Stan, you are right that I criticised the WHO before Dr. Chan became the Director-General. However, you are wrong when you suggest that this was a pre-Chan period at the WHO. She was, in fact, the pandemic flu czar when I was criticising the WHO.

    From the WHO:
    http://www.who.int/bulletin/volumes/84/1/interview0106/en/index.html/

    “Dr Margaret Chan is from China. She obtained her MD degree from the University of Western Ontario, Canada, in 1977, and joined the Hong Kong Department of Health in 1978, where she began her career in public health. She was appointed Director of Health of Hong Kong in June 1994. After two decades of working closely with WHO, Chan joined the organization as Director of the Department of Protection of the Human Environment in 2003. In June 2005, she became Assistant Director-General for the Communicable Diseases cluster of departments and took up the newly-created post of Representative of the Director-General for Pandemic Influenza.”

    I would suggest that the Representative of the Director-General for Pandemic Influenza, a position expressly created for Dr.Chan, might have something to do with the H5N1 situation reports.

    As far as my read on the situation reports at that time, I was completely correct. I said they were deliberately obscuring data suggestive of small clusters. They almost never mentioned this possibility until Karo, when it was undeniable. From that point on, they shifted to their position to “Oh, we’ve always seen these small clusters. Nothing new. Move on, nothing to see here”, etc.

    They were wrong not to mention the clusters then, they are wrong not to release symptom onset dates today.

  28. #28 revere
    December 28, 2007

    mono: At this point there will be no travel restrictions to affected areas. We can argue as to whether it is justified at this point (I would say definitely not) but it’s irrelevant. It’s not going to happen. That was a major issue during SARS with a much higher level of uncertainty and concern for what was happening. Tom’s Canada punched WHO in the balls on that one. It also won’t stop a pandemic from spreading. Most experts agree on that.

    This underscores the difficulty here. Pulling the trigger will set in motion consequences whose effects will be hard to predict. If the status stays as it is now (and you want the Phasing changed now) it could make it much more difficult to initiate rapid changes when they are needed if it is perceived it is another false positive. No one really knows when the optimal time to make the call is except that most of us believe there is an optimal time: not too early and not too late. Both too early and too late can have grave downstream consequences. Therein lies the quandary.

    This is difficult. I read some of the links you sent and the case against Chan doesn’t seem especially powerful. She made a couple of errors. I’ve made a few of my own. One hopes she learned something from them. At any rate, she is now in command of an important piece of the puzzle. So are the flu sites. So are the sovereign member nations. So is the virus we are all struggling to understand.

    I’m not going to list anybody further as an irresponsible critic of WHO because I don’t think it will serve a constructive purpose. I took aim at a specific target that really irked me and I’ll leave it at that. I intended to use it to make a point: that WHO isn’t a person but a lot of persons, some of whom have just risked their lives to get information we needed. If I am guilty of conflating Margaret Chan and front line workers (I don’t think I am) I think you could be fairly accused of doing the same. Margaret Chan isn’t WHO. She is the DG of WHO. Both China and France departed from convention in pushing their candidates, not because it isn’t a position desirable for a Great Power but because the state of Great Power politics made that a convention in the past. Many things are different now and this is one example. My own theory, which I expressed here, is that China didn’t want anything to interfere with the Olympics so they pushed for the person they thought they could have the most influence on. It is the reason I opposed her candidacy here. The big question now is whether that will pay off for them or not in ways that are bad for public health. That still remains an open question and I won’t prejudge it. I remain cautious and concerned but I don’t think either the Phasing or the info on Pakistan bears on it.

  29. #29 M. Randolph Kruger
    December 28, 2007

    Phila-I have more information, all contradictory to each posting. I agree, no one is sure except to say that Pakistan was screwing the pooch while we were providing aid. Khan had or still has an international warrant for his arrest outstanding. He is under house arrest in Pakistan and as I understand it he is their goat for sacrifice if it comes to bear. Someone will likely kill him too if it comes down to a downfall of Pakistan. But back to the WHO battle over the front liners and the political types.

    If you want the info, send me an email address via Revere. I’ll load your inbox with some very touchy stuff.

  30. #30 M. Randolph Kruger
    December 28, 2007

    Phila-I have more information, all contradictory to each posting from each source. I agree, no one is sure except to say that Pakistan was screwing the pooch while we were providing aid to them. Even France bailed out and they would sell technology to Adolf Hitler.

    Khan had or still has an international warrant for his arrest outstanding. He is under house arrest in Pakistan and as I understand it he is their goat for sacrifice if it comes to bear. Someone will likely kill him too if it comes down to a downfall of Pakistan. But back to the WHO battle over the front liners and the political types.

    If you want the info, send me an email address via Revere. I’ll load your inbox with some very touchy stuff.

  31. #31 Monotreme
    December 28, 2007

    revere, some of us will continue to push for phase 4 and associated travel restrictions, and more. Likely we will fail, but we will try.

    I’m not an expert, but I don’t agree that movement (not merely travel) restrictions won’t work. Draconian movement restrictions worked in 1918 quite well. In fact, they were the only thing that worked. Cancel air travel and we’re back to 1918. Note, this won’t happen at phase 4, but will happen at pandemic onset if there is a high CFR, imo, no matter what the WHO says.

    I’m glad that you (now) distinguish between front line workers and Margaret Chan. I always have. Even back in my Flu Wiki days I was careful to do that. You will find many posts where I praise Carlo Urbani. Sometimes people say “the WHO” the way some say “the CDC”. That is because the directors of these organisations speak for them and have near dictatorial power, unfortunately.

    We will have to agree to disagree about Margaret Chan. Two years that paragon of objectivity, China Daily, had this to say:

    “Dr. Margaret Chan, the WHO global special representative on avian flu, praised Chinese government for its cooperative and transparent measures in curbing bird flu.”

    http://www.chinadaily.com.cn/english/doc/2005-12/12/content_502751.htm

    No wonder they like her so much.

    Meanwhile, this from Dr. Julie Hall, also of the WHO:
    November 1, 2006

    “Scientific research released this week said that the new strain — called H5N1 Fujian-like — had spread widely over the past year, being found in almost all poultry outbreaks and some human cases in China and now becoming prevalent in Hong Kong, Laos, Malaysia, and Thailand.

    Despite that prevalence, the Agriculture Ministry has not given the WHO any samples of the new strain, said Julie Hall, an infectious disease expert at the WHO’s Beijing office.

    ‘There’s a stark contrast between what we’re hearing from the researchers and what the Ministry of Agriculture says,” Hall said in a telephone interview. “Unless the ministry tell us what’s going on and shares viruses on a regular basis, we will be doing diagnostics on strains that are old.’”

    [snip]

    She said the ministry has not shared bird flu virus samples from poultry since 2004 — a key step in developing diagnostic tools and vaccines.

    The study by Chinese and American scientists released this week found that one out of every 30 geese and one out of every 30 ducks in live markets tested positive for H5N1 in six southern Chinese provinces during yearlong surveillance, which began in June 2005.

    In that same period, however, the ministry reported only three outbreaks in those same provinces, Hall said.

    [snip]

    In September, the Agriculture Ministry accused the U.S. Centers for Disease Control and Prevention for causing a delay in its attempt to share bird flu virus samples, saying that the agency had not yet completed import procedures.

    Hall questioned the assertion then, saying that China’s Health Ministry has so far shared six samples with the CDC lab designated by the WHO using the same import procedures without any problems.
    http://www.iht.com/articles/ap/2006/11/01/asia/AS_GEN_China_Bird_Flu.php

    Dr. Chan is now Director-General of the WHO. Anyone know where Dr. Hall is?

  32. #32 Stan
    December 28, 2007

    This is my last post on this as I feel that Revere has made the point so well that more commentary will only take away from his clearly articulated post. Monotreme, Tom, niman, etc, descriptions of the H5N1 situation have been and continue to be more wrong than that of the WHO. This is really undeniable. Tom was certain that an H5N1 pandemic would begin in the Fall of 2006 and unabashedly stated that it would kill 10 million Americans. Niman was touting phase 6 in June of 2005. You yourself have suggested on previous occasions that a pandemic H5N1 virus already existed!

    These are just a few instances of you all being extremely wrong yet you continue to be harshest attackers of the WHO!! Can you imagine how harsh your attacks on them would be if they’d been as wrong as you?

    Again we must revisit what Revere wrote as it was spot on:
    “….Such people are either so terrified that any attempt at reason is fruitless or so intent on justifying their own fear they are glad when the news is bad and angry when the pandemic they have so far warned must happen has not yet occurred.”

  33. #33 Monotreme
    December 29, 2007

    Stan, I never said the pandemic has started. Instead, I have said that pandemic-capable strains have likely evolved but dead-ended because the environmental conditions were not right. I am not the only one to make this suggestion.

    [Note, my previous comment has been delayed. Hope this one goes through]

  34. #34 Tom DVM
    December 29, 2007

    “WHO is NOT a regulatory agency”

    On that Revere, we agree.

    Then exactly what is their function in your opinion?

  35. #35 Monotreme
    December 29, 2007

    [I've tried to post the following a couple of times. In case its too long, I'll split it into two parts]

    Part 1

    revere, some of us will continue to push for phase 4 and associated travel restrictions, and more. Likely we will fail, but we will try.

    I’m not an expert, but I don’t agree that movement (not merely travel) restrictions won’t work. Draconian movement restrictions worked in 1918 quite well. In fact, they were the only thing that worked. Cancel air travel and we’re back to 1918. Note, this won’t happen at phase 4, but will happen at pandemic onset if there is a high CFR, imo, no matter what the WHO says.

    I’m glad that you (now) distinguish between front line workers and Margaret Chan. I always have. Even back in my Flu Wiki days I was careful to do that. You will find many posts where I praise Carlo Urbani. Sometimes people say “the WHO” the way some say “the CDC”. That is because the directors of these organisations speak for them and have near dictatorial power, unfortunately.

  36. #36 Monotreme
    December 29, 2007

    Part 2

    We will have to agree to disagree about Margaret Chan. Two years that paragon of objectivity, China Daily, had this to say:

    “Dr. Margaret Chan, the WHO global special representative on avian flu, praised Chinese government for its cooperative and transparent measures in curbing bird flu.”

    http://www.chinadaily.com.cn/english/doc/2005-12/12/content_502751.htm

    No wonder they like her so much.

    Meanwhile, this from Dr. Julie Hall, also of the WHO:
    November 1, 2006

    “Scientific research released this week said that the new strain � called H5N1 Fujian-like � had spread widely over the past year, being found in almost all poultry outbreaks and some human cases in China and now becoming prevalent in Hong Kong, Laos, Malaysia, and Thailand.

    Despite that prevalence, the Agriculture Ministry has not given the WHO any samples of the new strain, said Julie Hall, an infectious disease expert at the WHO’s Beijing office.

    ‘There’s a stark contrast between what we’re hearing from the researchers and what the Ministry of Agriculture says,” Hall said in a telephone interview. “Unless the ministry tell us what’s going on and shares viruses on a regular basis, we will be doing diagnostics on strains that are old.’”

    [snip]

    She said the ministry has not shared bird flu virus samples from poultry since 2004 � a key step in developing diagnostic tools and vaccines.

    The study by Chinese and American scientists released this week found that one out of every 30 geese and one out of every 30 ducks in live markets tested positive for H5N1 in six southern Chinese provinces during yearlong surveillance, which began in June 2005.

    In that same period, however, the ministry reported only three outbreaks in those same provinces, Hall said.

    [snip]

    In September, the Agriculture Ministry accused the U.S. Centers for Disease Control and Prevention for causing a delay in its attempt to share bird flu virus samples, saying that the agency had not yet completed import procedures.

    Hall questioned the assertion then, saying that China’s Health Ministry has so far shared six samples with the CDC lab designated by the WHO using the same import procedures without any problems.
    http://www.iht.com/articles/ap/2006/11/01/asia/AS_GEN_China_Bird_Flu.php

    Dr. Chan is now Director-General of the WHO. Anyone know where Dr. Hall is?

  37. #37 Monotreme
    December 29, 2007

    Part 2 [links removed because they appear to have caused problems posting]

    We will have to agree to disagree about Margaret Chan. Two years that paragon of objectivity, China Daily, had this to say:

    “Dr. Margaret Chan, the WHO global special representative on avian flu, praised Chinese government for its cooperative and transparent measures in curbing bird flu.”

    No wonder they like her so much.

    Meanwhile, this from Dr. Julie Hall, also of the WHO:
    November 1, 2006

    “Scientific research released this week said that the new strain � called H5N1 Fujian-like � had spread widely over the past year, being found in almost all poultry outbreaks and some human cases in China and now becoming prevalent in Hong Kong, Laos, Malaysia, and Thailand.

    Despite that prevalence, the Agriculture Ministry has not given the WHO any samples of the new strain, said Julie Hall, an infectious disease expert at the WHO’s Beijing office.

    ‘There’s a stark contrast between what we’re hearing from the researchers and what the Ministry of Agriculture says,” Hall said in a telephone interview. “Unless the ministry tell us what’s going on and shares viruses on a regular basis, we will be doing diagnostics on strains that are old.’”

    [snip]

    She said the ministry has not shared bird flu virus samples from poultry since 2004 � a key step in developing diagnostic tools and vaccines.

    The study by Chinese and American scientists released this week found that one out of every 30 geese and one out of every 30 ducks in live markets tested positive for H5N1 in six southern Chinese provinces during yearlong surveillance, which began in June 2005.

    In that same period, however, the ministry reported only three outbreaks in those same provinces, Hall said.

    [snip]

    In September, the Agriculture Ministry accused the U.S. Centers for Disease Control and Prevention for causing a delay in its attempt to share bird flu virus samples, saying that the agency had not yet completed import procedures.

    Hall questioned the assertion then, saying that China’s Health Ministry has so far shared six samples with the CDC lab designated by the WHO using the same import procedures without any problems.”

    Dr. Chan is now Director-General of the WHO. Anyone know where Dr. Hall is?

  38. #38 paiwan
    December 29, 2007

    Stan:

    My logics are:
    1. Even 1 millions people’s life is more important than Olympic.
    2. 1 millions people’s life is more important than resolving WHO and has her re-structured.
    3. To re-structure a swift/ responsive/ competent international health organization is more important than who has held the post.

    If GS Chan has felt that she could not delivered her responsibility under the current stucture of WHO, then she should resign and call for the resolution. Subsequently, WHO as her design has taken the full responsibility, if the stucture can not fit, then she shall call for re-invention.

    So what?

    No excuse can exchange 1 million people’s life.

    We are entitled to creat a totally independent and responsible international health organization.

  39. #39 highflyer
    December 29, 2007

    WHO bashing is a constant noise (and it is not background noise unfortunately) accompanying next to every news piece discussed on flu boards. I am sure WHO has made mistakes and that some countries and governments are not at all fulfilling our wishes for transparency and timely information.
    Despite that, the very outspoken critics of the WHO, Margaret Chan, any prominent one working for the WHO and basically every government or public health agency, failed to prove their point.

    Instead they reiterate post after post and year after year the never ending blame, and it is tiresome. And in the midst of all that paranoia and fearmongering and blame I am wondering what they actually achieve by doing so.
    Some flu-board posters do prefer easy answers, they seem to long for good boys/bad boys scenarios, distrust governments, health officials and just cannot stand and understand the ambiguity and miriads of unsolved scientific questions. And above they need someone to blame for whatever. They cater to these needs at least.

    If I could tell them one thing it would be this:
    even if you were right in one or more of your outrageous accusations, which you might or might not be as far as we can judge the little to no evidence that is there supporting your claims.
    Please give it a rest. If you cannot, then do better. Get the education to do so, go out there and prove your skills in diplomacy and epidemiology, risk your life and face the inconveniences attached to field work.
    Until then: the discussion of wether WHO is great, mediocre or a total failure has reached levels, where it is totally unconstructive and does not lead to any useful action or idea. Instead it wastes bandwith, emotions, time and it does not achieve anything that helps us to prepare for a pandemic or to survive it.
    Rather the opposite.

    I give you the benefit of the doubt that all you intend to do is to our benefit. I expect you to give the same benefit of the doubt to the WHO.

  40. #40 anon.yyz
    December 29, 2007

    “Dr. Margaret Chan, the WHO global special representative on avian flu, praised Chinese government for its cooperative and transparent measures in curbing bird flu.”

    No wonder they like her so much.

    ==================================================
    The above quoted from

    Monotreme at

    http://scienceblogs.com/effectmeasure/2007/12/bhutto_birdflu_and_who_bashing.php#comment-691265

    Using the same logic, Boxun and Epoch Times must also like Monotreme very much. Does that make him an agent of Falongong or Taiwan or any other Chinese dissident group? Hardly enough, but possibility can not be ruled out. So this is kind of like “when did you hit your wife?”

    (http://epochtimes.com has a description about the FLG on the front page. The site supports 13 languages in addition to Chinese. One has to wonder who has the money and time to put up something so elaborate.)

    It is also called ad hominem. The thing is, the three biggest basher of WHO/China in relation to pandemic flu viz. Monotreme, TomDVM and Niman (hey – the new 3 musketeers LOL) almost always (that’s just because I can’t possibly have read every thing you guys have written) use ad hominem, or circular logic to argue their points of views against the WHO. None has quoted hard evidence.

    Niman generally pushes for sequence release, and suggests frequently that the sequence has not been released may be due to something really ugly about the sample that the WHO doesn’t want to disclose.

    TomDVM doesn’t even put forward circumstantial evidence, and simply write well prosed long conjectures with no core that by the time you finish reading, you really have no idea what evidence was given.

    The common thing about these bashings is that you have to start with a belief that there is a conspiracy, or you don’t like the WHO, then you cannot rule out the possibility of the charge. Then this inability of ruling out the charge reinforces the original distrust. As a result, a most evil or worst suspicion, not based on hard evidence, but based on prejudice, then become established as the ‘accepted wisdom’ without question.

    Interestingly main stream media do not support these kinds of circular logic, biased reporting. Perhaps all of the wild WHO bashing on the Internet originated from the 3 musketeers. No doubt the WHO has problems in transparency, but there is no point in extrapolating from sketchy observations. As an analogy, one has to decide whether to watch CNN, or to read the National Enquirer.

    One should not forget the WHO is not run by one personality in the form of the Director General. There is oversight by an Executive Board. Member nations also have strong say and indeed influence.

  41. #41 Jonathon Singleton
    December 29, 2007

    Excuse me Stan, but as an unpaid freelance transgenic pathogen research analyst, I’m greatly perturbed by your characterization of Henry Niman’s work as “more wrong than that of the WHO.”

    Folks at Recombinomics (including Niman) have, for a number of years, illuminated the doom ‘n’ gloom and given us “GMO Free” food for thought…

    A case in point = the evolving definition of what H2H means vis a vis disease transmission @ Recombinomics Commentary — “H5N1 Cluster Concerns” (December 29, 2007)

    Happy New Year:*)

  42. #42 herman
    December 29, 2007

    Stan,
    I agree with you totally. WHO should revert to stage 1 alert level. Bird flu has hit a dead end, like swne flu; so you can go back to sleep now.
    WHO is perfect, and everyone else is wrong.
    There are still a few people in Egypt, Pakistan, Indonesia,and Vietnam facing death daily from bird flu infections, with a mortality rate of about 60%, but why worry? Those countries are far away, the people are primitive, and we are rich and sophisticated. Like the deaths daily in Iraq, it is not a problem for Americans.
    So please do not worry about it Stan. You are safe from bird flu in the US. The virus has burned itself out.

  43. #44 Monotreme
    December 29, 2007

    The problem with the WHO and public health organisations more generally, is that they are an unholy mixture of science, medicine and politics. Although they often present themselves as impartial purveyors of the truth, they are strongly influenced by political considerations. Most top public health officials are not selected on the basis of merit by the scientific or medical communities. Instead, they are chosen by politicians who apply the same criteria to their selection that they use for all their appointments:

    1. Loyalty to the politician
    2. Ability to keep their mouths shut when told to (see number 1)
    3. Competency (a distant third)

    My constructive suggestion is that the political components of public health organisations be separated from the scientific/medical components. Let professionals choose the leaders of the scientific/medical organisation and let politicians choose their own liaisons. Politicians would still make all policy decisions, but the scientific/medical organisation would provide unbiased information. If it was not possible to obtain critical information, like symptom onset dates, then the scientific/medical organisation could simply say that.

  44. #45 revere
    December 29, 2007

    Mono: As I have said many times here, “public health” has the word “public” in it. It has always had a political/social component. Always. Not as a defect but as a feature. I have been a public health scientist for 40 years. Some of the best public health people have been skilled at diplomacy and communications. WHO’s Candau, who was dictatorial, wily and smart as hell, was one of their best DGs. I have known every Commissioner of Health in our state since the 60s. There have been great ones, good ones, indifferent ones, bad ones and terrible ones. They have all been appointed by politicians, politicians you and I voted for. Your comments at your forum and mine here are also political in nature. Your constructive suggestion is a political suggestion. Science is also highly political (as you know) and the leaders of our scientific organizations are political (since I have been at that level I speak with more than casual authority). Your broad brush assessment of “most top public health officials” is uninformed, inaccurate and naive. Moreover, trying to separate the scientific from the political when it comes to public policy is an internal contradiction and a fool’s errand. Your main complaint seems to be that WHO or whoever (usually the member state) hasn’t released information you are interested in (onset dates, symptoms). I’d like to see this information but it isn’t always possible or appropriate to release on the internet. I’d rather see viral sequences as required public information, not personal medical information.

  45. #46 M. Randolph Kruger
    December 29, 2007

    Here is my problem with all of the above and its simple. A pandemic is fully underway in birds across this planet. I think that everyone would pretty much concur that the human cases came from birds as all of the previously released sequences show bird origins. Thats a given. It would also appear that it has followed the patterns in the H1N1/1957 and other flu pandemics. The bug was discovered ten years ago and within I think five it started killing both humans and birds. So its clearly transgenic and moving.

    Now we move fast forward ten years from the first detection. The WHO that is charged by the member states with ensuring compliance with the by-laws and really that is the best description of their mandate has done a piss-poor job of keeping us informed. In fact they are engaged in an omission campaign to obscure the facts. I think its to prevent panic but we are not children and we would all prepare even more if someone actually told us what was going on. Even as late as the 18th they removed the graphics from their own website that showed an increasing CFR…Why was that? Get back to me.

    Politically and in law they have no real authority as their by-laws can only be described as an agreement like a corporation. This is one of the few things that has been able to slip past the Congress. They can neither review or ratify anything we do with this group. We pony money they take it and thats part of the problem, no accountability. If there were then the DG wouldnt be the DG any longer. Complicity in a crime or perhaps a conspiracy?

    Indonesia was screaming rape two years ago and every nation ponied up money to save the poor Indons. They stole the money even by Indonesian standards. The money was never used except to bolster their UHC which might not have been such a bad idea but ask next time. Damned near nothing went into the surveillance and stamping out of the breeding grounds. Now its a BF petting zoo and they booted NAMRU out, or really more took the place over.

    Indon is now the worst off and this is after we sent all the money in there? With another billion or two dollars if you use the above criteria we would be paying to GET panflu.

    Then we have Supari. What an excellent piece of political work. They use their new found status with their unique bug to force their way onto the executive board and demand, yes demand by extortion that the West build them facilities to make BF vax and guarantee them basically the entire production capability of the world in exchange for their samples and data.

    We thrash and argue and tighten, loosen our positions but the bottom line to that is that such facilities would never, ever be used to make vaccines for BF. Time frame for it would be too short to even get it off the ground. So they have to do something with their time and facilities in between. That is making other stuff in competition with other countries and facilities. Then once they are going along, they NAMRU us. They nationalize the facilities that we paid for. Big Pharma isnt stupid and I would say they have collectively a billion times the intelligence of the upper management of the WHO. Indeed it is a paymaster, serf and then paymaster again arrangement. Bird flu is not the only bug out there and there is money to be made. Again the healthcare thing is a service and not a right. Even in Indon.

    So the big picture gets a bit muddy. The West being totally intransigent in this matter tells them to go pound sand. Me too, I dont like extortion. Nor am I in the business of putting other people into business. Congress begins to weigh in at this point with the Administration because while they have no direct ability to influence the outcome of meetings, they let their presence be known. That known is in their bio-med constituency who funds their campaigns and influences the right people. Thats where the politics comes in on our side.

    No way are we going to give them almost a billion dollars, have it side tracked into their UHC, then never used for what it was intended and we are not going to have a competitor in the biggest game since the Black Plague. Nor are we going to have someone in a position of authority in the Indon media admit that they have stolen the money by saying, “Its only 20%”.

    Now we gave the money to the WHO and the DG who is there now was in charge when this Indon Bimbo (name calling of Supari) and others took our cash and was out the door to order new teak floors for the dacha in Thailand. We apparently are not supposed to care. Did we hear an immediate response to that in any WHO poop sheets that came out? Nope! Wont either.

    So who do we see about that? 20% of 1 billion is a chunk of change and it came mostly from the US. This is where strong leadership comes in. The DG can and should work to resolve problems but grand theft auto is a crime in every country. Singing like a karaoke star at a dead serious meeting where the stakes are literally the fate of the planet aint what I call serious. Her assertion was that they were so close, but so far. Without ink on a deal I would say that it was never even close and then there is that money thing. Now we are funding a singing career.

    George Patton was on of the US’s most effective generals. He couldnt keep his mouth shut in the political arena and that finished him. But when you wanted something done you called Georgie. Instead we have a politician of some very dubious credentials in charge as an appeasement of the Chinese. Look up her name and her actual involvement in research. Her name is there but I can find very little actual research. That in itself is not terribly unusual but it points to a career in administration which is really politics, rather than getting the bugs stamped down. Again though, do we need George or do we need Margaret. History may be about to decide. George had spin, but it was good spin and he backed it up by kicking the enemy’s ass shortly thereafter.

    Again fast forward. Pakistan now has human to human transmission albeit limited. Is it coincidence that the UK basically moved from Pan Level 3.0 to 3.1 if you use the WHO and US standards on their own three weeks ago? Is it coincidence that the WHO and Paki’s started handing out Tamiflu paks in Abbotabad last week? Four other countries have begun to move towards Pan Level 4 on their own in the last two weeks. China is one of them.

    This by all definitions puts us WELL past Pan Level 3. Look at the WHO’s own criteria. Its being violated like a 13 year old girl at a frat party. Its not people wanting this shit to come, its people that are far more pragmatic about it making statements of the obvious. The obvious is that prophylaxis is by DEFINITION Pandemic Level 4 and above. So we sit and wait and I pray that its not. Mono is mostly right about this. They are being less than transparent. Tom DVM is stating only the facts that we are seeing stuff on the periphery that doesnt make sense if you take into account the simple facts of what defines a pandemic. Niman has made predictions and been off but mostly only in the timing. But the receptors he defines are the ones that nearly each and every time are involved. Whats going to be the one that kicks it loose, or not? I dont know or care. All I want to see is that if it comes we get as many thru it as possible and that is based upon transparency first, then dissemination of information second, and having a drop back plan. So far I dont see any of this out of the organization that we are sending so much money to. I also see zero leadership and that ladies and gentlemen will sink this ship faster than anything. Do we really need to worry? Do we believe what they say?

    Here is a news flash. Bird flu is now transmitted by human to human methods. No question of it. This might have happened in Turkey but they too screwed the pooch, mucked it up and did so with the help of the WHO. There are now dozens of cases around the world that were discounted by the WHO because they werent lab verified. Okay, so if 2 billion people die are they going to PCR each and everyone of them to prove or disprove bird flu? I dont think so. Statistically speaking, this aint even a blip on the screen. So why worry? Because we can all see the other things happening. You dont spend 500 million on a non problem and I sure as hell dont want to make it just the first installment for the Indons. Things HAVE to change at WHO, politically, financially and in the manner that they deal with the world public. Even a poor slob in Africa who might get it if you tell him the truth will very likely take measures to protect himself. If he has time he might protect himself to the point that he survives.

    Now I agree there is a lot of animous going across the channels here. We are NOT the only ones out there discussing this very contentious gig. Wiki, Trackers, Mono’s blog etc. But the general feeling is that the WHO is doing jack and its their own fault because of the spin meisters and the leadership. Not the ground guys. Takes real nards to walk into a hot zone. I would do it if I had too, but I will avoid had to if I can. Each statement they put out is as limited in information as possible, and its couched so they got an out if this shit launches into us. That has to change.

    The simple facts are just that, simple. Human to human transmission is underway in some manner. Thats really all we need to know. If it starts to extend in a country such as Pakistan or India, Indon then we would literally have hours as evidenced by the Paki brothers return to the US. Which was about 28 hours of actual airport action. He would have taken Asia, the EU, and the US in an afternoon. All he would have to have done is honk and shed virus along the way. Bio weapon.

    Its been said its hard to be at the top. Okay, we got Ms. Chan who I have really zero respect for at the top position, but she is there and you bloom where you are planted. Dr. J. Hall is still at WHO as a CSR. I dont think that they are in much agreement at the WHO as to what to do and like us, its beginning to be a divided camp. I have always avoided name calling on my friend Reveres blog when I could because it accomplishes nothing. Calling someone the three musketeers who have an opinion isnt productive. And isnt right. It immediately alienates them.

    The evidence anon.y is directly in front of us all. The real problem is how we are interpreting it. A virus, a transgenic virus is into the human population in an undetected manner in a country where healthcare is about zero. It has breached a key trigger point, Niman was right about that. Tom stated that it would happen almost two years ago if you care to go back a bit and look, Mono has been saying it for almost two years too. Timing is off but with people dying I wouldnt hold any of this against them. I guarantee the dead know that the bug was there. In fact, if the truth be likely known both countries of the world and the WHO have been withholding information from us since the first cases. Then there is that upping of internal pandemic status. Someone knows something and they arent telling us.

    How do I know that? Its a guess, a supposition at best but its based in the simplicity of it. The facts dont add up with what they are saying to us. When the government passes out 300,000 paks of Tamiflu to a population and tells us there is no cause for concern, we scuse me but bullshit is bullshit even if its in Pakistan.

    So do we continue to bash Chan? You betcha, because with the position at the top comes responsibilities and that means criticism. Her responsibilities are those that the member states say they are. She has to be feeling the heat. Who makes the decision to call pandemic level 4 at WHO? Is it management by committee or is it the DG? If Pan Flu breaks then I expect her immediate resignation because as they say in aviation when you have a crash, there is a prima facie case that someone, something, or a process was fucked up. The proof is laying in an ocean or a pile of mud in front of you.

    We are all haggling over how to interpret the data. For me, I think its out and running and thats based on chasing the H1N1 origins on my own for three years. Nothing hard in science, but its a hunch. I think we are well past hunches though on H5N1. I dont want to be right, nor does Tom, Mono, Niman or Revere or anyone else. But if we are going to have a pandemic, then lets be the best prepared we can for one… even if it doesnt come. And that begins with knowing what they know en toto.

  46. #47 AnnieRN
    December 29, 2007

    WHO has a scale–which they developed–spelling out various consequences of an infection which are required to occur, in order for WHO to go up the scale. (“In order to go from 1 to 2, this has to happen. In order to go to 3, that has to happen.” Read the scale. In the very simple language of the scale–written by WHO– the rating for “4″ appears to have been met. The scale does not specify how many people have to be affected by H2H, nor how they contracted the infections (from other people’s blood, or breath, or whatever.) As they now refuse to stick to their own rules, they shouldn’t be surprised if they are criticized.
    At the same time, “4″ is not the same as “6″, and nobody should panic and construe a “4″ as automatically leading to an inevitable pandemic. “4″ simply means that further precautions need to be taken, and further preparations need to be made. But “4″ needs to be recognized and acknowleged.

  47. #48 Tom DVM
    December 29, 2007

    “WHO as an intergovernmental agency.”

    We agree…with all the inherent restrictions.

    a) The World Health Organization is not a regulatory agency.

    b) The World Health Organization is not a scientific research agency.

    The World Health Organization is an intergovernmental agency; a political agency within a political body.

    Then why do they pretend to be otherwise?

  48. #49 Stan
    December 29, 2007

    Jonathan, to me Recombinomics reads like tabloid (ie full of speculation with a few truths sprinkled in). If you don’t believe me, take an hour or two a do a careful review of the archives and you’ll see how much garbage has been posted there over the past several years. If I were Henry, I’d be embarrassed.

    How many times has niman proclaimed that the pillars of influenza would crumble…or something similar? Maybe not as many times has he’s stated that the pandemic has already started, but enough times to cause everyone who knows who he is to remember him saying it. How about a peer-reviewed paper? Maybe he could write one about how he feels we were at stage 6 in June of 2005. He could do one on the raging pandemic he proclaimed was ongoing in Thailand in October 2005. How about doing one on how the 1918 panflu virus was not avian, like he proclaimed in October 2005? I’ll be Taubenberger would learn something from that one huh?

    I could go on and on, but I’ll let you find the hundreds of other examples in the Recombinomics archives. Now after doing your little review, keep in mind that this guy is one of the chief attackers of the WHO. Not just professional disagreements either, we are talking full blown vicious attacks.

  49. #50 J. Wilkes
    December 29, 2007

    Interestin g debate. I came across another article on WHO policy. It discusses WHO’s proposal for names for bird flu strains: http://crofsblogs.typepad.com/h5n1/2007/12/should-we-play.html

  50. #51 Monotreme
    December 29, 2007

    revere, we disagree what the “public” in public health should mean. Many at PFI_Forum and elsewhere have tried to talk to their public health officials. They initially contacted these public health officials with the expectation that these people would be happy to talk to the public about pandemic prepreparedness. Boy were they wrong. Instead, they were met with ignorance, stonewalling, arrogance, condescension and paternalistic attitudes. The disillusionment they felt as a result is genuine and ought not be ignored.

    It is true that politicians sometimes appoint good people as public health officials, but that does not make the system as a whole wise or fair. It is also true that politics sometimes intrudes into science, but this is something I personally find loathsome, as do most scientists I know. Of all the human activities, science is probably the least susceptible to political influence/corruption. That is one of the things I like about it. Scientists are human like anyone else and make mistakes, but in the US at least, science is about as close to a true meritocracy as we are going to see. We all know who the good scientists in our respective fields are.

    I think the current public health system is composed of authoritarian, anti-democratic institutions. As such, it is particularly susceptible to cronyism and incompetence. I would like to see much more peer-review in this field. The NIH would be a good model, imo. Yes, I know the NIH is not perfect, but it is a paragon of transparency and accountability compared to the CDC and the WHO.

    Data is data. No scientist should ever manipulate it for any reason whatsoever. If one cannot release data because a politician has forbidden it, then that should be clearly stated. Any other course of action is collusion in fraud. As far as onset dates go, many were released to the press by families angrily trying to find out why they weren’t warned of the risk. This information was *not* withheld to protect the public. In fact, the effect was just the opposite.

    I have long argued that viral sequences should be deposited in GenBank as rapidly as possible. I also believe that no such sequences should be patented. I think we are in agreement on that.

  51. #52 highflyer
    December 29, 2007

    AnnieRN: “WHO has a scale–which they developed–spelling out various consequences of an infection which are required to occur, in order for WHO to go up the scale. (“In order to go from 1 to 2, this has to happen. …”

    What you and most others ignore (those that, since two or three years now, take offence at the fact that the WHO did not raise phases and rephrased the wording) is:

    You make the wrong assumption that the skale of the WHO is fixed, stored and clear byond doubt at least as much as the meter or time is (which are not either). That every little cluster or incident, without further consideration or thought or discussion shows exactly whats happening, can be measuread against a scale with clear criteria and bingo the decision is made.
    Fact is, the WHO does not know exactly how the scale looks.

    They are confused, just on a much higher level than the average blogger and pandemic flu follower.

    The phase is a temporarily assessment, and agreement by scientists to scale the unscalable. The next pandemic is, to a certain degree, not predictable at all. And only scattered, partially contradictory evidence and data about other pandemics which were never watched that closely in the way they developed are at hand to do highly sophisticated guesswork.

  52. #53 herman
    December 29, 2007

    “I’d rather see viral sequences as required public information, not personal medical information.”
    I beg you. No matter what stan says. Please concentate on what Revere is saying. Randy can tell me I am full of shit all he wants. It does not matter.
    All I can say, is that I feel a horrible pain from seeing a young girl in Vietnam die from bird flu. No matter how hard I try, I cannot get forget her death.
    I have had a great honor to know through the internet the following persons: Revere, Randy, and Monotreme.
    Please forgive me for all the pain I have caused you. But I know, not matter what happens to us, that you will honor the death of that young girl in Vietnam. May peace be with you always.

  53. #54 anon.yyz
    December 29, 2007

    M. Randolph Kruger,

    About “The 3 musketeers” comment, I was being generous in describing the ceaseless use of long knives and the sabre rattling. If one were to use the standards of depiction that these three gentlemen use regularly, one could find another “Three Something”.

    If you like, I can simply call them The Trio.

  54. #55 Tom DVM
    December 29, 2007

    We are appeasing the appeasers…and history and previous pandemics have shown that there will be a personal price paid for this on all of our behalfs.

    The world would be a pretty boring place if we were all monocultured in our opinions…

    …we all hope for a better outcome.

    …and in my opinion, the shortcomings of the World Health Organization are not neutral…but will without doubt due far more harm then good…

    …and it doesn’t have to be that way…

    …all they have to be is honest…tell the scientific truth…the whole scientific truth…even when it hurts…

    …at the moment they are pretenders.

  55. #56 paiwan
    December 29, 2007

    Fm Monotreme: As far as onset dates go, many were released to the press by families angrily trying to find out why they weren’t warned of the risk. This information was *not* withheld to protect the public. In fact, the effect was just the opposite.
    —————————————–

    As a direct victim of 2003 tsunami myself in Phuket, the above statement serves as perfect example of the importance of releasing the immediate information.

    When the earthquake happened, a Thai scientist provided his analysis that the tsunami would hit Phuket. But the government was reluctant to release this notice, because that X’mas season was the peak for tourism income in a year, they were afraid this kind of notice would scare tourists.

    In three hours, Phuket was hit by serious tsunami in last 300 years, 6,000 more died which included a grandchild of King of Thailand.

    Since then, the warning system has started to alert us. We have received several warnings after 2004, and tsunami has not happened. But no one complain this warning system.

    Natural disasters have their cumulative factors. I disagree with Stan’s viewpoints. Virus is much dangerous and complicated; to keep alert is better than complacent.

    Fm anon.yyz: If you like, I can simply call them The Trio.
    —————————————————-

    This is the second time that I read his comments as personal attack on people, it is very insulting. Therefore, I would respond to him like this: The dogs in Beijing are trained not to bark, but to bite. Anon is certainly not qualified for China yet.

  56. #57 anon.yyz
    December 29, 2007

    Judging from paiwan’s anger, I thought I might have committed a major faus pas, so I googled for the term “The Trio”. All I could find were several references to folk and pop music groups. This is indeed puzzling.

    It is no secret that I am ethnic Chinese, so just continue the smear. I think by now most know what is really going on – more deflection from the real subject matter.

  57. #58 caia
    December 29, 2007

    Revere — Perhaps somewhat off-topic, but I was wondering if there was a mechanism on Scienceblogs (as there is on some other blogs) to allow one to see the original post only, without comments?

    I ask because I have once or twice considered linking posts of yours, but shied away because one or more comments that followed were off-putting, off-topic, or offensive. And since it is (a) comment(s) that apparently prompted this post, it seems you share that evaluation.

  58. #59 revere
    December 29, 2007

    caia: Not as far as I know. I will inquire, however, from the Seed Overlords.

  59. #60 M. Randolph Kruger
    December 29, 2007

    anon.y-Nyah. Just lay off the name calling. I never do it unless someone goes after me personally here. I can be radically violent with my responses when I get tired of people on the personal attacks. Hey Hey I hate Reveres positions on many things, but someone goes after him then I let them have it hard and fast. I am Paiwans attack dog!

    Lighten up guys. We arent seeing extended chains yet. If we do, we can revisit this one and I’ll get a rope, Mono can put it over the tree limb, and Tom can kick the horse out from under Auntie Margaret after Niman reads from the good book. But I doubt it will get to that simply because she will go of her own volition.

    She was absolutely hammered in the SARS gig. I dont know right or wrong on that one. If it’s true then the wrong person is in the job. I am like Revere though a bit. Give here a little time. About six months more before drawing a conclusion. We see extended chains and the Olympics coming up and they dont call it Pan 4, then she is a political hack and the politicals in all of the affected countries will call for a head….hers!

  60. #61 Tom DVM
    December 29, 2007

    Hi anon-yyz.

    I for one didn’t know you were ethnic Chinese and it makes no difference one way or another…

    …you’ve got guts…you say exactly what you think and so do I…You and I are big boys…we can take it.

    I have learned to constructively criticize the World Health Organization or the Canadian Food Inspection Agency or Health Canada or The Public Health Agency of Canada…as a whole…

    …as an ‘amorphous blob’ because I do not know what goes on inside these agencies and therefore will not comment specifically unless they have identified themselves like my friend Dick Thompson, who was the spokesperson for the WHO…

    …and I do not criticize any government or agency which my tax dollars do not directly fund…that is where I draw the line.

    I have a good deal of experience with regulatory agencies and I find the good one are conveniently silent on the issues even though they know there are major problems and will be the first to state them in private conversations…

    …if some members of these agencies do not want to be ‘tarred with the same brush’ then they should come clean and not continue to be complicit in their silence.

    I personally think that the World Health Organization is almost as dangerous in their incompetence as the ‘bug’…and I may be very well wrong in my opinion…

    …but I am going to continue to voice it 1) because I can and 2) because I am hoping at some point that they will wake up.

    If they don’t they will be complicit intentionally or unintentionally by their scientific ignorance in the greatest human tragedy to ever occur on this planet…in my opinion…and I hope I am wrong.

    So continue to voice your opinions…the World Health Organization doesn’t…they just plagerize ‘talking points’ written by someone else…disgusting really!!!!!!!!!!

  61. #62 M. Randolph Kruger
    December 29, 2007

    Bhutto killed by Bird Flu….

    http://www.anorak.co.uk/twitterings/178882.html

    Film at 11.

  62. #63 kresel ?s?nmaya hay?r
    December 29, 2007

    Bhutto may have many other wrongdoings but I don’t understand why she is criticized because of the nuclear bomb, in those years many nations developed such defense systems, and whether it was as a balance in the muslim world or as a defense against India (which probably already had it in those years) both are understandable I think.

  63. #64 Stan
    December 30, 2007

    Erich, I think you and niman would get along quite well….

  64. #65 Erich Simon
    December 30, 2007

    Actually, Niman is just down the turnpike but declined my comment a coupla years ago concerning whether or not the H5 virus is weaponized and manmade (got the attention of Nature magazine though). That first Google reference, by the way, was “Stutterer Bernanke Tips Hand on Gold” (not ‘hat’).
    I jumped in tonight after years of reading this blog. I’ve been following this subject far in advance of today’s bloggers. I’ve come across information that has since been censored and pulled from the internet. My interests had been purely financial. Things have changed though.

  65. #66 paiwan
    December 30, 2007

    Anon:

    Let me express what I have felt:

    1. I did not know your ethnic background in the first place. I personally do not believe that here neither any point discounted nor Brownie point added due to ethnic differences. I do not care about it.

    2. I admitted that I have been upset about your attacks on persons twice, I do not know if this is your habit. I intentionally did one time to you, then you would understand that how others have grace for you. I hereby apologize to you because it has caused pain to you.

    3. As Tom says pretty clear, we can debate on the value difference. I certainly do not like Chinese government’s treatment on dissent and lately Yahoo’s being tried in the US’s court for releasing personal information and caused people jailed in China. But this is not a right place. Yes, I admit that in many places, I can not trust China’s information.

  66. #67 medclinician
    December 30, 2007

    There are some who discuss many issues in depth. Some health professionals are on the front lines in research, patient-care, and have first hand knowledge and experience. It is difficult to have a presence on the net and at the same time actually do wet lab and hardware research. The world is full of opinions and comments on organizations and governments. Action, as opposed to words, may not be as effective through massive organizations, as people who continually fend off blows for preparing for events which continue to be denied. Some will continue do research and also try and sift out truth from fiction. Have you considered that when actual events play out, it may not matter at all what WHO thinks, what they have done, what certain key famous names policies were or what arm chair generals postulate to be the truth? Some of us will be out in the field, as in 911, picking up the bodies. How many here have been there or will be there trying to help those who are infected or setting up clinics are trying to comfort the dying. So many words, and so little action.

    Medclinician

  67. #68 Tom DVM
    December 30, 2007

    and I might add…

    …So massive a threat ‘potential’…and so little regulatory action.

    Words have real consequences.

    Are we going to have antibiotics and oral electrolyte powders to treat ALL secondary bacterial infections in the young?

    That is the World Health Organization role and obligation.

  68. #69 revere
    December 30, 2007

    Tom: Why blame WHO for the inaction of your (and my) governments? Are they so stupid they only act when WHO tells them too? (in fact it is more likely the other way around). If WHO is “criminal” (talk about hyperbole) aren’t the Canadian and US governments even more so on this issue as they have it within their power to take the actions you want to take?

  69. #70 Late Nite Comic
    December 30, 2007

    Good evening, ladies and germs! (badda-boom) I just “flu” in from Pakistan, and boy, are my clusters tired! (rim shot) Seeing all those poultry farms reminded me of Nelson Eddy and Jeanette MacDonald–you know, “When I’m culling yooo-oo-oo-ooooo!” (cymbal crash)

    Wow, tough room! I know you’re out there–I can hear you recombining! (rim shot) OK, show of hands–how many of you have a stock of Tamiflu at home, but no guns or ammo? OK, thanks. You know, I really don’t have a joke about that–I just wanted to know who to rob once the pandemic starts! (badda-boom) But seriously, I have the best doctor–if you get H5N1 and can’t afford Tamiflu, for 20 bucks he’ll touch up your chest X-rays! (cymbal crash)

    Hey, I’d like to give shout-out to my homeys Herman and Tom in the house! For you, I’ll close with some of my favorite WHO jokes. Yeah, the pandemic may be a Grinch, but that doesn’t mean we can’t enjoy our WHO hash!

    Q: What do you call 500 WHO staffers marooned on a desert island without food or water?

    A: A good start! (rim shot)

    Q: If the entire WHO leadership were in a plane crash, who would be saved?

    A: Humanity! (cymbal crash)

    Q: Why did New Orleans get Hurricane Katrina while Geneva got WHO headquarters?

    A: New Orleans got first choice! (badda-boom)

    Thanks–you’ve been a great crowd! I’ll be here all pandemic, so tell your friends! And try the chicken–they say it’s to DIE for! (cymbal crash) OK Revere, play me off!

  70. #71 Tom DVM
    December 30, 2007

    Let me try and explain things as I see it…this way.

    On Oct. 17/2007 I had the misfortune of attending our counties “Interagency Pandemic Influenza Planning Team” update with the Head of Ontario’s Pandemic Planning in attendance…who went to great lengths to explain how our area’s planning was the model for the province, the country and in fact, we had the best plans in the world…a rather bold statement.

    The first chart presented indicated that for a population of approx. 200,000 people, there would be 24,000 sick, 600 people hospitalized and 150 deaths…the current total hospital capacity in the county is 371 beds and there are 300 doctors and 600 nurses of which they expected a third would be off at any one time.

    They had recruited a number of public health nurses to run triage tents (less than 20 nurses if I remember right) and they had the United Way, a local community charity arranging to have citizens to volunteer to assist.

    Where could they have possibly source these numbers?

    BBC Sept 30, 2005.

    “A flu pandemic could happen at any time and kill between 5150 million people, a UN health official has warned. David Nabarro, who is charged with co-ordinating responses to bird flu, said a mutation of the virus affecting Asia could trigger new outbreaks.

    Its like a combination of global warming and HIV/Aids 10 times faster than its running at the moment, Dr Nabarro told the BBC.

    But the World Health Organisation has distanced itself from the figure.

    The WHO spokesman on influenza, Dick Thompson, told a news conference in Geneva that the WHOs official estimate of the number of people who could die was between two million and 7.4 million.

    There is obvious confusion, and I think that has to be straightened out. I dont think you will hear Dr Nabarro say the same sort of thing again, Mr Thompson said.”

    These numbers were aggressively ‘sold’ by Dick Thompson and others at the World Health Organization for more than a year.

    As a result, Dr. David Butler of the Public Health Agency of Canada downplayed the risk by stating that and I paraphrase…a pandemic is not such a big thing…we lose more people to smoking each year in Canada.

    Therefore, to answer your question…it is a game of ‘follow the leader’…or ‘pass the buck’.

    The World Health Organization provided the fodder for sovereign regulators to downplay the risk…and no matter how hard the collective scientific community has tried over the past two years…planning is still based on 1) it ain’t going to happen…so let’s make it look good and 2) even if it happens we lose more to smoking each year anyway…

    …so the overall regulatory plan is don’t worry…be happy…make it look good…

    …and have someone else in the responsible position…preferably an unelected agency with rock hard immunity from responsiblity or prosecution.

  71. #72 revere
    December 30, 2007

    Late Night Comic: Bird flu victim to virus: Take my life. Please.

  72. #73 Tom DVM
    December 30, 2007

    “…so the overall regulatory plan is don’t worry…be happy…make it look good…

    …and have someone else in the responsible position…preferably an unelected agency with rock hard immunity from responsiblity or prosecution.”

    This is to ensure that there cannot be an effective post-pandemic inquiry…all evidence will conveniently be vanished.

    The head of Canada’s Public Health Agency is Dr. David Butler-Jones.

    …and thanks Late Nite Comic…that was really good…can I quote you?

  73. #74 revere
    December 30, 2007

    Tom: So your complaint is that WHO allowed your officials to be stupid and cowards. But you don’t blame the cowards or charge them with stupidity. OTOH on Iraq I blame Congress for being stupid and cowardly and listening to Bush. I don’t just blame Bush. I guess it’s a difference of opinion.

  74. #75 Tom DVM
    December 30, 2007

    ” But you don’t blame the cowards or charge them with stupidity.”

    Repeatedly…but I can’t move them…because they live on the yellow brick road and have the Wizard of Oz backing them up.

    But now that you bring it up…I have a simple question for the “cowards” as you call them.

    If you have no pharmaceuticals…even the bravest of doctors and probably more importantly nurses… will walk away…they will and cannot treat pandemic influenza with placebos.

    So I ask that packages to dispense to all young persons with famillies (at the very least) be avaliable so to provide all treatments required if there is no functioning healthcare including open hospitals/triage tents…

    …that would give such parents and civilization as a whole to save the defenseless and also our future.

    Seems kind of simple doesn’t it…a relatively small investment for a threat potential that has never been encountered by humanity before.

  75. #76 M. Randolph Kruger
    December 30, 2007

    So I guess it gets down to an election Revere, and whether to smoke or not. The numbers that Tom is quoting is based upon that damnable 5% number. That alone scares me.

    If it lost even 1/2 of its CFR right now, a full third of the people would die within a couple of months to a year or so on this planet. I cant see where this is leading other than to a disaster that like Katrina, we can see it out in the ocean and its creeping towards us. We are told its the strongest (at the time) hurricane ever recorded in the Gulf. So, lets all go down to the bars on Bourbon Street and wait for it. We saw how that played out. Is the sea beginning to rise or is it holding its own? If we had proper information we would know.

    It certainly cant be worse than what we are doing now which I equate as does Tom to a big fat nothing. Pezz from Fairview TX did their little exercise Tom and they were forced to use the 5% scenario….They lasted 11 days. He put it at less than 3 if it were anything approaching double digit CFR’s.

    BTW Tom, I DONT want the WHO becoming a regulatory agency, nor do I want one world government. The push is for the United States of CanAMexico and I dont have too many problems with the Canucks, its the Mexicans and farther south. Not that they are bad peole but its turning us all into serfs of the system.

    Revere posits and maybe right or wrongly that beefing up the infrastructure in healthcare would be productive. The costs for this are extremely high and to date have produced dubious results. There is very little that they can do to a BF patient except give them Tamiflu (may or may not work), morphine, electrolytes, an off antigen flu shot, and intubate them when they turn sour. Thats about it. After that its a stay in the hospital, prayer (yep Revere prayer) and someone has to feed you. At 5% we might just get by with the ventilators we have and the people to work them if its not a slam dunk fast hit. OTOH, if its the hard case. We are screwed and big time at that.

    Canucks are a hard bunch and are better prepared because the weather does turn shitty up there often. But if the power goes out, they like everyone above the 38th parallel in winter may be trying for the sunny beaches of Florida or California suddenly.

    Everyone is going to be a coward in this one Revere if it happens. Tom is pragmatic and I doubt he will hang out in Ontario during the winter because its just not smart to do. Whats he going to do, treat sick puppies and dogs during a pandemic? They might try to hang on to him and have him treating people. I know thats a plan in the Tennessee PFP. Medical students, retired docs, etc. all will be thrown into the fray.

    I gave my ortho doc a proposed emergency action authorization that was circulated around for comment among the responders. It basically said that under a state of emergency that doctors of all kinds would be subject to pickup and arrest if they didnt respond to the call. She flipped out when she saw it. Her comment was that she didnt know jack about HPAI and that she wouldnt respond. I dont blame her. She did her rotations and said she can treat bone infections and bacteria but what could she really do?

    I responded that she might only be able to give comfort and ease the pain. The implication being that it might get down to euthanizaton of the ones that we know are going. I would hope it never got to that. But who would do it in all conscience? Tough decision. Cowards will be in long supply. Heroes are going to die in place.

    I still referto the criteria established by the US NPFP and the WHO. We are now at Pan Level 4 according to their own rule book. Who is supposed to make the call? I guarantee Auntie Margaret isnt going to do it without first knowing its on its way for sure, then she will quietly resign before it hits citing differences of opinions and all of the usual muckety-muck.

    The front liners are going to take this one straight in the shorts if it happens… no leadership. I do say though give here a bit more time to get this thing under control. If it doesnt, call for her resignation before it does get totally out of control.

  76. #77 Patch
    December 30, 2007

    Finally, a post I can sink my teeth into. So many times I’ve
    “discussed with vigor” issues with my good friends Randy and Tom. And I was becoming increasing convinced that there were few who still had an open mind about H5N1. Thankfully, Revere has maintained one (and open mind) and this has continued to be the one and only site I look to for serious discussion.

    Stan is correct. Niman has been right. But he’s been wrong too. More wrong than right IMHO. I’m not sure Tom has been right yet, but has made some predictions that have not come to fruition (thankfully). Both Niman and Tom COULD be right. I acknowledge that. I’m not sure they would acknowledge they could be wrong, but that’s another topic. But they also have the luxury of making predictions, assumptions and statements with no repercussions. The WHO does not have the luxury.

    I may not think too much of my boss, but I may still have great respect for the people who work around me. And I believe they are doing the very best they can with the companies best interests at heart. Therefore, regardless of my opinion of the WHO leader (or for lack of knowing her, the opinion I am forming from listening to all of you), I truly believe that the people who comprise the WHO are doing the very best they can, with the best interests of the world at heart. And I’m not sure that your criticism of the organization as a whole is doing the pandemic preparedness cause any good.

    Once again Revere, my hat’s off to you. And thanks to the many people who have posted and affirmed my belief that this is not a done deal….at least not yet.

  77. #78 Jody Lanard
    December 30, 2007

    M. Randolph Kruger wrote: “Well folks I cant find any WHO worker being killed by the locals in the last 10 years. If someone has a reference then by all means post it.”

    Here is a link to the very moving August 22, 2003 WHO website page on which “Senior WHO official, Dr David Nabarro, describes his experience in the UN bombing” in Baghdad: http://tinyurl.com/ywu68g

    Among the many UN and other officials who died in that bombing was Nadia Younes, who had been seconded to the UN Baghdad office from her position as Executive Director in charge of External Relations and Governing Bodies at WHO.

    Monotreme wrote: “Dr. Chan is now Director-General of the WHO. Anyone know where Dr. [Julie] Hall is?”

    Dr. Hall is now Principal Medical Advisor, Office of Health Protection, Australia Department of Health and Ageing.

  78. #79 Patch
    December 30, 2007

    Oh…and I extend my personal thanks to the members of the WHO who work diligently to keep us informed and safe.

  79. #80 Pixie
    December 30, 2007

    I would be willing to moderate my own criticism of Margaret Chan’s WHO except for the fact that they control several key elements of importance for international, as well as private-citizens-of-the-world, decision making. They have the final authority and control over:

    1. the Situation Updates
    2. the confirmed positive case count
    3. the Phase chart
    4. substantial influence over and possession of scientific samples, sequences, and other hard data

    As long as these items are considered to add up to the authoritative and final word on “where we are” with regard to a pandemic, and as long as WHO has proprietary hold over them, and asserts this authority at every turn, they can’t, it seems to me, both have their cake and eat it too. If they don’t want the criticism, they don’t have to set themselves up as the final word on these critical issues. They cannot have it both ways, have both ultimate control as the grand final-word pooh bahs, and ultimate empathy from us for their “limited capacity” predicament. It’s a show of arrogance and manipulation of the public to continually try to straddle that fence.

    I expect the numbers of actual H5N1 cases reported as “officially confirmed” by WHO to be no more accurate than the number of seasonal flu cases which are “officially confirmed” each year by my state public health department. Nobody calls it “fear mongering,” to intimate that more cases of flu circulated within my state than the official numbers state, and there doesn’t even need to be any implied belief in “incompetence” or “conspiracy” to believe that those stats just don’t add up to the entire picture. That is just, at its most basic, how the world works. WHO is not going to be able to collect nor project an authoritative and accurate picture of what is truly developing, pandemic-wise, because that’s just the way things go in the world and in public health in general, for very many reasons. Usually we’re ok with that ambiguity, and can discuss projections of deviations from the accepted narrowly defined “official” pronouncements and stats with adult cynicism based on the experience we have had of the performance of similar administrative colossi.

    But boy, try to say that the WHO numbers for true H5N1 positive cases are probably off (based on other normally considered credible sources of evidence), or point out that the situation updates are dramatically thinner than they were in 2005 (which people can see for themselves), and that that, if examined and fleshed out more fully, might call the phase level itself into logical question, and you are sometimes shortly treated like a green recruit at boot camp getting slapped around by his drill sergeant.

    I don’t mind cutting WHO some slack, but then they should be willing to cut us some slack on these issues (listed above) where they have so tenaciously asserted their own very complete (and, yes, powerful) authority to have the very last word on these matters. They should say instead that really, when it comes right down to it, they don’t have a handle on the whole situation either for a myriad of reasons. If WHO were to urge every citizen and every nation state to not rely on WHO alone as the depository of ultimate pandemic information and authoritative, accurate, decree, and to instead use their own heads to examine the information at hand for themselves, that would be a refreshing sharing of power, and a more realistic way to approach these unfolding events considering WHO’s own self-acknowledged constraints. But I’m not going to hold my breath that that will happen. I like oxygen.

  80. #81 revere
    December 30, 2007

    Tom: What pharmaceuticals are you thinking of? I thought you didn’t believe that vaccines or Tamiflu would work. Elderberry?

  81. #82 Tom DVM
    December 30, 2007

    “But they also have the luxury of making predictions, assumptions and statements with no repercussions. The WHO does not have the luxury.”

    The thing is Patch…that I and Dr. Niman etc….HAVE NOT ACCEPTED THE RESPONSIBILITY for world pandemic public health…I have accepted the responsibility for Public Health and Agricultural viability in my neck of the woods…but that is a different matter.

    If they would like me to accept full responsibility then I can be reached through Pandemic Flu Information Forum.

    If I did professionaly accept the responsibility…their ‘talking points’ would be the first thing to go out the window…and there would be a code of conduct in place for all employees similar to codes for professionals such as veterinarians.

    Anyway, If I was responsible, I would

    1) make them prove that pandemic and seasonal flu vaccine works…and the same for Tamiflu…because all of the money is being spent here without irrefutable proof of benefit. Secondly, if Tamiflu was to be used off label, as a preventative for example, then again, they would have to prove the benefit outweighs the risk…and I mean research by independent third parties not paid by ROCHE.

    2) I would suggest that as much vaccine as possible be produced against secondary bacterial opportunistic invaders…because this type of vaccine is proven…and many of the viral deaths, in my experience, cannot be prevented…the virus is just too fast in some susceptible individuals.

    3)I want cheap, off-patent, broad spectrum antibiotics paid for and stockpiled right now…as in yesterday…for at least fifty percent of the current populations (because I believe the increased population since 1918 (tripled) and movement of this population (air carriers) will result in a 50-65% attack rate in the first eighteen months.

    4) I want all supportive therapies required to be stockpiled and dispensed to young famillies the day the pandemic is confirmed…and of course in my opinion, these packages would contain prednisolone…but that argument is for another day.

    5) I would immediately liason with the farming community in all countries and pay the farmers to be prepared to supply cities with food in the eventuallity of a pandemic…and I would suggest the general population hug a farmer every day and thank them for providing such food for very little in the way of security or financial return.

    6) I would immediately turn to the fast food companies to see if they could provide meals during the pandemic (as there is no body better) and I would notify them that I would be succonding some of their fast food outlets to dispense medical packages.

    7) I would arrange healthcare worker advice phone lines…to advise parents how to use these medications at home.

    8) I would actively prepare armies and others in the communities to keep the electrical grid up…and would provide luxury living areas for essential workers on site to live with their famillies isolated and protected for the duration.

    …and that is just the start.

    …and in fact, I pray every night to the God’s above that I am wrong and H5N1 will go away…unfortunately it ain’t going to happen because now there are a whole lot of pretenders compteting to be the pandemic virus…some of which are not influenza’s…

    …and H5N1 anyway, has reached ‘critical mass’…making it unstoppable…from an animal virus point of view…and humans are just another animal.

  82. #83 Tom DVM
    December 30, 2007

    Sorry, I forgot one:

    No vaccines from chickens and eggs…becuase biosecurity is a figment of someone’s imagination and humans will act as reverse vectors in a pandemic and in a few weeks there will be no chickens or eggs for vaccines…

    …so either they do the ‘Manhattan Project’ required to produce syntheitic (PROACTIVELY PROVEN…by independent third parties) or we forget pandemic vaccine and concentrate on ‘pneumovax’ type secondary bacterial vaccines…which will be far more effective anyway…in my opinion.

    These type of viruses in about five percent of the population will kill so fast that no treatment will be effective…and those who live will be faced with very serious long term sequelae…as in emphysema (COPD) liver and kidney malfunctions etc. Many will die in the aftermath due to these effects…unfortunately.

  83. #84 M. Randolph Kruger
    December 30, 2007

    I guess that counts as a kill Jody.

    Pixie got this one. Most of the people on this planet are adult enough to be able to handle bad news. It would be nice if they just cut to the chase on this though and just tell us. And about that damned chart page from the WHO WPRO….Someone tell them to put that back up there!

    I read an almost exact rendition of suggestions that Tom made about two years ago….Tamiflu was getting into question then. About that Tamiflu in the water thing. Are we making superbugs for the future or just one sonuvabitch H5N1 and other AI’s…. Time will tell.

    Item 7 goes out the window Tom the second that three coal fired plants go off line in the winter. The phones will last a max of 3 days after that on battery when the grid snaps.

    Item 8 is not really possible if there is no fuel to fire those plants. It takes six months to bring a nuke back up on line properly.

  84. #85 Tom DVM
    December 30, 2007

    Revere. As to those broad spectrum off-patent antibiotics, I would use amoxycillin or tetracycline or trimethoprim Sulpha etc. etc.

    …but of course, I would bow to your and others expertise on these matters…to pick the most effective from the off patent and therefore most economical group…

    …and then we would have to force production, one way or another…as in a ‘war footing’…today!!

    …and if I am wrong and the pandemic doesn’t come…then I will personally accept full responsiblity.

  85. #86 Erich Simon
    December 30, 2007

    HP H5 was made in Russia as a MAD weapon in case the Russian’s got the short end of a nuclear exchange. It was tested at Vxxxx on the Aral Sea. In 1991, the Russians plowed the virus under the earth. But the crystals got into the local bird population. Most of the virus was carried WEST, the so-called Qinghai strain.
    The virus that flew the roughly 1850 miles to Bird Island on Qinghai lake migrated over a three day incubation period in a wild goose. That bird died but infected another, which pony expressed the virus to Guangdong. The Chinese know about this dynamic and have accepted payment from Russia in oil (Russia is supplying the Chinese with 70% of its oil needs over the next decade as opposed to the former 2%).
    When SARS erupted, many of the SARS cases were suspect HP H5 cases. The US military/military contractor took anthrax out of an Army depot in Maryland and sacrificed 5 Americans around that time. Then they used anthrax clean-up (and Satellite imgagery to locate the bull-dozed “novel pathogens”) as an excuse to go to Vxxxx and attempt to remove all of the pathogens that were leaching into the groundwater, particularly with the Aral losing most of its size to irrigate the surrounding cotton fields.
    This is the first post of this information to the public domain, although parts, like the origin of the anthrax used in the attack in the US are now public knowledge.
    The HP H5N1 virus is expected to go airborne from animal to man like LP H1N1 did in 1918. The result is going to be entire regions of the planet with 100% CFR. The rotting corpses have themselves been designed to remain infectious (SARS patients were also infectious in long duration). This information comes from Bob Webster.
    Tony Fauci (recanting his long held pontification to the contrary) and Julie Gerberding have informed a Congressional sub-committee that H5 is going to be the next Pandemic. The only question was which strain. The fact is that multiple strains are going to erupt and with an average CFR (and growing) of 60%. This is untenable.
    D Rumsfeld met with his big pharma cronies to expedite a vaccine but none will ever be forthcoming, so he decided to manufacture Oseltamivir, a drug designed to mask H5 diagnosis and provide false negatives to avoid public detection of virus spread and forestall panic until the Get-Out-Of-Town plans were formalized. The CDC became designated front runner for sequence collection, the WHO (after the assassination? of whistle-blower Dr. Lee) became global coordinator and all of the original H5 sequences were sequestered to Los Alamos.
    These events and the behind-the-scene countermeasures are long in place now. Unfortunately the case can be made for a preemptive Pandemic, one for which there is a cure.
    Erich Simon MBA

  86. #87 anon.yyz
    December 30, 2007

    paiwan,

    I don’t care about bigots. The battle is against bigotry. You don’t blame all Germans for what the Nazi’s did. It was the idea that killed people.

    Bigots are as much victims as are the bigoted, may be even more so. Bigots simply internalize the venom, until the brain no longer functions normally. Then they have to find an outlet to infect other bigots, those who are vulnerable.

    Those who are the targets of bigotry only receive the venom on the surface, and if there is inner strength, they won’t descend to the bottom as bigots would. It wasn’t obvious or intuitive at first and it took me a while to figure out why the bigots keep calling themselves victims. They are indeed victims, not of the bigoted, but of their own lack of moral compass.

    Now, if only there is another sock puppet to blame for one’s demons, we can all go back on track.

  87. #88 Monotreme
    December 30, 2007

    Dr. Lanard, thank-you for your information on the current whereabouts of Dr. Hall. When did she leave the WHO?

  88. #89 M. Randolph Kruger
    December 30, 2007

    Erich-Jeez! If you have proof of this I would like to hear or see it. Vektor had flu in the freezer for sure but could never get it to work. End result is what you suggest. But you kill bugs with burning and even they aint dumb enough to plow it under.

    On the other hand, things were a little dicey. And they are as crazy as we were back then with bug bombs. So its all based upon information. I was in the military back then and we were specifically told to watch for infections of the type and nature you describe. Never happened. Gulf War Syndrome though apparently is a real thing and indicative of a chemical or bio attack. I think the latter. Thats conjecture on my part because I have no proof. .

    I dont discount what you are saying just out of turn. I like my friend Melanie would turn to you and say prove it or its Prozac. Post up what you got more than the blogosphere and we will trot down to Congress and I guarantee that you would see the bio-Manhattan project for flu. Incontrovertible proof please.

    Ken Alibek referred to influenza as a possiblity but has always asserted that it would get out and mutate and kill even the Russians and thats why they dropped it. Short end of the stick doesnt mean they would launch a weapon that would kill humanity. Also this is supposed to kill people in a highly pathogenic manner. We havent gotten there yet and I would hope that we dont. But the plan for all bug bombs was to incapacitate and if able, kill the enemy. So are we to believe the pressure cooker wasnt working and the fudge they were making wasnt quite done yet? I dont mean to disparage you but I need proof.

    Until you come up with something that has a human attached to it I rank this right up there with Charlie Sheen and the WTC’s. Its possible, but not probable. Even the Russians arent that stupid.

    Waiting Erich.

  89. #90 anon.yyz
    December 30, 2007

    Pixie,

    Did you not recently suggest that Indonesia is a client state of China, likewise Supari via the WHO DG Margaret Chan? Pakistan too?

    Every one knows Indonesia is a “client state” of, if you want to use that term, the U.S.

    I think you are fabricating news, not reporting it.

  90. #91 Erich Simon
    December 30, 2007

    Attn: Mr. Kruger

    The outdoor BioWeapons facility formerly subordinated to the Soviet Union is Vozrozhdeniya. You can research the name and a lot of coincidences will fall into place. Nature magazine approached me for an article I wrote, “Wherefore H5N1″, but declined publication after several months of scrutiny. It wasn’t for the lack of facts… they were told not to publish because of the “controversy” and I, like others (e.g. Ted Kopple’s last show on Nightline three Novembers ago) have been censored.

    I never went back and updated the piece, now a year and a half old, because events are simply moving along too quickly and what’s the point. Maybe I’ll post the beginning of my analysis of the subject on this site in the coming days; I work with a publisher and don’t engage in blogs. For my last economic writing (I’m a financial event impact consultant, which is how I came upon H5 so many years ago) you can google: Stutterer Bernanke Tips Hand on Gold, although the piece is not about Bird Flu.

  91. #92 daedalus2u
    December 30, 2007

    RMK, Gulf War Syndrome isn’t from a chem or bio attack, it is what happens to normal physiology when you subject people to immune system stimulation under conditions of high stress and continue to do that for a few weeks.

    What happens is the immune system stimulation causes expression of iNOS via NFkB which causes NO levels to get very high. That high NO from iNOS is what causes hypotension during sepsis. That high NO level causes feedback inhibition of the expression of eNOS and nNOS which lowers the basal level of NO after the iNOS is cleared in a couple of days. NO inhibits NFkB, so if you have a high NO level, the expression of iNOS is less. This dynamic is what I call the “low NO ratchet”. Each instance of immune system stimulation under conditions of low basal NO causes that basal NO to ratchet lower. Keep up the immune system stimulation and NO ratchets lower until it saturates and you reach a new stable state with hysteresis.

    NO is what causes mitochondria biogenesis, so if you have low NO, you have fewer mitochondria. That shows up as chronic fatigue. Fewer mitochondria generate the same ATP at a higher potential which causes more superoxide which pulls down the NO level perpetuating the low NO state.

    It is low NO that leads to not enough mitochondria and to an overly exuberant immune response that causes things like ARDS.

  92. #93 revere
    December 30, 2007

    daedalus2u: I don’t agree. There is good evidence that anticholinesterase inhibitors have played a part in GWS and stress opens the blood brain barrier, allowing a variety of environmental agents entry. There is also good evidence that GWS is not non-specific, although probably some different things have gotten mixed together. If you look at the environmental exposures of these guys, the question is not whether some of them are sick but why they aren’t all sick. The idea that it is stress alone is pretty well debunked in the medical literature on this difficult problem. A series of papers by White, Proctor and their colleagues at the VA are among those that have examined these issues.

  93. #94 caia
    December 30, 2007

    Revere — Thanks.

    Also, your reply to Late Nite Comic? FTW. (For The Win)

  94. #95 M. Randolph Kruger
    December 31, 2007

    Erich-I was aware of some 20 facilities in the USSR. They admitted 10. Each day the sun rose, each day our KH-11′s took nice pictures. But it was the humints that brought the story really out. We were warned as late as 88 in the military that they might be making superbug flu. The question… Were they? The answer was yes, but they simply couldnt make it work.

    By all means post your stuff here. Sheyit, I like spook stuff. Revere would probably be fascinated too. Again I dont discount what you are saying but coincidences are just that. You have to have someone or something that is incontrovertible to back it up. Something say that would hold up in a court of law?

    If Ken Alibek who works for us now said it wouldnt work, it wouldnt. Disposal of flu into the ground? Like I said, only a total moron would dispose of biocrap into the water table. They were and are scientists even to the end in old Mother Russia. There had to have been someone in charge and the prescribed method is heat for most bugs and that means burning it. But again, show me the bugs.

  95. #96 gilmoreaz
    December 31, 2007

    MRK,

    If brought down properly it’s less than a week to bring a nuke up to enough power to “sync” with the grid. This assumes you have full staffing. Currently the industry leaders (Exelon) are refueling in less than 25 days and replacing (4) steam generators in under 3 months.

    The wild card is you need a coal fired plant (aka: black site) to fire up a nuke unit as the diesel back-ups for emergency power (allowing for a safe shut down) aren’t enough for re-starts.

    .

  96. #97 Erich Simon
    December 31, 2007

    Mr. Kruger,
    If you snail mail me at the following address: PO Box 1001, Newtown, PA, 18940 your email or mailing address, I’ll see about updating and forwarding the facts (public and nonpublic) of HP AI A H5N1 following the introduction below, written and assessed by me in 2006. I work with a group of top tier investment specialists looking to turn a profit on Pandemic. Unfortunately, as an accomplished mainstream research analyst (retired) pioneering studies on products that you use everyday, no such profit is forthcoming (which is one reason why I am at this late date sharing some of my findings). This writing is proprietary and not for redistribution.

    WHEREFORE H5N1

    Viruses themselves are not technically alive. Although some, like SARS, with 29,727 nucleotides within the span of something visible only under electron microscope would question the very essence of the word Marvel. Viruses are the bridge between the dead and the living.

    There were much goings-on in Asia when Influenza A (H5N1) made its debut in 1997 in the human population of Hong Kong. That was the date identified by Dr. Robert Webster from St. Jude Children’s Research Hospital, a man with enough scientific credentials in avian (bird) flu to fill the pockets of most all others put together. The virus has since been traced to a goose from a southern Chinese Province called Guangdong in the year before. The exact date will never be known, that moment when the virus flickered to life when it made first contact with its first host.

    But in that dawn Asia experienced a financial crisis that came to be known as the Asian Contagion. Also in that year, one out of every five North Koreans died from starvation. The remaining four survived on tree bark and cannibalism, punctuated by families surrounding emaciated family members when the smell of death was near so as to consume the bodies in advance of the starving mob, a society reduced to the inner cortex, ‘the reptilian brain’. The USSR collapsed in 1991 and in 1998 so did its currency, the Rouble, which was supplanted by Vodka, their survival was somewhat less macabre. But no less corrupt.

    And Japan? The well-greased homogeneity had long known that the dark spot on their horizon was June 30, 1997, when the British colony and financial-hub vestibule of Asian capitalism, Hong Kong, would revert to Communist rule. The event conjured the financial equivalent of images of hills in Vietnam being overrun by ant like clouds of beserker adolescents, sprinting rifles towards helicopters overloaded with fleeing masses, careening into the ground, souls transported on the winds of explosion and flame. Such was the fear in the minds of the men who presided over the Nikkei going into June 30, 1997.

    The financial exodus and prevailing apprehension came and went in that year. But whether or not the death knell was sounded by the changing of the financial guard in Hong Kong, it was definitely sounded when Dr. Webster discovered that a highly pathogenic (HP) H5 virus had broken the species barrier and jumped from bird into human. Thought to be a scientific impossibility, not far removed from say the capacity for a dog to impregnate a cat, Webster found himself staring down a barrel of biblical proportion, although he himself was probably not aware of the full ramification until just last year. The order went out to slaughter every bird for as far as the eye could see (with a telescope). Was it a coincidence, the overlap of these sea changes in Hong Kong?

    Or was it the larger coincidence of a region suffering the ravages of overpopulation? After all, China has five times the population of the United States living on a same-sized piece of real estate. Japan has half the population of the US living on a piece of ground the size of California, two thirds of which is uninhabitable. Mountains. And their day of reckoning did not come in 1989 when a good portion of what was half of all the money in the world fled their equity markets. It came in 2001 when the government declared an official Depression, ushering more than 32,000 Japanese to their deaths, the ‘honorable’ way. They killed themselves.

    The Spanish Flu of 1918 (H1N1) is what the scientific community thinks about when they think of H5N1. The 1918 Flu was the single greatest mortality event of modern record and it put an end to the First World War. In the words of one physician speaking in an official capacity at the time, had The Flu Of 1918 progressed a scant two more weeks, it would have ended civilization and ushered in the next Dark Age. The H1N1 genome was published in the journal Science in 2005. And it didn’t take much to turn H1 into a killer, just a handful of alterations in the virus’s 4,400 amino acids.

    All human flu comes from birds. The seasonal flu and sporadic pandemic (e.g. 1957 and 1968) are mixtures of human and bird flu through mutations in other animals (usually the swine) resulting in dumbed-down human versions, dramatically reducing related casualty. A bird flu that doesn’t mix with a human flu but jumps directly into a human host (like The Spanish Flu) is not really a human flu per se. It is a bird flu in a human host, an ‘alien’ virus. The body’s response is completely opposite that of the seasonal flu. Rather than being saved by your immune system fighting a known opponent, your immune system actually goes into a fighting frenzy against an unknown attacker that never ends, called a cytokine storm. Actually, the fight does end, but only after your lungs fill with blood and drown your organs of oxygen. This lack of distinction between The Bird Flu of today and the implied seasonal flu is an ambiguity exploited by the media to assuage the public.

    Just how unique are these two alien strains? Frank Obenauer in a more recent issue of Science looked at 2,169 distinct avian virus genes. There were only two that showed a conspicuous protein tag at the end of one of the nonstructural genes. The 1918 H1N1 virus and today’s HP H5N1. Coincidence?

    There are 16 H’s (Hemagluttinin) and 9N’s (Neuraminidase) in the avian A strain universe and only two have attained HP form, the H5s and the H7s. First identified in poultry populations in Italy in 1878, the highly pathogenic strains cause mortality rates approaching 100% within 48 hours. Today’s H5 does the job in as little as twenty and lives up to its nickname: Chicken Ebola. The Spanish Flu (H1N1) was a mere smitten alongside the HPs.

    In November 2002 SARS came onto the scene in Guangdong Province, the same place where H5N1 originated. SARS is a corona (Latin for crown) virus distinct from an avian virus. Only this particular corona was deadly beyond compare. And it killed its victims in exactly the same way as H5N1, through deep lung necrosis. In one account a doctor from Guangdong carried the SARS virus to the Metropole Hotel in Hong Kong, where he infected nine on his floor, simply by breathing the air, in a role known as the ‘superspreader’. These nine then transported the virus to four continents. In two days.

    SARS was so deadly, in fact, that the Chinese built a full scale hospital in eight days, utilizing 7,000 workers, but when the virus clustered in the medical staff, all doctors and nurses refused to go into work. SARS invaded 29 countries, infected more than eight thousand people and killed roughly ten percent of them, an unusually high case fatality ratio. Four heart-pounding months later, the SARS threat was contained and the planet dodged a bullet. Only to be revisited by HP H5N1, the T Rex of the virus world, which returned with a vengeance. Just what is going on down in Guangdong?

    The Head of Biosecurity in China recently admitted that an individual who had died from SARS had really died from H5N1 and that his team wanted to release mutational sequences to The New England Journal of Medicine. And this when at the height of the SARS outbreak, China claimed a mere twenty-two infections. Even more peculiar, the gesture was followed by a fraudulent email claiming to be the same Head of Biosecurity and requesting that the story be retracted without further a clue.

    If the fraudulent retraction had come from inside China, it was most likely the Head of Agriculture attempting to put a lid on the fact that haphazard poultry vaccinations had inundated the country with chickens that are alive but secreting the virus in their droppings. Not only a worst case scenario for spread, the fact highlights the fiscal impossibility of continued culling since without compensation, the rural poor are doomed to starvation (over a billion birds have been culled around the planet). Or did the fraudulent email come from outside of China? The plot thickens.

    The HP H5N1 sequences were finally published in The New England Journal of Medicine. And they told a story rather left untold and for reasons much worse than a Chinese poultry vaccination gone horribly awry. The SARS death was indeed an H5 death, meaning that the H5 virus had been in circulation longer than some wanted to believe, and raised the question of just how many were really dying of H5, misdiagnosed or underreported. But far worse than that, and casting shadow on the official by-line that the virus had not mutated into a form “easily transmissible between humans”, H5 was exploding in every direction and undergoing hundreds if not thousands of mutations, ricocheting across the landscape like a ball in a pinball machine. And there was once again confirmation of the ancestral link to Guangdong.

    With all fingers pointing to Guangdong the shroud of obfuscation raises suspicion on the origin of H5N1. And SARS. These two viral human killers, the deadliest ever unleashed, both killing through deep lung necrosis, both labeled “novel pathogens”, both just happening to pop up at the same time and both in the same place is a little more than coincidence. Enough of Coincidence already!

    Well, maybe ONE more coincidence. But it isn’t the unexpected and untimely death of the honorable Dr. LEE Jong-wook, Director-General of the World Health Organization (WHO), who just happened to succumb on the eve of an important global summit at a time when the facts of H5N1 were beginning to loom large. But first some more about our T Rex…. (remainder reserved)

  97. #98 M. Randolph Kruger
    January 2, 2008

    gilM-You probably werent aware of the requirement for the nuke operators to remove the “three mile island” reactor heads developed by Wilcox in the 1960′s. These were found to be substandard after 3 Mile Island the DOE gave them til 2005 to start the removals. They weigh 120 tons each and they have to cut thru the containment, remove the very radioactive old one, inspect the containment and reactor vessels with robots they’ll throw away later on, eddy current the vessel walls, containment and all of the piping. They arent allowed to restart one that has a head available. Currently 3 are offline in the Eastern US. It takes about a year to just do the inspections.

    http://goliath.ecnext.com/coms2/summary_0199-2881149_ITM

    Some diagrams are out there that indicate that it takes about a month to do this. So far it has taken about a year to 18 months per. Not to do the work, just to satisfy all that everything is okay…….

    But in ideal conditions they can indeed refuel them in that time. As a side note, I made a suggestion to my state senator that they draw up plans to bring SSN’s up the Mississippi to key points along the river and anchor them. We are not allowed to move them under powerunder the strategic arms limitations but towed up stream its like getting that Coleman out and plugging it up during a storm. 5 or 6 of them and it would go a long way to ensuring that things stay on. Reactor blooms are very easily seen from space. I imagine that unless we did a lot of notifications the Ruskies might get a little nervous.

    The NE is a different story. Key points are that there arent enough rivers to get into the center of the country where the power would be needed. Even though they have a grid in the area around Chicago/Detroit its not designed to take high loads into the center of the country, its in reverse. The West is a house of cards. There are generators and switch points in Phoenix area that just cant take the load period.

    Bush Administration has been pushing for wires since the blackout and 9/11. The environmentalists have stopped most of them and held them up in court. So its a set up for disaster if and when the shoe falls.

    Erich… but that isnt proof. Its an explanation. Its for my way of requisite order to say you are molding facts to support the hypothesis. I need something more solid. Conspiracy theory’s are out there for little green men but I havent seen any. There will be money to be made in a pandemic no question. Simplest thing is to watch the CFR’s initially if it breaks and then short the market accordingly. But you may not be aware that I am in Memphis, I move a lot of little hairy things for the BSL at St. Jude. You have to have proof Erich and yes I agree the DG’s death was…”coincidental”. But it serves no Chinese purpose other than to be able to buy a little time if what you assert is true. If its right, it will mutate this year and a crapload of people will die. No matter what we do. I dont know about this year, but so far it aint lookin’ so good for the human race even if it cuts the CFR by 1/2. That I can heartily agree on. Killing a DG of the WHO is like hitting a bus driver. Even if they put a putz in charge, you can get rid of them pretty easily.

    But as I said its not proof that the Ruskies let it out. I cant see them plowing just BF under the soil, not with all of the other stuff thats even crazier than this. That would be a cognizant act with something that they KNEW would do us all. They are crazy but the Ruskies are not stupid. Far from it. If the Chinese knew it, then it would be hard pill to swallow and they likely would attack while the chickens in the oven. Failing to do that they would lose all of their ability to use that huge army they have. They would be dying as they marched.

    Norko? Yep, I am surprised that they are not eating the rubber off of trucks. President Kim will be dead within a year or so. There is no more money to provide aid to them from Beijing. Its all going outbound to fund the oil imports. So yep, his little machine will tumble like a house of cards once the start to pull on it a bit.

    Its okay though. If the Dems get the White House then demand will fall to nothing as they tax and spend for social programs, as will the economy. Clinton was able to do most of his social programs because of the peace dividend. The military was shrinking and the spending with it. Short the market in advance of an anticipated Hilary win, Obombme too but to a lesser degree. Edwards? Shit, he and his wife are zillionaires and are as two faced as Al Gore on environmental issues.

    Typical Dems… Do as I say, not as I do. At least you know you have money grubbing capitalists in every Republican soul. Stay true to the cause.

  98. #99 Erich Simon
    January 3, 2008

    Attn: Mr. Kruger
    In the economic chaos of 1991 the Russians plowed the H5 virus under the earth along with bleach. The US military went in and said that the ANTHRAX in the mix (no mention of HP H5) had clumped and the bleach had never permeated…

    Ken Alibek said that China is the one who made HP H5 (and other stuff like the Ebola that is circulating, never before recorded in China). But no such gamut of pathogens could escape from an indoor (Chinese) containment facility.

    Alibek quit his post when I concluded my analysis in August 2006. He realized the ramifications of a circulating HP H5 that was ‘dumbing up’ and dividing. He has since gone into vaccine production/hiding (like members of the CDC, DEFRA, and all the rest!). You should also know that Warren Buffet gave more than 21 billion dollars to the Gates Foundation for the hunt for an HP H5 cure, instead of passing on his fortune. He claims to not believe in “dynastic wealth” when this was not his motivation.

    As one of the world’s foremost HP H5 researchers (didn’t ask for it, just happened that way), I was approached by one of the largest options and futures trading companies in the world to develop a short list for Pandemic investing for a test readership of 70,000. I could and did not. Like I said, no one but me understands exactly what is going on here.

    There is a (government?) trojan attached to my browzer since 2004 when I uncovered a now cenzored outbreak in Brazil while poking around in the European commodity market reports (the report was rescinded within 48 hours). I would prefer to communicate one on one or through the mail.

    Erich

  99. #100 M. Randolph Kruger
    January 3, 2008

    Erich-I wouldnt want to deprive my fellows here of your info. I can understand you might have a personal interest here, but you still havent produced anything yet that proves your statement. I dont hide anything here. I spill my conservative guts all over these lefties like I just ate five pizza’s and drank two gallons of beer.

    Please continue to enlighten us with what you have but you have to have a body that will make corroboratng statements to what you say. I still say that the Ruskies who I have met my opposite in their military across the years since they gave it up wouldnt do this. In fact, I found them to be a frightened bunch by the stuff that they had in the freezers and I never saw some of the freezers.

    But you could write a good spy novel about it and until you produce something here, remember the words of Lady Melanie…. Cite your sources. If you are trying to turn this into a commercial gig of some kind then please dont do it here. I will save Revere the hassle of telling you that. This is a political/medical blog and if you want to sell something then there is that little space to the right and left and top of the postings.

    FYI-I saw the official statements made by the NBC people that went for the Army. They found nothing that was unsafe by intl standards in 6 sites. There were 3 other facilities that were determined to be “questionable” because they couldnt get an answer as to what kind of research was going on. This means they were happily making something that was prohibited. These are Russians, they are not going to dump something into the soil that is even remotely questionable. Its their back yard, they dont crap in it. There are sites that need to be cleaned up, there are sites that are damned mess too.

    In 1985 the Rusks were working hard on flu. They went on for another five years mutating this crap in the lab and then gave up because they could never, ever get it to jump thru the hoops. They destroyed their stores by fire in 1990 as the leadership feared an accidental release.

    There were many facilities and of course there is always the ONE that gets away. I cant ascribe to your post without something substantial and more than this browser trojan you speak of. If thats the case you are infecting us all. I have the blocker on, the hard blocker, and even a secondary one.

    I am also very, very good at tracking stuff on the net. How is Hans H? Birgit?

  100. #101 Erich Simon
    January 4, 2008

    Mr. Kruger,

    You can google: Is a Global Killer Lurking in China? I wrote that in the middle of 2006 when I was awakening to a confluence of scientific and media realities across the continents (I hold an associate masters from IIST in Japan and am well acquainted with the Asian way of life). Since then I have connected a lot of dots, while all along reading sites like EffectMeasure. I have noticed a certain myopia surrounding most of the commentaries on the H5 juggernaut. I have the luxury of cross-reference and a daytraders ability to garner between the lines, and in this last year things have been coming together too large to communicate.

    I’ll attempt to interject time permitting. I’m not looking for anything, except perhaps a survival group to entertain a property purchase upstate in Pennsylvania (I’m one of the founding VP’s… marketing, of the Pennsylvania State Employees Credit Union).

    My concern today is that given the ramification of a Pandemic that will remove 5.25 billion (I can make that case), a preemptive removal of a bulk of the population via a Pandemic for which there is a vaccine is a strategy that I believe is more than just on the drawing board.

    And this incredible realization is why I decided to open up to a blog like this one. Believe me, all I wanted to do was ladder some bonds and live off the interest and travel about. Only my gut tells me that we’re about to be blind-sided.

    Erich Simon MBA

  101. #102 zets
    January 7, 2008

    the discussion of wether WHO is great, mediocre or a total failure has reached levels, where it is totally unconstructive and does not lead to any useful action or idea. Instead it wastes bandwith, emotions, time and it does not achieve anything that helps us to prepare for a pandemic or to survive it.

  102. #103 Erich Simon
    January 10, 2008

    Zets,
    Indeed. If this one is manmade, then MN is the only thing keeping us alive. If this one comes from MN, then most of us will not survive.
    I have some ideas on how to survive, how to segregate the time/space quarantine et al. And disposable cash to match.
    Erich

  103. #104 highflyer
    January 10, 2008

    Erich and Zets:

    So you seem to agree to my post from more than ten days ago? Zets: if your whole post is a direct quote of what I wrote, and not a single word from yourself, please indicate it. You reposted what I wrote December 29, 2007 5:17 AM :

    Until then: the discussion of wether WHO is great, mediocre or a total failure has reached levels, where it is totally unconstructive and does not lead to any useful action or idea. Instead it wastes bandwith, emotions, time and it does not achieve anything that helps us to prepare for a pandemic or to survive it.

  104. #105 Erich Simon
    January 18, 2008

    Attn: highflyer, Mr. Kruger

    To continue on the Bhutto, birdflu and WHO bashing…

    I think that you, Mr. Kruger, have a pretty good grasp of the events at hand but can not accept a pre-emptive Pandemic strike or the stage set of H5N1 as the propaganda virus that will be broadcast into the public domain when the time arrives (while another planet-scrubber military virus for which there is a vaccine that will be distributed to the chosen few/wealthy under the guise of an H5 “new” vaccine. Then will come the Superspreaders/high altitude aerosal release inundating the jetstreams and mimicking the rapid contagion of the 1918 influenza, which killed whole villages of Inuit with 100% CFR as it seeded itself around the planet, blowing invisibly on the wind). Also by the way, H5 has adapted to nerve and I think blood receptors, as it evolves to cause death, one step, one breath and lights out. This hints at why the original H5 sequences are kept under lock and key, for obfuscation, on the origin and what is coming. It most certainly is not for proprietary financial gain in vaccine development.

    My father came over after the war and is one of the Neurologists accredited with establishing the science of Neurology in New Jersey. The Neurology Department at Mercer Hospital in Trenton, NJ is named after him (Dr. Erich H. W. Simon(e)). His best friend was a Neurosurgeon from the University of Pennsylvania, whose father held the chair of Neurosurgery at Northwestern and whose (adopted) sister, N, married the most prolific President of the United States in this country’s history.

    It was discussed/known before that administration that given demographic extrapolation that most of the planet’s population would be exhausted by 2010 approximate. It is public knowledge that the President was afraid of nuclear Armageddon. Viral contagion was probably going to be the (designated) means of resolving scarcity of resource and the wars associated with that coming reality (I was sent to learn survival skills in Quebec…, one of the locations where I believe reside one of the many global interconnected and decentralized 5th? generation Cheyenne Mountains). At that time, virus technology was so sophisticated that ethnic specific viruses were designed to wipe out entire global ethnic populations (genetic mutational drift nothwithstanding).

    The bottom line is that Dark Ages are not evolutionary linear events. They are cyclical. And SARS CoV was a shot across the bow, while HP AI A H5N1 is either the chosen planet population removal agent, released accidentally or intentionally, and depending on that verdict, then it would appear that it is at the very least the wolf in sheep’s cloths that will provide for an ‘organized’ dissolution. And if you haven’t noticed, this is the year for the collapse of the banking industry, well under way, per my financial client iterations going back to 2001.

    E. out