The national bird flu plan is quite explicit in its promises to local public health. There aren't any. The plan is, "you're on your own." Fair enough. A pandemic happens everywhere so there's no "outside" to send help from. But how well prepared is local public health? Bush has given them the power and supposedly provided them with money to handle bioterrorism attacks. That should have been some help. It wasn't.
Unfortunately what the left hand giveth, the Right Hand taketh away. From Cape Cod, Massachusetts:
But budget cuts over the past few years, coupled with a lack of staff, have left departments struggling to keep up with even daily tasks, including inspections of septic systems and restaurants and answering complaints, Cape Cod health agents say. Planning for an avian flu pandemic and other public health threats, as required by the state health department, is nearly impossible given the other demands, they say.
''We barely keep our head above water just doing our daily routine,'' said Glenn Harrington, Mashpee's health director.
''It's a balancing act and I think we're falling further behind,'' Sandwich health director David Mason said. (Cape Cod Times [Massachusetts])
A survey done by the Massachusetts Coalition for Local Public Health revealed 70% of responding local officials said they were understaffed and ill-prepared. Forty-five percent didn't have the resources to beet basic public health needs. Only half of the state's 350+ health departments responded, however. Many said they were too busy. Bioterror money can buy fancy technology the health and fire departments don't need but it can't be used to hire a full time health agent.
In addition to planning for emergencies like bird flu, health departments on Cape Cod have also been swamped with other threats in recent years, like rabies and West Nile virus.
''The workload has just grown immeasurably,'' said Orleans health director Robert Canning. Besides himself, the department has an assistant agent and two full-time clerks.
Mason compared health department officials to a computer antivirus system.
''We're out there (doing things like) inspecting restaurants for the public. We're not visual, like police and fire,'' he said.
[snip]
Nowhere is the lack of staffing and funding for health departments more apparent than when it comes to the avian flu plan, said Brent Reagor, secretary of the Massachusetts Health Officers Association, one of the groups in the Coalition for Public Health. Reagor, who is also deputy health director for the town of Acton, said his department predicts they will need to give seven flu shots per minute in order to meet the state's requirement that 80 percent of a town's population be vaccinated within 48 hours.
He figures that would require about 300 volunteers per day to do everything from directing traffic to cleaning up the emergency dispensing site, which is usually a school or other large public building.
Failure to fund our public health infrastructure will ultimately be the Achilles Heel of the nation's response to a pandemic. The fault lies with the Administration, the Congress and local communities, who would rather have lower taxes than health communities. Unfortunately those of us who would rather pay now rather than pay later will suffer along with those who don't care to invest in a strong community.
Public health is "public."
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Low key response to the potential public health problems posed by avian flu is not limited to small underfunded health departments. Monday's New York Times reported NYC's plan for possible pandemic: stay home. "(c)overing your mouth when you cough or sneeze; not going out if you have fever and cough" said NYC Health Commissioner Dr. Thomas Frieden . "These are very important things people can do to reduce the spread of infection, and if there were a pandemic, they would be our first line of defense."
http://www.nytimes.com/2006/07/11/nyregion/11flu.html
NYC is not strapped for cash. At present it has multi-billion dollar surpluses. Its pandemic plan is mostly that people, especially health care workers, should not get sick. If they get sick, people shouldn't infect others. It doesn't sound as though a lot planning has gone into this.
The new issue of Health Affairs has a collection of articles on emergency preparedness, including reviews of state and local departments, the issue of coordination/cooperation with public safety agencies, etc. Do check it out.
/begin rant/
With local - state, cantonal, county, etc. - public services cut to the bone or functioning on a shoe string, or, as does exist in some places, carefully calibrated in terms of duties+work load / personnel and materiel, to function with about 10% of fat or leeway, it is the job of the Federal Gvmt. to address, organise, and pay for matters that can be considered exceptional, affecting the nation as a whole.
That is the one of the aims of a Federal type structure. It is why people set it up! That is what it is for!
So the Federation says you' re own your own, local authorities say you' re own your own, nurses and doctors say you' re on your own, grandparents and po-lice will say you' re on your own, and finally Mommy will say you' re on your own.... (not literal, the spirit of the thing...)
Brilliant. Outta sight stellar.
Solidarity and cohesion are forged in many ways. A federal Gvmt. is supposed to promote it and invest in it - even if there is nothing they can do practically prevention wise (e.g. giant meteorite.)
/end rant/
(from Switzerland.)
Wish I could, Cervantes, but I don't have a subscription and single articles are pricey. Care to summarize?
Ah, good point, only abstracts are available to the common rabble. I'm planning to do a post about it either this evening or tomorrow. (I have access through my university library.)
I just completed a class in Public Health. Interesting to say the least. We had to identify ways to improve the health and safety of the people in a community. Granted most of the suggestions would cost money, but preventative care (and preventative activities) are the best way to improve and / or prevent many health issues. That being said... I do not think Bush knows enough about anything to contribute any solutions. Nor is he surrounding himself with those persons knowledgable to advise. Political favors are evidently paid by appointment.
Now,
I thought I would die laughing when I read this.
Interviewer from People:
Do you think Gore is right on global warming?
George Bush:
I think we have a problem on global warming. I think there is a debate about whether it's caused by mankind or whether it's caused naturally, but it's a worthy debate. It's a debate, actually, that I'm in the process of solving by advancing new technologies, burning coal cleanly in electric plants, or promoting hydrogen-powered automobiles, or advancing ethanol as an alternative to gasoline.
http://people.aol.com/people/article/0,26334,1210402,00.html
Something to share with everyone who will find humor in this.
As one of the big time responders that will go into action during a bird flu event you have to understand that we could throw 1 trillion dollars at this problem and still not get it right. There are just too many people on the planet and the demon is out there and he is hungry. I see people feeding the Ethiopians and stopping a human disaster. So more people grow up over there, grow more goats and cows that eat the grass that creates the problem. Birth control? Maybe retroactively when nature takes its course. I see the rant about global warming is up there agin. So lets see the same people who said in the 70s that we were in a global cooldown are now saying its a global warming. Yeah its hot out there, been hotter before though and right in advance of an ice age. Thats it! The dreaded TyranoSuV's did them. Couldnt have possibly been a natural event and the effects of its happening. Had to be them gas guzzling dinosaurs that did themselves.
What about the temperature range then. To hear them talk about it they say we are all going to be cooked and drowned. Hey Al G. wasnt our fair state undewater? How did the dinosaurs live in such a temperature? Who puts sunblock on dinosaurs?
Are we going to lose people from global warming? I dont know. Are we going to lose them from bird flu? I dont know. Can anyone say what is happening is from human intervention in global warming. NOT with any degree of certainty and no one including Heidi "we are all going to die" Cullen can say that scienticially. Prove it and you have a convert...instantly. .
Before you thump the Kyoto accords in my direction as a fix I have a MODIS/TERRA picture for you to look at and all you have to do is hit my email address and I will send it to you. Its the satellite that was conceived under Reagan, prototyped under Bush 1, then launched under Clinton prez 2. The results take a year to download because of the data it produces. Its in the tetraflop of data level and samples the earths greenhouse gas levels and where they are, where they are produced.
So Rocky Mountain Highs, before you jump you should have the facts straight. This one picture produced two years ago shows who the great polluters are. It aint the SUV's and the USA, Europe, Russia or even Japan. NOPE its China and Central Africa. China produces so much polution that Hawaii, Alaska and California cannot hope to get their emissions down to an acceptable level. China just takes up the slack. It drifts all the way across the planet to as far as western Europe. India is another and Central Africa generates theirs from slash and burn. Alaska doesnt meet the Clean Air Act during the winter. So do we sign the Kyoto and lose our jobs so a Chinaman can take it while we comply and they dont? We would lose jobs because we would no longer be competitive. The Kyoto gives them 20 years to comply. If they started today and spent 3/4 of their economy they couldnt comply. They would still get extension after extension. If China complied with just the US standards it would bring the emissions down by 1/3rd.
So what is this thing? Picture one of those nasty Weather Channel thunderstorms. Its colored green, yellow, red and for levels that are unmeasurable-black. Now look at a map of India and China. Both have basically a thunderstorm of green house gases over them in the winter that encompasses both. It has only a touch of green on the perimiter, a swatch in a circle of yellow, then about 300 miles of red/orange, then easily 1000 miles of black center. Its that thick.
It only takes about 15 years for the gases to be reabsorbed so we have a pump effect. Just as its starting to get better each fall, thats when they crank it up again. They account for by a number of scientists who dont politicize it 44% of the worlds greenhouse gases. Much of the greenhouse gases are produced by those critters I mentioned above too. Cows and goats produce one hell of a lot of methane. On the other hand I want them to stop cutting down the forests...period. Not so much as the wood and deforestation. More so the left over stumps. Termites eat them. They account for as much as 15% I am told.
As for the expenditures on the bird bug. Nothing you can spend, say or do will change the fact that some sort of pandemic will be coming down the pike within five years. Big, baddassed and like the Ethiopian demon. He is hungry and he is going to take a few. Can we stop it? Not if the UN/WHO is in charge or even if we ended up with Hill/Billy Clinton in the next White House. Nature is just going to take what it wants and then leave. Just like it does in Ethiopia when there are too many people.
Please I'd like to get your experts' reaction to this article:
vietnamnews. vnagency. com. vn
Bird flu under control but foot-and-mouth a problem (12-07-2006)
- Can birds get FMD?
- How can the symptoms of H5N1 be told apart from the symptoms of FMD in e.g. swines?
- How easy is it to distinguish H5N1 from FMD virus in laboratory conditions?
- other points worth making?
Maria: I know something about FMD but I'd rather punt this to the vets in the readership. Tom DVM? Any comments? Others?
promedmail news:
In Qinghai region there have been an outbreak of "foot-and-mouth disease"...