Scott McPherson's Web Presence

This afternoon, I challenged and questioned the World Health Organization's decision to move its pandemic doomsday clock from Phase 4 to Phase 5.

Then, on my drive home, I heard a familiar voice on my radio. I immediately recognized it as Dr. Margaret Chan, the head of the WHO. Later, I found out that it was Chan who personally made the decision -- and takes the responsibility -- for moving the world to One Stroke from Midnight.

I absolutely support Dr. Chan, because she is getting to be an old hand at these things.

A history lesson is in order for the newbies who are coming to this Website. Dr. Chan is a dual Canadian and Chinese citizen. I am confident that distinction has literally saved her life at least once.

In June of 1997, Dr. Chan was the public health secretary of the City of Hong Kong when the city was handed over to the Communist Chinese by the British government. Barely six months later, Hong Kong citizens began dying from a sudden outbreak of a new and novel strain of influenza. At first, Chan was told -- ordered -- by the Communist handlers to ignore the situation and to downplay it however possible. At first, she did this. But it was soon apparent that this novel virus was moving with devastating efficiency from person to person.

This virus was then typed. It was an avian flu that jumped the species barrier and began infecting humans directly. It was moving quickly and she recognized that drastic action was necessary. So, in direct conflict with her new Communist bosses, she disclosed the existence of H5N1 -- H5N1 -- and ordered the culling -- the destruction -- of all commercial poultry in the city.

Amazingly, her handlers stood down, the Hong Kong government moved quickly, and an H5N1 avian flu pandemic was averted.  That original human strain of H5N1 was moving person-to-person and she stopped it in its tracks with her actions.

Next came the beginning of 2003. In neighboring Guangdong province on the mainland, and an area under direct Communist control, people were getting sick and dropping dead of a strange and deadly virus that moved far more quickly than influenza. Initially, she was unable to even inquire into the affairs of a neighboring province.  The Communists had settled in, and they had established a ridiculous and centralized reporting infrastructure that meant everything went through Beijing.  Eventually, she felt compelled to act, again risking dismissal, imprisonment (or worse) from her bosses. 

The virus would eventually be known as Sudden Acute Resipratory Syndrome, or SARS. Her actions help save lives and she helped beat back the disease.

Some have been critical of Dr. Chan's handling of the SARS crisis. Those criticisms usually revolve around the delayed quarantine of E block of the Amoy Gardens apartment complex within the city.

Let me set the record straight on this.  Hong Kong's residents were and are very independent.  Amoy Gardens block E was a 33-story, 8-units per floor apartment complex.  It took Dr. Chan several days before it was decided by the authorities that she even had the authority to quarantine an entire apartment building.  Then, many residents attempted to break quarantine.  Eventually, the government was able to convince the residents to evacuate the building and move to different accommodations, because reinfection with SARS was possible via the sewage system of the building.  Once the residents were moved, the outbreak ended.

One only needs to read former Time editor Karl Taro Greenfield's superb - and I mean superb - chronicle of the SARS epidemic, titled "China Syndrome - the True Story of the 21st Century's First Great Epidemic" to appreciate both the restrictions placed upon Dr. Chan by the Communist bureaucracy and her resourcefulness in overcoming those obstacles.

Decisions made in these situations are similar to battlefield decisions, and events move very, very rapidly. I am sure some decisions hang heavily on her to this day.  But she has never shirked away from her duty.

In 2003, the WHO brought in Dr. Chan to become director of the Department for Protection of the Human Environment. She rose to the position of Director General in November 2006, following the sudden and tragic death of her predecessor, South Korea's Lee Jong-wook, who died in late May, 2006 after he underwent surgery to remove a blood clot on his brain.  Her direct experience with H5N1 and SARS got her the assignment.

So as far as pandemics go, this ain't her first rodeo.  She has stared down two pandemic candidates and helped beat them back.  She has seen both diseases up close and personal.  So if Dr. Chan felt compelled to make the call and push the button and take us to Phase 5, I am not qualified to question her decision.  I am with her all the way.

No one alive has the experience she does to make that call.  No one else has the blend of medical, scientific and political knowledge necessary to make that call.  She is unique among her peers and the world is fortunate to have her where she is. 

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Just in:  We are at Phase 5.

Everyone who has read this blogsite for any duration of time knows of my quest to get the WHO to raise the pandemic threat level from 3 to 4.

Two days ago, and for a wildly different reason, the WHO has seen fit to do just that.  Now there is speculation that the WHO is about to raise that pandemic threat level again, to Phase 5.

I think that is a bad idea.  I will wait while you pick up your jaw from the floor.

OK, let's talk.

It took a mammoth event to get the WHO off the schnide in the first place.  Now, with the pandemic alert level at 4 of 6, I think we should let that level sink in a bit.  The WHO cannot be seen as crying wolf, especially if there is no evidence that the virus is causing massive, exponential infections beyond those unfortunates who recently traveled to Mexico.

We will see evidence of these expanded infections quickly if they are to come.  Evidence of expanded infections would mean the virus is causing widespread infections.  I don't mean an infection or two in a town that does not go beyond a person or a family.  I mean infections that go from 5 to 100 in a couple of days.

A lack of same would mean this virus may have temporarily lost some of its bluster.  "Temporarily" could be a few days, a few weeks or the virus could lay dormant until the late summer or early fall -- just like 1918.

I just don't think we are seeing the groundswell (yet) in cases that would signify a raising to Phase 5.  If -- and I mean IF -- the WHO raises the threat level, it could be because there are so many nations reporting a pocket of cases in a number of countries.  But there is so much surveillance going on now that evidence of a rapid expansion of cases beyond those people who recently traveled to Mexico would be quickly forthcoming.

 We are also not seeing an exponential increase in Mexican cases.  If this virus was lethal, we would see a continuing acceleration of extreme respiratory distress, and an increase in deaths.  In the past two days, these Mexican cases haveapparently slowed down.  This is decidedly good news and we all certainly hope that  this trend continues.

Everyone is prepositioning assets in the field.  We have anecdotal evidence of increased Federal activity right here in Florida, and I am certain other states have similar initiatives underway.  Everyone is on alert and on their guard.  So let's let Phase 4 do its thing -- what it was designed to do -- and get everyone moving to prepare for Phases 5 and 6.  Tell people what to buy and how to recognize infection.  But let's not pull that Phase 5 trigger unless and until the number of follow-on cases have justified the acceleration.

Of course, there is always the possibility that things are afoot that no one knows about.  But I do not think that anyone knows enough about this virus at this point that would justify a move to Phase 5.  Scientists and researchers are having trouble why this virus has changed its business model to sicken humans, when there are no apparent major changes to be seen in either the HA or NA strands. 

One more thing:  because of the Guillain-Barre side effect problems back in 1976, the government and vaccine makers had better make damn sure there is nothing in that syrup to prompt the kind of anomaly that occurred in 1976.  And putting it in the trivalent fall cocktail makes a hell of a lot of sense. 

Phase 5 is the equivalent of the Department of Homeland Security going to Code Red.  In both cases, the only next available step is "Holy *#&#!"

Phase 5 triggers a number of corporate and government responses, and they all cost money and effort.  Let's not move to Phase 5 unless there is demonstrable, defensible evidence that this virus is causing massive infections growing out of those limited number of clusters.  It is a huge move and should not be taken lightly. 

The statement that just came out of Houston clarified the circumstances surrounding the first death in the United States of a person due to swine influenza.  Initial news reports said the child was Mexican and the family took the child to the US for treatment.

Wrong.

The child was Mexican, but the family was visiting relatives in Brownsville, Texas when the child suddenly became very ill.  The child wound up in Houston and died there.

This disclosure will, as you can imagine, create far more questions than answers.  This child was shedding virus all the while he was here.  Let's watch and learn.

A 23-month toddler has died in Texas of swine H1N1.  First reports indicate the child is Mexican, and was brought to the US for treatment.

Reports are very fluid right now, but the death is attributed to the time spent traveling to the US to seek treatment, rather than the actual severity of the virus. 

I mention that the child is Mexican because this is not, apparently, the case of an American dying of an infection in, say, Cleveland.  This is a person of Mexican nationality who was brought across the border in the mistaken belief that treatment in America was a better decision than staying in Mexico.  This decision doomed this child much more than the severity of the virus.