Scott McPherson's Web Presence

While I was flat on my back, wishing my local health people had a test for Ad14 that I could test (positive) for, a few seemingly random news stories came across my bedside table.  When treated separately, they just appear to be common news.  When looking at the Big Picture, however, they reveal a disturbing trend.

First up is the developing situation in Paraguay.  Paraguay is located in South America, and is bordered on the northeast and southeast by Brazil.  Brazil has experienced a few recent outbreaks of yellow fever in the interior of the country, resulting in several deaths.  This is no surprise; Yellow fever is endemic to Brazil's rural interior.  But the reaction of Brazilians to the new outbreaks was an interesting sociological phenomenon.  Literally hundreds of thousands of Brazilians began clamoring for yellow fever vaccine, and several medical centers were overrun by anxious Brazilians seeking shots.

From the Reuters story of last month, Millions seek shots in Brazil yellow fever scare:

The government has denied the country faces an epidemic of the mosquito-borne disease. But authorities are warning tourists traveling to Brazilian forests, national parks and rural areas to get vaccinated at least 10 days before their trips.

More than half of Brazil's 27 states are partially or entirely yellow fever risk areas, including the Amazon and Brasilia. Most of the coast, which attracts the bulk of tourists, is considered free of the disease.

As fears of an outbreak mounted, the Health Ministry gave states more than 3.2 million doses of yellow fever vaccines this month, more than three times the average monthly distribution in 2007.

On Sunday, people in Sao Paulo stood in line for more than four hours at an airport health station to get shots, according to local media. In Brasilia, hospitals temporarily ran out of vaccines last week as demand surged.
http://uk.reuters.com/article/homepageCrisis/idUKN15537481._CH_.242020080115

Now back to beautiful Paraguay, home to jungles, crops and former Nazis on the run: Paraguay is experiencing a similar resurgence of yellow fever, with one important distinction:  A case of yellow fever had not been reported in Paraguay in 34 years.  There have been more Mengele sightings than human yellow fever cases over the past three decades!  Suddenly, and despite the government's attempts at stamping out the disease, no less than five documented human cases occurred at the same time, at a central farming camp, according to AP:

Yellow fever outbreak strikes Paraguay

ASUNCION, Paraguay - Paraguay asked international health authorities on Thursday to supply 600,000 doses of vaccine for yellow fever after the first cases were detected in the country in 34 years.

Antonio Barrios, a public health official, said the government had 100,000 vaccine doses but wanted to bolster stocks as a "reserve measure" after five cases of yellow fever were detected this week in a central farming region.

Barrios said the request was being made to the Pan American Health Organization. An expert on vaccination issues at the Washington-based offices was not immediately available for comment.

Barrios said the five cases of the mosquito-borne viral disease were found in and around a town in rural San Pedro department some 240 miles (400 kilometers) from the border with Brazil. In January, Brazil reported eight deaths after an outbreak in rural areas.

No deaths from yellow fever have been confirmed in Paraguay, but health officials said it was awaiting pathologists' reports on two people who died recently of unknown causes.

"Pathologists are working in the laboratory to determine whether they died as a result of yellow fever or as a result of some other ailment," public health minister Oscar Martinez said.

The government has announced vaccination plans in and around San Pedro of all those between 1 and 60 years of age. Others were also seeking vaccinations elsewhere at public hospitals.

http://www.msnbc.msn.com/id/23058833/

Then, local residents began behaving like -- like, well, like Brazilians.  Also from the AP:

4,000 block Paraguay road, demand vaccines

ASUNCION, Paraguay - Some 4,000 people demanding vaccinations against yellow fever blockaded a highway near the capital Wednesday, a week after the disease made its first appearance in Paraguay in 34 years.

The blockade snarled traffic for hours on a major route near Asuncion before authorities negotiated a peaceful end to the demonstration, police officer Francisco Monges said. There were no reports of violence.

Paraguayan health officials last week announced five confirmed cases of yellow fever that originated in a remote farm community, but no deaths. The outbreak prompted South America's second-poorest country to urgently request 600,000 doses of vaccine from international health authorities.

Demonstrators complained the government had been caught short of doses and demanded a major vaccination campaign against the mosquito-borne disease. Hundreds of people lined up this week at hospitals around Paraguay, demanding vaccines that were unavailable.

Separately, Paraguayan health officials said they were preparing to rush in 50,000 vaccines on a refrigerated plane from Brazil. Peru also had pledged thousands of doses.

Paraguayan authorities had no immediate response to calls for a wider vaccination campaign. They initially said they were concentrating vaccination efforts on residents of the affected community of San Pedro, some 240 miles from the border with Brazil.

The last reported case of yellow fever in Paraguay was in 1974.

The World Health Organization says an estimated 30,000 people worldwide die annually from the disease. Symptoms can include fevers, vomiting, jaundice and bleeding from the mouth, nose, eyes and stomach.

http://www.msnbc.msn.com/id/23149574/

And wouldn't you know it, dagnabbit, but somebody forgot to go to the store and restock the Yellow Fever vaccine.  Hot off the presses today, from Reuters:

Global supply of yellow fever vaccine depleted-WHO

GENEVA, Feb 27 (Reuters) - The world's supply of vaccine against yellow fever, which kills tens of thousands each year, is under extreme pressure, a senior World Health Organisation (WHO) official said on Wednesday.

So there is a buzz (forgive the terrible pun) going round in South America about the reappearance of Yellow Fever.  Add that to the list of things steadily heading our way, along with Dengue fever and the spread of West Nile Virus in the continental US.  Here in Florida, attention is turned toward local government budget cuts, and one of the first things slated for elimination is:  Mosquito control.  Let me state again:  West Nile Virus is here.  Dengue is coming, maybe on the next flight from Santo Domingo to Miami.  And now, at this time, local governments want to cut mosquito control? 

It's not like we haven't been through a yellow fever disaster before in the United States.  I refer you to Molly Caldwell Crosby's excellent book The American Plague, which details the 1878 plague's effects upon the hapless city of Memphis.  An Amazon.com review of the book concludes:

Over the course of history, yellow fever has paralyzed governments, halted commerce, quarantined cities, moved the U.S. capital, and altered the outcome of wars. During a single summer in Memphis alone, it cost more lives than the Chicago fire, the San Francisco earthquake, and the Johnstown flood combined.

Now let's turn our attention to yesterday's AP story about the alarming spread of drug-resistant tuberculosis across the planet.

Drug-resistant TB spreading fast

LONDON - Drug-resistant tuberculosis is spreading even faster than medical experts had feared, the World Health Organization warned in a report issued Tuesday.

The rate of TB patients infected with the drug-resistant strain topped 20 percent in some countries, the highest ever recorded, the U.N. agency said.

"Ten years ago, it would have been unthinkable to see rates like this," said Dr. Mario Raviglione, director of WHO's "Stop TB" department. "This demonstrates what happens when you keep making mistakes in TB treatment."

Though the report is the largest survey of drug-resistant TB, based on information collected between 2002 and 2006, there are still major gaps: Data were only available from about half of the world's countries.

In Africa, where experts are particularly worried about a lethal collision between TB and AIDS, only six countries provided information.

"We really don't know what the situation is in Africa," Raviglione said. "If multi-drug resistant TB has penetrated Africa and coincides with AIDS, there's bound to be a disaster."

Raviglione said it was likely that patients — and even entire outbreaks of drug-resistant TB — were being missed.

Drug-resistant strain now in 45 countries
Experts also worry about the spread of XDR-TB, or extensively drug-resistant TB, a strain virtually untreatable in poor countries. When an XDR-TB outbreak was identified in AIDS patients in South Africa in 2006, it killed nearly every patient within weeks. WHO's report said XDR-TB has now been found in 45 countries.

Globally, there are about 500,000 new cases of drug-resistant TB every year, about 5 percent of the 9 million new TB cases. In the United States, 1.2 percent of TB cases were multi-drug resistant. Of those, 1.9 percent were extensively drug-resistant.

The highest rates of drug-resistant TB were in eastern Europe. Nearly a quarter of all TB cases in Baku, Azerbaijan, were drug-resistant, followed by about 20 percent in Moldova and 16 percent in Donetsk, Ukraine, WHO said.

High rates of drug-resistant TB were also found in China and India, the world's two most populous nations that together are home to half the world's cases.

Drug-resistant TB arises when primary TB treatment is poor. Countries with strong treatment programs, like the U.S. and other Western nations, should theoretically have very little drug-resistant TB.

That is not the case in China, however, where the government says 94 percent of TB patients complete their first TB treatment.

"There's a huge, gross discrepancy there if they are then reporting 25 percent of the world's multi-drug resistant TB cases," said Mark Harrington, executive director of Treatment Action Group, a public health think tank. "They are clearly nurturing a multi-drug resistant TB epidemic and failing to report XDR-TB at all." (bold mine)

With growing numbers of drug-resistant TB patients, there is concern some national health systems will soon be overwhelmed.

New drugs needed
"We are totally off track right now," said Dr. Tido von Schoen-Angerer, executive director of Medecins Sans Frontiere's Campaign for Access to Essential Medicines. He said only 30,000 multi-drug TB resistant patients were treated last year.

Experts said new drugs are needed if the outbreak is to be curbed, along with new diagnostic tests to identify drug-resistant TB strains faster — current tests take about a month for results.

WHO said a new diagnostic test able to provide results within a day is being tried in South Africa and Lesotho. If successful, the test could be introduced across Africa in a few months, though new labs would be needed to run the tests.

"Multi-drug resistant TB is a threat to every person on the planet," Harrington said. "It's not like HIV, where you are only infected through specific actions. TB is a threat to every person who takes a train or a plane." (bold mine)

http://www.msnbc.msn.com/id/23356049/

Where did we ever get off thinking we had "conquered" disease?  Look at the data on XDR-TB, the most lethal form of the disease.  Look also at where these cases are multiplying:  China.  India.  Russia and former Soviet territories.  Did I mention China, home to the 2008 Olympics? 

I have heard statistics in the recent past rearding the number of MDR-TB (that's moderately drug-resistant) and XDR-TB (or eXtensively drug-resistant) in the former Soviet Union.  How about 200,000 new cases a year?

Please allow me to pull directly from the Website of the Woodrow Wilson International Center for Scholars:

The substantial success in controlling TB during the Soviet years has been lost, and TB deaths have skyrocketed in Russia over the past 18 years, particularly among working-age men. Much of this increase is due to overcrowding in urban centers, and in prison populations especially, explained Dr. Keshavjee. Globally, TB strains—including MDR- and XDR-TB strains—kill approximately 1.8 million people per year, he said, disproportionally affecting the poor and immunocompromised.

Worldwide each year there are approximately 400,000 cases of MDR-TB tuberculosis, strains that are resistant to the first-line and most effective TB drugs, and often select second-line drugs. Due to the relative weakness of second- and third-line drugs, effective treatment of MDR-TB often requires an 18-24 month course of rigorously managed, directly observed therapy. XDR-TB strains are only susceptible to questionably effective third-line drugs. Because of this, XDR-TB requires a longer course of drugs and often times surgery if treatment is effective at all. Russia has a 14 percent prevalence of XDR-TB among TB positive patients, one of the highest rates in the world. Particularly frightening, said Dr. Keshavjee, is the increase in person-to-person spread of drug-resistant TB: “At least 10 percent of new cases of TB in the [former Soviet Union] are MDR [strains] and 50 percent of re-treated cases are MDR.” 

...In addition to the extremely slow response to TB, mentioned earlier, it is also difficult to accurately determine how many people may be suffering from TB due to inadequate data collection systems within Russia. While Russian officials claim 120,000 new TB cases per year, the World Health Organization puts the number closer to 150,000-160,000, he said. MDR-TB rates are even more difficult to judge, with broad estimates for those receiving treatment ranging from 17,000 to 58,000. Feshbach emphasized the importance of remembering that Russian statistics only include first incidence of TB, so relapse and re-treatment are not included in the counting. There are also inaccuracies in counting deaths when both HIV and TB are detected. HIV deaths due to TB are counted as an AIDS death, not a TB death. (bold mine)
http://www.wilsoncenter.org/index.cfm?topic_id=116811&fuseaction=topics.event_summary&event_id=239772

We are aware of the American citizen who was in indefinite, judge-ordered lockup in a Phoenix, Arizona jail for months because he refused to treat his XDR-TB with the proper respect.

Anna Spector's Infectious Diseases Blog

Robert Daniels made headlines in the United States when he was put in solitary confinement in a hospital ward after disobeying a judge's order to wear a mask (he went to a 7/11). He was diagnosed with a kind of tuberculosis that is very difficult to treat, XDR TB. Daniels, whose mother is Russian, and father is American, had been living in Moscow, but decided that TB treatment would be better in the US, so he went to Arizona. After a year of forced hospitalization and the removal of one lung, Russia Today reports that Daniels is better, but that Arizona officials wanted him to continue treatment he thought was not necessary. So Daniels has fled back to Moscow.

Among the torture Daniels' lawyer says he was submitted to were 24 hour a day light, and no telephone calls or TV.

http://infectiousdiseases.about.com/b/2007/10/16/xdr-tb-causes-robert-daniels-to-flee-us.htm

Well, at least he is back with his droogs, eh?    Good luck to us all.

For the past five days, I have been flat on my back with.... a flu-like illness.  Not the flu nor the worst case I have ever had, but significant enough that I stayed in bed and didn't move much. Call it parainfluenza or adenovirus14, it knocked me down real good. I am back in the saddle, however, and will resume blogging shortly. 

Scott

My blogsite has been silent for the past few days, as I had to rush out of town and only now have returned to the Golden Keyboard.  My drive from Miami to Tallahassee was full of potentially whimsical and penetrating commentary regarding the recent book release from our favorite foreign health minister, Siti Fadilah Supari of Indonesia (pictured). 

All of this started with a phone call this past Tuesday from my good friend Sharon Sanders, founder of Flutrackers.com.  Sharon tipped me off regarding the release of the Supari book, which blames the United States military-industrial complex, the pharmaceutical cartel, President George W. Bush, the Andromedan galactic government, Lee Harvey Oswald, Britney Spears, steroids and global warming for the collective failure of her nation's government to contain H5N1. 

And just when I had penned a tome worthy of such a supremely ridiculous book premise, along comes the Indonesian government to sabotage my initiative by acting sanely!  Damn them, anyway!

You see, back in January, 2007, Indonesia stopped sending human H5N1 samples to the World Health Organization.  The government's reasons were locked in some strange logic vault, so it is hard to follow their line of reasoning (if reason factors anywhere in this argument).  Anyway, Indonesian leaders believed that if they withheld their native human bird flu samples from the rest of the world, the rest of the world would capitulate to their demands of free vaccine for all Indonesians!  Plus they would get two front-row seats for the American Idol finale, and ten box seats at Wrigley Field on the first base side (they get to bring their goat).

The WHO responded by saying not even they could get American Idol tickets, and they better look elsewhere.  Indonesia then sent samples from the suspected Bali H5N1 cluster cases that occurred in rapid-fire fashion in August, 2007.  But the government abruptly stopped again when they learned American Idol had been over since May, and Jordin Sparks had won.  They really liked that beat-box dude.

Of course, let us not forget the reason why the Bali samples were sent:  The December 2007 Global Warming Summit was coming to Bali, and with all those world leaders coming down, they didn't want Bali to be Ground Zero of the Next Pandemic.  So the Indonesian government lifted their self-imposed insanity -- er, moratorium -- and sent two samples (big deal) to the WHO.  When it became apparent that the Next pandemic would not start during the Summit, however, they returned to their pattern of withholding samples. 

So why the sudden and dramatic turnaround in governmental attitude?  Why is Indonesia now sharing H5N1 samples? Usually it means somebody wants something that is of greater value than what they possess.  According to Reuters, that "something" is the ironclad assurance that Indonesians will get vaccine by the thousands of liters if their sample turns out to be The Trigger of the Next Pandemic.

But I have my own theories.  Here they are:

1.  They saw that the current Northern Hemisphere vaccine protects against seasonal flu as well as it does against falling debris from a dead spy satellite, and they knew they were doomed anyway, so what the Hell?

2.  They believed the US gave Fidel Castro bird flu, and that is why he is too weak to govern, and they didn't want to wind up the same way old Fidel did.

3.  They did get those Idol tix from Fox!  Plus Supari gets to sing on the Season Finale.  With Blake Lewis. And Simon will be gagged.

Of course, none of these are the correct answer.  She will sing and dance with Paula Abdul. 

Seriously, what is clearly going on is this:  Indonesia has lost the handle completely on containment of H5N1.  As we all know, the disease is endemic in poultry, wild birds, pigs, cats, dogs, and possibly even certain villagers.  They also know -- or suspect --  their deal with Baxter is insufficient to protect the entire country from the disease.  So they have successfully negotiated a settlement with the WHO, and I am betting a good deal of that settlement was financially brokered by the Bill and Melinda Gates Foundation.  That is entirely speculative on my part, but it took someone with access to incredibly deep pockets to financially back that agreement, and the only entity that I am aware of with that kind of financial clout is the Bill and Melinda Gates Foundation. Senator Barack Obama's presidential campaign comes a close second, but they are too busy trying to fend off the "other Bill," as the prospective First Philanderer tries to buy Democrat delegate support even as Obama wins them.  It's the American Way!

But I gleefully digress.  Indonesia is throwing in the towel, and I strongly suspect they know something we don't.  Their people must have performed their own calculus and determined that H5N1 is beyond their capabilities, maybe even Baxter's, to solve.  So they have turned back to the WHO and the UN for help. 

Why in God's name they ever thought the US was capable of manufacturing a bird flu biological weapon is beyond me.  We can't even get a platinum record from a recent Idol winner. 

An excellent interview with one of Indonesia’s top influenza researchers reveals refreshing candor and focus. A tip of the cap to multiflusite poster AlaskaDenise for the link: http://www.thejakartapost.com/detail...218.H05&irec=4

Specifically, writer Emmy Fitri of the Jakarta Post sat down with Udayana University-based virologist and microbiologist I Gusti Ngurah Mahardika for a chat after the nation of 18,000 islands experienced its 103^rd confirmed human fatality from H5N1. This, sadly, was before the nation reported, in rapid-fire succession, its 104^th and 105^th deaths over the weekend.

Two excerpts are particularly worth highlighting. The first deals with Dr. Mahardika’s take on what we worry about with H5N1 and pandemics. I found it to be succinct and maybe we can all grab some new talking points from his words, since he is at Ground Zero:

Question : H5N1 mutated from a flu initially confined to birds, but can now infect humans. Is it possible to roughly predict how long it would take for this virus to mutate into a "pandemic" strain?
Answer: H5N1 itself is a product of natural evolution; an assortment of viruses from quails, geese, teal birds and wild birds found in Hong Kong. They meet at bird markets -- the perfect place for avian viruses to meet and mingle.

What we know is that it's still not easy for the virus to be transmitted from human-to-human, although it has proven that it can.
At present, human-to-human infections remain unusual, meaning that the flu has yet to acquire the full ability to be transmitted in this way. Perhaps it is still in the "trial and error" phase.

Are you saying there have been cases of human-to-human transmission of bird flu?
Yes, there have, but only a limited number of cases, like in early cases in Hong Kong (in 1997). What has made the avian influenza able to infect humans was mainly the presence of a genetic susceptibility in the human recipient.
We never can tell how long it will take for a virus to mutate into a pandemic strain, able to be passed from human-to-human. It could take a very long time or could come sooner than we thought.
We are also in the dark on whether the current H5N1 will be able to trigger a pandemic, or if it could happen with a mixture of H5N1 and other viruses -- we just don't know.
At least we can still hope, and buy time, while we brace ourselves for a pandemic.
What I see nowadays while we're buying time, instead of preparing ourselves for a worst-case scenario, people are making much ado about a (bird flu) vaccine (for humans) and a material transfer agreement for virus sharing.
These are really not necessary and ill-timed. We are wasting time over unimportant issues.

If bird flu is to be considered a natural disaster, perhaps it will be the only natural disaster humans have had time to prepare themselves for.

A second passage should be required reading for all:

As you once said, weather plays an important role in the emergence and re-emergence of outbreaks. Do we have weather-related studies to support prevention measures enforced here?
There are no studies specifically targeting bird flu but general knowledge is applicable not only for the bird flu virus but also other zoonotic viruses which thrive in highly humid conditions.
I don't think we need to put too much emphasis on this to justify what we already know -- I also believe that officials here, both at the agriculture and health ministries, must realize this also; they have data on the increase of outbreaks around this time. But unfortunately, we are not accustomed to being prepared, before trouble hits home.
We don't need rocket science for that. We need innovations and investment. Public campaigns must be intensified with the same warnings, and let people know what will happen if they don't heed the warnings.

Agricultural lifestyles, seen in densely populated urban settings like Tangerang, have a high risk of harboring diseases transmitted by animals. What is your comment?
I believe people know about bird flu -- at least they've heard of it. But we're talking about the Kampung Tengah livelihood. Why would people dare to sell a sick chicken or eat a sick chicken?
Our poverty and backwardness get in the way of us seeing better managed poultry and a clean and healthy environment. It should be easier done than said, now, with more and more fatalities. The government must be ready, at all cost, to remove poultry from housing areas, especially in crowded cities like Tangerang and Jakarta. At all cost -- otherwise it will be too late. (bold all mine)

“Too late”, of course, can be applied to both the poultry industry in Indonesia, as well as the human population everywhere. We should feel free to apply it to both. His criticsm of the Indonesian government’s ongoing tiff with the WHO should not be dismissed. Nor should his admonishment that a vaccine is not a magic bullet. I have maintained that fact over and over and over again, and I am grateful to see someone who has stared Death in the face to confirm this. Vaccines will come too late in the game to really help anyone. Antivirals may lose their ability to prevent or limit viral replication. As Dr. C. Everett Koop has said, we are fighting today’s (tomorrow’s) pandemic with the same tools we had 100 years ago.

OK, I have a confession to make.  A few weeks ago, I trumpeted the news about the coming victory by the Blu-Ray format in the high-definition DVD war over rival HD-DVD.

But then Toshiba went and cut their HD-DVD players by 50% across the board.  So I grabbed my Best Buy Reward Zone coupons (some $110 worth), and sprinted for my local Best Buy.  I bought the last $199 Toshiba A-30 HD-DVD player they had in stock for $89.95, basically.  And I haven't looked back.  It even came with 300 and the first Bourne movie, so I was set!  Plus, I got two free in-store, and five more free by mail.

And I will tell you that I think I am having more fun with HD-DVD than I am with Blu-Ray!  So I guess I feel a little like the guy who went over to Europe in 1946 and bought up as much real estate as possible. The Spoils of War include a half-price piece of very sophisticated equipment, plus outfits like Amazon.com and Best Buy have been running 50% or Buy One/Two, Get One Free deals on HD-DVDs.  So I have been stocking up on HD-DVD movie titles like, well, like I stock up for a bird flu pandemic.

What I have found from perusing high-definition Websites such as http://www.highdefdigest.com/ is that there are certain movies where the HD-DVD transfer and audio is actually superior to the Blu-Ray transfer.  Terminator 3 is the best example, but there are others.  And there are certain titles from Warner Brothers that are only on HD-DVD, even though the company makes discs in both formats.

Some are waiting until Paramount and Universal both wave the white flag and move to Blu-Ray.  And Paramount was a dual-format manufacturer up until last summer, when they went HD-DVD exclusive.  Bad decision.  But their misfortune can be your good fortune.  Universal, even if they decided today to go all Blu-Ray, can't encode their HD discs for BD for many months.  There is too much catalogue wrapped up in HD and all that remastering takes time.  So two major film studios are hitched to HD-DVD at least until the end of the year.

And that "end of the year" thing is key.  I will explain presently.  Here's a few little tips to Toshiba to try and hang in there longer on this format war.

First, keep the price of players low, low, low.  You have been dealt a possibly lethal setback by Netflix, Wal-Mart, Best Buy and others.  All of these companies are banking on Blu-Ray now over your format.  So continue to hit the format where it is most vulnerable: In the pocketbook. 

The economy is about to tank, which is very bad for consumer electronics manufacturers.  People are nonetheless sinking their dollars into HDTV at an accelerating rate.  Cable and even satellite software for that format is still scarce (but getting better).  The BD people think one format -- Blu-Ray -- should be the standard, and that is based on the money the Blu-Ray Cartel (read: Sony) is spending to sway minds. 

But people vote with their wallet, and they don't like being dictated to in terms of what format they should watch.  And they especially don't want to see prices stay artificially high for players and movies after the battle is won.  So, after shelling out thousands for that HDTV, if they can get an upconvert DVD player to make all those older DVDs shine, why not pay a few dollars more to get a legitimate HD player?  With Blu-Ray players still selling for upwards of $300, a sub-$150, full 1080P player with extremely impressive upconvert capabilities (I think my HD player may actually be a better upconvert player than my Samsung BD player, but I welcome differing opinions) will sell extremely well.  That's right, price the A-3 1080i player at $99, and the A-30 1080P player at $149.  And then tell the world how good its standard DVD upconvert capabilities are, plus it runs full HD movies too!

Second, keep the price of software -- the HD-DVD movies -- low, low, low.  Price them just slightly above the cost of a regular DVD.  And keep those dual-format DVDs coming.  Better yet, make them 2-disc sets, with the DVD on a separate disc.  Not everyone can have two HD players, and having a standard DVD plus the HD-DVD means standard DVD owners can invest in the upgrade later; or HD-DVD owners have an SD they can play in the bedroom player.

Third, get on the horn with Spielberg and get those HD versions of Jaws, Indiana Jones, etc. on the counter!  Imagine Jurassic Park on HD-DVD.  Or a younger Harrison Ford fighting against myriad Nazi villains.  I own King Kong on HD-DVD (my first purchase), and the picture quality is immaculate.  The Brontosaurus Stampede scene should sell out both any HDTV plus any HD-DVD player in a store.  It is reference-quality.  People want man-eating dinosaurs in their living rooms, stat!  Or man-eating sharks.  Or man-eating anything!  Also wanted in the worst way are HD versions of Saving Private Ryan, etc.  And memo to Peter Jackson:  How about the enhanced Kong on HD?  I wanna see that underwater creature in HD.  You know -- the sensational scene you cut from the theatrical version!

Fourth, remaster those old Universal Hitchcock movies.  All of them, from the 1950s on.  “Shadow of a Doubt,” “Rope,” “Rear Window,” “The Trouble With Harry,” “The Man Who Knew Too Much,” “Vertigo,” “Psycho,” “The Birds,” “Marnie,” and “Frenzy.”   I own Warners' Casablanca on HD-DVD, and it is like watching a new movie.  I also own Forbidden Planet on HD-DVD, and it looks dated but marvelous!  Old stuff sells.  People want classics in HD.

Plus, putting out all these blockbusters before holiday buying holiday season 2008 could save the franchise.  It might also prompt Warner Brothers to reconsider its decision and keep manufacturing HD-DVDs.

Fifth, make sure all studios are doing that picture-in-picture commentary thing on their discs.  That rocks!  And BD doesn't have anything comparable.

Sixth, make firmware upgrades available on certain movie titles.  Throw the firmware upgrade into certain big releases as a second disc, free of charge.  Make it easy, easy, easy to do a firmware upgrade.  Maybe even have some sort of routine where the software can check to make sure the firmware is current, and prompt the user to perform the upgrade now if they want, straight from the disc.  I think Sony does this with their PSP titles.

Finally, someone get the following message to Toshiba.

If indeed you are considering abandoning the format, as yesterday's Hollywood Reporter has theorized(http://www.hollywoodreporter.com/hr/content_display/news/e3ib77125d96b22e86027d0bfb0c25aa58d), then you owe it to the people who stuck out their necks -- and their wallets -- to make an affordable, quality combo HD/BD player NOW.  There are no reference-quality combo HD/BD units available today, and they are priced like Soviet space capsules.  Toshiba would do well to build a $300 combo unit to support the old user base and win fans from the new user base.  that might allow Universal and Paramount to continue to deliver HD-DVD films while transitioning to BD.

Now I am going to pop in Kong again.  Love to see those Brontosaurs fall off that cliff!