Entries in Popular Culture (52)

CDC warns of zombie apocalypse!

Faithful readers of this blog (do I HAVE faithful readers anymore?) know that I have taken about a year's sabbatical from blogging on disease.  that does not mean I have neglected the topic entirely; it just means that I have left the topic to those bloggers (Crof, FLA_MEDIC, maryn, others) who have much more informed comment than I.

But I am happy to report that I have returned to blogging on a topic with which I am intimately familiar:

ZOMBIES.

Today, the Centers for Disease Control has issued a warning to prepare for a Zombie Apocalypse. 

http://www.foxnews.com/health/2011/05/18/cdc-warns-public-prepare-zombie-apocalypse/?test=latestnews

The actual CDC warning appears here:

http://emergency.cdc.gov/socialmedia/zombies_blog.asp

Zombies have always been a curse upon humanity, as chronicled by Max Brooks in his important and long-suppressed historical work, The Zombie Survival Guide:  Recorded Attacks.

Of course, what the CDC is trying to do is capitalize on the tremendous success of the comic and TV show The Walking Dead and the wonderful films of George A., Romero in an effort to promote planning and preparedness for disasters.

Their message is a simple one:  If you've planned for the Zombie Apocalypse, you've planned for pretty much everything. 

Oh yeah -- that's me, just right of center, and toward the top of the photo.

Don't miss AMC's The Walking Dead Sunday, Oct. 31 at 10PM Eastern

This past June, I had one of the best experiences of my life.  I had the great good fortune to be a zombie extra on the set of the upcoming AMC television series The Walking Dead.

I won't try (at least not in this particular blog) to go into great details; an interview with horror Website www.gorestruly.com covers my experiences in great detail.  The interview with Yours Truly can be found at: http://www.gorestruly.com/2010/10/22/the-walking-dead-a-zombie-interview/

Emergency managers, disaster recovery experts, pandemic planners, and survivalists can rejoice!  I have just written a Computerworld blog proclaiming the value of this series at sharpening critical thinking skills!  The blog can be read at: http://blogs.computerworld.com/17247/dr_planners_can_learn_a_lot_from_the_walking_dead .

Picture?  Sure, from www.gorestruly.com, photo credit AMC TV.  those of you in foreign lands:  Fox is broadcasting the series all over the planet!  So no matter where you live, you can enjoy The Walking Dead.  Please watch!  And look for "limping zombie."

WTF? Wall Street firms get swine flu vaccine before you do

Today's news coming out of Wall Street was so preposterous I had to read it three times before it really sunk in.  Here, I will let you read it yourself.  From the AP:

Large NYC employers getting swine flu vaccine

NEW YORK — Some of New York City's largest employers — including Wall Street firms like Goldman Sachs and big universities — have started receiving doses of the much-in-demand swine flu vaccine for their at-risk employees.

The government-funded vaccine is being distributed to states, where health departments decide where to send the limited doses. In New York, health officials are allowing businesses with onsite medical staff to apply for the vaccine.

Doctors for large companies can ask for the vaccine along with other doctors but must agree to vaccinate only high-risk employees like pregnant women and those with chronic illnesses, said Jessica Scaperotti, a spokeswoman for New York City's Department of Health and Mental Hygiene.

Last month, the city began offering vaccine to schoolchildren, as well as pediatricians and obstetricians who asked for it. Scaperotti said only half of the pediatricians in New York City have requested vaccine

"As the vaccine became more available we expanded it to adult providers," Scaperotti said. She called the large employers "a great avenue for vaccinating people at risk."

But a critic said Wall Street firms shouldn't have access to the vaccine before less wealthy Americans.

"Wall Street banks have already taken so much from us. They've taken trillions of our tax dollars. They've taken away people's homes who are struggling to pay the bills," union official John VanDeventer wrote on the Service Employees International Union Web site. "But they should not be allowed to take away our health and well-being."

The union has about 2 million members, including health care workers.

The swine flu vaccine has been in short supply nationwide because of manufacturing delays, resulting in long lines at clinics and patients being turned away at doctor's offices. The vaccine started trickling out in early October, and there are now nearly 32 million doses available.

The government, which ordered 250 million doses, has recommended that the limited supply go first to high-risk groups: children and young people through age 24, people caring for infants under 6 months, pregnant women and health care workers.

Swine flu — which scientists call the 2009 H1N1 strain — is widespread throughout the country now, much earlier than seasonal flu usually hits.

Nationwide, about 90,000 sites are expected to receive vaccine — mainly hospitals, clinics, doctors' offices, county health departments and pharmacies.

Other big New York City employers that have received doses of the vaccine include Columbia University, Time Inc., the Federal Reserve Bank and several hospitals. The distribution was first reported by Business Week.

Goldman Sachs has received 200 doses and Citigroup has received 1,200, health officials said. So far, 800,000 doses have been delivered to 1,400 health-care providers in New York City, including public schools, pediatricians and hospitals.

Citigroup, "like many other large New York City employers, has partnered with the Department of Health to act as a distribution site for the H1N1 vaccine through the company's health clinics," the company said in a statement Thursday. "The vaccine is being provided only to employees in high-risk categories as defined by the CDC."

Goldman Sachs spokesman Ed Canaday said Thursday that the city's health department "decides in its sole discretion who receives the H1N1 vaccine — both the amount and timing."

"Goldman Sachs, like other responsible employers, has requested vaccine and will supply it only to employees who qualify," Canaday said.

While vaccinating children is a top priority for health officials, Scaperotti said only half of the pediatricians in New York City have asked for it.

Some pediatricians' offices that have received the vaccine, though, said the supply is not meeting the demand.

Manager Linda O'Hanlon at Uptown Pediatrics in Manhattan, said the office has received 500 doses so far — not enough for a practice with almost 7,000 patients.

"We have about 800 appointments" set up for patients who want to get vaccinated, she said.

Associated Press writers Stephen Barnard and Sara Lepro in New York City and Valerie Bauman in Albany, N.Y., contributed to this report.

Gee, I wonder just how many toddlers and children ages 2 to 24 that Goldman Sachs will find in their corporate HQ?  I am not one to ordinarily agree with unions, but I think the head of the union quoted in the story hit the nail upon the head.

There have been myriad stories, including one in the New York Times, about New Yorkers waiting hour upon hour to get their children vaccinated.  Just Google 'vaccine delay shortage" and you'll get national and local stories by the hundreds. 

So children get passed by while Wall Street fatcats get vaccine? Just exactly what target group do they belong to, overweight, bloated, overpaid executives? 

This adds to a vaccine credibility problem entirely of the Obama Administration's creation.  They have succeeded in creating a caste system for vaccine.  And I do not care how many hundred doses Citigroup or other banking firms got and how small that might be compared to the general public.  Perception is reality. 

If Wall Street bankers want vaccine, they can bloody well stand in line for it with the rest of humanity.

Intranasal and Novartis H1N1 vaccines still not for egg-sensitive people

Recently, I was sitting in my dentist's chair when an assistant remarked she could not receive flu vaccine due to her allergy to eggs and egg products.

I listened intently and replied,

"Cauuuuuuggggggwwwwwllllllhhhhhh.  MMmmmugggggggwwwaaaaaawwwwaaahhh."

After the assistant removed all the stuff in my mouth, I then translated:  I would check this out and get back to her.

Well, I happened upon the insert to the monovalent H1N1v vaccine manufactured by Medimmune. Medimmune manufactures a live virus, intranasal vaccine principally for youth, and they are one of the four FDA-approved pandemic vaccines.

But I noticed this entry:

4 CONTRAINDICATIONS
4.1 Hypersensitivity
Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal is contraindicated in individuals with a history of hypersensitivity, especially anaphylactic reactions, to eggs, egg proteins, gentamicin, gelatin, or arginine or with life-threatening reactions to previous influenza vaccinations.

Likewise, I also saw this factoid:

------------------------------DRUG INTERACTIONS-------------------------------
• Antiviral agents active against influenza A and/or B: Do not administer Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal until 48 hours after antiviral cessation. Antiviral agents should not be administered until 2 weeks after Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal administration unless medically necessary.
(7.2)

So, you have to be off Tamiflu and Relenza for at least two days prior to accepting this vaccine into your schnozz.  Probably because FluMist is live virus, and the antivirals might kill the virus before it helps you.

Finally, immunocompromised persons should not receive the vaccine intranasally. 

5.4 Altered Immunocompetence
Administration of Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal, or FluMist live virus vaccine, to immunocompromised persons should be based on careful consideration of potential benefits and risks. Although FluMist was studied in 57 asymptomatic or mildly symptomatic adults with HIV infection [see Clinical Studies (14.3)], data supporting the safety and effectiveness of FluMist administration in immunocompromised individuals are limited.

I had never realized that FluMist was not for persons with sensitivity to eggs.  So in the event others thought as I did (or did not), this is offered as a helpful; and potentially lifesaving reminder.

Buit wait, you say!  Wasn't there word Novartis was making a vaccine from cells, rather than eggs, and they had whipped up a whopping ten liters of vaccine?

That's what the media ballyhooed.  But again, directly from the Novartis package insert:

CONTRAINDICATIONS

History of systemic hypersensitivity reactions to egg proteins, or any other component of Influenza A (H1N1) 2009 Monovalent Vaccine, or life-threatening reactions to previous influenza vaccinations. (4, 11)

So there you go.  None of the four vaccines can be taken by persons sensitive to eggs.  I am unsure how much of the US population falls into that category, but I am betting it is a significant number.  Better save the antivirals for them!  Easpecially persons with egg allergies and under age 50.

Scott

PS.  I will try to blog from the CIDRAP Summit in Minneapolis.  Mostly, I hope FLA_MEDIC and I get around to some used book and comic stores! FLA_MEDIC should be quite the celebrity after this is all said and done!  He is appearing with Robert Bazell of NBC News, one of my favorite correspondents, and Katie Couric's producer.  The print editors are no slouches, either. 

I think I will tell Mike some Katie Couric stories when she was a cub reporter at Channel 4 in Miami and I ws running for office......

Swine H1N1 flu case fatality rate is edging higher worldwide

I don't know how many of you have caught this or done the math, but the case fatality rate (CFR) from swine flu has actually increased, at both global levels and within the United States.

The published global CFR in late June was plugging along at .002, while the US CFR was at .0045.  Now, the US CFR is .0056, and the global CFR is at .0045.  So the world has caught up with America in terms of its death rate, and the figure of .0045 places this pandemic squarely within the HHS Category Two pandemic status.  But the threshold to Category 3 status is .0051.  For the past two weeks, the US CFR has exceeded the Category 3 benchmark.  Like the hurricane that spawned this HHS analogy, those winds -- and deaths -- have to be sustained.  The next few weeks will tell us if we are seeing a drop in the CFR, or if the numbers are holding steady.  That may also signal the waning of the pandemic's first wave.

These death numbers do not sound large until you look at large numbers.  If the current CFR holds, by the end of the pandemic, we could be looking at over 400,000 dead in the United States alone.  In Florida, for example, the final death toll could reach 30,000. 

This is probably why the WHO has chosen its words very carefully when describing this pandemic as "moderate" and not as "mild."

How is this possible, you ask?  Swine H1 is "mild," the public health authorities are telling us!  You are even hearing the words "no worse than seasonal flu" mentioned!

I would answer this way:  First, read Dr. Kawaoka's analysis of swine flu in today's/tomorrow's papers.  Second, re-read my blog about totally botched risk communication, and Google/read Dr. Sandman's similar remarks about recent botched risk communication.  Third, remember we are in the beginning stages of a global health crisis that will take at least eighteen months to finally play out

Pandemics are not for institutions with ADD, nor are they for institutions who like quick resolutions at the end of a 60-minute show.  Nor are they for institutions who demand happy endings, unless you count the conclusion itself as happy.  They are slow, historic, and life-changing events.  We should treat them and respect them as such.