Tuesday, May 05, 2009

tussin....,

WaPo | Toward the start of Mexico's swine flu outbreak on April 24, Ángel Flores Maldonado had so many patients at his office that when he finally escaped at 10:15 that night, the line still stretched into the street.

The doctor does not work at a hospital, or a clinic, or the government respiratory center, but on the evening shift at a pharmacy in the poor, crowded neighborhood of Iztapalapa, in eastern Mexico City. "The same but cheaper," reads the sign at this popular pharmacy chain, Similares, and that is the calculation many Mexicans seem to have made while the virus spread through the capital.

"In Mexico, we are very unaccustomed to going to the hospital. Here, if someone has a cold or anything else, they buy something in the pharmacy, or they leave it be," Flores said. "This is why Mexicans are dying. Because we are very indecisive about going to a hospital until it's too late."

Several theories have emerged as to why all but one of the confirmed deaths from swine flu have occurred in Mexico. Much of it is speculation -- that Mexico City's 7,300-foot elevation exacerbates respiratory illnesses, that there may be a slight variation between the viral strain prevalent in Mexico and swine flu elsewhere, that Mexico is further along in disease transmission and other countries will eventually see severe cases.

But a critical factor, according to specialists here, is that flu victims have delayed checking into hospitals until their condition has deteriorated so much they cannot be saved. While medicines are plentiful and cheap at Mexican pharmacies, swine flu antiviral medication was often not available or prohibitively expensive.

"Some patients arrive late at the hospitals, and to a certain degree this is a problem of education," José Sifuentes-Osorio, an infectious-disease specialist at the National Institute of Medical Sciences and Nutrition, said in a radio interview Monday. "Many of our people, independent of their socioeconomic situation, self-medicate for three or four days, and they lose precious time."

Has Oil and Gas Collapse Sealed Fate of Peak Oil?

This is an interactive slide show. Click the image above to access the popup window link.

Monday, May 04, 2009

"peak oil" or "limits to growth"

The Oil Drum | There is a good deal of evidence that we are now a little past "peak oil". Many of us find it doesn't feel quite like we had imagined.

A lot of us had expected that peak oil would be basically a liquids fuels crisis, caused by geological limits. We expected that the solutions of the Department of Energy's Hirsch Report would be sufficient to forestall a crisis, especially if we had started 20 years ago, instead of now. These solutions included things like more oil from tar sands, improving automobile efficiency, and electrification of transport.

Now, when we seem to be at peak oil, we find the current situation feels a lot more like a "box" caused by limits to growth, rather than a liquid fuels crisis. The limits are of many forms--not just geological limits relating to oil--but other resource limits as well, such as fresh water, and concerns about climate change and the environment. The financial system is even behaving strangely.

The fact that the financial system is also in distress is a surprise to many people. There is good theoretical reason to expect that once growth in underlying resources slows, a financial system based on compound growth will run into difficulty. This was predicted by M. King Hubbert and many others. The connection is not easy to see, though, and it is understandable that many would believe that the financial system would have had problems, even apart from limits to growth.

The fact that so many limits are involved makes it difficult to substitute one resource, such as biofuels, for another, such as petroleum products.

The fact that so many limits are involved also means that it is not just liquid fuels that are being constrained by the limits to growth box. In the diagram above, I show electricity, the credit system, the industrial system, and the agricultural system as being fenced in by limits, in addition to liquid fuels. I could probably have included many other systems as well, such as the international trade system, governmental systems, and long term promises, such as pensions and social security systems.

The world is finite, so it should not come as a great surprise that the various limits are being reached, to varying degrees, simultaneously. Systems such as the electrical system, the credit system, and the agricultural system all depend on availability of finite resources, so are affected as we start reaching limits of various kinds.

what makes us human?

Scientific American | Language Clues - Whole-genome comparisons in other species have also provided another crucial insight into why humans and chimps can be so different despite being much alike in their genomes. In recent years the genomes of thousands of species (mostly microbes) have been sequenced. It turns out that where DNA substitutions occur in the genome—rather than how many changes arise overall—can matter a great deal. In other words, you do not need to change very much of the genome to make a new species. The way to evolve a human from a chimp-human ancestor is not to speed the ticking of the molecular clock as a whole. Rather the secret is to have rapid change occur in sites where those changes make an important difference in an organism’s functioning.

HAR1 is certainly such a place. So, too, is the FOXP2 gene, which contains another of the fast-changing sequences I identified and is known to be involved in speech. Its role in speech was discovered by researchers at the University of Oxford in England, who reported in 2001 that people with mutations in the gene are unable to make certain subtle, high-speed facial movements needed for normal human speech, even though they possess the cognitive ability to process language. The typical human sequence displays several differences from the chimp’s: two base substitutions that altered its protein product and many other substitutions that may have led to shifts affecting how, when and where the protein is used in the human body.

A recent finding has shed some light on when the speech-enabling version of FOXP2 appeared in hominids: in 2007 scientists at the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany, sequenced FOXP2 extracted from a Neandertal fossil and found that these extinct humans had the modern human version of the gene, perhaps permitting them to enunciate as we do. Current estimates for when the Neandertal and modern human lineages split suggest that the new form of FOXP2 must have emerged at least half a million years ago. Most of what distinguishes human language from vocal communication in other species, however, comes not from physical means but cognitive ability, which is often correlated with brain size. Primates generally have a larger brain than would be expected from their body size. But human brain volume has more than tripled since the chimp-human ancestor—a growth spurt that genetics researchers have only begun to unravel.

One of the best-studied examples of a gene linked to brain size in humans and other animals is ASPM. Genetic studies of people with a condition known as microcephaly, in which the brain is reduced by up to 70 percent, uncovered the role of ASPM and three other genes—MCPH1, CDK5RAP2 and CENPJ—in controlling brain size. More recently, researchers at the University of Chicago and the University of Michigan at Ann Arbor have shown that ASPM experienced several bursts of change over the course of primate evolution, a pattern indicative of positive selection. At least one of these bursts occurred in the human lineage since it diverged from that of chimps and thus was potentially instrumental in the evolution of our large brains.

Other parts of the genome may have influenced the metamorphosis of the human brain less directly. The computer scan that identified HAR1 also found 201 other human accelerated regions, most of which do not encode proteins or even RNA. (A related study conducted at the Wellcome Trust Sanger Institute in Cambridge, England, detected many of the same HARs.) Instead they appear to be regulatory sequences that tell nearby genes when to turn on and off. Amazingly, more than half of the genes located near HARs are involved in brain development and function. And, as is true of FOXP2, the products of many of these genes go on to regulate other genes. Thus, even though HARs make up a minute portion of the genome, changes in these regions could have profoundly altered the human brain by influencing the activity of whole networks of genes.

Sunday, May 03, 2009

humans are responsible for swine flu

Physorg.com | Our demand for meat means pigs, turkeys, chickens, cows and other animals must be mass produced in crowded, feces-ridden factory farms like the one in Mexico that is suspected of starting the current swine flu outbreak. These farms are incubators for disease.

While it's easy to point fingers at Granjas Carroll and Mexico, disease-ridden animal factories can be found all over the world. According to the Centers for Disease Control and Prevention, studies have shown that 30 to 50 percent of pigs raised for food in the U.S. have been infected with some strain of swine flu. Hans-Gerhard Wagner, a senior officer with the U.N.'s Food and Agriculture Organization, has called the "intensive industrial farming of livestock" an "opportunity for emerging disease."

Other harmful organisms, including salmonella, campylobacter, listeria and E. coli, also spread from animals to people. E. coli is found in the feces of farmed animals and often sprays in every direction when animals are eviscerated at slaughterhouses. A study published in the journal Nature revealed that not only are U.S. meat and dairy products more commonly contaminated with E. coli than other foods are, they also contain a substance that can raise the risk of E. coli infection.

Although health officials have been quick to point out people can't get swine flu from eating pork, they have failed to hammer home one significant detail: Raising pigs for pork is what puts us at risk for swine flu in the first place.

The fewer pigs, chickens and other animals we raise for food, the fewer animal-borne diseases there will be. It's that simple. And since meat is high in saturated fat and cholesterol and can cause heart disease, diabetes, certain cancers and a host of other health problems. We would all be better off if we stopped eating it today.

h1n1 systematization


Northwestern ROCS | In our simulations for the spread in the United States we take Mexico City to be the starting point of the infection. The initial conditions of the model are chosen to match the available information on confirmed cases in the United States and Mexico, and we permit for a bracket of unconfirmed cases. We take into account the travel of individuals between counties in the United States and the incoming flux of airline passengers from Mexico City. We consider a worst-case scenario based on assumptions made from the information we have gathered thus far. The key factors in our modeling approach are very accurate human mobility datasets on scales from a few to a few thousand kilometers. We obtained the underlying multi-scale human mobility network indirectly by our recent investigation on the geographic circulation of dollar bills in the United States, which is an excellent proxy for human mobility and includes small scale daily commuting traffic, intermediate traffic, and long distance travel by air. Our simulations consist of multiple layers, each layer possessing and increasing degree of accuracy and complexity. Our final projections are done with a fully stochastic model that incorporates the inherent randomness in disease dynamics that is particularly important at the onset of an epidemic when the number of infected individuals is small compared to the whole population.

CDC H1N1

CDC | CDC continues to take aggressive action to respond to an expanding outbreak caused by H1N1 (swine flu).

CDC’s response goals are to:

1. Reduce transmission and illness severity, and
2. Provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC continues to issue and update interim guidance daily in response to the rapidly evolving situation. This includes guidance on when to close schools and how to care for someone who is sick at home. Supplies from CDC’s Division of the Strategic National Stockpile (SNS) are being sent to all 50 states and U.S. territories to help them respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus.

Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.

Saturday, May 02, 2009

history and possible future of american coal

Uppsala University | Future coal production will not be entirely determined by what is geologically available, but rather by the fraction of that amount that is practically recoverable. Society demands energy, not energy from coal. This means if this energy can be obtained less costly and more practically from other energy sources, potentially nuclear power or wind, those will be favored.

Increased coal prices do not necessarily lead to increased production, increased reserves, and the transformation of resources into reserves. The price development and feasibility of other energy sources must also be considered, since it is the energy that is demanded. Increased coal prices might therefore also be a burden for the industry as investors may move towards cheaper energy sources. Increased concern around CO2 emissions from coal is likely to decrease coal’s price competitiveness, because of the potential from CO2-taxes and increased costs of carbon-capture and storage (CCS). A closer discussion of this is beyond the scope of this study, but has been performed by others (Kavouridis and Koukouzas, 2008).

There is a common belief in some form of self-regulating coal supply cycle (Thielemann et al., 2007), where increased prices and human ingenuity will automatically lead to reserve growth and higher production. Our results suggest that this theory should be reevaluated. The historical evolution of U.S. coal reserves shows a trend towards reduced recoverable reserves. There are a number of different factors causing this, ranging from land-use restrictions to changes in definitions. The historical trend towards reduced recoverable amounts is clear and likely to continue in to the future, with even stricter regulations imposed by increased environmental concern.

A steady decline in the heating value of U.S. coal has also been observed and this can be seen as a sign of the increased depletion and the movement to less optimal seams. This trend is likely to continue in to the future, justified by increased depletion of high energy coals in Appalachia and an overall increased dependence on subbituminous western coals. By 2030 the average calorific value could be slightly above 20 MJ/kg. This also implies that the coal production forecast in the International Energy Outlook (2007) would require the production volumes in 2030 be 70% higher than today. Whether this can be achieved is very questionable as shown by the historical production trends and the depleting reserves in many key producing states.

Using the recoverable reserves as an estimate of what is realistically available for production will yield a coal output of around 1400 Mt by 2030 through the rest of the century. This would require a massive development of the coal reserves in Montana, as they are the largest undeveloped reserves remaining for future exploitation. Unless this happens, US coal production could reach a peak around 2030. The demonstrated reserve base allows a significantly higher production volume to be reached but this should be regarded as unrealistic, as it completely ignores regulations and restrictions. The restrictions have proved to be a key factor for the amount of coal available for production and ignoring restrictions when creating possible future scenarios is a fundamentally flawed approach.

To summarize the geologic amounts of coal are of much less importance to future production than the practically recoverable volumes. The geological coal supply might be vast, but the important question is how large the share that can be extracted under present restrictions are and how those restrictions will develop in the future. Production limitations might therefore appear much sooner than previously expected.

from bust to boom?

WSJ | A massive natural-gas discovery here in northern Louisiana heralds a big shift in the nation's energy landscape. After an era of declining production, the U.S. is now swimming in natural gas.

Even conservative estimates suggest the Louisiana discovery -- known as the Haynesville Shale, for the dense rock formation that contains the gas -- could hold some 200 trillion cubic feet of natural gas. That's the equivalent of 33 billion barrels of oil, or 18 years' worth of current U.S. oil production. Some industry executives think the field could be several times that size.

"There's no dry hole here," says Joan Dunlap, vice president of Petrohawk Energy Corp., standing beside a drilling rig near a former Shreveport amusement park.

Huge new fields also have been found in Texas, Arkansas and Pennsylvania. One industry-backed study estimates the U.S. has more than 2,200 trillion cubic feet of gas waiting to be pumped, enough to satisfy nearly 100 years of current U.S. natural-gas demand.

The discoveries have spurred energy experts and policy makers to start looking to natural gas in their pursuit of a wide range of goals: easing the impact of energy-price spikes, reducing dependence on foreign oil, lowering "greenhouse gas" emissions and speeding the transition to renewable fuels.

A climate-change bill being pushed by President Barack Obama could boost reliance on natural gas. The bill, which could emerge from the House Energy and Commerce Committee in May, is expected to set aggressive targets for reducing emissions of carbon dioxide, the most prevalent man-made greenhouse gas.

Friday, May 01, 2009

the nafta flu

truthout.org | La Jornada columnist Julio Hernández López connects the corporate dots to explain how the Virginia-based Smithfield Farms came to Mexico:

In 1985, Smithfield Farms received what was, at the time, the most expensive fine in history - $12.6 million - for violating the US Clean Water Act at its pig facilities near the Pagan River in Smithfield, Virginia, a tributary that flows into the Chesapeake Bay. The company, according to the US Environmental Protection Agency (EPA) dumped hog waste into the river.

It was a case in which US environmental law succeeded in forcing a polluter, Smithfield Farms, to construct a sewage treatment plant at that facility after decades of using the river as a mega-toilet. But “free trade” opened a path for Smithfield Farms to simply move its harmful practices next door into Mexico so that it could evade the tougher US regulators.

The North American Free Trade Agreement (NAFTA) came into effect on January 1, 1994. That very same year Smithfield Farms opened the “Carroll Ranches” in the Mexican state of Veracruz through a new subsidiary corporation, “Agroindustrias de México.”
Unlike what law enforcers forced upon Smithfield Farms in the US, the new Mexican facility - processing 800,000 pigs into bacon and other products per year - does not have a sewage treatment plant.

America’s top pork producer churns out a sea of waste that has destroyed rivers, killed millions of fish and generated one of the largest fines in EPA history. Welcome to the dark side of the other white meat.

Smithfield Foods, the largest and most profitable pork processor in the world, killed 27 million hogs last year. That’s a number worth considering. A slaughter-weight hog is fifty percent heavier than a person. The logistical challenge of processing that many pigs each year is roughly equivalent to butchering and boxing the entire human populations of New York, Los Angeles, Chicago, Houston, Philadelphia, Phoenix, San Antonio, San Diego, Dallas, San Jose, Detroit, Indianapolis, Jacksonville, San Francisco, Columbus, Austin, Memphis, Baltimore, Fort Worth, Charlotte, El Paso, Milwaukee, Seattle, Boston, Denver, Louisville, Washington, D.C., Nashville, Las Vegas, Portland, Oklahoma City and Tucson.

Smithfield Foods actually faces a more difficult task than transmogrifying the populations of America’s thirty-two largest cities into edible packages of meat. Hogs produce three times more excrement than human beings do. The 500,000 pigs at a single Smithfield subsidiary in Utah generate more fecal matter each year than the 1.5 million inhabitants of Manhattan. The best estimates put Smithfield’s total waste discharge at 26 million tons a year. That would fill four Yankee Stadiums.

google flu trends


google.org | We've found that certain search terms are good indicators of flu activity. Google Flu Trends uses aggregated Google search data to estimate flu activity in your state up to two weeks faster than traditional systems.

here go the stupid....,

NYTimes | Egypt has begun forcibly slaughtering the country’s pig herds as a precaution against swine flu, a move that the United Nations described as “a real mistake” and one that is prompting anger among the country’s pig farmers.

The decision, announced Wednesday, is already adding new strains to the tense relations between Egypt’s majority Muslims and its Coptic Christians. Most of Egypt’s pig farmers are Christians, and some accuse the government of using swine flu fears to punish them economically.

According to World Health Organization officials, the decision to kill pigs has no scientific basis. “We don’t see any evidence that anyone is getting infected from pigs,” said Dr. Keiji Fukuda, the World Health Organization’s assistant director general. “This appears to be a virus which is moving from person to person.”

The outbreak has been dubbed swine flu — now officially called influenza A(H1N1) — because scientists believe it started in pigs, but they do not know if that was recently or years ago. The name change was designed to allay fears about pigs and eating pork.

Egypt has not reported any cases of the new virus that has hit 11 other nations, but the country has been hard hit by avian flu.

The great majority of Egyptians are Muslim and do not eat pork because of religious restrictions, but about 10 percent of the population is Coptic Christian. As a result, Egyptian pig farmers are overwhelmingly Christian. And although some of the country’s Christians are middle class or wealthy, the Christian farmers are generally poor.

On Thursday, several urban pig farmers in Cairo said they see the government’s decision as just another expression of Egyptian Muslims’ resentment against Christians. Last year, there were several violent incidents that some believed were aimed at Christians, including the kidnapping and beating of monks. The Egyptian government denied the incidents had sectarian overtones, saying they were each part of other disputes, including a fight over land.

flu prompts shutdowns in mexico, texas


NYTime | The swine flu continues to spread slowly but surely, with 114 confirmed cases in 12 states on Thursday, up from 91 in 10 states on Wednesday. Many more states have suspected cases, and 11 countries have been affected so far.

But little else seems sure about the disease, including how bad it will turn out to be and even its name, now officially influenza A(H1N1), according to the World Health Organization.

“This is a rapidly evolving situation,” said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention. “It is a situation filled with uncertainty.”

Dr. Besser praised a decision by the W.H.O. on Wednesday to raise the global alert level to Phase 5, one step below a pandemic. He said the move would not affect the United States, which is already taking measures against the outbreak, but would alert other countries to get pandemic plans in order. On Thursday, officials of the health organization said Phase 5, which means a pandemic is highly likely, was still the appropriate level.

In this country, hundreds of schools have closed, including Fort Worth’s entire school district of about 80,000 students. Texas has 26 confirmed cases.

On Thursday, the White House disclosed that a member of the Obama administration delegation that traveled to Mexico in mid-April probably contracted the disease. The man had flu symptoms when he returned to Washington, and spread the illness to his wife and son, but he and his family have recovered and he is back at work. Robert Gibbs, the White House press secretary, said the man did not work closely with the president and never posed any risk to him.

In Canada, the confirmation of 15 additional cases on Thursday brought the total number of cases there to 34.

Mexico now has 312 confirmed cases and 12 confirmed fatalities. More than 2,500 cases are suspected, and at least 150 people are believed to have died of the disease.

emergency medicine backchannel scoop...,

After I returned from a public health meeting yesterday with community leaders and school officials in Comal County and Hays County, Heather suggested I send an update to my patients in the area, because what we are hearing privately from the CDC and Health Department is different from what you are hearing in the media. Some of you know some of this, but I will just list what facts I know.

- The virus is infectious for about 2 days prior to symptom onset

- Virus spreads more than 7 days after symptom onset (possibly as long as 9 days) (this is more unusual than ordinary flu)

- Since it is such a novel (new) virus, th ere is no "herd immunity," so the "attack rate" is very high. This is the percentage of people who come down with a virus if exposed. Almost everyone who is exposed to this virus will become infected, though not all will be symptomatic. That is much higher than seasonal flu, which averages 10-15%. The "clinical attack rate" estimation from CDC and WHO may be around 40-50%. This is the number of people who show symptoms. This is a huge number. It is hard to convey the seriousness of this to those outside of the medical fields.

- The virulence (deadliness) of this virus is as bad here as in Mexico, and there are folks on ventilators here in the US, right now. This has not been in the media, but a 23 month old in Houston is fighting for his life, and a pregnant woman just south of San Antonio is fighting for her life. In Mexico, these folks might have died already, but here in the US, folks are getting Tamiflu or Relenza quickly, and we have ready access to ventilators. What this means is that within a couple of weeks, regional hospitals will likely become overwhelmed.

- Some of the kids with positive cases in Comal County have had more than 70 contacts before diagnosis as a minimum figure.

- There are 10-25 times more actual cases (not "possible" cases -- actual), than what is being reported in the media. The way they fudge on reporting this is that it takes 3 days to get the confirmatory nod from the CDC on a given viral culture, but based on epidemiological grounds, we know that there are more than 10 cases for each "confirmed" case right now.

- During the night, we crossed the threshold for the definition of a WHO, Phase 6 global pandemic. This has not happened in any of our lifetimes so far. We are in uncharted territory.

- They are advising President Obama to declare an emergency sometime in the next 72-96 hours. This may not happen, but if it doesn't, I will be surprised. When this happens, all public gathering will be cancelled for 10 days minimum.

- I suggest all of us avoid public gatherings. Outdoor activities are not as likely to lead to infection. It is contained areas and close contact that are the biggest risk.

- Tamiflu is running out. There is a national stockpile, but it will have to be carefully managed for law enforcement and first responders as it is not enough to treat the likely number of infections when this is full-blown. I don't think there is a big supply of Relenza, but I do not know those numbers. If I had to choose, I would take Relenza, as I think it gets more drug to the affected tissue than Tamiflu.

- You should avoid going to the ER if you think you have been exposed or are symptomatic. ER's south of here are becoming overwhelmed today-- and I mean that -- already. It is coming in waves, but the waves are getting bigger.

- It appears that this flu produces a distinctive "hoarseness" in many victims. The symptoms, in general, match other flu's; namely, sore throat, body aches, headache, cough, and fever. What is not too common in regular flu cycles is vomiting and diarrhea which seems to be associated with this, further dehydrating victims. Some have all these symptoms, while others may have only one or two.

- N-Acetyl-Cysteine -- a nutritional supplement available at the health food store or Wimberley Pharmacy, has been shown to prevent or lessen the severity of influenza. I suggest 1200mg, twice a day for adults, and 600mg twice a day in kids over 12. It would be hard to get kids under 12 to take it, but you could try opening the capsules and putting it on yogurt. For 40 pounds and up, 300-600 mg twice a day, for less than 40 pounds, half that.

- Oscillococinum, a homeopathic remedy, has been vindicated as quite effective in a large clinical trial in Europe, with an H1N1 variant. You can buy this at Hill Country Natural Foods, or the Wimberley Pharmacy.

I will try to keep everyone posted if I have any new information. Meanwhile, don't be afraid, stay informed and try to avoid infection. The fewer people infected the easier it will be for our public officials to manage it.

If any of my patients become ill, or suspect infection, call the office, do not come without calling and DO NOT go to the ER. If one member in a family is identified all would be given the Tamiflu or Relenza (that is normal course of action) if there is enough distributed to fill prescriptions. Public health stated that one family member identified or suspected to have contracted the flu it will require the whole family to be ‘quarantined’ in their own home until enough time has passed for the remaining household to have contracted it or be considered infection free ( 7 to 10 days per person). As another suggestion, if any member of the family is on routine medication- fill those prescriptions now. Have plenty fluids, Motrin, soups, etc available and make contingency plans in case your family is affected.

Thursday, April 30, 2009

containment not economically feasible...,


NYTimes | “Containment is no longer a feasible option,” Dr. Keiji Fukuda, deputy director general of the World Health Organization, announced Monday night in Geneva after a meeting of the agency’s emergency committee on the spreading swine flu virus. “The world should focus on mitigation. We recommend not closing borders or restricting travel.”

Many countries are still ignoring that advice. The globe is a confusing welter of bans, advisories and alerts on some pork and some people.

On Wednesday, Homeland Security Secretary Janet Napolitano was heavily pressed in Congressional hearings to ignore the advice and close the border with Mexico. She defended her decision not to do so, saying it “would be a very, very heavy cost for what epidemiologists tell us would be marginal benefit.”

President Obama defended it too, telling a reporter that it would be “akin to closing the barn door after the horse is out.”

Experts on the global movement of flu say Dr. Fukuda, Ms. Napolitano and Mr. Obama are right. The world, they say, must bow to the inevitable: closing borders would not only fail to stop the virus, but would also cause economic collapse and possibly add to the death rate.

“But it’s wrong to think we’re throwing up our hands and saying ‘Let ’er rip and let’s hope for the best,’ ” said Dr. Martin S. Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention in Atlanta. “This has all been in the national pandemic flu plan since 2007.”

Closing borders is dangerous because many goods needed in a pandemic are made abroad, said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, including most masks, gowns and gloves, electrical circuits for ventilators and communications gear, and pharmaceutical drugs and the raw materials to make them. (For example, most suppliers of shikimic acid, the base ingredient in the antiviral drug Tamiflu, are in China.)

“You cut those off and you cripple the health care system,” he said. “Our global just-in-time economy means we are dependent on others.” Much of our food is from overseas. “A Kellogg’s Nutri-Grain bar has ingredients from nine countries in it,” he noted.

The fallback position, experts said, is mitigation, the use of “nonpharmaceutical measures.” They include personal ones like washing hands and wearing a mask, occupational ones like working from home or arranging care for children who are sick or whose schools close, neighborhood-level ones like closing theaters, museums or restaurants, and metropolitan-wide ones like shutting a school system or canceling a major league ballgame.

mapmaker discusses the spread thus far...,

from phase 4 to phase 5

WaPo | The World Health Organization took the unprecedented step yesterday of warning that the world is probably on the verge of a pandemic, as new cases of swine flu mounted, the first death was reported in the United States and the dangerous virus appeared to arrive just outside the nation's capital.

The WHO's action came after the agency convened an unusual "global virtual science meeting" involving several hundred experts and officials to help assess the situation. The agency raised the alert from "phase 4" to "phase 5" two days after elevating it for the first time because the never-before-seen virus was spreading in Mexico.

Saying influenza viruses are "notorious for their rapid mutation and their unpredictable behavior," WHO Director General Margaret Chan told reporters: "This is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic."

The new alert level could prompt a variety of measures, including more intensive efforts to identify cases and stricter measures to prevent the illness's spread, such as discouraging or banning public gatherings.

With the virus now clearly being transmitted person-to-person in the United States, WHO officials said the outbreak appeared to be on a trajectory toward the highest alert level -- "phase 6" -- which is marked by sustained transmission in at least two regions of the world. That would mark the beginning of a pandemic -- a global spread of the virus.

"It's clear the virus is spreading, and we don't see any evidence of this slowing down at this point," said Keiji Fukuda, the WHO's interim assistant director general for health security and environment.

While there is a chance that the epidemic could stop on its own, officials said that such an outcome is impossible to predict and that governments around the world should plan for the worst.

"There may be a possibility that the virus will die out and stop, and that would be the best for us. But it can turn the other way. So the important point for us is to continue to maintain our vigilance and track its movement," Chan said. "Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world."

call 1 800 CDC - INFO



This podcast, intended for the general public, demonstrates how to put on and take off disposable respirators that are to be used in areas affected by the influenza outbreak.

centers for disease control on youtube


In this video, Dr. Joe Bresee with the CDC Influenza Division describes swine flu - its signs and symptoms, how it's transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.

Wednesday, April 29, 2009

flu may have spread within new york city

NYTimes | The swine flu outbreak in New York may have spread beyond one school in Queens — where victims now are estimated to number in the hundreds — to pockets across the city, including at least two other schools, officials said on Tuesday.

At Public School 177, a school for autistic children in Fresh Meadows, Queens, 12 students had fever or other symptoms that could indicate swine flu. The school, at 56-37 188th Street, which was closed as a precaution, is about half a mile from St. Francis Preparatory School, at 61-00 Francis Lewis Boulevard, where the first cases were detected several days ago. Tests of students there have not been completed.

About half a dozen children at Ascension School, a Roman Catholic school on 108th Street near Broadway in Manhattan, have come down with fever. That school was not closed, but health officials will test students for swine flu on Wednesday.

Mayor Michael R. Bloomberg said at a news conference that two people had been hospitalized with suspected swine flu — a young boy just admitted to a hospital in the Bronx, and a woman treated on Sunday at a hospital in Brooklyn. Both had family members who had traveled to Mexico, he said.

There were also unconfirmed reports of cases at Ernst and Young, an accounting firm in Times Square, and at Teachers College at Columbia University.

Though the symptoms of the virus in the New York cases have been mild so far, Mr. Bloomberg and Dr. Thomas R. Frieden, the city health commissioner, raised the possibility for the first time on Tuesday that people in the United States could die from the spreading outbreak, even as they urged New Yorkers to keep calm.

“It is here, and it is spreading,” Dr. Frieden said.

The big puzzle, Dr. Frieden said, is why the symptoms of those who have fallen ill so far in New York are mild, and whether the virus will just fizzle or get worse over time, becoming more like the outbreak in Mexico.

Fuck Robert Kagan And Would He Please Now Just Go Quietly Burn In Hell?

politico | The Washington Post on Friday announced it will no longer endorse presidential candidates, breaking decades of tradition in a...