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31. jaanuar 2006


üks päris kena selgitus koos piltidega, teemal - miks, millal ja milliseid maske võiks kanda gripipandeemia ajal link


The Battle to Stop Bird Flu link
pikk jutt, mõned väljavõtted ainult

tehti arvutisimulatsioon rõugetega - levik, valitsuse tegevus jne

The first: "The superspreader hypothesis isn't necessarily true," Smith says. This rule holds that in any population, the more social individuals - the hubs - are the principal conduits for spreading disease. Shatter the network by inoculating or removing these hubs, the theory goes, and you'll stand a better chance of knocking out the disease. But EpiSims has shown that we're all more popular than we might think. Even the most reclusive of us runs to Walgreens for toothpaste or drops by Boston Chicken for takeout. For a highly communicable disease like smallpox or influenza, these incidental interactions spread disease just as well as extended encounters. So chasing after the hubs can mean chasing after 80 percent of the population - a huge waste of time and energy. Better simply to inoculate the entire city.

A second revelation: With a lethal pathogen like smallpox, response time is all. As the delay stretches from 4 to 7 to 10 days before officials move into action, EpiSims found that the outbreak becomes increasingly lethal. It turns out that, in the ticking moments after an epidemic strikes, when health officials act is more important than what they actually do. Start with inoculation. Or quarantine. Or school closings. It doesn't matter. What does matter is reducing the time between first outbreak and first response.

tehti nüüd linnugripipandeemia simulatsioon:

EpiSims has begun assessing the threat of avian influenza. They're modeling the health care system down to the hospital bed, to see what happens if flu victims flood hospitals, fill the beds, and then spill back into their homes. They're taking into account slight behavior changes, so if people start wearing surgical masks, SARS-style, disease transmissions in the sim will fall off according to the masks' particulates-per-million filtration rate.

EpiCast reveals that, in contrast with flu epidemics of decades past, an outbreak today won't progress "like a wave across the country," spreading from town to town and state to state. Instead, no matter where it erupts - Seattle, Chicago, Miami - it will swiftly blanket the nation. "It starts in Chicago one day," Germann says, "and a couple of weeks later it's everywhere at once." Thank the airlines. Even though disease has piggybacked on air travel for decades, we generally had only isolated outbreaks of low-transmission viruses - like when SARS leapt from Hong Kong to Canada in 2003 but failed to spread beyond Toronto. In an epidemic of a highly communicable disease, the airlines' hub network would effectively seed every metropolitan area in the country within a month or two - and then reseed them, repeatedly.

EpiCast showed that local intervention measures can have some impact: Close the schools, enforce a quarantine, and the disease will slow down. That buys the federal government time to develop and mass-produce a vaccine. But Germann quickly adds a caveat: Acting locally may not be enough. In a worst-case outbreak, without a viable vaccine, "the disease will climb, and eventually go exponential. And once it's on the exponential curve, it's very difficult to contain." Cue Richard Preston.

In November, the Department of Health and Human Services released its pandemic influenza plan. The report offers a thorough and frank assessment of the havoc a full-fledged pandemic would wreak. The nation, the report says, "will be severely taxed, if not overwhelmed." Disease will break out repeatedly, for as long as a year. Hospitals will run out of beds and vaccines. Doctors and nurses will be overworked to the point of exhaustion. Mass fatalities will overwhelm mortuaries and morgues with bodies.

Rather than an all-out response focused on one particular region, a flu epidemic would force the government to ration its resources to serve the entire nation.

29. jaanuar 2006

1918a jutt

seekord siis medõe jutustus link

Since so many nurses had enlisted for the Red Cross, often there was no more than one nurse to fifty patients. Even though we were probationers and not given very much responsibility, and there were ward maids and orderlies to take care of many of the disagreeable details, we had a great deal of physical labor. It was a city hospital and patients had to be very sick before they were admitted. We had to change each bed every day, bathe all our patients, rub them down with alcohol, dress bed sores, give out the medicines, attend demonstrations, and generally assist in the irrigations and injections, tappings for spinal and lung fluid, and all the other treatments for patients in the medical and receiving wards. …

That was the year of the influenza epidemic, and we worked so hard that we fell unconscious into our beds at night and had to drag ourselves out of sleep in the morning. I had to take cold baths when I got up because if I got into warm water I fell asleep. Most of the nurses were keen and zealous over the work. We were all so busy we did not have time to suffer over the human misery we saw, although it was heart-breaking to see young people dying all around us of the flu. Often we had to prepare for the morgue as many as eight corpses a day.

Every morning we were expected to have our wards in order by ten o'clock, and it used to give me pleasure to see everyone cleaned and washed and neatly tucked under white counterpanes in the long rows. They were good patients because they were poor and did not expect too much. They were uncomplaining, and they accepted their suffering with stoicism. They did get good food and clean bedding. In the middle of the morning we gave everyone eggnogs, and in the male wards most of the men who were in the habit of drinking got a good stiff drink of whiskey in the eggnog. …

One got into the habit, in the hospital, of consistent, sustained effort and of disregarding fatigue, both physical and mental.

pilt haiglast

pilt 1918a pandeemia aegsest erakorralisest haiglast link

infrastruktuuri hoidmine olulisem kui haigete eest hoolitsemine

ÜRO viis läbi pandeemiasimulatsiooni, olulisim järeldus oli see, et infrastruktuuri (vesi, toit, energia) säilitamine on pandeemia korral olulisem kui haigestunute eest hoolitsemine.

UN may use 'flu-casters' if pandemic hits link

DAVOS, Switzerland (Reuters) - The United Nations is considering using "flu-casters," modeled on television weather forecasters, to publicize vital information if a global flu pandemic strikes. They could broadcast latest developments from emergency-response facilities at the U.N.'s World Health Organization in Geneva, according to David Nabarro, the U.N.'s top influenza coordinator.

"The flu-casters would draw out the maps and keep people engaged at regular intervals ... beaming it from the WHO bunker," Nabarro told Reuters in an interview at the World Economic Forum in Davos. The WHO's Geneva bunker, a $5 million facility built in a former cinema, is the world's nerve-center for tracking bird flu and other deadly diseases.

The room will become a global command center if the H5N1 bird flu virus, which has killed at least 83 people in Asia since 2003, mutates into a form which spreads easily among humans and sparks a flu pandemic which could kill millions.The screen-filled bunker could link the "flu-casters" with TV networks via satellite feeds.

Nabarro was speaking as the United Nations analyzed results from a top-level catastrophe simulation to set policies that envisage governments, companies and the media working together to fight a global flu pandemic. The exercise has produced surprising conclusions that could prove key should the disease start to spread quickly among humans.

One of the most important conclusions was that maintaining infrastructure -- water, power and the provision of food -- could take a higher priority than providing care to the sick, Nabarro told Reuters.
"It is maybe even more important to concentrate on the essentials of life for those who are living than it is to focus on the treatment of those who are sick," he said. "We learned a lot."

A pandemic could see travel and trade halted, workers forced to stay home, schools closed and a number of other dramatic measures designed to limit the spread.
The U.N. aims to forge fixed partnerships with key actors who would be involved in any pandemic response effort, which would include community groups, aid groups like the Red Cross, businesses and the media, Nabarro said.

"The focus on business is important. They have skills and can do things that governments cannot," he said. Clear communications would also be crucial.

The simulation assumed that the world was 40 days into the outbreak of a deadly pandemic.
"What became clear to us was, if we don't work together effectively and get prepared, we will be badly hit by that pandemic," he said.

The pandemic preparations will call for novel approaches if officials are to limit the potential catastrophic damage -- such as the use of mobile phone technology to distribute questionnaires and information, Nabarro said.

Nabarro also warned there was still a lot of work to be done in the event of an outbreak.
"Governments are starting to realize that they are nowhere near prepared for the damage that it could cause," he said at a panel discussion.

28. jaanuar 2006

WHO juhendist ja inimestest

WHO avaldas eile uue juhendi mustandi:
WHO pandemic influenza draft protocol for rapid response and containment http://www.who.int/csr/disease/avian_influenza/guidelines/RapidResponse.pdf

no et kuidas võiks käituda pandeemia alguses, piirata levikut jne

kaks huvitavad asja jäi silma
1) WHO on väga ettevaatlik oma faaside muutuse väljakuulutamisega
praegu on pikemat aega juba faas 3, kuigi olukord ja tegutsemine vastab 4.faasile
ja sellest on nüüd juttu (esimest korda kui ma seda näen WHO kirjatükkides):

A WHO decision to change the phase of pandemic alert will be made separately from the decision to initiate a rapid response or rapid containment effort. Since a change in phase is expected to trigger a number of potentially cascading actions by countries, possibly including travel restrictions and border closures, such a decision will be highly visible and is expected to have significant political, social and economic implications.

2) PPE (isiklikud kaitsevahendid) loetelu, mille võiks enamvähem enda varude koostamisel ka aluseks võtta (erandiks siis Tamiflu, mida enam võimalik reaalselt hankida ei ole, küll aga peaks veel olema piisavalt nii maske kui kaitseprille)

Personal protective equipment (PPE) kits consisting of:
Surgical and N-95 masks
Surgical gloves
Disposable boot covers
Disinfectant wipes for equipment
Biohazard bag for proper disposal of contaminated items
Pictograph directions
Hand-washing soap or hand disinfectants (alcohol-based hand rubs)
Disinfectant for cleaning surfaces in health care settings
Instructions written so they are easily understandable in multiple cultures
Antiviral drugs (oseltamivir in 75mg tablets)
Antibiotics to cover the most common secondary pneumonias

3) hingamisaparaatidest, millest ka Eestil puudus on

Consideration should be given to stockpiling a small number of ventilators (for example, 10 to 20) regionally. However, if ventilators are stockpiled, then the groups maintaining the stockpiles must also plan for having respiratory staff and technicians available to use and maintain these machines plus all associated supplies needed to use these machines.

aspekt, mida ei tohi unustada - et masinad võivad sul ju olla, aga neid ei ole võimalik kasutada, kui puuduvad vastavalt väljaõppinud inimesed .. sh võivad nad olla pandeemia ajal surnud/haiged/paranemas/hooldamas oma haigeid/valvamas oma lapsi/kardavad tööle tulla -mis tähendab siis, et neid tuleb välja õpetada 2-3x rohkem kui normaaloludes

selle nädala ekspressis oli mh juttu hingamisaparaatide võimalikust puudusest link

1000 voodikoha vabastamine gripihaigetele ei ole väga keeruline, sest sisuliselt lõpetatakse ära plaaniline haiglaravi, kuid intensiivravi voodikohtade arv, eriti hingamisaparaatide arv on väga tõsine probleem. Praeguse prognoosi kohaselt on minimaalselt vaja juurde 50–60 hingamisaparaati.

27. jaanuar 2006

level 4&5 - hullem pandeemia kui 1918

Continuing the discussion of the conditions we can expect to encounter and what the reasonable planning criteria are each level, we now get to Levels 4 and 5, which are the most difficult to plan for. The reason for this difficulty is that both of these levels represent events that are unprecedented in the history of industrial society, and so in some degree anything I or anyone else say is purely conjecture.

But having made that introduction, and resuming my role as planning helper, we can begin to look at just what we;re up against. In my original planning criteria, Level 4 was stated to be a Pandemic situation worse than 1918. For the purpose of this discussion, I’ll place an estimated fatality level at 5%, with many other people suffering long-term debilitation from their encounter with the virus. Similarly Level 5 was stated simply to be Pandemic Plague. Now, as I am not a medical practitioner, I do not claim to be using those terms correctly. What I intended to suggest with that label was a highly virulent illness, spreading H2H and with a fatality rate in excess of 10% of the population. Similar to the plagues of the past.

In our planning for previous levels, we have become used to stockpiling those materials whose supply we feel will become interrupted for a while, such as medicines, foodstuffs, water and fuel. At this point, the guidance becomes much less precise and yet more urgent:

You will need to provide a supply of everything you anticipate needing for an extended period. It may be months or even years before some of the things you have grown to depend on will again be available. If ever.

I am lumping Levels 4 and 5 together for two reasons; first, I don’t view them as distinctly different planning problems, and second, if we experience a Pandemic at either of these levels, the world we live in and the social and economic conditions in your local area will be drastically different from what they are today. So what general guidlines can I offer for planing;

1) Medicines - You will need to stockpile a year’s worth of maintenance medicines simply because, as Michael Osterholm pointed out in his testimony before Congress, the production of medicines in this and other countries will be disrupted due to supply chain failures. You will need to be self reliant for a good long while. If there is a substance whose availability is a matter of life and death, you will need enough to insure a steady supply in the face of major disruption. You should also be looking at what, if any, alternatives you may have in front of you for maintenance without those, or any meds. Some may face the sudden unavailability of life saving therapies such as dialysis.

2) Doctors and Hospitals - There may be very little emergency treatment available for injuries or acute disease. You should be prepared with sufficient first aid materials and learning to be able to treat all but the most severe injuries yourself. It may be a long wait before you can obtain professional medical treatment.

3) Personal Supplies and Toiletries - What do you use? How much do you plan to stock? Do you really need it? What will you do either as an alternative or without it?

4) Food and Water - How much can you really store? What is your plan for an ongoing supply past what is on your shelves? Do you have, or can you get to open ground to grow some of your own food? Can you catch rain or dig a well if you need to? Did you include seeds and tools in your stockpile?

5) Light and Heat. What is the climate where you live? What renewable source of energy will you use for light and heat, as normal utilities will most certainly be disrupted, and however much fuel you store will eventually run out. Think of needs for heating, cooking, lighting and cooling.

6) Personal Safety - This is the point where the discussions in the “Post Pandemic Violence” thread become applicable

the list goes on for quite a while. I think you get the idea. Once we get to these higher levels, you also need to consider one additional concept..

You may not personally survive. Or some portion of those sheltered with you may not survive. What will you, or your loved ones do if one or more succumb to the virus. Does everyone know how all the gadgets you have loaded up on work? Can your children safely run the lights? the heat? Cab they prepare their own food if the adults are incapacitated?

level 3 - sarnane pandeemia kui 1918

OK folks, this is where we need to fasten our seatbelts, place our tray tables in their full upright and locked positions and hold on tight. The ride gets very bumpy from this point forward.

The reason for the above disclaimer is simply that Level 3 encompasses a pandemic situation with an extent similar to that of the 1918 pandemic. At this point, individual imaginations and individual circumstances must prevail when planning for these conditions. We have only seen anything like this once before, nearly a century ago. Back then the nature of the pandemic and its results differed even between cities and towns within the US. Times have changed, medicine has changed and most important, H5N1 circa 2006 is not H1N1 circa 1918. Even so, we can begin to determine both our expectations and the unknowns.

We can expect that we will see fatality rates of approximately 1–2% of the population. We do not know for sure, but if cytokine storm is the primary kill mechanism, then the young will be a disproportionate share of the fatalities. The bacterial pneumonia kill mechanism may be somewhat blunted this time around due to the availability of Pneumovax, sparing some of the older population who might otherwsie have made it through the viral episode but succumbed to the bacterial secondary.

(The problem isn’t that 1–2% die in one year. It’s that 1–2% additional die in a period of days or weeks, as well as the normal 1–2% that die over the course of that year. And unlike the normal mixture of young folks due to accidents and older folks like myself due to the illnesses of age, it is substantially those in the prime of life and their children. Or possibly, just their children. And there is no guarantee that the number will either be limited to the 1–2% level, or will ever reach that high. So we must discuss preparations to deal with whatever contingency actually shows up.)

We do not know, but can assume that the flu wave will rise quickly in any given locale, peak and then subside in some period of weeks to perhaps a couple of months. We do not know, but can assume that there will be more than one wave of infections. We do not know whether illness during the first wave will confer immunity during the second or subsequent waves. We do not know whether it is better to get it in the first wave and have done wih it, or shelter in an attempt to avoid any contact with the virus. We do not know whether isolation will in fact shield us from exposure to the virus. We do not know how much advanced warning we will have that the virus is running, and how much time we will have to implement isolation or contingency plans.

And most important - we do not know that things will ever reach up to a Level 3

If we assume for planning purposes that things will be on the bad side, then you must take some time to pursue what the pessimistic implications of Level 3 actually are. My personal assumptions for planning at Level 3 are:

1) Traditional medical care outlets will quickly be swamped, overloaded and become unavailable. This includes both your Doctor’s office and the hospital. Given the lack of surge capacity in the US medical system, one should not count on any medical care being there when needed. This may be overly pessimistic, but that is the planning point I am using. I suspect the local pharmacies will be equally impacted by such an onslaught.

2) Supermarkets may experience a great deal of panic buying as word of impending flu spreads. Before the actual onset of flu in the US, resupply will be able to backfill some of the holes. Once the Pandemic strikes at any major locales, the Interstate system may well have blockages in areas, and there may be attempts either by National or State or Local governments to embargo movement of trucks or trains through their areas. Shortages of commodities will become more the rule than the exception.

3) Businesses will encounter rising absenteeism rates due to illness, death or fear of the above. It will be hard to buy things or to get things done.

4) Utilities should be considered undependable. It is not clear whether utilities are currently planning for such a situation, and as such they may run out of skilled staff to keep things running. Further, once things go down, they may be off for a long time.

5) Going out in public will involve a very real risk of exposure and infection. One should assume that public gathering places will be closed (restaurants, churches, schools, etc.) venturing out from ones place of safety should only attempted with appropriate protective clothing, and full hygiene afterwards, and then only for the most serious of needs.

6) Public safety agencies (i.e. police and fire) will be hard pressed to keep “boots on the ground”. Assistance may or may not be available if you call, assuming that cell or landline phone systems are working at that time.

7) Banks and other financial institutions will probably be closed for normal transactions. Money may be hard to come by, even if you have accounts with cash in them.

8) For those who live away from cities, you may well have family or acquaintances who have fled the conditions within the cities show up on your doorstep seeking shelter. You will need to decide in advance what you will do when this occurs.

9) The depths of these conditions will be short lived. As seen in 1918, after the wave passes, there will be a period, perhaps extended during which illness rates drop precipitously. There will be a return to some degree of normalcy for some period of time. Services and utilities will get back online. Some commodities will again be available for purchase.

As in the previous planning levels, your goal is to insure that you have whatever supplies can be anticipated to be needed by your family for the duration of this situation. As before, we will start with the assumption that you are building upon a base of a full complement of supplies for the previous level. Your individual planning will depend to a great degree on your own circumstances and values. Do you intend to go into isolation while the rest of the world faces the influenza. Will you emerge between waves for resupply? Will you remain out in your community? Will you volunteer to help others? All of these will create different planning situations. How you proceed is strictly up to you.

Reasonable Preparations for Level 3

Just looking at the title of this section, I am not sure that it isn’t an oxymoron. It is at Level 3 where the expectation is that things are going to become decidedly unreasonable. As I pointed out in my section on anticipated conditions, this is the level where ones imagination may provide as good a guide as anything else for preparation. At this point, I have to step aside and let you take complete control of your planning, because only you know what you will need, and what conditions you think you will be facing. But let’s begin.

Since we are assuming that at Level 3, we encounter conditions which are equivalent to the pandemic of 1918, we are assuming a fatality rate of between 1 and 2% for our planning. From this number alone, we are assuming that it is dangerous to be out and around a whole lot, that normal services and commerce will be disrupted to a lesser or greater extent, and that there may be little to no reasonable expectation of medical, public safety or support services. Thus, we need to approach the provisioning with an eye toward being totally dependent upon our own resources for some period of time.

The first question you will need to sort out is whether you are intending on taking the path of total isolation. From the postings of many of the people on this Wiki, I feel that for most of you, the answer will be in fact, planning on total isolation. That being the case, the very next question you will need to answer is the period of time you expect to have to isolate yourself and your family. this is important not only from the standpoint of how much stuff you will need to acquire and store, but what kinds of stuff you will need, and the relative quantities. In areas such as mine, where winter weather is a big factor in comfort or even survival, you will also need to establish, up front, what the timing of the Pandemic might be, relative to the calendar.

As an example, suppose my own family’s Level 3 plan assumes sheltering during two waves of influenza with a total duration of 5 months. Whether we thought that 5 month period began in May or October would dictate very different stockpiles. In winter, a substantial stock of heating fuel would be required. In summer, none. In winter, food storage may be assisted by cold outdoor temperatures, so preparation of a few days worth of meals at once could be accomplished to save cooking fuel. in summer, that would not be possible. In winter, we could derive water from snow if need be. In summer not. In summer, we could gather edible weeds and berries from our property as a food adjunct. In winter, not at all.

I can’t tell you what your plan will look like, I can only teach you what to consider. In my own case, given the way things look now, I am planning to deal with a pandemic which starts with a wave in late winter, runs for a couple of months, eases, and then has a second wave in the fall. Your own plans will differ.

The next question you will have to sort out for yourself is what will be happening around your region during such an event. A city dweller can expect that conditions will be different from what us rural folks experience. Other threads have discussed the possibility of violent behavior. I am not planning on a great deal of that going on around here. Some, but not a great deal. What will the local and federal government be doing. Will populations be forceably shifted. Forceably isolated? Will equipment or supplies be commandeered?

I can’t answer any of the above questions. All I can do is give you the guidance to sit down and write down an outline of what you expect will be going on. Will there be fuel deliveries to your town. Could you buy gasoline if you wore gloves and mask? Would you want to? What about trash pickups. Do you want to put trash out by the road that provides clues that you still have fresh supplies?

Having gone through the lecture, now lets look at the provisioning aspects.

Food: You will need to plan out just how many meals you will need to be able to provide for the period you are planning for. Thus if you are assuming 3 months of isolation for 4 people, that means having to provide about 1000 meals. Have you considered what you can store that will do that? I suppose 1000 Power Bars is one approach, but a combination of canned and dry goods is what I would be looking at. For instance, how many meals can one get from a 25 pound sack of rice. Dried beans are another of the key commodities. Canned meats, Canned juices. How will you cook your food. How much fuel will you need per meal. this is the time to consider how you will achieve your goal. Is there a possibility of safely going out for resupply some time during the period?

How about in the Spring. Can you grow some of your own food? Have you ever tried to do it before now? Do you even have a few garden tools on hand? If birds and mammals can carry the virus, is it safe to do this?

Water: What is your water supply. How will you provide a safe supply of drinking and washing water during the planning period. Again, with 4 people going for 3 months of isolation, you will require a minimum of 360 gallons of water as a bare minimum. Do you plan on storing all of that at once? How will you insure its security against leaks, contamination or theft? If you are counting on a municipal supply, how much backup supply will you have on hand against possible interrruptions?

Medicine: This is easy. You will need a full supply of all maintenance medicines for all family members for the entire period. Or longer if you think things will not be back to full normal operation when you emerge. Or are you planning on having your local pharmacy be available during the period. How will you dress and what protective clothing/equipment will you use when visiting the pharmacy? Besides maintenance medicines, you will already have a stock of medicines needed to deal with influenza in your home. But what other medicines might you need if your Doctor and pharmacy were not available for a while. Now would be a good time to have this discussion with you family doctor and see whether he would be comfortable in prescribing some medicines against anticipatable illnesses. Even if he gives phone direction for actual use, you will at least have the supplies. Even if he can recommend OTC things to have on hand.

Clothing: Do you have enough clothing to deal with an interruption in supply of new clothing. Do you have sufficient to deal with a reduction of washing capabilities? How much do you have now, and how much will you need to stock. Is it capable of seasonal weather changes?

Energy Supplies: How do you intend to deal with basic heating, cooking and lighting requirements. Once you are self sufficient for the long term, you can no longer count on consumable supplies such as gasoline, kerosene, propane and batteries for your entire energy supply. In my own case, our house has alot of South facing windows, is well insulated, and even in mid-winter, can generate sufficient heat from solar energy to stay warm during daylight hours. Have you looked into such simple techniques as opening and closing blinds for heat control. Are your lighting devices capable of being run on rechargeable batteries. Have you considered getting solar battery chargers, solar cookers and solar water sterilizers? Does your house have a fireplace? Can it actually operate as your sole source of heat? Have you tried that? Where is your long-term source of fuel for it? How much fuel will you actually need. Do you have it or can you get it? What is your cooking method. How much fuel per meal does it consume? Is it even safe to store as much fuel as you will need?

Fire Fighting: If you are going to be using candles, kerosene or propane heaters or fireplaces, have you considered you may need to have fire extinguishers around to deal with the problems that could arise from their use?

Communication: How will you stay in touch with the rest of the world. What if cell systems are down but landline systems are still working. What if the only communication is the local (or distant) radio station. Or just the TV station. Do you have battery or crank operated radios or TV’s? How about walkie-talkies if you have family members out and about your property.

Addictive Habits: What stuff can you possitively not do without. Cigarettes? Coffee? Alcohol? Cookies? Consider now how much you will need to prevent having to go cold turkey in the middle of otherwise trying circumstances.

Money: You will need to consider how much cash to keep around. Katrina taught us that in a disaster, a povket full of money can make all the difference in personal comfort and safety. Assume that price gouging and profiteering will be the norm.

Cash: Did I say you’d need cash on had? You will

Self Defense: What are the civil order or disorder conditions you will encounter. How will you deal with what is going on? (And don’t just think Gun.)

OK. There is a great deal to consider and incorporate into your plan before you just run around willy-nilly and buy a bunch of stuff. As in the previous planning levels, the goal is to understand just what your needs for supplies will be, and then stock up your provisions to meet those needs. By definition, you will already have a good start on both the planning process and the provisioning process from the lower levels. You just need to move forward to the concept of longer duration and sparser conditions. If you are seriously considering that conditions will reach a 1918 magnitude pandemic, and that normal supply systems will be compromised, you need to take the time to consider all of your activities and what you will need to put away now so that you can continue to function during the period you anticipate.

It would be very useful to you to actually plan out on a sheet of paper all of the things you will need, and how much you will need. If you then discuss it with another family member, they may see either gaps or overages in your plan. Once you work it out between you, at least you will have mutual support that you are doing the right thing.

level 2 - raske gripipuhang

Level 2 - Description of Conditions and Basic Planning criteria

The conditions I am using for planning at Level 2 is that there is a pandemic flu circulating around the world. It is moderately to very contagious, and of moderate virulence. Those people who take sick with it experience a severe case of flu. Many more patients will experience serious issues and complications arising from the infection, and a substantially larger than normal number of fatalities will occur among those groups normally affected adversely by the flu, and now some from those groups normally less affected. For my own planning purposes, I am assuming a death rate from the flu of 1–2 per thousand of population.

In my planning model for Level 2, the flu is beginning to have a substantially greater impact than is usually seen during a normal seasonal flu wave. Substantial numbers of people suffer bouts of the illness ranging from somewhat mild to those who proceed to life threatening severity, and those who while making it through the flu itself develop secondary respiratory (bacterial) infections.

The impact on daily life will be much more noticeable than at Level 1. At this level, whole businesses may close for a period of time due to some combination of excessive absenteeism due to illness, stay-at-homes who do not wish to expose themselves to potentially sick coworkers and the occasional death of key individuals within the business making it difficult to resume normal operations. Schools may close for some period during the height of the wave in any given area.

As in Level 1, there will be local shortages of prescription and over-the-counter medications and other supplies. Stores may have some difficulty in obtaining prompt resupply due to disruptions in staffing either in store personnel or in the delivery crews. As a result, there may be some localized shortages of a number of staple items at supermarkets, but not as a general shortage, just swaths of shelves here and there which are empty due to heavy demand and slow resupply.

Since the US depends heavily on “just in time” resupply, it is not clear to me whether there will be sufficient surge capacity to meet some demands for some products.

Doctor’s offices and hospitals will be substantially impacted. Not only will the demand for treatment exceed any normal or heavy flu season, but the trend over the past decade to reduce the equipment and staffing levels down from “peak” capable to “average” capable will mean that there are insufficient beds, staff and supplies to meet a quickly spreading flu wave of a nastier than usual flu. This coupled with illness among medical Care personnel will mean serious gaps in the ability of some to obtain timely and appropriate treatment.

As in the planning for Level 1, I personally feel it is prudent to assume that all of the members of your household will be down with this flu simultaneously. Since we already provided for this situation substantially in our Level 1 plan, we will now need to determine what additional supplies and preparations are required to get us safely through the Level 2 scenario.

Reasonable Preparations for Level 2

As stated previously, the assumed impact of the Pandemic wave is that of a severe influenza wave more severe than even the worst of seasonal flu years.

As we begin to anticipate the conditions associated with higher planning levels, it becomes more difficult to accurately predict just what will actually be occuring. Thus, our plans should include sufficient lattitude to allow for things going differently than we had thought. This usually means over stocking rather than under stocking. It would be better to be surprised by the fact that things were not as bad as you had planned for, rather than discovering that things were worse than you had provisioned for. Also, since this is a planning exercise, I am electing to state the worst case conditions below. This is not a prediction of how things will actually be during a Level 2 wave, just an attempt to cover all bases…..

From this level upward, it is important that each planner take into account the individual circumstances of their own situation as a major planning point. Thus, where you live, what size town you live in or near, extended family who may need help or shelter all come into play. It is not possible for me to advise you about your own situation, you need to sit down and consider fully what may occur during a flu wave.

I anticipate the following conditions to occur:

1) Doctor’s offices will become unreliable as a source of care. Individual offices may have insufficient staff available to remain open, or will be so overworked that access will be very limited.

2) Hospitals will be overtaxed by the caseload that is presented to them. Along with staff shortages due to illness, there will most probably be shortages of some of the basic supplies and medicines that are needed to continue full operation. Patients may well be triaged such that only the most critically ill will be admitted (or even seen).

3) Local pharmacies will probably be out of stock of many of the medicines needed for flu treatment. Since their supply chain may be overloaded and under staffed, the “just in time” delivery scheme may no longer work for all items at all times.

4) Supermarkets and other outlets may experience shortages of some items, such as experienced in our Level 1 planning. In this case, those shortages will probably be wider (more items), deeper (shortages more acute) and linger than we had planned for in Level 1. In some cases, the shelves may be cleared of some items in response to either actual need, or panic needs. Which items will be affected is not accurately predictable.

5) Businesses will experience high absenteeism. Some employees will be out due to illness, some due to fear of coming out, and here and there due to death either of themselves or of a close family member.

6) Going out in public represents a very real risk of exposure and infection. Visits to stores or other public accommodations will need to be done with the full understanding of the risks involved. Proper protective measures and hygiene are mandatory.

7) Utilities will continue to operate, but if staffing shortages develop, there may be some failures in localized settings. If the systems are challenged by a major external event such as a winter storm, it may take a substantial time before full services are restored to all. If a catastrophic event occurs, it is possible that outages could take weeks to months before services are fully restored.

As in the previous planning levels, your goal is to insure that you have whatever supplies can be anticipated to be needed by your family during this condition. From this level on up, it is also prudent to determine in advance what you would do if faced with certain contingencies. (Examples: Old Aunt Tillie from the City calls and asks if she can come out and live with you as things are cold hungry and scary where she lives. Or some member of your family takes seriously ill to the extent that a hospital is the only alternative. Who goes with, who stays home? Who returns home from the hospital which will be a focus point of infection. If not, where do they go? What if they were turned away at the door?)

As in previous planning levels, we will start with the assumption that you are building upon a base of a full complement of supplies for the previous level. Your individual planning will depend to a great degree on your own circumstances and values. Do you intend to go into isolation while the rest of the world faces the influenza. Will you remain out in your community? Will you volunteer to help others? All of these will create different planning situations. How you proceed is strictly up to you. Some basic guidelines:

Food: Build up from the two week supply you laid away for Level 1. At this point, at a minimum, you should be able to go without any outside supplies of any sort for at least 4–6 weeks. You need to look at shelf stable items such as ultrapasteurized milk to fill in some of the normally fresh foods you buy frequently. Bread can either be replaced by rice or pasta, or else you might acquire a bread machine and start using it now, so you are fully comfortable with it and the bread it produces. Sufficient flour and other ingredients to turn out enough bread to go that long would then become a stocking item.

At this point don’t forget comfort foods. The situation will probably be stressful and depressing to you and your family. A supply of whatever foods you find soothing and comforting will be a valuable addition to your stock.

Medicines: Building on top of your Level 1 preparations, you should now increase your reserves of your maintenance medicines to last for 6 weeks. If you are on maintenance meds, it makes little sense to provide for food and water if you also don’t have a supply of the meds you need to keep you healthy and functioning. As in Level 1, you should endeavor to work with your Doctor to preposition those medicines which he thinks will be needed in the event of a severe influenza outbreak. As in Level 1, you should plan to work with your Doctor to understand when and how he would want those reserves used.

Toiletries - You should remember to include sufficient toothpaste, toothbrushes, toilet paper and anything else you will find you need to maintain a comfortable and familiar lifestyle. You use it anyway, so it can easily be rotated out of a standing stock as needed during “normal” times.

Clothing and Laundry products - Remember that during an extended period, you will need sufficient clothing to maintain a healthy and sanitary existence. This is especially true if you have ill family members. Bedding and bedclothes may need to be cleaned multiple times during such an illness. Even without power, I have managed to wash some simple things in a sink using detergent and warm water. Be prepared to improvise if need be. Make sure you have enough clothing so that if you need to go out, you can change into fresh apparel on the way in so you can disinfect your outdoor clothes. A plentiful supply of bleach and white vinegar would be a good idea.

Water: I still don’t personally think you need to worry about substantial stocks of water. A two week supply should be adequate except for situations in which you derive your water from an electrically pumped well. Then if you do not have a backup generator such that you can pump water into storage after the loss of power, you should prepare a supply sufficient to last for the 6 weeks of this planning period. I would still not maintain this large of a stock during “normal” times, but would rather wait until it is obvious that an illness wave is a real probability. Then I would fill my stock. It would therefore be prudent to acquire sufficient acceptable storage containers for the purpose now, and stroe them until needed. For planning purposes, assume that you will need to have at least 1 gallon perperson per day as a minimum. Don’t forget that a water heater tank holds 30–60 gallons, and so can be counted into the stock for planning purposes.

Backup Lighting and Heating (Cooling) - At this point, your planning should begin to take into account the possible need to operate for some periods of time without utilities. As I noted above, it is anticipatble that due to absenteeism, the utilities may be hard pressed to keep things up, and may have great difficulty fixing things when they break. I do not, however anticipate that the utilities will be off, as a general rule, at this level.

Depending on your life style, there are many (and some very expensive) things you can do to support your comfort during extended outages. In my case, I have a generator large enough to run and heat the house. Unfortunately, to do this full time, I would require about 15–20 gallons of gasoline per day. Obviously this won’t be how things can go for weeks at a time. So think about how you would retreat into a more manageable “survival module” within your home, allowing portions of the house to run cold and dark. You will therefore require far less energy. Solar cookers, solar battery chargers and the sun coming into a Sotuh facing window are all areas to look into.

To keep things habitable, I have on hand auxiliary propane heaters which can operate far more economically than a whole-house generator. You need to plan this kind of appliance with care. Carbon monoxide and fire are always dangers with these devices, so you must have appropriate CO monitors and extinguishers at hand to support your use of the heater.

Battery consumption of lighting devices is a very important but manageable issue. Incandescent flashlights are about the worst consumers of battery power. Flashlights which use LEDs and area lights which use compact fluorescent lamps are far more energy efficient. As an example, I have a fluorescent area light which runs for 20 or more hours on 4 D cells. I have a bunch of LED flashlights which will run 40–50 hours on 3 AA batteries. if you will be depending on batteries for light for any period, then you will need to look into more modern devices than the old fashioned flashlight.

Radio - I personally have a hand cranked radio that runs for about an hour on 100 turns of a crank. It never requires batteries. Or you can insert rechargeables and run for hours on an extended period of cranking.

Information resources: Same message as before. Do your research now. before you are in a stressful, or dangerous situation.

Again, this is a planning exercise first and foremost. Sit down and ask yourself “What will I be doing during such a situation?” then based on what you determine, you need to plan out how you will deal with normal and abnormal situations and what supplies you will need on hand to deal with them. Once you have made a detailed list of the required supplies, you can figure out how you are going to acquire and store them.

I am not able to provide you with specific instructions on provisioning your family, just planning recommendations and general guidelines. You will need to take over from here.

level 1 - tavaline gripipuhang

Level 1 - Description of Conditions and Basic Planning criteria

At this point, we take the planning tree in the specific direction of influenza preparations. This does not preclude making additional plans for possible hazards specific to your own situation and planning for them as well. There will usually be much overlap between them. A good example of a situation specific plan would be those folks in New Orleans who survived the rapidly rising flood waters which chased and trapped them into the attics of their homes because they had previously experienced bad flooding and had stored an axe in the attic. They used the axe to cut through the roof and escape. Others, unfortunately were trapped and drowned in their attics.

The conditions I am using for planning at Level 1 is that there is a pandemic flu circulating around the world. It is moderately contagious, and of low to moderate virulence. Those people who take sick with it experience a bad case (perhaps the worst of their lives) of flu, but except for those who are candidates for trouble with seasonal flu, they eventually recover without further problems.

Although there will be some slowdowns in stores or service related businesses due to high absentee rates, in general, things continue to function much as they normally do. Some spot shortages may occur locally in stores where demand for sickroom supplies such as Tylenol or tissues exceeds the supply, but this will be a local issue, not a national or international one. Pharmacies these days don’t seem to run excess shelf stock, and can run short of some medicines on even normal days, depending on next morning delivery to fill holes. Be aware that you may need to be familiar with more than one pharmacy in your area, or else be prepared to be given a short fill on some flu related prescriptions and then come back in a day or two for the rest.

Doctor’s offices and hospitals (in the US, I don’t know about the rest of the world) will be stressed, and some spot issues with hospital emergency rooms going to bypass status will develop, but in general medical support, advice by phone and emergency treatment for those who become seriously ill should still be available. (Digression for a hint: The hospital in my area is a major trauma center which catches medivac helicopters, ambulances and walk-ins to the ER. The basic priority structure is the same - helicopter, ambulance, walk-in. If you or someone in your family is in need of ER care, it is better to call for an ambulance. They will be seen and treated HOURS sooner).

In planning for this level, I feel it would be prudent to assume that all of the members of your household are down with the flu simultaneously. Thus, one who is planning for this level will need to determine what supplies it will take to get through such a situation.

Reasonable Preparations for Level 1

As stated previously, in Level 1 planning, we assume that the impact of the pandemic wave is roughly equivalent to that of a very bad seasonal flu outbreak. Since we have experienced these conditions many times before, the following conditions can be expected to occur:

1) Doctor’s offices and hospitals will saturate with walk-ins and phone calls seeking treatment guidance.
2) Hospitals will fill to capacity with patients who are experiencing serious impact from the flu and are in need of professional supportive care.
3) Pharmacies may experience spot shortages of the most frequently prescribed medicines
4) Supermarkets and other outlets may experience spot shortages of a wide variety of over-the-counter medicines and sick room supplies, including the basic remedies such as Tylenol, Expectorant cough medicines, decongestants, tissues and many, many others
5) Some businesses will experience slowdowns or operational problems due to high absentee rates
6) Doctor’s offices, hospitals, drug stores and supermarkets may be places at which you experience a higher than usual probability of being exposed to the influenza which is circulating.
7) Utilities (water,gas, electricity and telephone) may be reasonably expected to continue in normal operation, or at worst experience minor disturbances in service which will be corrected quickly.

Thus, the goal of Level 1 preparation will be to insure that you and your family have all of the supplies on-hand that you can anticipate needing in the event of such conditions. As I stated previously, my planning criterion for this level is the entire family is down with the flu simultaneously. Provisioning for this level is intended to cover this contingency, plus one additional outside problem, such as a severe winter storm.

While each individual doing the planning must determine his own requirements, the common areas to plan for are:

Food: There should be sufficient food in stock at all times to allow for proper feeding of the entire family for a period of at least two weeks, also assuming illness is rampant within the house. Thus, one should stock not only sufficient quantities of the normal day-to-day foods that the family would eat when healthy, but also sufficient foods to deal with possible major influenza as well. Thus, one should make sure to stock easy to prepare and easy to digest foods such as cream of wheat or rice cereals, dehydrated soup mixes, soft drinks, oral rehydration concoctions and anything else you or your Doctor normally recommend for an ill individual who may be nauseous, have diarrhea, or just be almost non-functional.

Medicines: Within this category fall both maintenance medicines and flu medicines. One should make sure that they have on hand, at all times, their normal maintenance medicines, plus an additional 2 week reserve that they never tap into, except to rotate it with fresh stock when they refill their prescriptions. I know that these days, it is hard to build a reserve supply of medicines when HMO’s literally monitor usage to the nearest pill, but there are still strategies with which one can accumulate a reserve (starting with purchasing the meds for cash, if possible). Then one should make sure to have whatever additional medicines could be anticipated to be needed on-hand in the event of serious illness (i.e a diabetic may need additional insulin to cover glycemic stresses due to flu, or may need additional oral meds to prevent HHNS [hyperglycemic-hyperosmolic nonketotic syndrome - very common in type II diabt]etics under severe illness conditions]). You should enlist the assistance of your Doctor in planning out what to have on-hand for this situation. It will be alot easier for the Doctor to speak to you by phone and tell you how to take a medicine which you have pre-positioned in your reserves than to have you visit his office or even call a prescription into a pharmacy for you to pick up.

Water: In a Level 1 situation, I would stock water out to fill the requirements of the entire family for the duration of the 2 week illness window. While I don’t anticipate losing water as part of any widespread failure of utilities, it is always possible that a local, or even household plumbing problem can shut down the supply till everyone is sufficiently well enough to tackle the repair.

Fuel for heat, Cooking, etc. - Here again, I don’t think that elaborate preparations in this regard are required for Level 1. Just enough to keep things running and livable in case of bad weather or some other possible hardware or localized system failure. You should already have provided for this in your Level 0 stock.

Batteries and Flashlights: Same as for fuel and heating supplies.

Information Resources: This would be a good time to compile a series of quick guides on what to do for anticipated health situatons, both flu in general, and the specific needs of any household members in particular. While the Web may still be fully available to you, how efficiently do you think you will be in looking up some critical care information for children or the elderly while you yourself are barely functional (I’ve had to do this once. It is really not what you want to be doing at that time). Pulling all of the information together into an easy to read and execute plan is something you should do now. It will also make sure that the first time you see the material is not during a crisis.

level 0 - ei ole pandeemiat

tavaline igapäevariskide olukord siis

Level 0 - No Pandemic.

This level represents the basic emergency preparations that any person should make in anticipation of adverse events occuring. Thus such potential hazards as Hurricane, Earthquake, Flood, Blizzard, Major Trucking Strike, Serious personal or family illness all carry with them the possibility that you may need to provide for your own needs for a limited period of time. Such needs may include backup lighting, water, medicines and food for a period of several days. If you live in a cold climate, emergency means of heating may also apply.

For a level 0 preparation, you should assume a period of at least 3 days in which you will be on your own, and provision accordingly. In a level 0 situation, you can also assume that normal societal support structures will resume after a few days of emergency.

From my previous posting, it should be obvious that while level 0 denotes no pandemic flu is present, it does not mean one should not prepare. The preparations which one should undertake for level 0 are those that would be needed to make it through any reasonable emergency situation. The supplies and provisions one sets aside must be tailored to their individual circumstances and means.

The areas of planning one needs to visit include Food and Water, maintenance medicines, family communications plans (how do you get in touch with spouse, children, parents, etc in the event things happen quickly), shelter, warmth and cooling, and any special needs one may have.

Basically, one should sit down and examine their daily life and determine everything they need on a normal day to function normally, and then provide themselves with a reserve supply sufficient for at least 3 days. (I personally prefer a week, but 3 days is adequate as a starting point). This includes items such as prescription medicines, a battery TV or radio, flashlight and batteries, toiletries, changes of clothing…….

With the exception of extra water and some of the other pieces of hardware, this level should not oblige you to purchase, stock or carry anything more than you would otherwise already have, unless you are living so close to the edge that you need to re-examine your lifestyle anyway.

etapiviisiline planeerimine

Fluwikie foorumis üks eriti metoodiline inimene :D lõi enda jaoks süsteemi,
kui ma õieti mäletan siis oli ta programmeerija vai süsteemianalüütik ;)
ja kuna ta lahkelt lubas seda levitada - ja mulle see süsteem meeldis - siis panen selle siia üles ka
jupikaupa, kuna päris pikk on teine

süsteem siis säärane, et määratles levelid, millise raskusega pandeemia võiks tekkida,
siis kirjeldas võimalikke riske sellise leveli korral - ning seejärel tõi välja vajalikud ettevalmistused iga etapi jaoks
pikk jutt, aga keda teema huvitab - võiks lugeda küll :)

The basic approach to this system is to define a series of possible levels of pandemic impact, and then determine what preparations you need to make for each. If you start with the lowest one and fully prepare for it first, then the next level up adds additional preparations, etc. Thus, as you prepare, you are fully “covered” for at least the lower levels, and then need only to add additional supplies or plans for the next higher levels.

In my personal case, I have defined 6 planning levels. In this and subsequent postings I will define what I consider the definition of each of the levels and what needs to be done to prepare for them (this is an ongoing effort, controlled to a great extent by the feedback and acceptance I see here in the forum)

The levels I use are:
0) No Pandemic
1) Pandemic impact about the same as a very bad seasonal flu outbreak
2) Pandemic impact worse than a severe seasonal flu outbreak
3) Impact approximates 1918 pandemic
4) Impact exceeds 1918 pandemic
5) Impact approaches pandemic plague

Guardian: linnugripp kui 21.sajandi must katk

Bird flu 'could be 21st-century Black Death'
Larry Elliott in Davos
Friday January 27, 2006
The Guardian link

Avian flu has the potential to develop into a global pandemic that would be as devastating as the Black Death of the 14th century, the World Economic Forum warned yesterday in its assessment of the risks threatening stability and prosperity.

In a worst-case outcome, experts charged with weighing up systemic dangers said there might be riots to gain access to supplies of vaccines, a collapse of public order, a partial flight from the cities and large-scale migration.

hm, huvitav, esimest korda vist kui ma näen võrdlust musta katkuga .. siiani on ikka võrreldud 1918.a. pandeemiaga
mustast katkust kirjutab wikipedia siin
soovitan lugeda, päris põnev :)
paar lõiku:
The Black Death was a devastating pandemic that first struck Europe in the mid-14th century (1347–50), killing about a third of Europe's population, an estimated 34 million people. A series of contemporaneous plague epidemics also occurred across large portions of Asia and the Middle East, indicating that the European outbreak was actually part of a worldwide pandemic.

In addition to its drastic effect on Europe's population, the plague irrevocably changed Europe's social structure, was a disastrous blow to Europe's predominant religious institution, the Roman Catholic Church, resulted in widespread persecutions of minorities such as Jews and lepers, and created a general mood of morbidity that influenced people who were uncertain of their daily survival to live for the moment.

It is estimated that between one-third and one-half of the European population died from the outbreak between 1348 and 1350. As many as 25% of all villages were depopulated, mostly the smaller communities, as the few survivors fled to larger towns and cities. The Black Death hit the culture of towns and cities disproportionately hard. Some rural areas, for example, Eastern Poland and Lithuania, had such low populations and were so isolated that the plague made little progress. Larger cities were the worst off, as population densities and close living quarters made disease transmission easier.

kommentaar samale artiklile linnugripifoorumist:

There were two epidemics in 15th century Iceland that killed 50%+ of the population- neither of which could have been Bubonic Plague. There were no rats in Iceland!!!

Plague without rats: The case of fifteenth-century Iceland
Journal of Medieval History
Volume 22, Issue 3 , September 1996, Pages 263-284
Gunnar Karlsson*

University of Iceland, Faculty of Arts, Sudurgata, 101, Reykjavik, Iceland

In the fifteenth century Iceland was ravaged by two epidemics which usually have been identified as plague. It is shown here that these epidemics were no less lethal than the Black Death in Europe. The first one probably killed half the population or more and persisted in the country for at least a year and a half. Since, for several reasons, it can safely be assumed that Iceland was not populated by rats at this time, this may offer the strongest available proof that an epidemic like the Black Death was not dependent on rats for its dissemination.

* GUNNAR KARLSSON is professor of history at the University of Iceland at Reykjavik. He has published on aspects of the history of Iceland in both the medieval and the modern periods.

26. jaanuar 2006

Tamifluvarud erinevatel riikidel

linnugripifoorumis (Curevents) tehtud kokkuvõte:

TAMIFLU ON HAND (in descending % of population);

Kuwait - 5M doses/2.4M citizens = 208% coverage (104% w/ full dose)
Canada - 35M/32.8M = 107% coverage (53% w/ full dose)
New Zealand - 835,000/4M = 21% coverage (10% full dose)
Australia - 3.5M/20M = 17.5% coverage (8.7% full dose)
Singapore - 500,000/4.4M = 11.4% coverage (5.7% full dose)
UK - 2.4M/60M = 5% coverage (2.5% full dose)
Jordan - 60,000/5.8M = 1% coverage (0.5% full dose)
USA - 2M/296M = 0.67% coverage (0.33% full dose)
California - 70,000/33M = 0.2% coverage (0.1% full dose)
Turkey - 100,000/70M = 0.1% coverage (0.07% full dose)

STATED GOALS (in descending % of population);

UK - goal 25% of population (~15M doses) by August (12.5% full dose)
Algeria - goal 7M/32.7M = 22% coverage (11% full dose)
Japan - goal 25M/127M = 19.6% (9.8% full dose)
USA - goal 20M/296M = 6.7% (3.3% full dose)
Spain - goal 2M (on order)/40M = 5% planned coverage (2.5% full dose)
UAE - goal 1M (on order)/2.5M = 4% planned coverage (2% full dose)


Virgin Air - 10,000 doses/ ? # of employees

hirmujutud :D

nõrganärvilistel mitte lugeda - ja noh, autor ei pidanud ka väga usaldusväärne olema :)
a kui närvid korras, siis võib ikka lugeda :D

By J. Grant Swank, Jr.
MichNews.com Jan 26, 2006

.. "If we had a significant worldwide epidemic of this particular avian flu, the H5N1 virus, and it hit the United States and the world, because it would be everywhere at once, I think we would see outcomes that would be virtually impossible to imagine," warns Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.

Avian flu could cause a billion humans to die globally, according to ABC News. That is why this week the Bush administration set in motion stockpiling $100 million worth of medicines. However, the vaccine is still in the experimental stage.

"Right now in human beings, it kills 55 percent of the people it infects," says Laurie Garrett, a senior fellow on global health policy at the Council on Foreign Relations. "That makes it the most lethal flu we know of that has ever been on planet Earth affecting human beings."

British officials are now spying out extra morgue square footage to those who would die because of the H5N1 virus. This virus type is brand new to the human race.

.. What concerns government officials worldwide is that many do not understand the magnitude of the problem. Newscasters are reluctant to hammer away constantly on the issue. Even politicians do not want to appear extremely panicky about avian flu. And therefore, nations go on their ways as if all is normal, no threat in sight, while huge populations remain uneducated about what could happen this winter.

Add to this the fact that the medicines are not equipped at present to combat the pandemic. Widespread disease occurrences would be practically impossible to ward off. That would mean that alarming numbers of humans would die without the hoped-for vaccine.

.. Thus far, infections have come from birds. But once the virus leaps from birds to human to human, then the pandemic sets loose. That would over-ditto the Spanish flu outbreak in 1918.

The avian flu could travel around the planet in a very short time. That is due to international air travel.

People would carry the virus on their hands. Therefore, shaking hands could spread the disease. Door handles and so forth could carry the virus. Whatever is touched could be contaminated.

Such widespread sickness could force blocking off entire geographies so that persons, quarantined, could not go out while others could not go in. Airports, interstates, subways, schools, shopping malls could end up blocked off to entrancing and exiting. Persons could be corralled with strangers who could be disease carriers.

The frightening prospects are numberless: no place to bury the dead. No one to bury them. Not enough caskets. No persons to provide decent burial rites. Orphans. Elderly struck down with no medical assistance. Hospitals shut down or quarantined.

Further, when the avian flu first hits, persons may think it to be the "old-fashioned flu." Therefore, it could spread quickly with persons not realizing the enormity of the danger. As a major killer disease, it would be subtle, indirect and especially cunning at its entry levels.

US Health and Human Services Secretary Michael Leavitt says: "We would do all we could to quarantine. It's not a happy thought. It's something that keeps the president of the United States awake. It keeps me awake." Leavitt says that he wishes there were more time left to perfect a solution.
ABC News’ "Primetime" broadcasts that a couple hundred thousand in the United States could be killed by the avian flu in "a few months." Even that number is regarded as low.

Everyone will be asking for the vaccine. But it won’t be available. When the vaccine finally is up and running, the supply will not be sufficient. Tamiflu by Roche pharmaceutical firm in Switzerland is on to a vaccine. It’s been marketed for flu. It was thought it may work against H5N1. Therefore, every aware nation was requesting Tamiflu in stockpiles. Only the rich countries, however, could get it. Even then, the supply was not up to what would be the demand. However, now it is believed that Tamiflu will not overtake a mutant virus.

25. jaanuar 2006

Nature - fiktsioon

26.05.04 Natures ilmunud lühike jutustus, kuidas võiks pandeemia areneda :D link

jutt lõppes sõnadega: Were we ready? Ready, my ass!

veel Oprahist ja Osterholmist

nobedad inimesed teevad märkmeid saate ajal ..
(he=Osterholm, she=Oprah)

paar huvitavamat lõiku

If the bird flu is anything like the 1918 pandemic, the highest death rates could actually be "those between the ages of 20 and 40." "In the months of September and October of 1918, 7 percent of the residents of Boston between 20 and 40 years of age died," he says.

How could individuals in the prime of their health be so susceptible to a disease? "It turns out that this virus multiplies very quickly in your body," Dr. Osterholm explains. "The people who have the healthiest immune systems are the ones that succumb to the virus because the immune system goes into overdrive."

The demographic least likely to survive the 1918 pandemic were pregnant women, Dr. Osterholm says. "Fifty-five percent of all pregnant women died from having this flu virus. There is no more precarious time in a healthy person's immune system, than [when they are] pregnant. Part of you says, 'Get rid of that [baby]. It's not all me.' And part of you says, 'This is the most precious cargo I'll ever carry. Protect it.'" This confusion makes bird flu extremely dangerous for pregnant women.
(ja ta jättis mainimata, et kuigi 45% haigestunud rasedadest jäi ise elama, siis loodetest ei jäänud praktiliselt keegi ellu)

Pandemics can last for up to two years, and since many of our medical supplies are shipped from overseas sources, Dr. Osterholm predicts that America will run out of masks, prescription drugs and other necessities before the threat is over.

Like the people of New Orleans learned, this is not the time to panic and feel hopelessness. It's the time to be prepared.
"What we have to do for pandemic flu preparedness is better prepare our world to get the living through it, the sick through it, and then come out the other end as well as we possibly can," Dr. Osterholm says. "That's the difference between being hopeless and hopeful. We're going to come out the other end…it's how well we can come out the other end."

arutlus rahvamälust

kommentaarid 1918a pandeemia kohta ja miks sellest eriti ei räägita

"Then, after it was over, no one wanted to talk about it, so it became lost in history."
It was so painful, they didn't want to speak of losing loved ones, or the bodies in the streets, doctors making housecalls and finding all had died,
(or, the people who hadn't lost anyone, or were born later, didn't want to hear about it; so depressing?)
so, between the war dead, the PTSD soldiers and the PTSD populace, wonder why people thought outlawing alcohol would solve some societal problems? Maybe they confused the symptom for the problem?
Very interesting: http://en.wikipedia.org/wiki/Roaring_twenties
does not even *mention* the Spanish flu pandemic!
Only keeps referring to "the end of WWI"

- history is written by who, taught by who, remembered by who, of interest to who?
Humans don't pass things along as carefully as perhaps they should.

24. jaanuar 2006

Nabarro: tegutseda tuleb nii nagu pandeemia algaks homme

jälle üks homne artikkel ;)

World must act as if flu pandemic imminent: UN official link


Many people appeared to be under the impression that they would have time to prepare for the widely feared pandemic but that was wrongheaded, Dr David Nabarro says.

"It's very hard to get people prepared for something that is as uncertain and unclear as this problem," Dr Nabarro said. "So many people, when I talk to them about getting prepared, seem to imply that we've got months in which to get prepared but I say to them: It may not be months. "It could be that we're going to get human-to-human transmission tomorrow so please act as though it's going to start tomorrow. Don't keep putting off the difficult issues."

The H5N1 bird flu virus has affected poultry flocks in the far east and Turkey, and has claimed some 80 human lives after spreading from birds to people. But experts fear the virus could mutate almost overnight and unobserved into a new form that would spread easily between humans and spark a repeat of the global influenza pandemics that killed tens of millions of people in the past century.

"There is a sensation for all of us who are working on this of standing on the edge of a really deep precipice and not knowing how far we're going to fall," Dr Nabarro said. "The moment the pandemic starts it's too late to get prepared."


oh, samast pressikonverentsist? teine artikkel veel: link

Senior UN System Coordinator for Avian and Human Influenza Dr. David Nabarro noted to reporters tUESDAY that he worries every day from receiving the news of a human to human transmission of the Avian Flu.
Nabarro said that "we are all standing on a deep edge and not knowing how far we are going to fall" when it happens. "Not only I am 'freaking out', to use the correspondents expression, and not mine, not only is that worry or anxiety because of the impact of a possible pandemic, but there is also that worry and anxiety because so many people when I talk to them about getting prepared seem to imply that we have months ahead to get prepared," he said. However he added that "I say to them it might not be months, it could be that we get human to human transmission tomorrow, so please act as though it is going to start tomorrow, don't keep putting off the difficult issues"."I am scared of the possible arrival of human influenza pandemic, everybody is scared of it," he said.

riikide pandeemiaplaanid

WHO kodulehele on üles riputatud terve hulga riikide pandeemiaplaane,
vt: link

eesti oma seal mõistagi ei ole - see on suuuuuur riigisaladus ;)

kes tahab lugeda mõnda - siis Uus-Meremaa oma on asjalik :)

ja majandus toimib siin ja seal ikka enamvähem samamoodi

milleks toiduvarud?

linnainimesel on heal juhul kodus paari päeva toidukogus ja väga paljud elavad praegu ühest poeskäigust teiseni ning kapis ja külmkapis haigutab tühjus :D

aga kui pood on kinni? mis siis saab?

"vanamoodsaid" taluinimesi, kel on sahver moose-mahlu täis, aidas kotid teravilja-soola-suhkruga, keldris kartulid-porgandid-hapukapsatünn ja soolatud siga .. neid on ikka väga vähe siiamaile alles jäänud

miks Osterholm räägib üldse toiduvarude soetamisest? sest kogu tänapäevane majandus on üles ehitatud JIT (just in time, täpselt õigel ajal) põhimõttele - mis tähendab seda, et tarneketid on pikad, igas etapis hoitakse varusid nii vähe kui võimalik (kulude optimeerimine!) ja muuhulgas tähendab see tohutut omavahelist sõltuvust, kui üks (või mitu) tarneketi lüli katkeb, siis on häda majas

kuidas saab näiteks piim poodi? talunik-auto-piimakombinaat-auto-pood ..
kuidas saavad ravimid apteeki? tooraine Aasiast, transport, toodetakse Euroopa maal, transport siia hulgimüüja juurde, hulgimüüja juurest apteeki ..

pood vajab omakorda toimimiseks elektrit ja sooja ja panka ja sideliine

igas punktis on hulk inimesi, kes töötavad - aga pandeemia korral on ennustatud töölt puudumist vähemalt 30%, kui mitte enam: surnud, haiged, paranejad; need, kes hoolitsevad kodus haigete eest või valvavad laste järele (kuna lasteaiad ja koolid on esimesed, mis suletakse); need, kes lihtsalt ei julge haigestumise kartuses tööle minna jne

sellistes tingimustes tagada süsteemi minimaalsetki toimimist on oi kui keeruline, rääkimata piisavast ..

elekter, internet, telefon, mobiilside, joogikõlblik vesi, toasoojus, kiirabi, tuletõrje, politsei - kõigi nende iseenesestmõistetavate asjade taga on inimesed - ja kui inimesi ei ole, või ei ole neid piisavalt - siis ka neid teenuseid EI ole

linnugripisurmad vanuste kaupa

1918a graafik vt alumist graafikut: link
enamus siis 15-25a

praegused andmed aga veidi erinevad:link

70% on alla 25a, üle poole alla 20a ..
vat see on üks ütlemata kurb statistika :(

see tuletab meelde paari veidrat asja ..

üks suvalise listi e-mail eelmisest suvest, kus muude segaste loodusnähtuste kõrval mainiti, et põlisrahvastel sünnib viimasel ajal väga vähe lapsi

Did you know that all over North America, migratory birds have stopped returning to their nesting grounds? And that salmon are no longer returning to their spawning grounds? And indigenous tribes throughout the world have stopped having children?”
Why would tribes stop having children? Maybe it’s because of their low survival rate during any process of change? Maybe because of the extra resources they take? Why would these things suddenly change?

ja siis teisest kohast kuuldud märkus, et üks eesti ennustaja, kes joonistab inimestele elukõveraid või midagi sellist :)
keeldub neid tegemast peale 2000.a sündinud lastele, kuna liiga paljudel neist pidi lühike kõver olema ..

CIDRAP info H5N1 kohta

Avian Influenza (Bird Flu): Implications for Human Disease link
Last updated January 23, 2006

väga pikk ja põhjalik jutt, konservatiivne ja ametlik info viirusest

Laboratory Testing for Influenza in Humans
Summary of Avian Influenza in Humans
The Current Outbreak of H5N1 in Birds and Other Animals
H5N1 in Humans: Epidemiologic Considerations
H5N1 in Humans: Clinical and Treatment Considerations
Vaccine Development for H5N1 Influenza
Current WHO and CDC Travel Recommendations
Use of Seasonal Flu Vaccine in Humans at Risk for H5N1 Infection
Surveillance Considerations
Influenza Pandemic Considerations
Infection Control Recommendations
Food Safety Issues

23. jaanuar 2006

ettevalmistatuse kasust

Planning for a disaster on our doorstep

üks päris mõistlik artikkel

paar lõiku:

.. we're overdue a serious flu epidemic, and when it arrive we're all going to know about it.

.. flu already kills 3,000 people across the UK each year and if it mutates into a superstrain scientists predict it will take them at least six months to come up with an effective vaccine.

.. We can't close our doors on it, either. It's been estimated that even if we were able to lock and bolt 99 per cent of the entry points to the county and pull up the drawbridge, it would only delay the arrival of the sneaky virus by a maximum of 10 days.

.. He's keen to increase public awareness of what risks we face, and what they can do if the worst comes to the worst. "If more people are able to help themselves, the emergency services will be able to concentrate on the vulnerable people who cannot," he said.

22. jaanuar 2006

ettevalmistused pandeemiaks

Planning for bird flu pandemic a community obligation

Arizona Daily Sun

Nobody likes to contemplate a disease that modern science seems powerless to cure.
Throw in a mortality rate of 50 percent, and there is good reason to plan early against panic.

That's what local health officials are doing as the avian flu advances westward from Southeast Asia into central Europe. Faced with life or death decisions, individuals tend to look out for their own interests and those of their immediate families first. But it's as a community that Flagstaff is likely to pull through such a crisis best.

The challenge is to recognize early that some tough decisions will have to be made, then make them.

* If there isn't enough vaccine to go around, who should get it first?
* Will all health and public safety workers be expected to remain on the job or be allowed to tend to their families?
* At what point will the sick and dying be told to stay home rather than come to the hospital and risk infecting others?
* How long will schools and businesses have to remain closed and will a citywide quarantine mean shutting off access by outsiders?

Those are all difficult ethical issues to ponder, but we should be thankful that we have the time and knowledge to address them in advance. From the bubonic plague of the Middle Ages to the Spanish Influenza of 1918 and even the polio outbreak in the early 20th century, most pandemics have struck without much warning and with little scientific understanding of their cause or cure.
loe edasi

21. jaanuar 2006

gripiviiruse säilimine erinevatel pindadel ja vees

* kõvadel, mittepoorsetel pindadel (teras, plastik) 24-48 tundi,
* paberil, riidel, salvrätikul 8-12 tundi,
* kätel peale nakkusega pinnaga kokkupuutumist kuni 5 minutit link

nood andmed siis toatemperatuurilt .. külmas seisab märksa kauem!

vees: 17 C juures kuni 207 päeva, 28 C juures 102 päeva link

linnusitas: 4 C juures 35 päeva, 37 C juures 6 päeva. link

külmunud linnulihas: mitmeid kuid

WHO uuendatud faktid linnugripi kohta

Avian influenza (" bird flu") - Fact sheet link
January 2006
The disease in birds
The role of migratory birds
Countries affected by outbreaks in birds
The disease in humans
History and epidemiology
Assessment of possible cases
Clinical features
Countries with human cases in the current outbreak

mõned lõigud:

Despite the infection of tens of millions of poultry over large geographical areas for more than two years, fewer than 200 human cases have been laboratory confirmed. For unknown reasons, most cases have occurred in rural and periurban households where small flocks of poultry are kept. Again for unknown reasons, very few cases have been detected in presumed high-risk groups, such as commercial poultry workers, workers at live poultry markets, cullers, veterinarians, and health staff caring for patients without adequate protective equipment. Also lacking is an explanation for the puzzling concentration of cases in previously healthy children and young adults.
When assessing possible cases, the level of clinical suspicion should be heightened for persons showing influenza-like illness, especially with fever and symptoms in the lower respiratory tract, who have a history of close contact with birds in an area where confirmed outbreaks of highly pathogenic H5N1 avian influenza are occurring. Exposure to an environment that may have been contaminated by faeces from infected birds is a second, though less common, source of human infection. To date, not all human cases have arisen from exposure to dead or visibly ill domestic birds. Research published in 2005 has shown that domestic ducks can excrete large quantities of highly pathogenic virus without showing signs of illness.
The incubation period for H5N1 avian influenza may be longer than that for normal seasonal influenza, which is around 2 to 3 days. Current data for H5N1 infection indicate an incubation period ranging from 2 to 8 days and possibly as long as 17 days. However, the possibility of multiple exposure to the virus makes it difficult to define the incubation period precisely. WHO currently recommends that an incubation period of 7 days be used for field investigations and the monitoring of patient contacts.


Initial symptoms include a high fever, usually with a temperature higher than 38oC, and influenza-like symptoms. Diarrhoea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients.
Watery diarrhoea without blood appears to be more common in H5N1 avian influenza than in normal seasonal influenza. The spectrum of clinical symptoms may, however, be broader, and not all confirmed patients have presented with respiratory symptoms. In two patients from southern Viet Nam, the clinical diagnosis was acute encephalitis; neither patient had respiratory symptoms at presentation. In another case, from Thailand, the patient presented with fever and diarrhoea, but no respiratory symptoms.
One feature seen in many patients is the development of manifestations in the lower respiratory tract early in the illness. Many patients have symptoms in the lower respiratory tract when they first seek treatment. On present evidence, difficulty in breathing develops around 5 days following the first symptoms. Respiratory distress, a hoarse voice, and a crackling sound when inhaling are commonly seen. Sputum production is variable and sometimes bloody. Most recently, blood-tinted respiratory secretions have been observed in Turkey. Almost all patients develop pneumonia. During the Hong Kong outbreak, all severely ill patients had primary viral pneumonia, which did not respond to antibiotics. Limited data on patients in the current outbreak indicate the presence of a primary viral pneumonia in H5N1, usually without microbiological evidence of bacterial supra-infection at presentation. Turkish clinicians have also reported pneumonia as a consistent feature in severe cases; as elsewhere, these patients did not respond to treatment with antibiotics.

haiguse äge faas

In patients infected with the H5N1 virus, clinical deterioration is rapid. In Thailand, the time between onset of illness to the development of acute respiratory distress was around 6 days, with a range of 4 to 13 days. In severe cases in Turkey, clinicians have observed respiratory failure 3 to 5 days after symptom onset.


Full Color Poster
Infection Control Handout link

a miks ei ole sääraseid olemas eesti keeles? :D

20. jaanuar 2006

Cheney - pandeemia võib põhjustada olulisi probleeme majandusele

WASHINGTON, Jan 20 (Reuters) - Vice President Dick Cheney said that if avian flu were to arrive in the United States, it could deal a blow to the U.S. economy because of disruptions to businesses, schools and transportation systems.
"It's the kind of thing I think that probably would have a major impact," Cheney said in an interview with radio talk show host Hugh Hewitt.

"I think also when you start to think about a pandemic, some of the early measures basically are to shut down transportation systems, close schools and public meeting places and so forth in order to minimize the possibility of transmission," Cheney said.

H5N1 avian influenza now mostly affects birds but it has occasionally jumped to people, killing just around 80 in six countries. The fear is that the virus could mutate into a human influenza, spread quickly and kill millions globally.
"There are things clearly that would have significant economic consequences were there to be such a pandemic," he added.link

1918 - west virginia

1918 flu pandemic ravaged W.Va. link/

mõned lõigud pikemast jutust:

An October 1918 letter written by a 16-year-old boy from Iowa paints a grim picture of Kanawha County. The Sioux Falls farm boy had traveled to Nitro to look for work. Upon entering the valley, his first sight was the unloading of boxes of soldiers' bodies at the Nitro train station. They hadn't been killed in the line of duty, but by the flu.

"Olive (a cousin) stayed with us most of the time as the rest were down with the flu," Spencer wrote. "We had a little burn side stove with a little flat rim around the top of it. Mom kept onions roasted on it all the time, and (we) would eat them. Mom would give us a little hot toddy to drink. It was made with a little whisky, water and sugar. We were told that would keep down the flu. It must have worked because the three of us didn't have it. There were a lot of people sick...and whole families died."

Fred and Molly Bennett had one of the most harrowing stories. In October 1918 their only child, a daughter, died from the flu. In April 1919, Molly gave birth to another baby, but Molly died two days later from complications of the sickness. In the following weeks Molly's sister and brother-in-law also died, leaving five children behind. Those children were sent to an orphanage, along with Molly's tiny newborn, who was delivered there in a cigar box by her father, Fred, the only other surviving member of the entire family. Heartbroken over the death of his wife and oldest daughter, and assuming his tiny newborn also would perish, Fred Bennett left Curtin and never returned.

Day-to-day life in 1919 became unrecognizable. Schools ground to a halt; markets, stores and banks shut down because there was no one to run them; and families barricaded themselves inside their homes, sometimes with little food and no supplies, in a vain attempt to keep away from the virus. As doctors began coming down with the same illness afflicting their patients, even rudimentary medical care was hard to come by.

Records from the West Virginia School for the Deaf and Blind in Romney reveal a two-month flu outbreak in the fall of 1918 that almost spelled disaster for the entire town. In the end, four students and teachers at the school died, but more than 200 became critically ill. "The school hospital and dormitories were filled with the sick," records said. "Four nurses were secured, but they soon became patients. The nursing fell upon the remaining teachers and officers and a number of voluntary residents of Romney."

pandeemiamälestused Edmontonist

Vivid Memories of Deadly Flu Epidemic, Edmundton Canada Sun
With fears of a deadly flu pandemic simmering in the national consciousness, two local seniors can't help but recall the deadly outbreak of Spanish influenza that claimed 70 million lives worldwide in 1918.

That virus - named for its early high mortality rate in Spain - originated in the Middle East in the spring of 1918 and killed by causing symptoms like bronchial pneumonia, heliotrope cyanosis and septicemic blood poisoning.

"It was a horrible time," recalled Lilian Hosking, 101. She lived in Wales during the outbreak, and says she was 14 when she contracted the virus. "I was in great pain, I couldn't leave my bed. I remember banging my head against the rails of my bedframe because of the pain. "But I got over it."

Hosking said her father later told her it was garlic that saved the nation from decimation.
"He said our neighbours never got it because they put raw garlic up all over their home - bags and wreaths of it everywhere," she said. "He didn't know if the garlic ate the germs, or if it just kept sick people from visiting because it smelled, but he said the neighbours swore by it."

Beatrice Taylor, 92, remembers her mother making masks out of gauze for the family to wear when they ventured outside. "I can remember going out and having to wear this mask. And you avoided being in crowds," said the Edmonton senior. "There were so many of our friends who either got very sick or passed away."...

(jutt arhiveeritud foorumisse ühest kanada ajalehest, artiklit enam veebis ei olnud)

1918 - Milwaukee

positiivne näide, kuidas kohati suudeti edukalt pandeemiaga hakkama saada .. ja võibolla on siit ka midagi õppida

Looking Back on an Epidemic - How Milwaukee fought the Spanish flu link
By George Wagner

While the Bubonic Plague killed a quarter of Europe’s population in the 14th century, the Spanish Flu of 1918 was more lethal. The wartime flu outbreak killed an estimated 25 million to 100 million people worldwide, 600,000 in the United States, 8,500 in Wisconsin and 1,600 in the city of Milwaukee. Unlike most flu seasons, this time those in the prime of life were most at risk—adults between the ages of 20 and 40.

Despite these alarming numbers, Milwaukee (and Wisconsin) had the lowest rate of infection of larger U.S. cities. That can be credited to a solid public health infrastructure that responded quickly to the threat.

This nastier strain usually brought typical influenza symptoms: fever, chills, muscle aches, headache, dry cough, lethargy. For the lucky, symptoms would subside after a few days or a week and not return. Many others, however, experienced serious complications—most often pneumonia—after briefly recovering. A good number of these pneumonias developed into what is called heliotrope cyanosis. The end would often come within 48 hours amidst gasping for breath, purple skin and coughing up blood.

Most ominously, the contagion was airborne. An infected person entering a crowded room could infect all present. Flu viruses could remain alive indoors for hours, infecting the unwary long after the carrier had departed. The virus could spread at will in crowded schools, churches, markets, theaters, offices and factories. To control the contagion, the sick were isolated and public places were closed.

On Oct. 10, as the deadly flu spread throughout Wisconsin, state Health Commissioner Harper ordered the closing of all public institutions. Steven Burg writes that Wisconsin was the only state to order the closing of all schools, churches, theaters, places of amusement and public gatherings. Most factories could remain open, although stores were required to curtail hours. Within a day nearly all local health boards, including Milwaukee, had complied.

Milwaukee sprang into action.
The Common Council conferred sweeping powers upon the health commissioner to combat the epidemic.
Temporary isolation hospitals were opened, including one at the Auditorium.
Health care workers and volunteers gave four-minute lectures to workers in factories.
Laid-off teachers went door-to-door throughout the city to inventory citizens’ health.
Notices were printed in papers.
Leaflets in several foreign languages were distributed.
Precautionary posters warning of contagion went up everywhere.
Businesses, such as billiard parlors, could be fined $100 a day if caught unlawfully opened.

In the October-November 1918 Bulletin of the Health Department, Ruhland wrote that these closings could do no more than “stagger the peak in incidence of infection.” But by avoiding the simultaneous large number of cases, he hoped to avoid the breakdown of the health infrastructure that had happened in Boston and Philadelphia, where thousands of new cases a day had overwhelmed the authorities.
The closings may have slowed the contagion’s spread, but isolating patients once they were sick was the only practice that seemed to make a difference.
Why did Milwaukee fare so well?
Certainly, the density of Milwaukee’s population would seem to have encouraged the contagion’s spread. Yet a solid public health system; quick and steadfast official decisiveness on issues of isolation and closings; cooperation across the public-private sector; massive volunteer efforts; a dedicated cadre of health professionals who stayed on the job; and a compliant public all added up to success.

pandeemia korral probleeme toiduainetega

The Science and Technology Committee said a pandemic is likely to cause shortages of food and other essential supplies because of workers being off the job sick.

While the peers said Britain is better prepared than most countries, more needs to be done. "It is going to affect everybody in all walks of life," Labor peer, Lord Mitchell, said. "Distribution networks in this country -- as we saw through the petrol crisis -- are very finely balanced and any interruption can affect it quite dramatically. link

19. jaanuar 2006

Eriti Karm Gripiravum

MASTER TONIC - A Natural Antibiotic

Raw Unfiltered Unbleached Non-distilled Apple Cider Vinegar
1 part fresh chopped garlic cloves
1 part fresh chopped White Onion (or hottest onions)
1 part fresh grated Ginger Root
1 part fresh grated Horseradish Root
1 part fresh chopped Cayenne Peppers or the hottest peppers available, i.e. Habanera, African Bird, or Scotch Bonnets, etc.

Fill a glass jar 3/4 of the way full w/equal parts by volume (i.e. a cupful each) of the above fresh chopped and grated herbs. Then fill jar to the top with RAW, Unfiltered, unbleached, non-distilled apple cider vinegar. Close and shake vigorously and then top off the vinegar if necessary.

Shake at least once a day for two weeks then filter the mixture through a clean piece of cotton (old T-shirt, etc.), bottle and label. Make sure that when you make this tonic that you shake it every time you walk by it, a minimum of once per day. Remember that all the herbs and vegetables should be fresh (and organically grown if possible) and use dried herbs only in an emergency.

This tonic is extremely powerful because all the ingredients are fresh. Its power should not be underestimated. This formula is a modern day plague tonic and when added to an incurable routine it can cure the most chronic conditions and stubborn diseases. it stimulates maximum blood circulation, while putting the best detoxifying herbs into the blood. This formula is not just for the sniffles, it has helped to turn around the deadliest infections like some of the new mutated killer viruses that defy conventional antibiotics.

The dosage is 1/2 to 1 ounce, two or more times daily (1-2 Tbs.). Gargle and swallow. (DON'T DILUTE with WATER.)

For ORDINARY infections, 1 dropper full taken 5-6 times a day will deal with most conditions. It can be used during pregnancies, is safe for children (use smaller doses and as a food is completely non-toxic. Make up plenty as it does NOT need refrigeration and LASTS INDEFINITELY WITHOUT ANY SPECIAL STORAGE CONDITIONS.

Ingredient properties:
-Garlic cloves (anti-bacterial, anti-fungal, anti-viral, anti-parasitical)
-White Onion, or hottest onions available (similar properties to garlic)
-Ginger Root (increases circulation to the extremities)
-Horseradish Root (increases blood flow to the head)
-Cayenne Peppers, or the hottest peppers available, i.e. Habanera, African Bird, -or Scotch Bonnets, etc. (a great blood stimulant).

Pro-biotic: antiviral, anti-bacterial, anti-fungal and anti-parasitical.

ainuüksi selle retsepti lugemisega purskuvad pisarad silmist suurte kaartena, nii et ilmselt põgenevad ka kõik viirused kabuhirmus ;)
katsetused ainuüksi igaühe enda vastutusel

1918.a. gripipandeemia mälestused Torontost

ühtlasi palve - küsige, kas teie vanemad sugulased mäletavad midagi 1918a gripipandeemiast Eestis ja kirjutage siia kommentaaridesse :)

lugu 1.
In the fall of 1918, Clara was a young woman and lived with her mother in a small apartment near the Danforth and Jones Ave. When her mother became sick, the doctor was summoned. "It's the flu," he said after a brief examination. "She's in God's hands."

Coughing and shaking from fever and chills, her mother grew weaker with every passing hour. Nothing Clara did seemed to help. Worried and frightened, she kept glancing out the bedroom window of their second-floor apartment, watching the endless line of hearses and carts that wheeled up the puddles and ruts of Danforth, then a dirt road. As far as you could see, nothing but mourners and their sad processions.

It had been days and days of families bringing their dead to the cemeteries on the outskirts of Toronto. It seemed to Clara that the flu was killing everyone it touched. As she sat there worrying and listening to her mother's raspy breaths, she noticed a big barrel of oranges in front of the corner grocery across the street. She didn't know whether it would help or not, but she just had to get some oranges.

Pocketing a few coins, Clara threaded her way through the endless line of mourners jamming the street, and marched up to the grocer's store. She had enough money for nearly a dozen oranges, and she spent every cent. One by one, the grocer dropped them into a paper bag.

Clara raced back across the street and up the stairs to her mother. She sliced open each orange, and squeezed all the juice into a cup. Teaspoon by teaspoon, she held them to her mother's lips. It took hours to finish all the juice.
By morning, her mother's fever had all but disappeared, and in a few days, was gone. And the Spanish flu that only days before had been taking the lives of young and old seemed to just fade away. Fewer and fewer mourners trudged along the Danforth. Soon enough, they stopped.

lugu 2
In 1918 my grandfather Dr. Charles W. L. Clark was a doctor in Toronto. He was one of the few ear, nose and throat specialists in this city but during the flu epidemic everybody with any kind of medical background was pressed into service. He was seeing patients day and night in their homes. He often spoke of how terrible it was to answer those house calls only to find that his patients had died.

He described one particularly tragic incident when he arrived at a patient's home late in the evening, his last call of the day. No one answered the front door, but it was open, so he went in. He found two children dead in the living room, then went upstairs and found the mother dead in the bedroom with her baby dead in the bassinette beside her.
link artiklile

huvitavad kommentaarid Hiina majanduse kohta

võibolla ei tähenda eriti midagi, võibolla tähendavad - huvitavad faktid nii või naa :)

foorumikommentaarid siis, linki ei ole

China has far more cash reserves than it needs compared to short term debt (one standard measure). In fact, China's total reserves to GDP ratio are approximately 50%. Cash reserves of 1% would be considered generous. 2 International Monetary Fund economists (Aizenmann and Lee) concluded that China is building its reserves "as a precaution against a crisis".

China has purchased a very, very, very large amount of strategic resources, fuel, wood, metals, grains, and they pay for it via their exports to western countries.

haiglatel soovitatakse pandeemia korral kasutada triaazhi abivajajate hindamiseks

Hospitals will have to use triage procedures devised for battlefield casualties to cope in the event of a bird flu pandemic, a Canadian critical care expert has warned.

.. Military-style battlefield triage may be needed at peak times when patient numbers outpace the number of beds, ventilators, the supplies and drugs and the number of people needed to tend to them, Dr Hawryluck told the seminar

"The military had used triage systems for many years," she said. Her system has already adopted the military color codes for patients, she said.

"The red people would be the highest priority for ICU care," she said. "Yellow - those are the people you know they might do well with ICU care, they might do well without, it would be nice if the resources were available," she added. People deemed "blue" or "black" would receive only palliative care - to reduce pain and suffering while they died, while people given a "green" rating would not require immediate attention. link

SODIS - kodune vee desinfitseerimismeetod

The Solar Water Disinfection (SODIS) process is a simple technology used to improve the microbiological quality of drinking water. SODIS uses solar radiation to destroy pathogenic microorganisms which cause water borne diseases.

SODIS is ideal to treat small quantities of water. Contaminated water is filled into transparent plastic bottles and exposed to full sunlight for six hours. link

suvisemal poolaastal ehk isegi siinkandis kasutatav

ülevaade pandeemiaohust -powerpoint

päris huvitav ppt ettekanne: link
ja sealt alla laadida siis PowerPoint Presentations - Overview of the Pandemic
mh küsitleti hulka eksperte ja tehti kokkuvõte nende arvamustest

mõnede slaidide tekst:

What are the most important consequences of a worst-case outbreak other than morbidity and mortality?
* Commerce disruption - transportation, communications, bankruptcy, economic depression

* Health care disruption - hospital overload, shortage of staff, shortage of supplies

* Food shortages - famine, disruption of supplies to the poor, deaths from shortages

* Public safety disruption - lawlessness, violence, public panic

* Political unrest - loss of trust in government, wars over shortages, rise in fascism, global terrorism

* Social fabric disruption - hHuman suffering and loss, migration

* Long-term effects - demographic, psychological

Summary of consensus predictions:
* How likely is a pandemic? 15% of experts; 60% of “experts” believe there will be a pandemic within 3 years; nearly 90% think there will be a pandemic in our children or our grandchildren’s lifetimes
* How many people will become ill in such a pandemic, worldwide? 650 million to 2.8 billion
* What will be the case-fatality rate? 3 to 7%
* How many people will die in this pandemic? 25 million to 165 million
* Will we have sufficient vaccine when a pandemic begins? Nearly all experts say no.
* Will we have sufficient anti-virals when a pandemic begins? Nearly all experts say no.
* The non medical social costs of a pandemic may well exceed the costs due directly to morbidity and mortality.

miks Türgis ainult lapsed surevad?

sellele ei tea vastust keegi :(

arvatakse, et vastus võib olla mingi kombinatsioon järgmistest põhjustest:
- ida-Türgis on 80%! elanikest alla 18a vanad, 8-10 last peres on tavaline,
- kodulindude eest hoolitsemine on laste töö,
- kuna lindude grippe on olnud ennegi, siis täiskasvanutel võib olla veidi immuunsust (üks suhteliselt suvaline arvamus),
- lapsed on väiksemat kasvu ja seega linnusitale lähemal,
- laste hügieenikombed on täiskasvanute omast viletsamad (mustade kätega puudutab nägu, ei pese käsi enne sööki jne),
- lapsed mängivad kanadega ja peavad neid lemmikloomadeks

nakatumisest lindude väljaheite kaudu

tervisekaitseinspektsiooni kodulehelt: link

Küsimus: Kas linnugrippi võib nakatuda ka nii, et astud jalanõuga haige linnu väljaheitesse ning siis puutud kokku selle jalanõuga või vaibaga, kuhu oled astunudd?

Haige linnu väljaheitest nakatumine on võimalik – vaibale sattunud väljaheide kuivab kiiresti ja tolmuga võib viirusi sisse hingata. Samal põhjusel ei soovitatagi (eriti lastel) viibida linnutoitmise kohtades, kus on nii väljaheiteid kui ka tolmu – väike laps on ninaga ohule vähemalt 1 meeter lähemal kui temast pikem täiskasvanu.

Kui tuppa tulles on jalanõud saastunud, siis tuleb need (ja ka vaip) vee-seebiga puhastada ja pärast seda käed hoolega puhtaks pesta. Käte pesemine on päästva toimega ka paljudest teistest haigustekitajatest lahti saamiseks ja enda kaitsmiseks. Seda teadmist peaks lastele varakult sisendama hakkama.

linnuliha tarbimisest

raadiost just öeldi, et Venemaa keelas Ukrainast lihaimpordi, kuna võib olla ohtlik inimeste tervisele

tervisekaitseinspektsiooni kodulehelt soovitused linnuliha käsitlemiseks:link

* Töödelge toorest ja keedetud/küpsetatud linnuliha ning muid toiduaineid eraldi (eraldi laud, nuga, nõud).

* Peske käsi toore ja keedetud/küpsetatud linnuliha ning muude toiduainete töötlemise vahel.

* Ärge sööge ega kasutage toiduvalmistamisel tooreid ja poolvedelaid mune.

* Peske käsi pärast toore, külmutatud ja ülessulatatud linnuliha ja kanamunade käitlemist.

* Kuumtöödelge (keetke, küpsetage) linnuliha ja kanamune: liha sisemuses peab temperatuur tõusma vähemalt +70°
C-ni (soovitatavalt +74°C); muna ei tohi olla vedel või poolvedel.

* Ärge sööge toorest linnuliha ja tooreid mune.

kui kiiresti inimene sureb linnugrippi?

vastus siis ühte foorumisse, kopeerin siia ka ..

veidi otsisin, parim allikas, mis leidsin: link

räägib ajast siis järgmist:
peiteaeg: keskmiselt 2-5 päeva, maksimum 8-17 päeva

surm saabus keskmiselt 9-10 päeva jooksul peale haigestumist, enamus patsiente suri "progressive respiratory failure" - ma ei oska seda tõlkida, aga põhimõtteliselt kopsud lihtsalt hävivad ..

siiani on kinnitatud H5N1+ surnud umbes pooled,
Türgis on kinnitatud juhtumeid 21, surnud siiani 4
21 haigestunust 18 on olnud lapsed, surnutest olid kõik lapsed ..

18. jaanuar 2006

gripiviiruse mutatsioonid tekitavad muret

Scientists studying virus samples from the human outbreak of avian flu in Turkey have identified three mutations in the virus's sequence. They say that at least two of these look likely to make the virus better adapted to humans.

The Turkey outbreak is unusual, because of the large family clusters of cases; the fact that many of those infected have only mild symptoms; and the speed with which infections have arisen — twenty cases, including four deaths, in less than two weeks. So scientists are urgently trying to establish whether the virus is behaving differently in this outbreak from previous ones in Asia. In particular, international teams are investigating the possibility that the virus is moving between people.

"With such a large number of cases within such a short period of time, human-to-human transmission is something that we've had to consider," says Maria Cheng, a spokeswoman at World Health Organization (WHO) headquarters in Geneva.

jutt läheb edasi sealt

17. jaanuar 2006

erinevad kalkulatsioonid

erinevad tõenäosused ja siis tulemused - eks too üks numbritega mängimine muidugi ole .. reaalseid numbreid ei tea keegi

erinevad nakatumise määrad ja nakatunute surevusmäärad ja nende erinevad kombinatsioonid

Influenza Pandemic Level Analysis

US Population 297,702,697
World Population 6,480,130,950
Low infection 25%
Med infection 50%
High infection 75%
Low mortality 4%
Med mortality 8%
High mortality 12%
Very high mortality 50% - (praegune reaalne väikese arvu nakatunute juures, jätkuks pandud siia)

Level Infect % - Kill % - Tot % - US deaths - World Deaths - Comments
I Low (25%) - Low (4%) - 1% - 2,977,027 - 64,801,310 - WHO's worst case
II Low (25%) - Med (8%) - 2% - 5,954,054 - 129,602,619
III Low (25%) - High (12%) - 3% - 8,931,081 - 194,403,929
IV Med (50%) - Low (4%) - 2% - 5,954,054 - 129,602,619 - 1918 infection rate
V Med (50%) - Med (8%) - 4% - 11,908,108 - 259,205,238
VI Med (50%) - High (12%) - 6% - 17,862,162 - 388,807,857
VII High (75%) - Low (4%) - 3% - 8,931,081 - 194,403,929
VIII High (75%) - Med (8%) - 6% - 17,862,162 - 388,807,857
IX High (75%) - High (12%) - 9% - 26,793,243 - 583,211,786

X .Low (25%) - VHigh (50%) - 12.5% - 37,212,837 - 810,016,369
XI Med (50%) - VHigh (50%) - 25.0% - 74,425,674 - 1,620,032,737
XII High (75%) - VHigh (50%) - 37.5% - 111,638,511 - 2,430,049,106

progressiivne Uus-Meremaa planeerib juba orbude paigutamist ..

Uus-Meremaa on ikka teistest riikidest mitu penikoormat ees oma ettevalmistustega :D
alles oli uudis, et massihaudade asukohad on välja valitud, täna on siis uudis, et orbude majutust planeeritakse..

Hundreds of children left parentless in a flu pandemic would be housed in makeshift orphanages in community halls or maraes, Child, Youth and Family (CYF) says.
Details of CYF's plan for coping with extra orphans comes as New Zealand health chiefs confirmed a bird flu pandemic was inevitable. link


CYF quality assurance general manager Bernadine MacKenzie said the department estimated 200 children would be orphaned when both parents died, and 800 more would need alternate care because one parent had died and other caregivers were critically ill.

The first option for orphans would be placing them with CYF-approved family, friends or foster parents, but with many people unlikely to want children who had been exposed to the virus, other options were needed, MacKenzie said.

It was likely CYF would create orphanages in community buildings such as empty schools, town halls or maraes, she said.

These orphanages would be manned by CYF workers, although staff numbers were expected to be well down, with a predicted 50 per cent of employees either dead, ill or caring for sick members of their family.

MacKenzie said social workers dressed in masks, gloves and aprons would continue to go into homes to investigate critical cases of suspected child abuse.

The draft report into CYF's flu pandemic plans would be finished next month, she said.

Acting director of New Zealand public health Dr Ashley Bloomfield said that while authorities did not know when there would be a bird flu pandemic, an outbreak was inevitable.

Bloomfield said New Zealand was following the advice of the World Health Organisation and preparing for an outbreak.

This included sending information to every home in New Zealand.

jahaa .. millal Eesti sinnani jõuab? :D

kirjeldus Argentiina igapäevaelust

ühes foorumis toodud kirjeldus elust Argentiinas peale riigipööret, annab päris hea ettekujutuse, milline on elu ühes tõsiselt p...ssekukkunud majandusega riigis (30+ vanuses isikud mäletavad küll ka 1990.a. algust talongimajanduse ja tühjade lettidega :D) link

oluline võiks olla lugeda seda sessuhtes, et seal on ka soovitusi, et kui on võimalik teha ettevalmistusi Jamaks Ajaks, siis millised need võiks olla ..

uuring potentsiaalsest pandeemiaohvrite arvust

Tegi miski säärane asutus nagu Insurance Information Institute uuringu, et kui palju siis võiks potentsiaalse pandeemia korral inimesi Ameerikas otsa saada - ja mis see kindlustustele maksma võiks minna. link

Although many variables could affect the number of people who could catch and die from the H5N1 flu, the U.S. Department of Health and Human Services (HHS) projects that in a severe influenza pandemic 1.9 million people in the United States could die. That figure was reached working largely from the experience of the 1918 pandemic—to date, the deadliest and most infectious known influenza strain. Laurie Garrett, extrapolating from the recent H5N1 outbreaks, calculates an “extreme… worst case scenario,” based on an assumption of 80 million Americans infected and a mortality rate of 20 percent, namely 16 million deaths.

Huvitav oli võrdlus 1918.a. pandeemiaga, et mis on selle ajaga võrreldes parem ja mis halvem.

Here are some of the most obvious changes regarding influenza from 1918 to today:
�� In 1918 there was a world war underway, which created higher-than-normal concentrations
of people in barracks and other assembly places, plus frequent and large-scale movement
of people to places where outbreaks had not occurred, facilitating the transmission of the
�� In 1918 a high proportion of U.S. medical resources were sent to Europe to serve the war
effort, further tilting the odds in favor of viral transmission in the United States because
medical resources here were unusually scarce.
�� The modern medical community now understands that influenza is a virus and has a better
understanding of how to constrain the spread of viruses.
�� Some of the deaths associated with the 1918 virus were due to bacterial pneumonia and
other conditions that “took advantage” of the weakened immune systems of those infected;
modern antibiotics can fight these secondary infections quite effectively.
�� Although there is no “cure” for influenza, some antiviral drugs (such as Relenza and
Tamiflu) and vaccines have been developed (although testing has not been completed)
that could mitigate the effect of the H5N1 strain; furthermore, the science and technology
necessary to develop vaccines is much more advanced.
�� Detection and confirmation of the presence of a virus is more rapid today; the World Health
Organization has 133 centers in 84 countries to collect and analyze viruses.
�� Through the Internet, television, cell phones and other means of communication, we can
disseminate information about the virus more quickly to more people in more places than
was possible in 1918.
�� We have better, and more specialized, health care facilities and equipment—emergency
rooms, intensive care units, mechanical ventilators, etc.—that can mitigate secondary
�� Countries are actively taking measures to prevent the virus from spreading, including
destroying diseased birds, vaccinating healthy birds,stockpiling antiviral medicines for
humans, planning quarantine scenarios, and conducting simulated outbreaks to train first
responders and medical professionals.

On the other hand, there are several reasons a new influenza pandemic could be as bad as, or
even worse, today than in 1918:

�� Widespread commercial air travel and extensive shipping of food (especially poultry
products) internationally create many more transmission opportunities and a means for
rapidly spreading contamination and infection.
�� The standard techniques for creating a vaccine for this virus might not work, or might not
work quickly enough (it takes roughly six months using current technology), to produce a
large enough supply early enough to inoculate even the highest risk groups, particularly if
two doses are required for the vaccine to be effective, (recognizing that for a vaccine to
work at all, it must be administered before a patient becomes ill from the virus).
�� The U.S. government’s recently issued pandemic response plan calls for states and
localities to be the main providers of health and other services and to pay for 75 percent of
the cost; many states will be hard pressed to come up with the money or the services
For antiviral medicines (as opposed to vaccines) to be effective, they must be administered
within 48 hours of exposure to the virus, and must be taken for five days or else they are
ineffective—those infected might not be able to get the medicine quickly enough or obtain
a sufficient supply to maintain the medicine’s effectiveness.
�� As noted earlier, some people in 1918 had a limited immunity to the virus because of
exposure to similar viruses in the several decades that preceded its arrival; that is not the
case today.
�� With the spread of HIV15 and the use of radiation and chemotherapy for cancer treatment,
many people today have compromised immune systems and may be less able to fight off a
virulent influenza strain.
�� The new virus could prove to be much more lethal than any previous virus.

100 asja, mis kaovad poodidest esimestena

Sarajevo sõjakogemuste kohaselt kaovad poodidest esimestena:link

1. generaatorid
2. veefiltrid/puhastajad
3. ajutised kempsud
4. kuiv küttepuu
5. lambiõli ja õlilambid
6. Coleman Fuel.
7. relvad, laskemoon, pipragaas, noad etc
8. käsi-konserviavajad
9. mesi, siirupid, suhkur
10.riis, oad, nisu

11. Vegetable Oil (for cooking) Without it food burns/must be boiled etc.,)
12. Charcoal, Lighter Fluid (Will become scarce suddenly)
13. Water Containers (Urgent Item to obtain.) Any size. Small: HARD CLEAR
PLASTIC ONLY - note - food grade if for drinking.
16. Propane Cylinders (Urgent: Definite shortages will occur.
17. Survival Guide Book.
18. Mantles: Aladdin, Coleman, etc. (Without this item, longer-term lighting is
19. Baby Supplies: Diapers/formula. ointments/aspirin, etc.
20. Washboards, Mop Bucket w/wringer (for Laundry)
21. Cookstoves (Propane, Coleman & Kerosene)
22. Vitamins
23. Propane Cylinder Handle-Holder (Urgent: Small canister use is dangerous
without this item)
24. Feminine Hygiene/Haircare/Skin products.
25. Thermal underwear (Tops & Bottoms)
26. Bow saws, axes and hatchets, Wedges (also, honing oil)
27. Aluminum Foil Reg. & Heavy Duty (Great Cooking and Barter Item)
28. Gasoline Containers (Plastic & Metal)
29. Garbage Bags (Impossible To Have Too Many).
30. Toilet Paper, Kleenex, Paper Towels
31. Milk - Powdered & Condensed (Shake Liquid every 3 to 4 months)
32. Garden Seeds (Non-Hybrid) (A MUST)
33. Clothes pins/line/hangers (A MUST)
34. Coleman's Pump Repair Kit
35. Tuna Fish (in oil)
36. Fire Extinguishers (or..large box of Baking Soda in every room)
37. First aid kits
38. Batteries (all sizes...buy furthest-out for Expiration Dates)
39. Garlic, spices & vinegar, baking supplies
40. Big Dogs (and plenty of dog food)
41. Flour, yeast & salt
42. Matches. {"Strike Anywhere" preferred.) Boxed, wooden matches will go first
43. Writing paper/pads/pencils, solar calculators
44. Insulated ice chests (good for keeping items from freezing in Wintertime.)
45. Workboots, belts, Levis & durable shirts
46. Flashlights/LIGHTSTICKS & torches, "No. 76 Dietz" Lanterns
47. Journals, Diaries & Scrapbooks (jot down ideas, feelings, experience;
Historic Times)
48. Garbage cans Plastic (great for storage, water, transporting - if with
49. Men's Hygiene: Shampoo, Toothbrush/paste, Mouthwash/floss, nail clippers,
50. Cast iron cookware (sturdy, efficient)
51. Fishing supplies/tools
52. Mosquito coils/repellent, sprays/creams
53. Duct Tape
54. Tarps/stakes/twine/nails/rope/spikes
55. Candles
56. Laundry Detergent (liquid)
57. Backpacks, Duffel Bags
58. Garden tools & supplies
59. Scissors, fabrics & sewing supplies
60. Canned Fruits, Veggies, Soups, stews, etc.
61. Bleach (plain, NOT scented: 4 to 6% sodium hypochlorite)
62. Canning supplies, (Jars/lids/wax)
63. Knives & Sharpening tools: files, stones, steel
64. Bicycles...Tires/tubes/pumps/chains, etc
65. Sleeping Bags & blankets/pillows/mats
66. Carbon Monoxide Alarm (battery powered)
67. Board Games, Cards, Dice
68. d-con Rat poison, MOUSE PRUFE II, Roach Killer
69. Mousetraps, Ant traps & cockroach magnets
70. Paper plates/cups/utensils (stock up, folks)
71. Baby wipes, oils, waterless & Antibacterial soap (saves a lot of water)
72. Rain gear, rubberized boots, etc.
73. Shaving supplies (razors & creams, talc, after shave)
74. Hand pumps & siphons (for water and for fuels)
75. Soysauce, vinegar, bullions/gravy/soupbase
76. Reading glasses
77. Chocolate/Cocoa/Tang/Punch (water enhancers)
78. "Survival-in-a-Can"
79. Woolen clothing, scarves/ear-muffs/mittens
80. Boy Scout Handbook, / also Leaders Catalog
81. Roll-on Window Insulation Kit (MANCO)
82. Graham crackers, saltines, pretzels, Trail mix/Jerky
83. Popcorn, Peanut Butter, Nuts
84. Socks, Underwear, T-shirts, etc. (extras)
85. Lumber (all types)
86. Wagons & carts (for transport to and from)
87. Cots & Inflatable mattress's
88. Gloves: Work/warming/gardening, etc.
89. Lantern Hangers
90. Screen Patches, glue, nails, screws,, nuts & bolts
91. Teas
92. Coffee
93. Cigarettes
94. Wine/Liquors (for bribes, medicinal, etc,)
95. Paraffin wax
96. Glue, nails, nuts, bolts, screws, etc.
97. Chewing gum/candies
98. Atomizers (for cooling/bathing)
99. Hats & cotton neckerchiefs
100. Goats/chickens

From a Sarajevo War Survivor:
Experiencing horrible things that can happen in a war - death of parents and
friends, hunger and malnutrition, endless freezing cold, fear, sniper attacks.

1. Stockpiling helps. but you never no how long trouble will last, so locate
near renewable food sources.
2. Living near a well with a manual pump is like being in Eden.
3. After awhile, even gold can lose its luster. But there is no luxury in war
quite like toilet paper. Its surplus value is greater than gold's.
4. If you had to go without one utility, lose electricity - it's the easiest to
do without (unless you're in a very nice climate with no need for heat.)
5. Canned foods are awesome, especially if their contents are tasty without
heating. One of the best things to stockpile is canned gravy - it makes a lot of
the dry unappetizing things you find to eat in war somewhat edible. Only needs
enough heat to "warm", not to cook. It's cheap too, especially if you buy it in
6. Bring some books - escapist ones like romance or mysteries become more
valuable as the war continues. Sure, it's great to have a lot of survival
guides, but you'll figure most of that out on your own anyway - trust me, you'll
have a lot of time on your hands.
7. The feeling that you're human can fade pretty fast. I can't tell you how many
people I knew who would have traded a much needed meal for just a little bit of
toothpaste, rouge, soap or cologne. Not much point in fighting if you have to
lose your humanity. These things are morale-builders like nothing else.
8. Slow burning candles and matches, matches, matches

16. jaanuar 2006

iga pere vajab oma pandeemiaplaani ..

Friday was the Rhode Island State Summit.
If a flu pandemic develops around the world, each community will have to cope on its own, Michael O. Leavitt, U.S. secretary of health and human services, warned Rhode Island officials yesterday.

The entire nation will be affected, so the federal government will not be able to marshal help from other areas. "Every community will have to rely on its own resources," Leavitt told an overflow crowd of hundreds of Rhode Islanders at the Crowne Plaza hotel.

"Every state needs a plan. Every tribe needs a plan. Every school, every business, every church, every family needs a plan," Leavitt said.

Leavitt's visit to Rhode Island was his fifth stop in a tour he plans to take to every state to push for action on pandemic-flu planning. He spoke unflinchingly of what would happen if there were a worldwide pandemic like the Spanish flu of 1918, which killed 40 million people.

"Pandemics are world-changing events," he said. A flu virus of similar strength to the 1918 flu would sicken 90 million Americans and kill 2 million. Even the healthy would be affected, because there would be fewer people able to stock grocery shelves, deliver fuel oil, care for the sick or provide other services.

If a pandemic arrives, Leavitt said, "We're not going to be able to stop it. Our preparation is to try to limit its impact.

"We may be the first generation in human history . . . that has had the opportunity to do something about it in advance." link

kassikatsed linnugripiga ja levikuviisid

väidetavalt üks oluline uuring, nakatati kasse kõikvõimalikel viisidel linnugrippi - ja leiti, et nakatuvad igat moodi ..
ja kuna kass on imetaja :D ja inimene on ka imetaja - siis annab infot ka inimeste kohta

kokkuvõtteks - et ei nakka see gripp midagi ainult aevastuse kaudu, vaid märksa tõhusamalt

To assess the spread of H5N1 influenza virus in mammalian hosts,
Rimmelzwaan et al. examined cats infected via the respiratory tract,
via the digestive tract (by feeding on infected chicks), or by close
contact with respiratory-infected cats. The researchers, led by Dr.
Thijs Kuiken, then examined mucous membranes (throat, nasal, and
rectal swabs) and organ systems (respiratory, digestive, nervous,
cardiovascular, urinary, lymphoid, and endocrine) for the presence of
virus and viral protein.

As expected, all cats were infected with H5N1 virus and exhibited
clinical signs of disease (fever, lethargy, labored breathing, etc.),
and virus was detected in throat, nasal, and rectal swabs, regardless
of the original site of infection. Most interesting, virus spread
throughout the organ systems with virus being found in respiratory
and digestive tracts, liver, kidney, heart, brain, and lymph nodes.
Furthermore, examination of infected tissues revealed cellular damage
at sites containing viral proteins, providing an explanation for the
increased severity of disease in humans.

These data underscore the potential for influenza virus to spread not
only from the respiratory tract but also from the digestive and
urinary tracts, greatly increasing the possible routes of mammalian
transmission. Systemic disease has long been known to occur in birds,
with the fecal-oral route of transmission being most important.
However, this is the 1st demonstration of systemic replication in
cats, providing a cautionary tale for humans regarding how influenza
is spread and how the disease presents itself.

.. "H5N1 virus infection needs to be included
in the differential diagnosis of a broader range of clinical
presentations than is currently done." In addition better
understanding of the mechanisms of spread, including possible
fecal-oral route in humans, "may limit the risk of H5N1 virus
developing into a pandemic influenza virus."


15. jaanuar 2006

sümptomitest veel

The incubation period (the amount of time between exposure to the virus and the beginning of symptoms) is 24 to 96 hours. link

Fever was often the first symptom, and dyspnea often occurred a median of 5 days after illness onset (range 1–16).

During the initial evaluation at hospital, all patients were found to have fever, cough, and dyspnea, and almost half had myalgia and diarrhea.

The hospital course was characterized by intermittent high fevers and persistent cough productive of thick sputum. One patient had a small amount of hemoptysis.

Later in the course of the disease, organ failure or dysfunction was commonly observed, including respiratory failure in 9 (75%) patients, cardiac failure in 5 (42%), and renal dysfunction in 4 (33%).

pandeemia mõju majandusele

kokkuvõttes: võrreldav depressioon majanduses 1930.aastatega, paljude majandusharude kokkukukkumine, kaos finantsturgudel, intressimäärade tõus, kinnisvarahindade tugev langus, etc.

link tekstile

.. The global economy would be badly affected by a pandemic. “A pandemic, even one meaningfully less virulent than the 1918 influenza, would have hugely disruptive effects,” says Sherry Cooper of BMO Nesbitt Burns. “Depending on its length and severity, its economic impact could be comparable, at least for a short time, to the Great Depression of the 1930s. The disruption in trade could be analogous to the Smoot-Hawley Tariff of 1930, but even worse given that the free flow of people across borders would be curtailed.

.. A flu pandemic would hit hardest trade, travel, shopping, education and any activity involving face-to-face communications. Industries with a greater exposure to open economies, that rely on trade or on global just-in-time supply networks would suffer badly. “The resulting collapse of the airline and land and water transportation industries, tourism and hospitality sectors, much of retail and wholesale trade along with essential imports and exports would be devastating, at least for some period,”?Cooper adds. “This would trigger foreclosures and bankruptcies, credit restrictions and financial panic.”

.. Large numbers of people would be unable to work because of illness, having to look after the ill or quarantine. Schools and old people’s homes would close as young children and the elderly would be especially vulnerable. Millions would try to work from home.

.. The world’s financial markets would be plunged into chaos. Canny investors preparing for a pandemic would be likely to sell shares in retailers, casinos, transport companies, airlines, insurers, industries with large numbers of staff and large exposures to volatile emerging markets, according to Citigroup. They would invest invest instead in local telecom companies, dot.coms, home entertainment, utilities, private postal services and less volatile developed markets and healthcare businesses. Reduced growth would lead to a decline in commodity prices, oil and energy.

As John Edwards, an Australia-based economist at HSBC, points out, news of a flu epidemic would also trigger a rapid global sell-off of bonds and equities and a flight into cash. The result would be a massive spike in long-term interest rates and the cost of borrowing. “Because low cash rates and increasing global confidence have driven up asset prices and encouraged more business and household leverage in recent years, the financial impact of a flight into cash could be catastrophic,” he argues. The price of gold and safe assets would go through the roof. Eventually, long-term interest rates would fall back but not before the damage has been done.

.. Surging death rates would lead to house price collapses worldwide and a fall in rents, pushing millions into negative equity and default on their mortgages. Financial institutions may start to collapse, wiping out more assets. All of this would lead to further declines in consumer spending, exacerbating the impact of higher bond yields and imposing severe deflationary pressures on the economy. A reduced supply of labour could lead to higher wages, as was the case after the Bubonic Plague.

.. In the long-term, the cost of a pandemic could be even greater by unfairly discrediting capitalism and the international liberal economic order. While temporary restrictions on trade and travel would be required to contain the pandemic, it would be imperative to ensure they are lifted as soon as possible after it subsides to allow the global economy to bounce back when the crisis is over. But today’s low public levels of support for free trade – despite the fact that liberalisation has been an astonishing motor of increased prosperity – suggests the system may not be able to handle such a shock and the World Trade Organisation and free-trade zones may all collapse.

.. Like after the Great Depression, many may turn their backs on capitalism even though the market economy would bear no responsibility for a bird flu-induced economic crisis. Voters may also reject intellectual property rights, blaming Big Pharma for failing to invent the right drugs, dealing a blow to technological innovation. A collapse in trade, research and development would be near-fatal, triggering a slump in productivity and living standards and a new era of decline, conflicts and geopolitical instability.

soome saun kui gripiravi

linnugripifoorumis arutavad soome sauna kasulikkuse üle

teemat alustas soomlane järgmiste soovitustega:

Heat your Sauna to 120 C at the level of your to rest.
1. Lay down, give no water to the stove, lift your feet to the roof and relax, take in 10-15 minutes of heat.
2. Sit up frow some water on the stove, breath freely, inhale the steam. Repeat 5 times.
3. Go out relax end enjoy the cool
4. Go back try to have the heat at roof top at around 100c and top bench at 87-95 and start steaming it.
5. Try to keep your body temperature hot, remember your lungs can take it but the virus cant.
6. Enjoy and have a lemonade, beer or some clean water.

ameeriklaste kommentaarid sellele:

* This sounds like some kind of suicide option.

* I was an exchange student in Finland when I was 16. You guys are nuts. You forgot to mention, after sitting in a sauna for a while and hitting yourself with a switch. Then, for kicks, tell the stupid american to jump into the rinse pool. Conveniently chilled to 2 degrees Kelvin, (at least my testicles told me it was 2 kelvin). they had to pull me out; of course they could barely see me through their tears of laughter. No wonder the Russians were stopped by the Finnish army all by themselves. You guys are nuts.

* Water boils at 100°C. How can a person tolerate 120°C for 10-15 minutes???

seevastu norrakas kommenteerib vastu: You mean in Finland you didn't get to go outside (-35 deg) and roll in the snow in your own personal steam cloud as we did in Norway!.......... it snaps you out of it!!! From memory, Sauna was and still is the 1st line of defence for colds and Flu in Scandinavia!!!!!!!!

(kes ei mäleta kooliprogrammist, mis on Kelvin, siis: Unit of temperature equal in size to the Celsius degree, but with the zero set by the absolute zero of temperature, -273.15°C. Ice freezes at 273 K, room temperature is about 293 K, and water boils at 373 K, at sea level. human body temperature is 310 K. Nii et 2 kelvinit oli ilukirjanduslik liialdus )

UK firmade ettevalmistused pandeemiaks

link artiklile

lühidalt eesti keeles: UK firmad valmistuvad pandeemiaks ja teevad oma hädaolukorra-plaane. Suurematest firmadest on 80% pandeemiaplaan olemas, arvestusega, et töötajatest puudub 25%.
Huvitav kui suurel osal Eesti firmadest on olemas Oma Pandeemiaplaan? :D
Peamiseks kavaks on kõik töötajad, kel võimalik, panna töötama kodust, kasutades internetti ja videokonverentsi (mis töötab muidugi vaid niikaua, kuni seisab püsti internet), klienditeenindajatele anda isikukaitsevahendid ning tõhustada hügieeniprotseduure.

Work at home or go abroad if bird flu hits
David Harrison, Catherine Humble and Adam Stones
(Filed: 15/01/2006)

Thousands of employees will be told to work from home if Britain is hit by a bird flu pandemic.

.. Up to 25 per cent of the population is expected to be infected by the virus if - as scientists predict - it arrives in Britain in a form that can be passed from human to human, according to the World Health Organisation.

Companies are drawing up emergency plans to reduce or cope with the loss of one in four workers. One expert warned that some could see their entire staff wiped out by the virus.

Vodafone, Norwich Union and the accountancy firms PriceWaterhouseCoopers and KPMG say they would make arrangements for staff to work from home. Some workplace meetings would be replaced by video conference calls.

A senior executive for Vodafone, which employs more than 13,000 in Britain, said: "Bird flu is a real threat and we are taking it seriously. Working from home means that people will be at less risk from getting the virus and could play a crucial role in keeping our business going."

.. Last week the World Health Organisation warned that the arrival of bird flu in Britain was "inevitable and possibly imminent".

The Sunday Telegraph surveyed dozens of large UK companies and found that more than 80 per cent had made emergency plans - including Asda, Tesco, Royal Mail, O2, Natwest and Ford. Most firms said they were basing preparations on projections that 25 per cent of the population could be infected by the virus.

A 25 per cent loss of staff would cut Britain's 28.8 million working population by 7.2 million - with devastating consequences for the economy. "If we don't prepare properly then the country could be plunged into an economic crisis," one analyst said.

British Airways is already carrying "disease packs" containing face masks, gloves and goggles which will be given to all passengers should the virus - which has killed 78 people since 2003 - become contagious among humans. A BA spokesman said: "We could lose a quarter of our employees and a quarter of our passengers. We have to be ready."

Scientists say it is only a matter of time before the H5N1 strain mutates into a form that can spread from person to person.

.. Bupa, the private health company, said that 30 per cent of the firms it insured had asked for stocks of Tamiflu for their staff but it had so far been unable to satisfy demand. Many clients had also asked to be supplied with face masks.

.. Employers are being urged to raise hygiene standards. John Lewis is planning to introduce alcohol-based handwashes for staff and customers inside their stores and anti-viral mats at the entrances.

fantaasiajutustus pandeemiast

kirjutatud ühe endise medõe poolt, kuidas võiks välja näha üks Kanada linnake tõsise pandeemia korral..

päris põnev lugemine :)
just sellest vaatenurgast, et mismoodi võivad asjalood kujuneda ja millele võiks planeerimisel tähelepanu pöörata jne ..


kodused toidu-vee- jm tagavarad

lühitõlge - ootamatuste vältimiseks võiks olla kõigil kodus vähemalt nädalane vee- ja toidutagavara, samuti muud hädavajalikud asjad nagu nt patareidega raadio, taskulamp ja pidevalt tarvitatavad ravimid.

soomlaste soovitused:

Yllättävistä tilanteista selviää vähemmin harmein, kun kotona on kotivara. Kotivara tarkoittaa, että kotiin hankitaan ruokaa ja muita päivittäin välttämättä tarvittavia tavaroita vähän enemmän. Kotivaran pitäisi riittää useaksi päiväksi, jopa viikoksi. Kotivara on normaalissa kierrossa olevia elintarvikkeita ja tavaroita, joita täydennetään sitä mukaa kun niitä käytetään. Näin elintarvikkeet pysyvät tuoreina ja tavarat käyttökelpoisina.

Tilanne, että kauppaan ei pääse, voi yllättää monestakin syystä. Yksinasuva voi sairastua, eikä kykene ostoksille tai perheenjäsen sairastuu. Yhteiskunta voi haavoittua; tulee lakko, liikenneyhteydet katkeavat tai laaja sähkökatkos häiritsee arkea. Voi sattua sellainen onnettomuus, että kaupat joudutaan sulkemaan tai ulos ei voi lähteä. Myös jakeluhäiriö voi estää tavaroiden kuljetuksen kauppoihin tai hankinnat kaupasta.

Joka perheellä omanlainen kotivara

* koostuu tavanomaisista elintarvikkeista
* voi vaihdella sisällöltään talouden ruokatottumusten mukaan
* sisältää mm. astioita veden varastoimiseen, lääkkeitä, joditabletit sekä talouskohtaisia välttämättömyystavaroita
* riittää viikoksi – kotivaraa käytetään ja täydennetään jatkuvasti

Yhden henkilön viikon kotivara voi olla esimerkiksi seuraavanlainen:

Perunaa 0,5 kg, riisiä ja makaronia 0,5 kg, öljyä ja rasvoja 0,5 kg, sokeria 0,5 kg, UHT-maitoa 1 l sekä vettä.

Lisäksi juomia, vettä ja herkkuja 16 l + 1 kg, leipää ja viljavalmisteita 1,5 kg, maitoa ja maitotuotteita 1,3 kg, hedelmiä ja marjoja 1 kg, vihanneksia ja juureksia 1,5 kg, lihaa, kalaa, kanaa ja kananmunia 1 kg.

Muista erikseen lapset, vanhukset ja sairaat! Muista myös vesi!

Kotivaraan sisältyvät myös välttämättömyystarvikkeet, joita tulee varata samaksi ajaksi kuin elintarvikkeitakin. Näitä ovat mm. henkilökohtaiset lääkkeet, hygieniatarvikkeet, vaipat, radio ja paristot sekä taskulamppu ja paristot.


kuna linnugripi viirus nakkab kontaktis limaskestadega, siis tuleb kaitsta - silmi, nina, suud, samuti käsi - kuna nende kaudu levib nakkus näo limaskestadele.
seega on vaja: maske, prille ja kindaid.

1) maskid - tolmumask liigitusega FFP2, parimaks loetakse 3M omi, müüakse Eestis ehituspoodides ja ka internetis,

ntx selline: link
Tolmukaitse mask FFP2 Standard klapiga, 13 kr

FFP2 näitab klassi, et kui efektiivne mask on, SARS-i ja gripi korral loetakse FFP2 piisavaks.
klapiga seetõttu, et siis ei lähe niiskeks seest, kui välja hingad

soovitavalt võiks varuda vähemalt 10 maski per täiskasvanud pereliige, lastele need kahjuks ei sobi :(

lastele võiks teha näiteks need veneaegsed vatimarlimaskid, 30+ vanuses isikud peaks neid mäletama ;)
vatikiht, marliga ümbritsetud, sätitud sääraseks ristkülikuks, ca 0,5 cm paks, too kattis siis nina, põsed, lõua tihedalt - ja siis igasse nurka marliribad, ja ümber pea kinni siduda ..

2) kaitseprillid - peavad katma silmad põhjalikult, nt sellised:

link allpoololevad korvprillid siis, hind 50 kr +

üks paar prille igale pereliikmele, edukalt kõlbavad ka suvalised ujumisprillid

3) kindad - ühekordsed lateks- või vinüülkindad, müügil nt Kaupmehe hulgilaos, 50 kr karp (100 tk)
karp igale näiteks ..

veel internetipoode Eestis:

pikem jutt siis siin:

h5n1 mutatsioonidest

väga segane värk igatahes :S

niipalju ma sain aru, et Vietnamis toimus muundus no 1, mis võimaldab viirusel ellu jääda 34 kraadi juures - mis olevat siis nina sisetemperatuur

ja Türgis on nüüd toimunud veel üks muundus, mis võimaldab efektiivsemat edasikanduvust, nii b2h kui h2h (linnult inimesele ja inimeselt inimesele)

siiani ongi vist üheks "probleemiks" tollel linnugripiviirusel olnud aeglane edasikandumisvõime, mis nüüd on lahendatud? ueh, oleks ainult veidi rohkem mõistust ja saaks sellest keemiast paremini aru ..


Mutation may make bird flu deadlier for humans
London | January 14, 2006 4:39:17 PM IST

Researchers from the WHO, who have sequenced the bird flu viruses that killed two people in Turkey recently, are worried over their findings that a mutated strain of one such virus has genetic make up that increases its chance of transferring to people.

According to them, this can make the H5N1 virus more adapted to humans than to birds, and more adapted to the nose and throat than to the lungs, thereby increasing the chances of bird flu being transmitted between people.

kommentaar sellele foorumist:

The change that allows H5N1 to grow at 34 C is PB2 E627K. This change was first reported in birds in the 16 sequences from Qinghai Lake. All reported wild bird sequences since Qinghai Lake have had E627K and it assume that the change is in all Turkey isolates. The Turkey isolate from Muhamet Kocigit is 99.5% homologous to Qinghai Lake isolates indicating it almost certainly has E627K.

The change that is new (but predicted in October) is HA S227N (also called S223N). This change allows H5N1 to more efficiently recognize human receptors on epithelial cells (lining respiratory tract). This change allows more efficient transmission to humans (and is not dependent on source - bird, B2H, or human, H2H). The size and numbers of clusters in Turkey suggests this change is in the birds, so now the H5N1 in Turkey has both HA S227N and PB2 E627K.

tehnotrendide-ennustajad linnugripist


Microsoft and Oracle are humbled, phone calls become free, and product design trumps functionality.

There's much to get excited about in 2006, according to five of Silicon Valley's leading venture capitalists -- as long as we don't all die first from a global outbreak of bird flu.

If nothing else, the five see lots of opportunities to invest the many millions of dollars in their hands.

At the Churchill Club's eighth annual ``Top Ten Tech Trends'' debate, held Thursday evening at the Crowne Plaza Cabaña Hotel in Palo Alto, each VC was asked to identify two trends, although several veered off the mark and delivered policy recommendations instead.

John Doerr of Kleiner Perkins Caufield & Byers, perhaps the valley's most famous VC for his early backing of such winners as Intuit, Amazon.com and Google, gave the evening's most dire warning in talking about avian flu.

Governments in the United States and elsewhere in the world are guilty of ``criminal neglect,'' Doerr said, in failing to make preparations for a pandemic that could kill tens of millions.

``How can I make this case?'' Doerr rhetorically asked the capacity crowd of 650.

``Cough,'' shot back Joe Schoendorf of Accel Partners.

More seriously, Schoendorf said this is the first time in 25 years of knowing the often excessively enthusiastic Doerr that ``he has grossly understated his case.''

When and if the bird-flu virus now spreading in Asia and Turkey first mutates into a form easily transmitted among humans, it will start to move around the world within 96 hours, Schoendorf asserted.

Steve Jurvetson of Draper Fisher Jurvetson said the U.S. economy could collapse within a week or two, stalled by the spread of disease or by people staying home out of fear.

Doerr, who's participated in all the annual debates, isn't just fretting about avian flu; he's also taking action. Kleiner Perkins last month invested in BioCryst Pharmaceuticals of Birmingham, Ala., which is developing low-cost drugs to prevent and treat any future outbreak.

(alguses nimetatud 3 tehnotrendi jutt läheb edasi, keda huvitab- lugege edasi lingi alt)

1918 - hispaania gripi algus New Yorgis, timeline

This is what happened in New York City in 1918 from Aug 14 to Nov 14 (roughly 90 days).

Aug 14: 4 dead, 10 new cases on Ship
Aug 18: 21 new cases
Aug 20: Reports of Mild Cases
Sep 5: 2 Dead, 16 new cases
Sep 14: Surgeon General Blue Says It Can Be Controlled Only by Intelligent Action of Public
Sep 17: 13 new cases on a Ship
Sep 19: 3 new cases
Sep 21: 31 new cases In New York
Sep 28: Cases in the city double; Number of Deaths in 24 Hours Equals Previous Total from July 1.
Oct 6: 61 Deaths
Oct 9: 2,503 new cases
Oct 11: 31,217 in the state
Oct 16: It is everywhere
Oct 21: 4,570 new cases, a drop of 305 cases over the preceding 24 hours.
Nov 14: It starts to wind down

SPANISH INFLUENZA HERE, SHIP MEN SAY; Officers of Norwegian Liner Attribute Four Deaths During Voyage to the Disease.10 OTHER PASSENGERS ILL Brooklyn Doctor Who Is Treating Them Says They Are Suffering with Pneumonia. 200 Passengers Ill at One Time. SPANISH INFLUENZA HERE, SHIP MEN SAY Health Officer Passed Ship.
New York Times (1857-Current file). New York, N.Y.: Aug 14, 1918. pg. 1, 2 pgs

LINER HAD 5 DEATHS DUE TO INFLUENZA; Big Passenger Steamship Reports 21 Cases on Voyage to New York. VICTIMS WERE EAST INDIANS Chief Surgeon of New York Port of Embarkation Upholds Measures in Force Here.
New York Times (1857-Current file). New York, N.Y.: Aug 18, 1918. pg. 9, 1 pgs

SPANISH INFLUENZA FOUND IN 'MILD FORM'; But Most of Stricken Voyagers Had Pneumonia or Bronchial Trouble, Says Dr. Copeland. TELLS REPORT OF EXPERTS Health Commissioner Lays Disease to Temperature Changes in Dodging U-Boats.
New York Times (1857-Current file). New York, N.Y.: Aug 20, 1918. pg. 20, 1 pgs

INFLUENZA KILLS TWO ON LINER FROM EUROPE; Ship Detained Seven Hours and 16 Patients to be Sent to Hospitals for Observation.
New York Times (1857-Current file). New York, N.Y.: Sep 5, 1918. pg. 22, 1 pgs

CITY IS NOT IN DANGER FROM SPANISH GRIP; Health Commissioner Says Persons Here Have Not Been Infected.
New York Times (1857-Current file). New York, N.Y.: Sep 13, 1918. pg. 7, 1 pgs

TAKES STEPS TO STOP INFLUENZA SPREAD; Surgeon General Blue Says It Can Be Controlled Only by Intelligent Action of Public. GIVES ADVICE TO DOCTORS Makes Known Course of Treatment--More Cases at Boston--Disease Appears at Newport.
New York Times (1857-Current file). New York, N.Y.: Sep 14, 1918. pg. 13, 1 pgs

MORE INFLUENZA FOUND.; Thirteen Cases on Vessel in Brooklyn Removed to Hospital.
New York Times (1857-Current file). New York, N.Y.: Sep 17, 1918. pg. 24, 1 pgs

NEW YORK PREPARED FOR INFLUENZA SIEGE; Three Cases, Originating in the City, Reported--Health Department Takes Action.
New York Times (1857-Current file). New York, N.Y.: Sep 19, 1918. pg. 11, 1 pgs
Three cases of Spanish influenza were reported to the Board of Health yesterday. They were not army or navy or incoming ship cases, but persons living on Manhattan Island, all in or near the middle section of Central Park West or in cross streets leading to it.

31 NEW INFLUENZA CASES IN NEW YORK; Health Department Begins a Campaign of Education to Combat the Disease. SEEK GERM OF THE MALADY Surgeon General Blue Asks State Health Authorities to Send Cultures for Study.
New York Times (1857-Current file). New York, N.Y.: Sep 21, 1918. pg. 7, 1 pgs
Eighteen new cases of Spanish influenza were reported yesterday, five in Manhattan, eleven in Brooklyn, one in the Bronx, and one in Queens. Six of the Brooklyn cases were British sailors from an Australian ship lying alongside a Brooklyn pier

NEW INFLUENZA CASES IN THE CITY DOUBLED; Number of Deaths in Twenty-four Hours Equals Previous Total from July 1. HELP RUSHED TO BOSTON. Doctors and Nurses from Many Quarters to Combat Epidemic.
New York Times (1857-Current file). New York, N.Y.: Sep 28, 1918. pg. 10, 1 pgs

DISEASE INCREASING HERE Sixty-one Deaths and More New Cases Yesterday--Permit Heat in Patients' Homes. First Real Test Tomorrow. REVISE TIME TABLE IN INFLUENZA FIGHT Will Not Affect Wall Street. Copeland Wants Nurses.
New York Times (1857-Current file). New York, N.Y.: Oct 6, 1918. pg. 1, 2 pgs

INFLUENZA SHOWS SLIGHT GAINS HERE; Many Cases Reported Yesterday, Dr. Copeland Says, Cover 48-Hour Period. DIVIDING SUBWAY CROWDS Hospital Situation Canvassed by Health Officers—Vigilance Asked of All Citizens.
New York Times (1857-Current file). New York, N.Y.: Oct 9, 1918. pg. 24, 1 pgs

Although there was an increase in the number of influenza and pneumonia cases reported yesterday, Dr. Royal S. Copeland, the Health Commissioner, was of opinion that the epidemic was at least stationary or making but slight progress. The number of new cases reported for the twenty-four hours that ended at 10 o'clock yesterday morning was 2,503.

31,217 CASES IN THE STATE.; State Health Officials to Plan Fight on Epidemic Here Today. No Gibbons Jubilee Celebration.
New York Times (1857-Current file). New York, N.Y.: Oct 11, 1918. pg. 11, 1 pgs

GRIP NOW EPIDEMIC THROUGHOUT COUNTRY; While Camp Cases Decrease, Disease Spreads Rapidly Elsewhere and Death Toll Is High.
New York Times (1857-Current file). New York, N.Y.: Oct 16, 1918. pg. 24, 1 pgs

INFLUENZA CASES DROP 305 IN CITY; Only 4,570 Reported by Doctors in the Last 24Hours.PHYSICIAN ASSAILS MAYOR Dr. Davin Calls Upon Hylan to Give Out the Names of Physicians He Accused of Profiteering. Must Furnish Heat.
New York Times (1857-Current file). New York, N.Y.: Oct 21, 1918. pg. 12, 1 pgs
Spanish influenza statistics for the twenty-four hours that ended at 10 o'clock yesterday morning showed 4,570 new cases, a falling off of 305 cases over the preceding twenty-four hours. Weekend figures, however, have not been a true index of conditions, because some doctors wait until Monday before reporting their cases.

EPIDEMIC A THING OF PAST.; But Health Department Expects Scattering Cases for a Month.
New York Times (1857-Current file). New York, N.Y.: Nov 14, 1918. pg. 12, 1 pgs

juhised ettevõtetele pandeemiaplaanide tegemiseks

link - U.S. Department of Homeland Security

Continuity of operations planning link - Seattle-King County Public Health

Pandemic Flu - Resources for businesses link

This document contains a range of information designed for general use in pandemic planning by businesses and other organisations in New Zealand.

veel üks:link


Lühidalt siis: reegliks on kõrge palavik. Üle pooltel juhtudel on olnud kõhulahtisus. Osadel köha ja hingamisraskused.


How can people who think they may have contracted bird flu recognize the symptoms? And what treatment should they seek? RFE/RL put those and other questions to Professor Peter Openshaw, head of respiratory infections at National Heart and Lung Institute, Imperial College, London. RFE/RL: What are the symptoms of bird flu in humans?

Openshaw: Sometimes it starts like ordinary flu, with a bit of a cold, but that isn't absolutely invariable, some people start off with a cough, and then become short of breath and develop muscle aches and fever. So getting a fever is a very important feature, if you haven't got a thermometer, you should get one and be able to measure your temperature and be able to note if it goes up to 38 degrees. If it's not you don't need to worry about it, it's probably a flu-like illness which is very common and which isn't necessarily due to bird flu.

RFE/RL: Since there are similarities with ordinary flu and other respiratory illnesses, when then should someone suspect it is bird flu?

Openshaw: That really is one of the difficultie; there isn't anything absolutely distinctive about bird flu except that it tends to be more of a gastric flu, with abdominal pain, vomiting, and diarrhea, which happens in about 50 percent of cases. It really presents like gastric flu, so you have to have some reason to suspect it in order to do the specific tests. The suspicion should really arise because of close contact with sick poultry. In the cases seen in southeast Asia there is a history of exposure to sick poultry in about 70-100 percent of cases, depending on which region you're looking at. So, a history of exposure to sick birds, and then developing flu-like illness should mean you have some tests performed to see if it's bird flu. But it's important to emphasize that [for] most people who develop flu-like symptoms in the winter, it's not going to be due to bird flu, it's going to be due to ordinary viruses.

RFE/RL: How quickly does someone become seriously ill?

Openshaw: Usually after exposure there's a lag of three days to a week before symptoms develop. People have often been ill for between three and eight days before they get admitted to hospital, so during that period virus levels are building in their system. By the time they're admitted, quite often it's a bit late for treatment with antiviral agents. It's quite important if it is bird flu that it's treated early, preferably within two days and ideally within eight hours of developing a fever of 38 degrees, which is why it's so important to have a proper digital thermometer.

RFE/RL: What are the severe symptoms?

Openshaw: Most people that die of it die of lung failure, their lungs are so badly affected by the storm of cytokines -- body chemicals that are released after infection with bird flu. Most people who die of it die of lung failure. About 20 percent go into kidney failure and about half or more than half develop problems with bone marrow; so the bone marrow isn't producing enough cells to deal with infection. So there's a general system shutdown that is the body's response to this overwhelming infection.

RFE/RL: What should someone do if they have reason to suspect they're infected?

Openshaw: You need to get to a medical facility that can look after you in terms of providing artificial ventilation if that's necessary, and one that can administer antiviral drugs, particularly in the early stages of the disease before the body goes into this cytokine storm phase; because it's only in that early phase that the antivirals are going to do anything. The treatment otherwise is supportive and to overcome any organ problems like lung failure and kidney failure from the virus spreading into those different parts of the system.


püha müristus .. nüüd nad arutavad linnugripifoorumis, et HIV võib kombineeruda linnugripiga (H5N1), see oleks küll üks jõhker viirus, mis sealt välja tuleks
ja nakatunud linnud on nüüd suundumas Aafrikasse, kus kohati on valdav enamus inimesi HIV-positiivsed

mitte, et ma midagi jagaks viiruste toimemehhanismist .. aga kõlab igatahes halvasti ausaltöelda :(

tsiteerin linnugripifoorumit

H5N1 likes to recombine
HIV likes to recombine

H5 and Ebola have already recombined

The identical sequence shared by H5 and Ebola Zaire from 1975 is an exact match. HPAI H5N1, especially wild bird H5N1, has a number of changes, so H5N1 flying will lead to more changes.

HIV seems to leave bits and pieces everywhere. There is probably more recombination in Africa involving two different virus types than anywhere (including Asia). Most of these changes will happen unnoticed because health care is poor and mortality rates are high.

There will be lots of mixing and matching and most changes won't be seen until the new improved version of H5N1 comes flying into western Europe in the spring.

Ebolast ja H5 on juttu:


ahjah, ja kui kedagi huvitab, kus asub linnugripifoorum,
siis see on: http://www.curevents.com/ ja Flu Clinic

linnugripi leviku graafiline esitus


rootsikeelne ta ju on, aga see-eest hästi ilmekas

esiteks vajuta lingile, mis on väikese maakaardi pildi all
Se rörlig grafik
ja siis Fortsätt on "edasi"

mitmesugused ettevalmistused


FluWikis üks kena lühike koond kogu linnugripi-teemast, mida peaks arvestama ja teadma.
kopeerin siia ainult esimese osa .. ja edasised pealkirjad

Preliminary considerations:
There will most likely not be a targeted vaccine until about 6 months after pandemic has begun; any vaccine prepared ahead of the pandemic will likely confer only partial protection.

There will most likely not be enough antivirals for treatment, let alone prophylactic use.

Assume a quarter to a half of the public will become infected over a 3 month period (a flu wave, of which there usually are 3 — the worst being the 2nd — a few weeks or months apart) and 3/4 to a half staffing everywhere for various durations.

Virus will be shed before symptoms appear (which can be 3 - 6, up to even 17 days) and after symptoms (21 days for children, 3–5 days for adults, longer for the immunocompromised).

Children and otherwise healthy young adults are disproportionately at risk.

All bodily excreta will be very dangerous, especially feces and sputum/mucus; virus often multiplies in gut and diarrhea is often first symptom, preceding respiratory symptoms.

We will probably need two or more times the hospital beds and ICU facilities.

There will probably be mortality of at least an extra 50% beyond normal; a high percentage of these are likely to be under 65 years old, which comprise workers in essential services.

Most patients should probably be treated in the home, or if more critical, in secondary ICU-like set ups in schools or other locations.

Hospitals will need to continue their usual work and erect a firewall to protect vulnerable inmates from flu .

Childcare and family nursing responsibilities will strain ability of healthcare workers and other essential infrastructure workers to provide services.

Public services such as water, power, waste disposal, communications, and transportation will likely be intermittently interrupted.

Deliveries of food and other essential commodities may be disrupted.

There may be civil disorder due to shortages and desperation.

Personal Bird Flu Preparedness

Should Birds in the US Become Infected:

Should a pandemic occur (hügieen ja enesekaitsevahendid)

If you get sick:

If you are nursing a sick patient:

WHEN SERVICES FAIL: (electricity, lighting, communications, water, food, transportation ..)

Maailma riikide pandeemiariski analüüs


Euroopa kõrgeima riskiga piirkonnaks on märgitud UK. Eesti on märgitud sarnaselt skandinaaviamaadega madala riskiga piirkonnaks, tulenevalt siis tõenäoliselt madalast asustustihedusest ja põllumajanduse vähesest osatähtsusest .. Erinevalt skandinaaviamaadest on Eesti võimekust pandeemia piiramise osas hinnatud vaid keskpäraseks.

FEMA soovitused kodanikele - toidu- ja veetagavarad hädaolukorraks

(FEMA - USA federal emergency management agency)


Soovitav siis varuda endale koju toidu- ja veetagavarad kaheks nädalaks.

isikliku ettevalmistuse juhendid


seal on viiteid erinevatele ettevalmistusjuhenditele

meditsiinilisest aspektist - ajalugu, sümptomid, ravimissoovitused ja ravimitevarude soetamine - soovitaks kindlasti seda:
Preparing for the Coming Influenza Pandemic by Dr. Grattan Woodson

USA valitsuse soovitused kodanikele, kuidas pandeemiaks valmistuda


Challenges and Preparation -- Individuals and Families

As you plan, it is important to think about the challenges that you might face, particularly if a pandemic is severe. It may take time to find the answers to these challenges. Below are some situations that could be caused by a severe pandemic and possible ways to address them. A checklist and fill-in sheets for family health information and emergency contact information have been prepared to help guide your planning and preparation.

Social Disruption May Be Widespread

Plan for the possibility that usual services may be disrupted. These could include services provided by hospitals and other health care facilities, banks, stores, restaurants, government offices, and post offices. Prepare backup plans in case public gatherings, such as volunteer meetings and worship services, are canceled. Consider how to care for people with special needs in case the services they rely on are not available.
Being Able to Work May Be Difficult or Impossible

Find out if you can work from home. Ask your employer about how business will continue during a pandemic. Plan for the possible reduction or loss of income if you are unable to work or your place of employment is closed. Check with your employer or union about leave policies.

Schools May Be Closed for an Extended Period of Time

Help schools plan for pandemic influenza. Talk to the school nurse or the health center. Talk to your teachers, administrators, and parent-teacher organizations. Plan home learning activities and exercises. Have materials, such as books, on hand. Also plan recreational activities that your children can do at home. Consider childcare needs.

Transportation Services May Be Disrupted

Think about how you can rely less on public transportation during a pandemic. For example, store food and other essential supplies so you can make fewer trips to the store. Prepare backup plans for taking care of loved ones who are far away. Consider other ways to get to work, or, if you can, work at home.

People Will Need Advice and Help at Work and Home

Think about what information the people in your workplace will need if you are a manager. This may include information about insurance, leave policies, working from home, possible loss of income, and when not to come to work if sick. Meet with your colleagues and make lists of things that you will need to know and what actions can be taken. Find volunteers who want to help people in need, such as elderly neighbors, single parents of small children, or people without the resources to get the medical help they will need. Identify other information resources in your community, such as mental health hotlines, public health hotlines, or electronic bulletin boards. Find support systems—people who are thinking about the same issues you are thinking about. Share ideas.
Be Prepared

Stock a supply of water and food. During a pandemic you may not be able to get to a store. Even if you can get to a store, it may be out of supplies. Public waterworks services may also be interrupted. Stocking supplies can be useful in other types of emergencies, such as power outages and disasters.

Store foods that:

* are nonperishable (will keep for a long time) and don’t require refrigeration

* are easy to prepare in case you are unable to cook
* require little or no water, so you can conserve water for drinking

mõningaid väljarebitud tsitaate :D

mõningad linnugripifoorumis kogutud tsitaadid "juhtivate ekspertide" kõnedest ja raportitest

Dr.Webster: Director, U.S. Collaborating Center (WHO)
Rose Marie Thomas Chair
Department of Infectious Diseases, St. Jude Children’s Research Hospital
Memphis, Tennessee

Because if it is catastrophic or super catastrophic, all of the services as we know them are likely to collapse. Each household will be dependent on its self for water for food and so on.

Dr. John Oxford: Scientific Director, Retroscreen Virology Ltd.
Professor, St. Bartholomew’s and Royal London Hospital
London, England

I think it will almost be like an Armageddon and people will find it very, very hard indeed to contend with that.

Dr. Michael Osterholm: Director, Center for Infectious Disease Research and Policy
University of Minnesota
Minneapolis, Minnesota

Suddenly the entire economy goes into a tailspin – when that happens, none of us have a clue as to what it might take as to bring that back out of that tailspin. I think that this is going to be an issue for economists, for policymakers, for leaders to begin to address because if we don’t the collateral damage from a pandemic could very well make the overall pandemic itself be just a small piece of the actual damage.

Author John Barry, The Great Pandemic: The Epic Story of the Deadliest Plague in History:

People rapidly lost all faith in authority, and didn’t trust anything that they were told. This created a sense of alienation, and made it every person for himself, or herself. It spread terror and isolation.

pandeemia piiramiseks võib olla vajalik kasutada armeed

The World Health Organisation yesterday predicted authorities might need to use the army and police to quarantine about 120,000 people to contain aninitial pandemic flu outbreak of just 19 cases.

Hitoshi Oshitani, a consultant to WHO, said his estimates highlighted the difficulty of formulating a rapid response toan initial outbreak of mutated bird flu transmitted between humans.Not only would such aggressive quarantining raise legal and human rights concerns, he said, but knowledge about how to use antiviral drugs as a preventative measure was limited.
Mr Oshitani, who presented his simulation at an international conference in Tokyo, said the first requirement was rapid detection."Timeliness is key. If we do things the way we do right now, it will probably be too late," he said, adding that two weeks after an outbreak was probably the absolute limit.

Experts said that preventing an outbreak from spreading rapidly would be difficult even if there was timely confirmation. Kenji Fukuda, a researcher at WHO's global influenza programme, said: "Right now we do not know the optimum dosage or length of treatment for prophylactic treatment."

pandeemia tekitab igasuguste ravimite puuduse


Pandemic Flu Could Cause Breakdown of Drug-Supply Chain[Jan 12, 2006]

The Wall Street Journal on Thursday examined how the drug-supply chain is "almost certain to break" in the event of a flu pandemic, which could cause the closing of drug factories and truck routes and lead to shortages of important medicines -- "quite apart from any shortages of medicine to treat the flu itself." The "very rules of capitalism that make the U.S. an ultra-efficient marketplace also make it exceptionally vulnerable in a pandemic," the Journal reports.

For example, many drugs are manufactured outside of the U.S. because of lower costs, while warehouses in the U.S. are generally kept nearly empty for efficiency reasons.

Many large hospitals stock only 30-day supplies of drugs because of costs and waste associated with stockpiling more, as well as drug manufacturing delays. According to the Journal, a supply-chain breakdown could cause the economy to "go into a tailspin" in the event of a pandemic flu, since "at the first sign of panic, all supplies disappear from shelves." To assist states and hospitals in bolstering medical preparedness, the federal government allocated $5 billion in grants over three years, but the money has been used toward priorities other than surge capacity at hospitals as well.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said, "Most if not all of the medical products or protective-device companies in this country are operating almost at full capacity." He added, "That's the reality of today's economy -- just-in-time delivery with no surge capacity." Indiana-based emergency physician Michael Bishop said, "You can't plan for a surge capacity in an emergency room of 500 or 1,000 patients from the 20 you see in a day. Nobody could afford to do that. You can't have 10 doctors and 100 nurses sitting around waiting for something to happen" (Wysocki/Lueck, Wall Street Journal, 1/12).

jahah - ega eestis teisiti ole, nojah, selle erinevusega - et me ei tooda üldse midagi ja sõltume ainult sisseveetavatest ravimitest